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Katie: Hello and welcome to The Wellness Mama Podcast. I’m Katie from barbaraoneill.online and in this episode I tackle a subject that I have not gone deep on on this podcast yet but is very much popular and a little bit controversial right now which is the topic of GLPs and in particular myths related to them, dosing studies, and cautions. And I’m here with someone who I feel like is most qualified to speak to this especially with the context and nuance of this audience. I’m here with my friend McCall McPherson who is a pioneering physician associate, an entrepreneur in the world of thyroid, hormone, and metabolic health.
She’s the founder of Modern Thyroid Clinic, the co-owner of Modern Weight Loss, and the owner of Thyroid Nation. And I love her really data-driven medical approach as well as her personal experience. And I feel like she has some really innovative solutions as well as a very unique approach to some of these topics, specifically the GLPs that we dive into today. In fact, I saw her at a conference recently, and we got into a conversation about the inflammation side of these. And what I found out from her really may surprise you. I will let you hear it from her in this episode, but let’s join McCall.
Katie: McCall, welcome. Thank you so much for being here. I’m so excited for our chat today.
McCall: I know. Thank you so much for having me. It’s exciting to be back.
Katie: And I have followed your work for a very long time. We’ve gotten to podcast before, and I’ll make sure that’s linked in the show notes. But really, I was excited to have you on now because I feel like you have really important context and expertise regarding some topics that seemingly are very much trending, but maybe not completely understood in today’s world. And I’m really excited for you to shed some light on that. I will also say it’s a rare thing that I have a guest who also has six kids. So that’s a fun thing that we have in common. And in our first episode today, I’m really excited to learn from you and deep dive into something I personally actually have no experience with, but see everywhere on the internet right now, which is the kind of prominence of GLPs and the potential. It seems like so much information floating around about them being sort of a miracle drug, some of them being dangerous and everything in between. And it seems like you have a tremendous amount of expertise as well as clinical experience related to these. So that said, broad topic, I will leave the door open to you as where we jump in, but I’m excited to learn from you on this topic.
McCall: You know, it is, I’m so grateful to have this conversation because it is one that is exactly as you said, it’s grossly misunderstood. And I think, you know, so much of what the general public is hearing right now are all these negative downsides about these medications. A bit of kind of fear mongering almost in the media without any explanation as to, hey, maybe perhaps they have additional benefits outside of weight loss. So, you know, one thing that I’d love to explore is having a conversation about risk versus benefits. Hey, what are the risks of these medications and what are the potential benefits? Weight loss related and then weight loss not related.
Katie: Yeah, that seems really important. Okay, so let’s dive in there because certainly these have gotten prominence as a sort of weight loss drug, but that, from my understanding, is not what they were originally designed for. So like, can you kind of walk us through the backstory of how did these even come to be and then how did they end up becoming weight loss drugs?
McCall: Yeah. So what’s interesting is these medications are actually not new at all. They’ve been around for two decades plus. So we have a lot of data on the safety of these medications. We have longer data than we normally ever do. They were originally created and made to treat diabetes. And what people were finding as they were doing the studies is, wow, these diabetic people are losing quite a bit of weight while they’re on these medications. And eventually it was so significant that we decided, hey, maybe we should look at these for weight loss. And so that sort of led to the next evolution of usage for GLP-1 medications, which we should probably say are things that most people have heard of, but are known as Ozempic or Mounjaro or semaglutide, Wegovy, tirzepatide, for those of you who sometimes aren’t familiar with what a GLP is. And now we’re almost, or at least I am, and quite a few other clinicians are, in the next phase of the evolution of these meds, and we’re like, okay, we’ve been using them for weight loss. We are seeing all of these other uses come to light. Studies as well are being done on all the other uses. And now we’re entering sort of phase three of the benefits of these medications.
Katie: And I know you and I got to connect at a conference last year. And one thing we got to briefly talk about was the inflammation side of this. And I had not heard anybody else explain this side. And I feel like maybe this is a missing piece that’s really important to understand for various reasons for someone who’s considering GLPs or on GLPs. But I loved your perspective on their potential role in inflammation. So can you walk us through what you’ve kind of uncovered related to that?
McCall: Yeah. So I think we have quite a bit of data. We’ve been collecting data on the inflammatory pieces of this puzzle with our patients since the very beginning of our program. And inflammation is important because it is part of what drives our aging process, our disease process, our risk for cancer, our risk for heart disease. It is a core and root cause for a lot of the things that create the breakdown of our health over time. And there’s not really in medicine a lot of things that address inflammation. It’s this abstract sort of thing, but there are measurable labs. When we first collected data or began collecting data with our patients, we would collect inflammatory markers about every 12 weeks.
And now we’ve started even rolling that back more and more. A perfect example of an inflammatory marker that’s measurable on a lab is called an hsCRP. Okay. So this is objective data, meaning this isn’t, oh, the patient reports feeling less inflamed. This is measurable. And we started measuring it and then counting back the clock till now we have data on people who have taken one single injection of a GLP and we’ve measured their inflammatory markers before and after one injection, two injections, one month of injections. And consistently we see inflammatory markers drop significantly, almost immediately. And the significance of that is kind of two part. One is it’s a marker for inflammation, right? Which again is important. Because it slows the breakdown of our body over time. But two, one particular marker, this hsCRP, measures our risk for heart disease, for heart attacks, for strokes, for the likelihood that we will experience the number one cause of death for people in our country, men and women alike, which is heart disease. And having that measurable number, anything above three means you’re at an increased risk for having heart attack, increased risk of a stroke. We have seen people’s CRP drop from 44 to two in two weeks, two injections. Who have had significantly stable CRPs over time. We routinely see people drop from 10 to four. It’s pretty fascinating. There is no medication or lifestyle intervention, because I know you and I deal a lot with more natural ways of healing.
There’s nothing that I’ve ever seen create this inflammatory drop as abruptly as I’ve seen with the GLP. I didn’t even go into this expecting that data to be so significant, but it is. And the reason we started running it is because our patients came back and immediately said, hey, McCall, I have less joint pain. Hey, I’m so much less puffy and I haven’t lost any weight. Or hey, my eczema is gone. My psoriatic arthritis is reduced. And then in line with that, I’m in the business of thyroid, right? So I’m the founder of Modern Thyroid Clinic. So we measure antibodies influenced by inflammation. And very, very early on with the utilization of GLPs, we were seeing significant reductions in people’s antibodies, undeniably over and over and over. And it’s just been, it’s been a fascinating journey. Now in the last six months there are studies coming out that are confirming exactly what we’ve been finding for the last three years. And they’ve started measuring inflammatory markers at about the six and 12 week mark, which is incredibly powerful because now we have research data to back up what we’ve been finding in our clinical practice for the last three years.
Katie: Yeah, I feel like I have not heard anybody else talk about this. And this potentially could be like a really drastic use for this. It could help so many people, especially as someone who used to have Hashimoto’s and paid very much attention to my antibodies and still keep track of that. Like you said, we all know that’s very common on this podcast. Anybody talking about chronic disease or autoimmunity, inflammation, of course, always comes up. And addressing that is seemingly a little bit more elusive and often very multifaceted and hard to track or know what’s working or what’s not.
So to see those drastic of changes on labs to me is really, really striking. And also, like to your point, when we’re talking about heart attack risk, that goes up for women after menopause, kind of to the same levels as men. And we know that’s like a really big killer, especially in the US. So if it’s able to address that, I feel like that’s a really positive use case. And I know there’s going to be some questions that come up related to also some of maybe the more negative things circulating about GLPs. And so I would love your take on those as well.
The first being the concern that some of that weight loss from GLPs can often be from muscle. And if that is always the case and/or are there ways to mitigate that? Because I know for women, especially in that postmenopausal age, maintaining muscle is also very, very important.
McCall: Absolutely. So I want to put a pin in the cardiovascular conversation to the heart disease risk, because there’s a couple studies that have come out that are fascinating in terms of their findings. But, you know, when we think about the negative things that people are hearing about, muscle loss is definitely a question I also get all the time. And it’s not what we’re finding is, look, it’s very easy to maintain muscle mass on GLPs as long as you are doing the things that you need to do in regular life to maintain muscle mass, which is eating enough protein and doing an exercise that creates the building of muscle.
A good way to lose muscle mass is to not eat enough food and not move your body. And so what’s happening in this standard approach of these medications is people are pretty heavily medicated. We’ve sort of put everyone into this one-size-fits-all dosing regimen that was actually created for diabetics, but now we’re treating non-diabetics with the same dose. We’re constantly escalating the doses of these medications. People are completely losing their appetite. They are not hungry. They do not want to eat. When they eat, they’re eating carbs because they feel nauseous, again, because they’re over-medicated. And so they’re not moving their body. They’re not eating protein. They’re not doing the everyday basic things they need to do. But there is no magic to these drugs. It’s not like you take them and you lose muscle. No, if you take them and you do your part, you can not only not lose muscle, we have people building muscle all day, every day in our practice. It is a very easy thing to do. And there are studies that even show there are aspects of these medications that promote muscle growth if it’s in the right environment.
Katie: That’s so fascinating. And I want to make sure we do circle back to the cardiovascular and heart attack side because you put a pin in that one. And I feel like, like I said, for women, especially now that I’m in my late 30s, I want to pay attention to the risk factors of that as I move into my 40s. So what do we know about heart disease risk and cardiovascular risk associated with this?
McCall: Yeah, you know, I think heart disease is underestimated. I’m so glad that you’re sharing this topic because I think as a society, we’re sort of hardwired to be afraid of cancer, right? It’s a tangible thing. But heart disease kills more people than all forms of cancer combined. It is the thing that we all need to be working on to protect ourselves in the future from. And there’s a couple studies I did want to point out. One is on diabetics. It’s called the PIONEER 6 trial, and it looks at risks for cardiovascular death and even just death of any kind, like all risk mortality for people with diabetes on a GLP-1 medication. And the risk of these people who are already inherently prone for cardiovascular risk from their diabetes have a risk reduction of 51% of dying from heart disease if they’re on a GLP. That’s crazy.
And then even from any reason whatsoever, whether it’s cancer or getting hit by a bus, if a diabetic is on a GLP-1, and this one specifically used semaglutide, their risk of dying is reduced by 49% for any reason, which is incredible. But a risk reduction of 51% of heart disease, it’s absolutely a game changer. And then the second study is called the SELECT trial. And again, it’s on semaglutide. And this one looked at non-diabetics. And it found a 20% reduction in heart attack, stroke, or death due to cardiovascular disease of any kind. And it’s pretty indicative of risk for people who, hey, I don’t have diabetes, but I’m using these medications either for weight loss or longevity. A risk reduction of 20% of the number one killer for men and women in our country is profound.
Katie : No kidding. And I feel like kind of peripheral to that. And I’m really curious if you’ve seen this clinically at all. So like I said, I don’t have any direct experience with this, but I have a lot of friends who have had amazing results with GLPs. And several of them have mentioned that they had kind of a change in a lot of their wearable data they tracked, whereas their HRV seems to decline at least for a while. Maybe they saw changes in their resting heart rate or their sleep score. And they kind of had this like, I’m getting bad grades, at least in the adjustment period. Is this something that you are seeing? And does this also maybe go back to dosing? Or what do people need to know and understand about that?
McCall: I definitely think it’s dose dependent. So I think there’s a decline, especially in HRV and heart rate. There’s shifts in heart rate, blood pressure. People are undernourished, but they’re also under hydrated. And that is really impacting those markers in a significant way. GLPs shut off our desire for food, or it sort of mitigates some of those cravings for food. Unfortunately, it does the same for drinking. So people are not naturally inclined to drink water to hydrate. So the number one side effect that we actually do see in our practice is decreases in hydration that is significant enough to change your biomarkers on wearable devices, for sure. Then you want to obviously increase salt, increase water, create some intentionality around this. And we see those markers increase back up, certainly.
Katie : That makes sense to me. And I feel like that probably is so true for many people across many kind of vectors is like, we need more salt and more hydration. I’m glad that’s getting more awareness in modern times. I also know I originally came across you and worked with you in the thyroid capacity because that’s what I was navigating at the time. And I’ve seen at least some concern related to thyroid patients and GLPs. And does that increase any risk factors related to our thyroid? And I figured you would be probably the most qualified to speak to this because you have such deep experience with both.
McCall: Yeah. So this was a big one. This is a big fear for people that I hear about literally all day, every day. And I do, I want to offer some distinct clarity in this because there’s both sides of the coin that I want to address. One is a lot of people are told if they have a thyroid problem, they can’t be on a GLP. If they have Hashimoto’s, they can’t be on a GLP. Those things are blatantly not true, not founded in science. They’re not even recommended as how to proceed using or prescribing these medications. So that is wildly unfounded and untrue. Then there is this risk, this black box warning for thyroid cancer that has created a lot of fear. And it did shift my own clinical practice when I first started doing this years ago.
And I’ve really dug into the data. In fact, a new study came out this month and we’re chatting in January of 2025. And it was the biggest study to date specifically looking at risk for thyroid cancer and people on GLPs. And so this is where there’s a lot of misunderstanding. Theoretically, in research done on rats, there was an increase in medullary thyroid carcinoma in rats on GLPs. There’s a couple dynamics and nuances that I think the general public isn’t aware of. One is rats happen to have a lot of GLP receptors on their thyroid, a lot more than humans do. Very, very dense amounts of GLP receptors. Additionally, when they were dosing these rats with GLPs, they were putting them on anywhere from 20 to 100 times the comparable dose to humans. So they were flooding these rats with GLPs.
And there was an increased risk for a specific, or an incidence really, for a specific type of thyroid cancer, medullary thyroid carcinoma, which happens to be one of the most rare forms of thyroid cancer. It accounts for about 3% of thyroid cancer. So because of that, these meds received a black box warning for medullary thyroid carcinoma. I actually do not think that people with a history or family history of medullary thyroid carcinoma should be on them, but that is a specific kind. There are other forms of thyroid cancer that are completely unrelated that I do actually, in fact, use GLPs with patients with a history of, for example, papillary thyroid carcinoma. So going back to the study that came out this month, it looked at, it kind of was two-tiered.
One, it compared rates of thyroid cancer in people on GLPs to another form of diabetes medication, no increased incidence. And then it was a meta analysis. It reanalyzed 37 previous studies that have been done on this exact topic and pulled data from them. Again, no increased risk of thyroid cancer. Study after study after study has shown this. So although there is a black box warning for these medications, I want to be clear that that has actually never translated to human data. I myself was doing an ultrasound on all of my patients quarterly who were on a GLP in my thyroid practice, because obviously it’s very important that I’m not causing thyroid cancer. Never once did we have nodule issues, growth, concerns. Eventually it was so redundant and unnecessary, I stopped requiring people to do it. So I think my clinical experience certainly aligns with what the data has shown.
Katie: Well, yeah, like I said, I feel like you have the most relevant clinical experience specific to that particular population subset. And I would guess for some people listening, maybe that’s a concern and maybe why they’ve thrown out the idea entirely is because they’ve read some of those more sensationalist headlines related to thyroid concerns. And I feel like I think that was really helpful context from you and really also is a perfect springboard into the conversation around dosing, which we’ve touched on a little bit and mentioning like people can be overdosed and certainly seems like can see some negative side effects when they’re overdosed. And I feel like this maybe could be its own whole conversation. But what do people need to know about dosage, especially if they’re working with a practitioner who maybe doesn’t have this level of understanding that you do?
McCall: You know, I think it’s so important that if you’re struggling with side effects, if you’re afraid of these medications, if you tend to be sensitive to medications in general, that you find someone who has a progressive approach. And it’s a little difficult and challenging now, but I think it truly is the future of GLPs. Because what’s fascinating is when we started our program years ago, we started with traditional dosing. We did the same thing that everyone is still doing now. And what we found was people were having side effects. They were nauseous. They were constipated. They didn’t eat food. They weren’t hydrating. They didn’t get enough micro or macronutrients. They were losing their hair. So slowly over time, before I ever heard the word microdosing, we started to adapt our protocols. We would reduce the dose. We would allow people to stay at smaller doses longer.
And what we found as we continued to tailor this to be more conservative, but also more unique for each person, not trying to shove everyone into a one size fits all box, we found that side effects completely were eradicated. So, you know, whereas initially, maybe three years ago, I was sending in multiple Zofran or anti-nausea prescriptions every day, we’ve sent in one or two in the last year. Like it just doesn’t happen anymore. And what’s fascinating is sadly, we’re taking the data that we have, which is normal in medicine. We have data for the use of these medications with diabetics, and we’ve now taken that dose that the data is from, and we’ve applied it to everyone across the board who one, might not have diabetes or Hey, maybe does have diabetes, but we’re expecting everyone to fit into this one size fits all box. And that’s just not the case.
That’s not how it works. And because of that, people are under eating, they’re micronutrient depleted, and they’re not able to move their bodies. They’re extremely nauseous, so they don’t want to eat nutritionally dense food. And from that, there’s the spiral of the side effects that you hear about. You know, Ozempic face, Ozempic butt, you know, even gallbladder issues come from this rapid weight loss, depletion of nutrients, overdose of medication, all of, not all of which, but a huge percentage of which is completely able to be eradicated if we simply, one, reduce doses, and two, tailor doses to each person’s individual response to the medication.
Katie: That makes so much sense to me and seems like it logically should be the intuitive approach, but seemingly it is not necessarily in these large scale operations that are just giving everybody the same standard dose. So I love that you have like really dove into the data and the clinical expertise to sort of dial that in. And I would guess that’s why you’re having such good results when a lot of other people are still experiencing side effects and all of these problems. And it seems like we could probably talk for hours and still not cover everything related to this, but I know you have a resource specific to this that I’m going to link to in the show notes, but for people who are intrigued and maybe want to really dive more into this and understand how it applies to them, what is that resource and what do you recommend as a starting point for people?
McCall: Yeah, so it’s just our GLP Decoded Guide. It takes you through a lot of tips and tricks that we use, kind of gives you the nuances of, hey, what creates success in these situations? What can help you get through side effects, prevent side effects, prevent hair loss or fatigue, all of these types of things. And I really, really do, I think it’s important that the biggest thing I could leave people with is bad things happen when you end up in a program where they give you a prescription and you sort of leave, you’re on your own and they shove you into this one size fits all box. But just because you might have a rough start with that, that doesn’t mean black and white it’s this class of medication. You know, it’s all about the dosing and the approach and how you are, are you looking at this from a holistic perspective?
Do you have someone on your team to help you with nutrition, with exercise instruction, what to do, what not to do. You need the partner of a true seasoned clinician so that you can have success and avoid the pitfalls that we hear about in the media, because truly they are avoidable.
Katie: Amazing. Well, I will put all those links in the show notes. I know you have a tremendous amount of resources. I’ll make sure people can find you and keep learning from you. I know I learned a lot in this conversation going into it with literally no knowledge whatsoever or experience in this. And I feel like you provide such a helpful and balanced view and context on this topic. Again, those links will be in the show notes for you guys listening on the go, but McCall, thank you so much for your time. I am deeply grateful.
McCall: Thank you for having me.
Katie: And thank you for listening. And I hope you will join me again on the next episode of the Wellness Mama podcast.
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