922: Thyroid Health Deep Dive: Labs, Remedies, Medications and More With McCall McPherson

Katie: Hello, and welcome to the Wellness Mama podcast. I’m Katie from barbaraoneill.online, and I am back today with my friend, McCall McPherson, to dive into the world of thyroid health, do a deep dive on that related to labs, medications, remedies, lifestyle factors, and so much more. And she has an absolute wealth of knowledge about this, as well as many other areas, but very specifically thyroid, which is how I originally found her. We also had a conversation recently related to GLP-1s, and that will be linked in the show notes as well. In this conversation, she really does a deep dive into understanding thyroid health and becoming your own primary healthcare provider related to thyroid health. And she gives a lot of really actionable things to understand, as well as what to know about your labs, how to manage your own care, lifestyle factors that come into play, and so much more. So let’s join and learn from McCall McPherson.

McCall, welcome back. Thanks for being here again.

McCall: I love it. I’m so grateful to be here. I always love our chats. Thank you for having me.

Katie: I love it too. And I will make sure our most recent conversation is linked in the show notes because we got to do a deep dive on GLPs. And I knew when I saw you at a conference last year, that I had to have you on to really dissect some of the myths related to this, because you had really important context I felt like from your clinical experience that gets lost in kind of the mainstream, more sensationalist conversation about these medications. So you guys that’s linked in the show notes, highly recommend listening. In this one I’m excited to circle back and go deeper on the original topic that led me to you in the first place, which is thyroid health. Back when I was researching my own Hashimoto’s and working to recover from that, I of course came across your work and learned from you then. And I know that there’s much more to this topic I would love to deep dive into today because many people listening have some form of thyroid complication going on.

And I feel like you have so much clinical knowledge here and also a really hopeful and helpful just way of explaining these things that kind of puts people back in the driver’s seat of their own health. I kind of guess to start broad, I know for a lot of women, and certainly this was my experience, even getting diagnosed with thyroid issues can be quite the struggle. I know I’ve heard from many women who were told your labs are normal, or that’s normal when you’re a woman and later went on to find out with a different practitioner that they did have something going on with their thyroid after being dismissed. And it seems like there’s just a lot to understand when it comes to thyroid health that not necessarily every doctor has the full knowledge about. One thing I say on here often is that at the end of the day, we are each our own primary healthcare provider and that the best things happen when we get to work with really knowledgeable partners in that journey, but that we still have to be in the driver’s seat. And when it comes to thyroid, there’s so much to understand that that can feel like a daunting task. So let’s kind of just walk broadly into the topic of thyroid health from someone who’s trying to be in their own driver’s seat when it comes to that.

McCall: I absolutely love that intro because I truly, truly believe at this state where we’re at in the realm of thyroid care, people cannot put their blind trust into clinicians for their thyroid, either for diagnosis or medication management or ordering the correct labs. And my whole mission in my life professionally is to pull back the curtain and literally share every darn resource so that people can be exactly that. So that they can drive their own care, be informed, empowered consumers of their health, especially in the realm of thyroid, because medicine has just not evolved enough, yet. We’re hoping to get there, but we have some work to do. And so if you’re struggling with fatigue and brain fog and dry skin and weight retention or weight gain and low libido and poor digestion and hair loss and classic thyroid symptoms, I always say, look, if it looks like a duck, it walks like a duck, it quacks like a duck, it’s probably a duck. So if you go to your doctor and they say, oh gosh, I ran this TSH, everything looks completely fine. You’re good. It’s not your thyroid. And they send you away. You cannot accept that as the truth. We have to dig deeper. We have to look at more and we need to get more labs, nuanced ranges, and we can absolutely dig into that too, Katie, if you want.

Katie: Absolutely. And I know you have a very specific guide on this as well related to thyroid labs. So I’ll make sure that’s linked in the show notes too, but that was so much my experience. I had multiple doctors actually test just one or two markers. And I heard multiple times like your labs are normal. Everything’s fine. This is just how you feel postpartum, or this is just how moms feel. And I accepted that at first, but to your point, like we can’t, we have to dig deeper to actually get answers. And it took me actually eight tries to finally get it dialed in. So I would love for you to kind of give us some benchmarks of how to get there much faster and easier than I did.

McCall: Yes. Amen. So, you know, number one is you have to get a full thyroid panel. So if you have thyroid symptoms, a TSH is not enough. In fact, it’s not enough to diagnose and it’s certainly not enough to manage. So a full thyroid panel, and we’ll link my thyroid lab guide that tells you exactly what labs you need. But if you want to hear them out loud, it’s TSH, free T4, free T3, which is your active hormone and it’s the least checked lab that is the most important one, and reverse T3. And that is a full thyroid function panel. Women also need to be being screened for Hashimoto’s. I can’t tell you how many patients have come to me and have had a thyroid problem for 10 years and have never been screened for the autoimmune component of Hashimoto’s. And you do that by way of TPO or thyroid peroxidase antibodies and thyroglobulin antibodies. So that’s like step one. Step one is, hey, we actually need to get like all the information, not a snippet of the information. And then the next barrier so often, sadly, that women run into is clinicians get their labs back, even if it’s a full thyroid panel, they glance at it. And if nothing is in bold or off to the side, their response is, your labs are totally normal. And what I think is misleading about that or misunderstood is there actually is not a standardized quote, normal range for thyroid. There’s nothing established that actually says, hey, this is where you should be. And this is where you shouldn’t be. It’s all based on what the lab dictates as normal. And every lab’s definition of what is normal, whether it’s a Quest lab to a Labcorp or even one LabCorp’s location by my office as compared to one by my house, those quote, normal ranges change from lab to lab, and lab location to lab location.

They’re just a collection of averages of a bunch of sick people going to the lab, checking their markers. So, there has to be a more optimal narrow range. And what I found over time, and we’ve established our own ranges at Modern Thyroid Clinic by collecting hundreds and hundreds of thousands of pieces of data on people with thyroid conditions and analyzing, hey, where do these people feel good? Where are they thriving in life versus where are they plagued with thyroid symptoms? And over the last 10 years, we’ve slowly narrowed our margins down more and more and more until we’re left with these very, very small margins of what actually is optimal. And we find if we can get people into truly optimal ranges, not just normal, they actually get their lives back. They thrive. Their symptoms dissipate. So that’s what we’re looking for. Ultimately, it’s not, oh yeah, your labs are normal, go on your way. And you’re stressed. Eat less and exercise more. That’s not going to be the answer.

Katie: Yeah, I’m so glad you brought that up because like I said, that was my experience was being told my labs were normal. And I didn’t understand for a long time exactly what you said, that that changes by lab and is simply an average. And that like normal and common is definitely not ideal, especially in a world where most people have some marker of metabolic dysfunction or chronic disease. So like, why are we using the average of sick people to create the ideal of what we’re actually we think we’re trying to aim for? And I feel like that context alone was such a paradigm shift for me and really helped me to like understand my own health better and then to be able to advocate for myself better as well. And it seems like even all those markers aren’t often tested for people. So they’re not even given the data to begin to understand their health. And it seems like the first step is advocating for yourself to even get the right labs to begin with, which can be an uphill battle. I know that you’re probably we’re on the same page on this. But one thing I remind people often is like we’re hiring these health care providers and we get to ask them that-

McCall: They work for us.

Katie: They work for us and we can fire them if they don’t work with us and find someone who’s willing to. And I had to do that, like I said, multiple times. But that was just absolutely life changing to me. And I love that you guys have used that data over time to really refine the range, because to your point, that should be the question is where are human beings thriving, not where are we like just below the minimum? And I feel like we see that same thing, for instance, with like protein requirements. We’re like, oh, here’s the minimum you need to survive and not have massive problems. And then that becomes the normal recommendation versus asking the question of like, what is optimal?

McCall: It’s the difference between treating sickness or promoting health, right? And I mean, I want my patients to live their life to their highest, fullest form. I don’t want them surviving every day. We want them to thrive in the same way that I want to thrive. And so, yeah, I think it’s misunderstood. And to just put a pin in that point, it’s, you know, if we are taking averages of people at a lab, who is going to the lab anyway? It’s people who are not well. They’re there to figure out what’s going on with them and why they feel so poorly or why they have this health condition. So it’s crazy to think that in America, we are taking those people’s information and now establishing what everyone else is supposed to look like. So yes, absolutely. And I always tell people too, to your point of, if you go to a clinician and if you go to a doctor and they say, no, I’m not going to run all these labs or your insurance won’t cover all these labs, which actually is wildly untrue. I check these labs on everyone every three months. It’s easier, even though it seems more daunting, to exit that partnership and go find a different partner. It’s difficult to change someone’s practice of medicine. It’s a lot easier to go to a new clinician, even if it’s just one appointment, which I know is, especially when you’re tired, you’re fatigued, it seems overwhelming, it’s frustrating. Just do it. Do not waste time. It is not worth your energy to try to convince someone to order a full lab panel that they honestly aren’t going to know what to do with anyway, if they’re not willingly running it.

Katie: That is such a great point. And like you just explained, I learned that lesson the hard way. And these are all lessons I wish I could give to my younger self instead of taking quite so long to figure them out. But I’m so grateful that there are now voices like you that are helping to kind of shorten that timeline for a lot of people and bringing all this context to the conversation. And I know firsthand from thyroid experiences, like the best outcomes happen when we are working with a practitioner who can help us dial in, especially things like medication when needed, work on the inflammatory side. There’s a lot of nuance there. And I’m guessing from all of your years in clinical practice, you’ve probably also seen patterns of things that are like sort of almost universally either beneficial or harmful when it comes to thyroid health. And I would love to at least touch on some of those because I know when it comes to thyroid, we do sometimes need to work with a doctor and be on medication. And there’s also a whole lot that’s within our hands and our home and our lifestyle and our diet that we can take immediate control over and start seeing positive change from.

McCall: Totally. And so we’ll kind of split that conversation into two parts. One is the partnership that you have with a clinician. And I think it’s so important that you do the things we’ve already covered, full thyroid panel, but also types of medications are wildly important in these situations. Very much like you, Katie, I had a terrible experience as a thyroid patient, and that’s ultimately why I do what I do now. But you know, for me and so many of our patients, the life-changing component is shifting if you have to be on a medication from a medication that is purely inactive, that a lot of people can’t really activate to make usable and incorporating some form in of active thyroid hormone or what’s called free T3. And these are medications like liothyronine or Cytomel or Armour, those types of meds. So that’s kind of one component that… The way that I view it is it can be an immediate supportive mechanism to make you feel better, to give you more capacity that you can then take or back into your lifestyle to further improve your thyroid function, to potentially reduce Hashimoto’s and, you know, patterns and things in that regard.

Definitely diet plays a big role, not only in your risk of severity for Hashimoto’s or other autoimmune diseases, but also even simply the activation of your thyroid hormones, how well your body is able to use your thyroid hormones or your thyroid medication directly influenced by diet. And some easy, easy things that I’ve kind of tips and tricks I’ve found are  number one is if you’re too tired to do a whole lot, bring in more nutrients. You know, like I say, green juice, not smoothies, but green juice where you can fit five or six pounds of veggies in one little serving and you can drink it easily. Can flood your system with a lot of micronutrients that maybe you haven’t been eating because you’ve been too tired to cook. Reducing inflammatory foods. You know, the top two that I have seen objectively in data on our Hashimoto’s patients that are the number two most common drivers from food for Hashimoto’s is number one, dairy and number two, gluten.

So if perhaps you could reduce one or two of those, even measure your antibodies and then maybe go dairy free and measure your antibodies three months later and see how they’ve been impacted. That can be a powerful, powerful way to influence antibodies and just thyroid function. And then, you know, stress, taking away a little bit of stress on your system, whether that’s not over exercising, whether that’s focusing on sleep, whether that’s meditation can also really not only impact thyroid function, but adrenal function. And those two, those two are so interconnected. Your thyroid and your adrenals are so interconnected that if we can improve one of those systems, the other system quickly follows suit.

Katie: That makes so much sense to me. And I love that point. And like often I think maybe women address one or the other, but don’t know that they kind of work in harmony so well and that you can seemingly use them to create this positive feedback loop. Which was one thing I noticed because I certainly had the experience of being in that very fatigued, everything felt overwhelming. I had no energy part of thyroid issues, but what I realized was even baby steps over time kind of created that flywheel effect. And like those little positive changes made room for more positive changes. And just like negative habits can kind of spiral into a negative flywheel, the same is very much true on the positive, especially I feel like for women, our bodies, because we’re more sensitive hormonally can also respond more quickly when we learn how to support them.

And I love, I want to circle back to what you mentioned about kind of getting enough nutrients and sending that, I consider it almost like a safety signal to send our body that signal of getting enough nourishment and nutrients. I feel like maybe this is something we lost when the conversation became about more about calories and macros. And I don’t have anything to back this up, but my theory is that our body and its wisdom will continue to have us crave food and calories until it gets the nutrients it needs. So when we’re eating the modern diet, that’s largely devoid of nutrients our body’s very much being on our side by continuing to request that we keep eating. Whereas if we kind of take a nutrient burst approach and send our body the safety signal that like nutrients are abundant, the body that like, it’s a factor that reduces the sensation of stress in the body. And also helps us not to crave foods that are not helpful for us. But I would love your take on that. If you’ve seen that in clinical practice, that’s just kind of a theory I have.

McCall: Absolutely. So I love when people come to me too, they’re tired. By the time they come to Modern Thyroid Clinic, this is like a decade long journey for them. They’re exhausted. The last thing I want to do is be like, okay, well, we’re going to leave here today and you are going to be on an autoimmune paleo diet for the next year. I really focus on what can we bring in as opposed to keep out, especially initially, because just as you described, you bring in nutrients, you flood your system with nutrients, micro and macro, and there’s a natural predisposition to have less cravings, to want less bad food. And so if we can create that in a way that doesn’t create more stress in your life, more obligation, right? If it’s this natural tendency, it’s so much easier for people to stick with. And I couldn’t agree more. You give your body what it needs to thrive and it won’t request all of the other things that you’re so used to customarily craving.

Katie: And on that note, I would love to get your take on kind of what are the best ways to do that from a nutrient perspective, but especially from a protein perspective, because I love that we’re seemingly seeing the conversation shift a lot more into that more positive frame of reference. And I hear so many women talking about making sure you’re eating enough protein and nourishing yourself well, which I think is a much more positive conversation than just trying to diet and the whole calorie conversation of the past. But I would love to know your take on this, especially thyroid specific. Like, are there kind of metrics that we can use as benchmarks to know how much protein to eat, or is it more varied? And are there any thyroid specific considerations?

McCall: Yeah. So I would say aim, I mean, my general recommendation is aim for about one gram of protein per pound of body weight per day for women, especially if they’re trying to build muscle. But I get a little bit creative in the way that I tell my patients to do this. So I do something called ordering your food and I don’t mean like ordering it takeout. I mean, so in the morning, if people eat breakfast, if they don’t intermittent fast, I prefer that they start their day and their meals with protein. So protein first and then micronutrient dense, low glycemic foods. So basically we are giving our body what it needs. First in a meal, but also in the day while simultaneously allowing our blood sugar and insulin to not be overreactive. So it allows our blood sugar, our insulin to remain sensitive, especially for thyroid patients. We tend to get insulin resistance. We tend to get prediabetes. We gain weight. Our metabolism shifts in a way that is not advantageous for us. So I try to keep breakfast protein, micronutrient heavy, no carbs.

I also try to do the same at lunch, where protein forward, heavy micronutrients second. And then if someone wants to raise their blood sugar a little bit, if they want to eat a little bit of carbs, they can, but they do it last. So they’ve already met, again, their body’s requirements of what it’s asking for to have thyroid function, to have energy, to reduce inflammatory responses. And then in an ideal world, I try to have my patients save carbs, sugar cravings or treats and things that they would crave for the evening. So that, you know, they’ve met all their micro macronutrients throughout the day that their body requires, but they’ve also kept their insulin and blood sugar as low as possible without fasting throughout the day so that we are combating insulin resistance and leptin resistance. And we’re working on healing metabolic dysfunction without ever having to fast, without stressing the body and simultaneously flooding it with what it needs to function at its highest level.

Katie: I love that. And even that mindset of just saving those things for later in the day versus the all or nothing mindset of skipping them, I would guess is so much easier for people. And I love that kind of approach of just rather than fasting, which I know is its own whole controversial topic for people with thyroid concerns, but just kind of figuring out a way to make sure your body’s getting the safety signals of the right amount of food and preload the things your body needs most. It seems like that is a really big paradigm shift for a lot of people and can probably make a huge difference. I would also love your take on the circadian aspect of this and light. And if there are anything special for people working on a thyroid challenge to learn from that. I know for me, making the change of getting morning sunlight and daily light exposure at the right times and avoiding kind of junk light at night made a big difference in my energy levels and kind of coincided with my healing journey. But I would love to hear any clinical experience you have or anecdotal of how this can be helpful.

McCall: Yeah, you know, I almost think about it, how a lot of the data done on this is done seasonally, like how thyroid patients in the winter, fall, when the days are shorter, when we don’t have access to as much sun, we need more thyroid hormone, we sort of go into this hibernation state. And that’s associated with lower metabolic function, right, lower energy, more demand for sleep. And so it’s similar. We can reroute that and shift that and try to increase those things, increase the amount of time we have throughout the day that we’re exposed to light. And obviously, the easiest way to do that is early morning sunlight, getting out in it, shifting our circadian patterns, which directly influences the activation of our hormones, the utilization of our thyroid hormones in the same way, as opposed to it being disadvantageous to us in the winter months, we can sort of reverse it to make it advantageous. So we can feel better, more energetic, more clear. That’s fascinating. No one’s ever actually asked me that question. I love it.

Katie: I love that too. And I hope that we’re going to get more understanding of circadian health and light in like, I feel like we’re starting to hear more about that. We’re understanding people using more amber hues and red lights at night versus bright blue bulbs. People are getting more sunlight. I know Huberman’s even really delved into that. And I feel like this will be a thing we hear more and more about, but I know it was drastically impactful for me. So anytime I get a chance to kind of slip that one in there, I always take it. You also mentioned insulin resistance and blood sugar issues. And seemingly this is a kind of related concern for a lot of people who have some sort of thyroid struggle. I know you already brought up some things that can be really helpful for that, but it seems like this dovetails with our first conversation, which I will link to in the show notes. But are there any additional considerations here related to specific ways that maybe women especially can address insulin and blood sugar related concerns?

McCall: Yeah, I mean, I definitely encourage people to check out the other conversation we had on GLPs. What I think a lot of people don’t understand is early, early signs of thyroid dysfunction are elevations in blood sugar, insulin, cholesterol. Okay, I was 27 when I had my most recent thyroid crisis and the physician tried to put me on Lipitor because my cholesterol was high, literally just because of my thyroid problem that was poorly managed. So understanding that a foundation, especially in the thyroid community, I can’t not say it. You have to have your thyroid optimized, or you are going to have insulin resistance, blood sugar dysregulation, and just slow breakdown of your metabolic function over time. So you have to solve that.

And like we mentioned earlier, it can’t just be quote normal. It needs to be optimal or again, early signs of not optimal are elevations in that blood sugar, leptin, et cetera. And then that just further breaks down as we age for sure. Obviously protein is huge. I can’t encourage people enough to at least dabble with a CGM, with a continuous glucose monitor and learn about the patterns of your blood sugar because they’re unique, right? But some basic things that you can do are protein first in your meals, and it will reduce the spike of your blood sugar when you eat. That doesn’t mean you have to not eat anything, right? You still can eat the normal things that you do, but ordering your food in certain ways can allow for more maintenance and control of your blood sugar.

Another easy hack that I’m sure you’ve discussed is if you simply walk for five or 10 minutes after you eat, it can reduce your blood sugar spike anywhere from 30 to 50%, which is crazy. Like a very short walk after you eat can change your long-term health outcomes in huge, huge ways. Because your insulin sensitivity is one of the most important markers for long-term health. So if we can keep that very, very sensitive, you can protect your longevity. So yeah, those are some easy, easy tips and tricks that I feel like most people can incorporate in their daily life.

Katie: Amazing. And I know we mentioned your lab guide already, but you have so many resources related to thyroid health, and I’ll link to those as well. But where would you point people as a kind of place to begin if this is something that they’re wanting to understand more of?

McCall: Yeah. So I would say right now, actually on our circle group, and I can send you the link to that as well, I’m offering my Thyroid Empowered course for free. I’ve only ever historically sold it. It is absolutely chock full of resources. It takes everyone from, hey, how does my thyroid work to what each type of medication is? How can I influence antibodies, hormones, adrenals, literally everything. So it’s such a powerful resource. Obviously our whole mission at Modern Thyroid Clinic is to create a place where people can come if they can’t find help. And we’re in about 30 states nationwide now. So expanding will be in 50 by the end of the first quarter. And I really, for all the people who can’t be our patients, I share my optimal labs. I share lab guides, how to take your medication before labs. So many resources from Modern Thyroid Clinic’s website, from our social media, because my goal for you all is exactly what Katie said.

It’s, I want you to be able to navigate your own health, be an informed and empowered consumer of your health, especially in the world of thyroid, because it is underdiagnosed and underappreciated how complex it is while simultaneously devastating the lives of women, families. I mean, I truly, I view our work as generational. If we can fix women’s health, we can fix families, we can fix their relationships with their kids, their grandkids. And so it’s not to be underestimated in its significance for sure.

Katie: I love that. Well, I will put all of those links in the show notes. I know you have helped so many people and hopefully we’ll get to help many, many more, including some of the listeners with this podcast. But McCall, thank you so much. It’s always an absolute joy to talk to you. And I have learned so much from you. Thank you for being here.

McCall: Thank you so much for having me. Hope to see you soon.

Katie: And thank you as always for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did. And I hope that you will join me again on the next episode of the Wellness Mama podcast.