Ep. 288 Best Ways To Improve Your Thyroid Health with Dr. Amie Hornaman

About Dr. Amie Hornaman:

Dr. Amie Hornaman, “The Thyroid-Fixer”, is host to the top-rated podcast in medicine and alternative health: The Thyroid Fixer™, with listeners around the globe. She is the founder of The Institute for Thyroid and Hormone Optimization, an organization with transformational, proven approaches to address thyroid dysfunction and support you in returning to full health.

Dr. Amie is also the creator of The Fixxr™ Supplement line with revolutionary, proprietary supplements that specifically address the struggles Dr. Amie saw in her patients: inability to lose weight, fatigue, low libido, hormone imbalance, and more. From the Fixxr™ products to her one-on-one programs, Dr. Amie is on a mission to optimize you …and give you your life back.

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Ep. 210 – Understanding the Thyroid’s Effect on Your Hormones, Weight Loss Resistance, and Metabolic Function with Amie Hornaman

Books mentioned:

Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine by Robert H. Lustig

Transcript:

Cynthia Thurlow: Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week, and impact over a million lives. 

Today, I was joined by Dr. Amie Hornaman. We last connected on Episode 210. She is The Thyroid-Fixer, a woman on a mission to optimize thyroid patients around the world and give them back their lives using her proprietary programming. She is the founder of The Institute for Thyroid and Hormone Optimization. Today, we spoke about the much misunderstood thyroid hormone T2. We spoke about clinical indications for using this in conjunction with regular thyroid methodologies, the role of shame, how thyroid hormones intersect with cholesterol, indications for compounded versus synthetic thyroid hormones, why it’s so much harder for women to build muscle in perimenopause and menopause, the role of weight loss resistance, and in particular, some of her favorite strategies for this. And lastly, discussing creatine monohydrate and thyroid health. I know you will find this conversation invaluable. Dr. Amie is always a pleasure to have on and brings fire to our discussion. 

Well, Amie, wonderful to have you back on the podcast. How are you doing today? 

Amie Hornaman: I’m wonderful. I’m so happy to be here. 

Cynthia Thurlow: Yeah. So, when I was coming up with ideas of things for us to talk about today, something came up that I have not talked about on the podcast before as it relates to thyroid hormones. And so, talking about T1 and T2. And so, for listeners that are listening, they’re saying, “I don’t know what you’re talking about. I know I’ve heard Cynthia talk about T3 and talk about T4. We do indeed have other thyroid hormones that are impacted in our physiology. And so, maybe we’ll start the conversation there touching on what we know about T1 and T2. Is this something that we need to be concerned about? 

In your clinical experience, what has been the research that you found has made it more compelling for you to consider having these conversations? Because as I was saying to you before we started recording many years ago, I used to think, “Oh, everyone needs to have natural desiccated thyroid, and no one needs synthetics, and synthetics are bad.” And now, I feel very differently. I think it’s very bio-individual. And so, when you’re getting the T1 and T2, that is likely coming in the form of these natural desiccated products as opposed to synthetic T3 and T4. So, for people that are listening, they’re like, “I don’t know what you’re talking about.” Let’s unpack what this represents, so that we can better understand this.

Amie Hornaman: Absolutely. Just like you, I’ve been focused on T3 and T4 and talking about that for years now. If I go back about 15 years, that’s when I started my research on T2. So, through those years, over the last 15 years of using T2 myself, using it with patients, really diving more into the research, the studies, that’s what brought it to the forefront for me to look deeper into and to start using a little bit more as a very, very therapeutic, natural plan, a therapeutic protocol to get people to that next level in terms of metabolic rate, energy, all the things that the thyroid does.

So, yes, let’s unpack. We know there’s T3 and T4. When we’re talking about the thyroid gland, we know it produces four hormones, but we focus on T3 and T4, because that’s what’s in the medication. That’s what’s in NDT, that’s what’s in your Synthroid, that’s what’s in your Cytomel, that’s what is in the medication that you get if you are hypothyroid. But we forget about T1 and T2. Those are also two thyroid hormones that the thyroid gland produces. When we look at natural desiccated thyroid, which is the dried out thyroid gland of a pig or a cow, usually a pig if it’s Armour or NP, we see that it does contain T1, T2, T3, and T4. But we have to look at the ratios there. So, when we’re breaking down each thyroid hormone, T1 is actually pretty inactive. It’s along the lines of T4, although it’s even less inactive than T4, because it doesn’t even convert to anything. It just stays there, hangs out. That’s T1. 

Then we move on to T2. It turns out that that is very biologically active. It works on a pathway to increase your basal metabolic rate and it works on the mitochondria. So, it works at the mitochondrial level instead of at the thyroid level, which I’ll get to that in a second. In that, it stimulates ATP, it stimulates brown adipose tissue, which also helps us with fat burning. So, we’ll tie this all together into metabolism. It actually helps people have better energy through the day, but a nice, steady energy. Not a jacked up, jittery energy. When we move on to T3, we also know T3 is active, that’s what really gets to the cell, that’s what every single cell has a receptor site on it for T3, that’s what’s going to give you an even better metabolism and better mood, and it’s going to improve all thyroid functions, because that’s the active thyroid hormone.

Then we have T4, which is inactive. But T4 converts to T3 most of the time. We always have to watch out for those nonconverters. We’re looking at your reverse T3 numbers to see how well you are converting that T4 to T3. But it has some effect on the body. All of those thyroid hormones are good. All of them are in, like we said, natural desiccated thyroid. But when we’re really looking at making an impact on you as a person, on your symptoms, that’s where we have to focus on the T2 and T3. When we back up and look at the history of, and where this came about, and how it even piqued my interest, I have to go back to bodybuilders, because they are the OGs of biohacking. They really are. If you look at bodybuilders, and whether you’re talking peptides, SARMs, certain supplements, even creatine, which we’ll talk about today, bodybuilders started it. They started using it first.

So, when we look back at T2 and T3 in the bodybuilding world, so this is where I’m going back 15 years, we see that, “Okay, if we are honest, bodybuilders will abuse medication, i.e., T3 in order to lose body fat. The smart ones, the ones the trainers to the pros, the ones that are at the top of their game and they’re producing these bodies of perfection that are getting their pro card and moving on to greater things, they knew better. They knew that abusing T3 is going to result in muscle loss as well as fat loss. Abusing T3 is going to shut down that competitor’s thyroid gland, and now they’re going to have a problem after that show is done. They would use T2. They would use T2, because it doesn’t burn muscle. They would use T2, because it doesn’t have an impact on the thyroid gland itself, and it won’t make a person hypothyroid or produce that negative feedback loop that thyroid medication can produce. So, we have to tip our hats to the bodybuilders, because they figured this out a long time ago, and now we see it moving into mainstream.

Cynthia Thurlow: Well, and it’s interesting, because as an example, I’ve been on this thyroid replacement journey ever since my non-desiccated product was pulled off the market in 2020. We tried everything. When I say we, my functional medicine providers, who I am not being critical of them at all. They have done the whole scope of things. But first, it was Synthroid, then it was Cytomel, then it was Synthroid and Cytomel, then it was increasing levels of Cytomel. Because if your T3 is not doing anything, the thought process is give more. And at one point, I think I was taking, I want to say 20 micrograms of T3, because it was just like, hit it harder, hit it harder, hit it harder and finally, I said, maybe we’re giving so much that it’s suppressing this feedback loop. And my body’s like, “We don’t need to make any T3, [laughs] because we’re getting so much exogenously.” 

So, I think you bring up a really good point that maybe the bodybuilders, who in many instances probably don’t get the respect they deserve, because you are right. They are these ultimate biohackers, doing these things for a long time. This is where I think T2 is particularly interesting, because for so many of us, like, now I’m on compounded. It’s gotten to the point where I’m on this crazy compounded dose that finally my nut levels are where they should be. It’s taken two and a half years and it is not because of intermittent fasting. People always ask me that and I was like, “I did really well on my non-desiccated product.” And as soon as that was taken off the market and was unavailable, that’s where this journey started and I had to find the right thing for me. So, if you haven’t yet found your right thyroid medicine, keep searching, keep looking for that right provider. They are absolutely out there.

I just have someone that’s so attentive to detail. We were doing microdose changes every two weeks to get me to a stable point, and now he believes, we’re finally, “This is my happy dose.” So, I’m on this crazy dose. I say crazy, because I’ve never heard of anyone being on a dose that’s the split between T4 and T3, but it’s what works for my body. It’s within a therapeutic range, but it’s completely compounded for my body. So, I know you’re probably going to ask, “What am I taking?”

Amie Hornaman: I am.

Cynthia Thurlow: It’s 37 mcg T4 and 4 mcg of T3.

Amie Hornaman: That’s not that much either. It’s amazing that that’s working so well for you, because it’s not that much. But you’re 100% right, Cynthia. You have to find the blend and the dose that is going to work for you. It really is about symptoms. When your symptoms are relieved, at the end of the day, I don’t even care what’s on paper on those numbers. If you tell me “I feel my best, I am symptom free, I am living my best life,” then that’s your optimal dose. 

Cynthia Thurlow: Yeah. Well, and the other thing that I want to tie into this and I have to thank you for our conversation that we had the last time we were talking on the podcast, low-dose naltrexone. Even though I have negative antibodies, we know that it has this anti-inflammatory effect. My functional med doc, who’s a friend of both of ours, so if I told you his name, you’d know who it was. 

Amie Hornaman: Right.

Cynthia Thurlow: He said, “If it’s going to work, it’s going to work. If it’s not going to work, it’s not going to work. So, let’s just try it.” And so, I just said, “I feel good.” It didn’t do anything to my antibodies, which have always been negative, but I said, “If this is what’s reducing the inflammation enough for my body to be like, ‘Okay, we’re going to accept that we’re on this thyroid replacement therapy and now we’re in a happy place.'” And so, for everyone listening, I probably should take a photo for every one of the bag, I’ve kept it because it’s unbelievable, of 20 different medications I’ve been on for my thyroid in the last two and a half years. I should take a photo and then I should just properly dispose of them. But to me, it’s really been astounding, even as a clinician, just how challenging this can be.

So, getting back to this T2, because I think this is really interesting, you mentioned it plays a role in metabolic function, enhancing fat loss and weight loss by increasing calories burned at rest. There was one research that I looked at it. It looked like there are quite a bit of rodent studies. And then there was one bit of research which cracked me up. This is two euthyroids. So, meaning, people that have a healthy thyroid amount two human subjects. We know this is not statistically significant, but still interesting. T2 treatment for three weeks yielded 4% loss in weight and resting metabolic rate increased substantially. And so, I thought this was interesting. Of course, it’s just two people. It could have been attributable to a lot of different things. But I think it opens up the opportunity to say that, I think that if we’re only going to look at T3 and T4, we may potentially be missing opportunities for other people. Because how many patients do you know that I saw in the hospital, I saw in clinic that would say to me, “You cannot touch my Synthroid dose. I will not take generic. This is the only thing that works for me.” And then you ask them how they feel and they’re like, “Not great.”

Amie Hornaman: Right.

Cynthia Thurlow: So, I think there’s this mindset. “If you’re going to go on thyroid medication, it’s going to fix everything.” And sometimes, it takes a bit of time. Sometimes, it’s not the right medication. But again, this T2 discussion, I think is really interesting. And so, when you’re working with your patients, when do you introduce the T2? Is it when they’ve already been on medications? Clinically, where are you finding the greatest benefit for your patients? 

Amie Hornaman: If it’s someone that’s struggling with weight, and normally, the thyroid patient is, normally, I say 9 times out of 10, it’s that woman that has done it all. She’s done the diet, she’s done the intermittent fasting, she’s worked out, she’s worked out twice a day, she’s done every workout under the sun, she’s taken every supplement under the sun, and she still can’t lose weight. No metabolism whatsoever. I’ll do both at the same time. So, I’ll start optimization in thyroid medication and I’ll also start her on T2, since that’s over the counter, it’s not a prescription. And then that way we’re hitting both lines for her metabolism. We’re optimizing her T4 and T3, preferably optimizing the T3 that T4 converts to T3. We’re optimizing her reverse T3. We’re taking down inflammation or taking down antibodies, if those are present in the case of Hashimoto’s. We’re using T2 to work at the mitochondrial level to increase her basal metabolic rate, to stimulate that brown adipose tissue. That’s going to help with the metabolism as well as her energy. 

So, we’re doing both at the same time. It all comes back to because that T2 does not have a thyromimetic effect. It’s not going to make her numbers look like she’s hyper. So, we know that if somebody– You probably experience this too. As you’re going up in T3, if you test your free T3 levels, they’re going to be a little bit elevated. And especially, if you test without leaving that 18-to-24-hour gap between your last dose of T3 and your testing, you could come back and actually appear hyper on paper. Now, you might say, “Listen, I’m not hyper. I’m still gaining, I’m still tired, I’m still losing my hair. No way I’m hyper.” But on paper, you look hyper. Well, that’s the problem with using T3 or increasing the dose of T3 in your case, because you’re going to appear hyper and then maybe, “Hey, over time, you might actually go hyper.” 

I’ve had a couple of patients that they were on this really nice dose of T3, and they reach out and they’re like, “You know what? All of a sudden, my heart rate is through the roof. I’m jittery. I’m anxious. I’m not sleeping.” So, what do we have to do? We have to dial back that T3 dose. With T2, we can just leave it there, because it’s not going to make them anxious, it’s not going to make them jittery. It has no cardiovascular effects, so it’s not going to increase their heart rate or send them into a tachycardia situation like T3 can. It’s just going to be there doing its work at the mitochondrial level increasing the basal metabolic rate. So, it’s really safe to do at the same time. 

Cynthia Thurlow: It’s really exciting, because I’m one of those people. When I first started thyroid medicines, I did not want to go on thyroid meds. In my mind, it was like giving up. And so, if you’re listening to this and you’re thinking that way, I fought my provider for six months, and then I was so exhausted, I finally went on it. It was like someone had turned a light bulb on. I’m like, “Why did I suffer for six months? This is silly.” But I think what’s really interesting and Dr. Sara Gottfried introduced me to this term, so I want to give her full credit, “thyroid pause.” So, understanding that in perimenopause and menopause, your thyroid is going to take a hit. It is not you not doing things the right way. 

Someone on, I think it was on Twitter, it was a male and I’m not anti-differing opinions, but he was talking about how proud he is at 60. He’s not on any meds. I was like, “That’s great. I wish I could say the same, but I take things to support my thyroid. I take things to support my sex hormones.” And he was like, “Well, can’t you just change your diet and your lifestyle?” I was like, “Who do you think you’re talking to?” I think you get to a point where you’re like, “There’s no shame in taking hormone replacement therapy, whether that be thyroid, whether that be testosterone, or progesterone, estradiol, or whatever constellation of things that you need to make you be able to function and feel good.” And so, I wanted to make sure that I mentioned that– 

I was referred to as a three-legged stool. As we go into perimenopause, it’s like our sex hormones, our adrenal glands, and our thyroid really take a big hit. And so, if you understand that as you transition from perimenopause into menopause, if you need medication, there is no shame in needing medication. If there’s a supplement that’s going to make you feel better, I’m all for it. But I think the narrative around medication being a bad thing, that needs to end. It’s not as if I’m saying there’s no harm in long-term. Blood pressure medication or diabetes medicine or high cholesterol medicine, obviously, those are oftentimes lifestyle mediated. That’s a little different. We would still advocate that women prioritize their sleep, and manage their stress, and lift weights, and try to prioritize protein, like, those lifestyle things are still important for everyone. 

But the shaming that goes on, I got blasted on Twitter a couple of days ago for this. I just said, “I’m sorry that you don’t understand, but I can’t do things better than I am.” That’s sitting from a place of judgment. And I’m telling you, as a clinician, most of my patients are taking hormone replacement therapy in one capacity or another. Let’s stop shaming women for advocating for themselves.

Amie Hornaman: Oh, 100%. If I can jump in there too, that pisses me off to no end, because hormones give us life. That’s what these people on Twitter blasting, you don’t understand. Hormones literally give us life. You’re doing hormone replacement, again, whether it’s sex hormones or even thyroid, to prevent bone loss, to protect your brain, to protect your heart. Because you do all the things to take care of yourself and you don’t want to lose all of your hair, gain weight for no reason, have dry, wrinkly skin, have pain during intercourse, all of those things that come with declining hormones. So, I always tell my audience or my patients that are on the fence and they’re like, “Eh, I don’t want to be on a “medication.”” I said, “You’re going to be on hormone replacement.” 

So, if we’re using NDT, if we’re using Synthroid, if we’re using Cytomel, if we’re using testosterone, progesterone, estradiol, we’re replacing hormones that are no longer being properly made by your body. If you had type 1 diabetes and I said, “You need to go on insulin because your pancreas isn’t producing the right amount of insulin.” Would you be like, “You know what? No, I don’t want to be on medication”? No, we would be like, “Well, then you’re going to die because you need insulin.” You need hormones the same way that you need insulin as a type 1 diabetic. You’re not going to die without them, but you’re not going to live a good life without them either. We have to separate the whole medication versus hormones into two separate categories. 

Cynthia Thurlow: Yeah. It’s interesting. For full disclosure, earlier this year, when I was meeting with my functional medicine doc, we did a slew of inflammatory markers and he said, “This is exactly why women make this assumption in menopause.” He wasn’t being judgmental. He’s just being factual. He said, “You do all the right things and look at the degree of inflammation going on in your body.” Because I had a period of time where I stopped my estrogen and my testosterone because I was on way too much for my body and I didn’t feel good, and so we had to start from scratch. I said, “This is six months without–” I was on progesterone the whole time, however, because I was like, “They’ll have to pull that from my cold dead hands. There’s no way I’m giving that up.” 

But it was very interesting to see how that impacted my cholesterol, how that impacted inflammatory markers in my body. I just said, “I don’t feel bad,” but this is a common misconception that women say, “I don’t feel bad, so I don’t need HRT.” And I’m like, “I will be totally transparent. I will share all my labs with people if they have a desire to see them.” This is what it shows on a cellular level, the degree of mitochondrial stress, the degree of oxidative stress and inflammation that’s going on. We know that menopause is a disease state, whether we like being told that or not, it really is. I think that the sooner we think about it that way, it makes sense to consider. 

Obviously, I know I have listeners that may not be in a position to be able to take HRT. We’ve got some cancer survivors and they’re just not in a position to be able to do that. But for everybody else, just get that fully informed consent, work with a provider that can go over the pros and cons with you, and then you both collectively make a decision for yourself. But to think that you have to ride out a dry vagina, and no sleep, and brain fog for the rest of your life. I was talking to a nurse who’s 10 years into menopause and she’s a nurse. I’m just going to keep saying this. She’s a nurse. And every GYN she saw was like, “Yeah, you need to lose weight.” And she was like, “I understand, but you don’t understand I eat very little. This is how much I exercise and I can’t sleep. I literally wake up 10 times a night.” 

So, with some advocacy work, she’s now seeing a different provider, and she’s finally sleeping. But she said, “If I didn’t know, if I hadn’t been listening to your podcast or Amie, your podcast, some women just wouldn’t know. They would just accept what they’re being told.” I think there’s no other way to put it. I think it’s really criminal that women don’t need to suffer in middle age. Now, I want to make sure that we touch on cholesterol, because this question came up quite a bit. I know when I was working in clinical cardiology, the first thing I would say, if someone had a grossly abnormal lipid profile was, what’s going on with your thyroid? Or, if you’re insulin resistant, what’s going on with your thyroid? So, how does thyroid hormone play into cholesterol levels and looking at our lipid panel results? Because I think for many people, this is why I always, I mean, thyroid plays with everything. We have to make sure that we’re looking at all these pieces. But when you’re working with your patients, how do you talk to them about the interrelationship of their lipids and their thyroid function?

Amie Hornaman: So, we always talk about the triangle. So, the thyroid is at the top and then one side down on the triangle, we have insulin, on the other side we have cholesterol. We know that thyroid, being the master gland, is going to control the insulin response. So, you could have high insulin, high glucose– You could look like a diabetic, even when you’re eating perfectly if your thyroid is off. And then on the cholesterol side, we have a direct effect of the thyroid being off to wonky cholesterol numbers. We also know that high insulin and being insulin resistant will drive up cholesterol. By the way, it’s the white, and I’m sure Cynthia said this many times, it’s the white stuff. It is the processed foods. It’s the sugar, it’s the flour, it’s all of those carbohydrates that drive up our glucose, that drive up our insulin that really has an impact on our cholesterol. It’s not the red meat, it’s not the egg yolks from the 1990s. It is the white garbage that we’re putting into our body that is driving up cholesterol. 

So, now you throw on a dysfunctioning thyroid or a non-optimized thyroid on top of that, now you have crazy cholesterol numbers. When I say crazy, listen, we all know that the cholesterol cap, so that standard lab value range has been reduced. It used to go up to 300. Now it’s squished down to 200. So, you get that little H next to your total cholesterol if you’re at a 230. Would I worry about that? Absolutely not. I have had super healthy patients living into their 70s, water skiing, exercising, hiking, walking around with cholesterol numbers in the 400s. Their arterial scans are beautiful. They have no issues whatsoever. So, we have to take cholesterol and that lipid panel and pair that up with each individual and say, “Is there a risk factor here? What’s the history? What’s the CRP? How much inflammation is going on? Are they taking care of themselves?” 

But at the same time, we have to go back to the thyroid. You have to check the thyroid, because if that is off, then you are going to have dysregulated insulin and crazy wonky cholesterol numbers. Be it the triglycerides, the LDL, usually a lowering of the HDL, the good protective cholesterol. Then, unfortunately, those are the people that get the unintelligible [00:25:12] band aid/Band-Aid, those are the people that get the statin prescribed to them, and they have all the side effects of the statin. It’s like, if we just optimize the thyroid, you wouldn’t need this Band-Aid. 

Cynthia Thurlow: Yeah, I think it’s a good point. It’s interesting. For 16 years, I worked in clinical cardiology and probably the last four years or five years, I would start reducing statins on patients who didn’t have documented active coronary artery disease. I would document why. I would say a total cholesterol of 100 is a marker for morbidity and mortality, because there are a lot of things that cholesterol does in the body that I think people forget about. They don’t understand that that’s where we derive our sex hormones from. If your total cholesterol is 100, I bet you, you have no libido. 

So, all these poor patients of mine, most of whom are men, just by pure happenstance and having conversations, I would say, you’re on 80 mg of Lipitor. I think it’s time to reduce it and explain why. And they were like, “Oh, this is great.” But the understanding that if you need to go on a statin because you have documented cardiovascular disease or peripheral vascular disease or carotid artery disease, we’re not telling anyone. We’re not telling anyone to change anything that you’re doing. We’re just suggesting that make sure your providers are looking regularly at fasting insulin that they’re looking at your fasting glucose. I’m just going to plug this stat that I have been talking about on social media the last two weeks. A fasting glucose in the 90s is not benign. I think we have this misconception that a fasting glucose in the 90s is benign. It is not benign. I’ll tell you why. 

Dr. Robert Lustig, who I hold in high regard and has been a podcast guest and wrote an amazing book called Metabolical talks about the fact that if your fasting glucose is between 90 and 99, you have a 30% increased likelihood of developing insulin resistance. So, if it happens once, I wouldn’t stress about it. But if you’re noticing a trend and you’re noticing a creep and you’re checking your glucometer in the morning and every time you wake up, your fasting blood sugar is 98 and you think it’s great because it’s less than 100, you’ve got work to do. So, I want to just make sure I plug that in. I’ve been talking about it more often because that metabolic health piece, I think, is so, so important. Thank you very much for talking about this thyroid piece. 

Again, if you’re being told you need to go on lipid-lowering medication, I would make sure your provider is ensuring you’re not insulin resistant and that you don’t have an underactive thyroid, because if you do have an underactive thyroid, that can skew the results that you’re looking at. I can’t tell you how many people. I would say, I’m not going to put you on medication until we figure out what’s going on with your thyroid. They were almost always very appreciative. Of course, I had a couple of people jump in the gun. They’re like, “Nope, I want to be on that lipid-lowering agent.” No, you don’t. Let’s make sure that you don’t have something that’s reversible that we could adjust and fix that. 

Amie Hornaman: Absolutely.

Cynthia Thurlow: Okay. I want touch on medications just one more time, because I think this is so important. When we’re talking about T3, I think it’s really woefully misunderstood. I think that the conventional endocrinologist is putting patients just on Synthroid, which we know is synthetic. There’s no shame if you’re on synthetic medications. That’s not what this is about. On synthetic T4, with the assumption that your body can convert T4 to T3, so T4 is inactive, T3 is active. Talk to me about how you make a determination between Cytomel, compounded T3. What are the indicators for you clinically? And then help us understand where T3 is converted in the body, because I think everyone assumes that thyroid does it all, and yet, this peripheral conversion is also super important. 

Amie Hornaman: Right. So, like you just said, T4 has to convert to T3. T4 inactive, T3 active. So, we just keep that in mind. That conversion process is very long. I always say, it’s like running five tough mudders that your body has to do, because everything has to be in alignment. You can’t be insulin resistant. You can’t be estrogen dominant. You better have adequate levels of iodine, magnesium, selenium, and zinc, vitamin D. You better not have a genetic SNP. The DIO1, DIO2 SNP that impairs conversion. There is a marker that we can look at. It’s called reverse T3. We can see whether you are adequately converting your T4 to T3 or whether there are some issues along the way. 

Now, of course, we’re going to address the issues. We’re going to look at all of those things that can interfere with conversion of T4 to T3 and address those. But at the same time, sometimes, it’s just a change of medication that’s required. So, I have a stat for you. This is interesting. I’ve been saying this stat for the last couple of weeks. Only 2% of hypothyroid patients and I might even argue that that’s high, do well on T4 only. 98% of hypothyroid patients do well on a combination of T4 and T3. So, we know that giving a little bit of T3 is very, very beneficial. Number one, you skip that middleman, you skip that need for conversion, and you give the cells exactly what they need. You give them the T3 that they have a receptor site on for. Your cells do not have a receptor site for T4. 

So, when your doctor gives you T4 only, you are literally crossing your fingers and wishing on a rainbow that this is going to help you, that this is going to convert perfectly over to T3, and then get to your cells to give you that symptom relief, to give you metabolism, grow your hair, strengthen your nails, allow you to poop every day, clear your brain fog, all the things. All the thing that the thyroid does. How we determine what direction to go with medication is just so individualized, but I’ll give you a couple of scenarios. If you have someone that is on T4 only, which I see all the time, and we look at their reverse, if that reverse T3 is above a 12, that is indicative. These are functional values. This is not what you’re going to see. You’re not going to see it flagged on your labs. If you come in at a 14, a 16, even a 20, you’re not getting flagged in your reverse T3 until you’re above a 25, which then there’s some real significant conversion issues going on. 

So, if someone comes in, they’re on T4 only, the reverse is above a 12, then we know, listen, we have to drop that T4 dose a little bit. We got to pull back on that, address any factors that we see that are impairing conversion, and then add in a little bit of T3. Now, if this person isn’t doing well on their Synthroid, on their Levo, maybe we do change them over to natural desiccated thyroid. Here’s the beauty of thyroid treatment. It can be personalized. Despite what you hear from your doctor, from your endocrinologist, it can be personalized. There is not one size fits all. We can put you on NDT and then even add in a little bit of T3 to that just to change that ratio, because NDT is roughly and I say very roughly, roughly 80% T4, 20% T3. 

So, when we’re giving all that 80% T4, sometimes we have to add in a little bit of T3 to change you. Maybe you do better at a 70:30 ratio, at a 60:40 ratio. Sometimes, it’s just a matter of adding in T3 to your already existing Levo or Synthroid dose. And then sometimes, you might be T3 only. So, that’s what I am. I’m actually T3 only. I do not convert. I need to do a genetic test to check those DIO1, DIO2s. But for me, it was a reverse T3 issue and then combined with trial and error. So, of course, I didn’t want to believe that I was T3 only, because we like to have a little bit of T4 in the mix. It’s like your savings account. When you’re talking about T4 and T3, you’re talking checking and savings. T3 is checking. You’re always drawn from your checking. It’s there, it’s fast acting, you spend it, your body uses it, it’s done. 

T4 sits in savings. It’s something your body can pull from when it needs and then convert it to T3. Well, I didn’t have any savings and that bummed me out. So, every so often, I would self-experiment. I would put in about 25 mcg of Synthroid just to see how I would do. And every single time, I would gain 10 pounds in a week. I do not convert, that T4 makes me go hypo. It brings all those hypo symptoms back, and it brings them back faster than what my reverse T3 would change to. So, we see in me and in some of my patients too that are truly T3 only. We see those hypo symptoms come back well before the reverse T3 goes above 12, because that reverse is climbing, climbing, climbing, but already you’re 10 pounds, 15 pounds heavier by the time you actually go for lab testing. 

So, some people are T3 only, but that’s a very normal number. It’s very small in the percentage wise of hypothyroid patients who are truly T3 only candidates, we’ll say. Most people do very well on T4 and T3. It’s just the matter of what do you need, what’s your dose, what’s that sweet spot? Just like all the changes that you went through, it’s finding what’s going to work for that person, individualized personalized medicine.

Cynthia Thurlow: I’m laughing, because the only other friend I know that does well. She talks openly, so I’m not disclosing any personal information. Elle Russ does only T3. She talks about it all the time. She’s like, “I know it sounds weird, but this is what works for me.” And I always say, “Listen, this is the power of bio-individualized medicine.” Or, we talk about precision medicine. I think that functional is evolving into integrative precision medicine, because it’s really getting granular about what works. I know for myself, I need both. But I think it’s great that you’ve been able to determine that that works really well for you. I’m curious. Do you have any women in your practice or people you’ve interacted with that you suspect are using T3 because they are already thin and want to be thinner? Like this body dysmorphia T3 phenomenon that I’m starting to see, because people– 

It’s interesting. Running a podcast, I’m sure you get this too, people want to overshare sometimes in emails. I appreciate all my listeners, let me be really clear about that. But people will bring things to our attention. Have you seen patterns that suggest X? I haven’t seen that in my practice, but I would imagine that people that are dealing solely in the thyroid realm probably are seeing people that abuse these medications. 

Amie Hornaman: Not as much as you would think and not as much as I saw back in my bodybuilding days, for sure, where we know that there was abuse. I think now with the GLPs out, now I’m seeing the women that want to lose weight and get thinner, they’re going to the Mounjaros, the tirzepatide, the semaglutide. So, they’ve shifted away from the T3 use and jumped over to the GLPs. 

Cynthia Thurlow: No, it’s interesting. I’ve had a couple of experts on talking about GLPs. It’s funny how I think when they work well for people, they work well, but then I tend to hear from the people who are like, “I got constipated. I couldn’t have a bowel movement and I was nauseous 24/7.” Nauseous, like when I was pregnant nauseous. And so, I think for every fad or trend that’s out there, there are going to be people that it just doesn’t agree with them. But I do know from colleagues that I talk to that there’s definitely pockets probably not unique to United States, probably everywhere now, but people who are just want to be thinner. They’re already thin, but they want to be thinner. This is the way they get to a point where they’re eating next to nothing, and they have no appetite, and so they’re not even wanting to eat. And so, we could have a whole separate tangential conversation about that.

Amie Hornaman: Right.

Cynthia Thurlow: I know because of your bodybuilding background, let’s talk about why it’s so hard for women in middle age to build muscle. Because I think this is a source of frustration. For many of us, I include myself in this, years of oral contraceptives, no one ever talked to me about the fact that being in that low estradiol state for years and years and years, I missed out on those peak bone and muscle mass building years. And so, having to work a lot harder at this stage of life than I would have had to do when I was younger. But what’s happening to our bodies that makes it harder to build and maintain muscle at this stage?

Amie Hornaman: Testosterone. So, with women as we age, it’s very important to remember that testosterone is actually the most abundant hormone in our body. Men have more of it. We know that. Obviously, they have more testosterone, but it’s the most abundant in our body, and it’s forgotten because it’s seen as a male hormone. So, your normal conventional doctor, or even conventional OB-GYN, if you go in and you ask for a hormone panel and this actually happened to me. I tested it out with a PCP I had years ago, I asked for a hormone panel. I got a lab order for estradiol, FSH, and LH. Didn’t even put on progesterone on there and certainly didn’t add testosterone. But testosterone is vital to so many things that we do. Libido, motivation, I call it the get-stuff-done hormone. You’re not going to want to do anything unless you have adequate, optimal levels of testosterone. Then, yes, there’s the muscle building aspect. I see that all the time. It’s one of the main complaints that I see on an intake form of patient symptoms, weight gaining at the top, fatigue, and then, yes, loss of libido and loss of muscle mass or the inability to put on muscle is absolutely on there, and that comes down to testosterone. 

Here’s one of the big issues too. With our standard lab value testing, most labs will cut a woman off in their range at 48. So, when we’re looking at total, not your age, but the total. Total testosterone, 48 is the last number of the range, the top end of the range. In my world, you’re not even optimal until you hit a total testosterone of 50. Now, we’re going to look at the free testosterone. We’re going to look at your sex hormone binding globulin as well. But that total testosterone, you’re not even optimal until you hit a number of 50, which means you have to be flagged high in order to even be at the bottom of the optimal range. And that’s where you’re going to start noticing changes in your symptoms. Now, okay, some women will do. They’ll say, “Listen, I’m a rock star. My total testosterone is a 45.” Okay, that’s fine. There’s that unique pocket of women that get optimized at a lower number. But I got to tell you, I never see a woman with a testosterone of a 20 saying that she feels fantastic. It’s always all of those symptoms listed out. 

Really, for putting on muscle, I got to tell you, as much as I used to compete in bodybuilding, I used to compete in powerlifting. I was pretty strong for my height. I’m 5’2″. I was strong, but I have never had the muscle shape and definition until now. I’m 49 years old. I’m talking competing in my 20s, where your hormones are supposed to be perfect, and you’re at the prime of your life, and you’re athletic and strong. Now, at the age of 49, now that I’ve gotten all my hormones straightened out and optimized and I’m on everything. I’m on testosterone, I’m on estradiol, I’m on progesterone. Now I’m seeing the reward for my efforts. Now when I go to the gym, I’m like, “Oh, yeah, there’re those striations and a little bit of bulk in my bicep. This is awesome. This is what I was going for 20 years ago and couldn’t achieve.” Well, of course, I wasn’t testing my testosterone levels in my 20s. Who knows? They could have been in the tank back then. Testosterone starts to decline in a woman really in her 30s. I have a lot of 30-year-olds walking around with testosterone levels in the toilet. Sometimes, a 3. I’ve seen a 2, I’ve seen a 3, and I’ve seen not even detectable testosterone numbers in females in their 30s and 40s, and definitely 50s, 60s and above. 

Cynthia Thurlow: Well, and I think the other thing about testosterone, it’s the get-shit-done hormone, which people just solely attribute it to libido. I remind people it helps with body composition and lean muscle mass and all these other things. But we don’t often talk about the fact that, if your testosterone is low, sometimes it’s genetics, sometimes it might be a SNP. I’ve had women that have had very low testosterone levels and we actually need to do some genetic testing, but it also can be exposure to endocrine mimicking chemicals. It can also be latent insulin resistance. I hate to keep harping on this, but when we know only 7% to 8% of the population is now metabolically healthy, it really becomes problematic helping people understand. Probably a larger issue for men, because they have more circulating testosterone. Ours is more potent. But I think it’s really interesting, especially for you being in that bodybuilding space that you noticed that now that you have more optimal levels of sex hormones, that now you’re actually seeing the results you had been trying to achieve when you were a younger woman. I think that’s really interesting. 

I find for a lot of women, the issues with sarcopenia really accelerate north of 40, the pancake butt. These are things patients say to me. I don’t talk about pancake butts, but they’ll say, “I used to have glutes. Now I have a completely flat rearend. I have no definition in my shoulders,” helping them understand that it can also be exacerbated by the wrong types of exercise. How many women are you seeing that don’t lift, or they don’t lift heavy enough, or they’re doing too much cardio, or they’re over fasting, or they’re still stuck in this mindset? Because we’ve conditioned our patients to believe that they need more carbohydrates and very little protein. If you think that’s going to change body composition, it really isn’t. It’s when I can get women to understand the importance of protein and to really prioritize that. It’s amazing how everything shifts. 

The other thing is looking at the research and helping women understand that as our estrogen levels are falling, so latter stages of perimenopause, early stages of menopause, that loss of estrogen combined with high FSH, so follicular stimulating hormone will accelerate this catabolic impact the breakdown of muscle. That’s another reason why you have to be eating enough meat and enough animal-based protein in particular to be able to offset what is happening in the body. I take Pilates once or twice a week and I look around the room. There’s another nurse practitioner that’s in there with me and she’s become a really good friend and I always say to her, I look around this room and I’m like, “These women are tiny, but they’re also sarcopenic.” But they don’t see it because in their minds they’re still small. 

We’ll get messages from people that will say, “Oh, I don’t have a problem because I’m still a size zero or I’m still a size two.” And I’m like, “I can pretty much guess that you have a loss of lean muscle and an increase in adiposity in your body, even if you haven’t gained weight or changed the size of clothing that you’re wearing.” But really helping women understand that that muscle mass that we lose has catastrophic impact on our health. 

Amie Hornaman: Definitely. Yeah, 100%. I see it as well. These are the women that they’ll complain about not being able to put on muscle. Listen, I was a cardio queen too, especially when I was competing. That’s what you did. You did cardio twice a day. But these are the women that they’re struggling, and it could come back to their thyroid. They’re struggling so much that they overdo. They don’t eat enough, they don’t eat enough protein, they don’t lift heavy because they want to get on the Peloton and go to town on that just to burn fat. They haven’t been educated that lifting heavy weights is actually going to burn more fat and make you look better than jumping on a cardio machine and staying on a treadmill for an hour like a hamster on a wheel. It’s not going to work. You’re actually going to end up burning your own muscle tissue.

So, if you look at the scenario, let’s say, someone has a thyroid problem, they can’t lose, they get frustrated, they reduce their calories, they increase their intermittent fasting, and they go to town on cardio. Well, there you go. There’s the perfect scenario for muscle loss. So, now you have the muscle loss, a sarcopenia, now you have the low testosterone as well, and it’s just downhill from there. It’s only going to get worse. Now you’re looking at, as you age, the increased risk of fractures because you don’t even have the muscle to support your body and protect your own skeleton. So, it can cascade into a multitude of different disease states and issues as we age, but it really starts back at we need to optimize your thyroid, we have to get you eating enough protein. Don’t do so much damn cardio, go lift some heavy weights and let’s optimize your hormones too and you’ll be good. It’s that simple. 

Cynthia Thurlow: Yeah, it really is. It’s important for people to understand that. Now, on the other side, weight loss resistance, huge problem, probably not unique to either of our audiences. What are the needle movers in your estimation? I was down a rabbit hole. I’m creating a course right now. And so, I was like, “Okay, weight loss resistance. What are the big needle movers from my perspective?” But I’m curious, what are the things? You talked about T2, we talked about weightlifting, optimizing protein. What are some of the other things that you found have been needle movers for your patients?

Amie Hornaman: Addressing insulin resistance. I love berberine for that. I really do. I think it’s as good if not better than metformin. I’ve done a couple of podcasts on that, just comparing the two and comparing the studies. So, I love using berberine for insulin control, addressing adrenals as well. I don’t go down the rabbit hole of adrenal fatigue a lot, because I think that’s an overused term. But you do have to look at what is the stressors in a woman’s life, what is she dealing with, what is her cortisol pattern through the day? I say pattern because it’s not a onetime test. This isn’t that you’re going to test your cortisol in the morning via blood and get that one picture and know what’s going on with your adrenal function. You’re just not. So, after we do a four-point saliva cortisol, we get that whole picture through the day. That’s important. 

Then cortisol will tie back to what we were talking about earlier, that reverse T3. So, dysregulated cortisol, either too high or too low, will come back and start to push up that reverse T3, and it will put your body into a survival state. This can happen whether you’re diagnosed hypothyroid or not. You can have an elevated reverse T3 at any point of time, even just your own thyroid hormone production, the thyroid hormones that your thyroid produces, T4 and T3. T4 still has to be converted, so we can see an elevated reverse T3 with dysregulated cortisol. There’re so many things with weight loss resistance. So, it’s going to be thyroid, insulin, testosterone, adrenals. After we breach those, then we can go down different rabbit holes of maybe some food sensitivities, maybe heavy metals, maybe mold. But I don’t even start peeling that onion until we deal with the basics. 

Until we get your thyroid optimized, your testosterone optimized, your estradiol and progesterone optimized too, I don’t want to forget those hormones, because we don’t want you to be estrogen dominant, that’s going to produce weight loss resistance too. Reduce the toxins, get you eating right, get you exercising right, balance your insulin, and then we can go out here into all these other things that you hear the functional world talking about. I don’t think we start with mold. We don’t start with heavy metals. We start with the basics. We give you that metabolism first and then if your body still says, “Mm, yeah. No, I’m not going to release this fat.” Then we figure out, okay, why and we start looking at all the other things. 

Cynthia Thurlow: I think it’s really important to have a comprehensive mindset about all those things. I find that one of the things that a lot of people forget about is just meat. So, this non-exercise-associated thermogenesis, so walking, Zone 2 cardio, which is really not even like cardio, but just being active throughout the day. I think a lot of people go to the gym, and they work really hard, and then they sit on their butt for 9 hours, 10 hours and they wonder why [unintelligible [00:49:05] their weight loss resistance. The other thing that I’ve started to explore more, and obviously, I am not an expert in this area, but reverse dieting. So, for the people who have gotten themselves, they’ve whittled their diet down, they’re not hungry for more than that one big meal. The people that are the chronic [unintelligible [00:49:23] matters as an example. I’ll say them, “How do you get enough protein in one meal?” I know I can’t. It’s not a place of judgment. I’m just saying, “How do you do that?”

The concept of reverse dieting is that something that you talk to your patients about if you see through their intake that they’re not eating enough food. I’m not even talking about calories. I’m just saying, you look at it and you’re like, “That’s not enough food to sustain someone’s life.” You’ve now gotten into a situation where your body is becoming increasingly weight loss resistant because it thinks you’re starving. 

Amie Hornaman: I see it a lot out of the desperation. These women, once they get to me, they’ve done it all. They have destroyed their bodies. They have tried everything under the sun to lose weight. So, absolutely, the starvation principle applies here. They’re not truly starving, but just like you said, they’re eating so little. They’re eating so little that their body is in that true starvation mode and is holding on to fat for dear life. Usually, we’ll see their leptin levels are really low. Sometimes, they’ll even have a very low insulin, like, a one, a two, very low insulin levels, which is for them not correlated at all with being healthy, with being in control. It’s correlated with them starving themselves. Yeah, absolutely. That reverse dieting, we would do after a show. 

So, again, back to the bodybuilding days. After you depleted yourself and restricted yourself sometimes to just a stupid level. We were not the smartest group of people doing these competitions. There would be some that would diet down to eating 800 calories a day, 1,000 calories a day. That’s not healthy. Okay, you step on stage for one moment in time, then you walk off that stage and now what? Now you’re craving. You’re craving all those things that you didn’t get the last 12 weeks. Your body is literally rebelling against you and you have to reverse diet or you’re going to put 40 pounds on in a week. I have seen it happen. I have seen people blow up after a show. So, yes, that reverse dieting principle comes from back in the bodybuilding days again, that we have to do something. And it’s not going to be comfortable and it’s going to be just a mental screw for you to eat more in order to literally build your metabolism up from the ashes. We’re bringing it back from it being dead. In order to do that, you have to eat more food. The right kinds of food, obviously, but yes, you have to eat more food. 

Cynthia Thurlow: Yeah, I can imagine because I feel like, obviously, that’s an extreme, the bodybuilding coming back from 12 weeks of restriction and intense training. But I think a lot of people that are in the fasting space, they’ll say to me, “Every time I break my fast, I binge.” And I’m like, “Then you’re fasting too long.” Because what people don’t realize is you’ve got this primitive premortal brain, the amygdala overrides the prefrontal cortex, and your prefrontal cortex is like, “I’m the executive thinking part of the brain, but the amygdala has overridden my thinking part and I’m just thinking that I’m starving.” And so, that starvation response is significant. I think that for a lot of people, it’s with the understanding of, did you fast too long? Are you fasting for your menstrual cycle? Is there too much going on? 

Certainly, I remind people, if you’re going through something traumatic in your life or something stressful, that’s not the time to add more stress by fasting. Maybe it’s the time to have a 12-hour feeding window. Maybe it’s the time to do more rest and don’t go to the gym every single day. I think for many people, they get so fixated on that one metric, which is weight loss. Instead of understanding that their body– You have to get healthy to lose weight. Ben Azadi says that all the time, “You have to get healthy to lose weight.” And part of that is a healthy mindset, because I think for so many of us, it’s that one metric that people get fixated on, and they’re so rigid and dogmatic that everything else in their lives could fall apart until they step on that scale and they see that number that they have identified is their success number. 

I, sometimes, will ask women like, “What’s your happy number?” Because if it’s evident that there’s a lot of focus on the scale and I’ll say, “Okay, I don’t want you weighing yourself every day. I don’t think that’s healthy for you.” Just like some people don’t do well having an Oura Ring or they don’t do well having an Apple Watch, because the metrics. I’m a data nerd. I don’t measure myself more than once or twice a month, because I can generally tell by the way my clothes fit. Do I feel bloated? No, I feel pretty good. My clothes aren’t tight. Okay, this is good. But for other people, it’s that they will live and die by that scale. I think it can be profoundly destructive. And in many ways, I think it doesn’t serve us as women because the scale doesn’t represent, unless you have a special scale that gives you a sense of body fat and hydration and all those things. You step on the scale, it just tells you that’s the number, that’s where you are today. Our weight can be up by three pounds to five pounds day to day just based on what we’re eating and what we’re doing and how hydrated we are. And so, I always say the scale is a liar. 

Amie Hornaman: I would agree. I’m the same as you. If I feel good, that’s all that matters. I might step on just to see, “Hey, [unintelligible [00:54:25] wear it as a baseline marker.” Like, “Hey, this is where I’m really happy, because I feel good in my clothes.” And okay, this is a good number, but other than that, no, I can’t weigh daily and I don’t recommend my patients to do that either. 

Cynthia Thurlow: No, I think it can be destructive. Well, let’s end our conversation talking about one of my favorite supplements, obviously, creatine monohydrate, which I know you are a fan of as well. How does creatine impact thyroid function and how do you utilize this with your patients or yourself personally? What have you found to be most effective? 

Amie Hornaman: I love creatine. And again, it’s kind of funny. We didn’t really plan this conversation to continually go back to my bodybuilding days, but it keeps getting pulled in. I remember back in, oh, gosh, this is the late 1990s now, when there was the EAS Body-for-Life contest, which I did, my sister did, my dad did, we all did together as a family, these before and after pictures. You had to use their products, and creatine was one of them. Well, my sister is a physician, so she wanted to do her due diligence and really look into creatine. Is it good for you? Does it have any side effects, anything? And that was the one supplement that had nothing but positive benefits associated with it. There was literally nothing she could find that correlated creatine with anything bad in the body. Side effect wise, nothing. 

Some people back then with the type of creatine we were using would hold a little bit of water, so you get a little bit of water retention. But that’s because of the mechanism of action of creatine, literally shuttling nutrients into the muscle cell and providing more energy, providing more hypertrophy of that muscle tissue. So, I’ve been a fan of it for decades now, literally decades, because I think we can honestly say, it really is the one supplement that has been out for decades that has nothing tied to it in terms of negative effects, negative consequences from use. So, I’m a huge fan, huge fan. I try to get my ladies to understand that. I think it is being pulled more into the regular market out of the bodybuilding world, out of the sports supplement world, and into the, “Hey, let’s use it for day-to-day function, day-to-day benefits,” in terms of our audience. Women are slowly realizing, and especially with your education of creatine, with your audience, realizing its importance, realizing the benefits, realizing that this can produce a little bit better workout. Yeah, those 5 pushups that you did, that you thought that number five was really hard, now you just banged out 7, and maybe two weeks from now, it’s going to be 10. And you just went from 5 pounds to 7.5 pounds, and then to 10 pounds. So, those little incremental strength changes, that’s going to come back and obviously benefit. 

When we lift heavy, we improve our testosterone and our growth hormones naturally, our levels naturally. So, the creatine gives us a little bit more strength. We’re stronger in the gym because we’re lifting heavy. That’s going to come back and improve our testosterone levels. That’s going to come back and improve our growth hormone levels. Now, what do we know about testosterone? It actually has a feedback on the thyroid, specifically with Hashimoto’s to lower Hashimoto antibodies. So, all this talk about testosterone, I didn’t mention that another benefit of it is to lower Hashimoto antibodies. We see this documented in studies. Of course, they were done with men, but we see it across the board in women as well. When we optimize a woman’s testosterone levels, her antibodies also go down and just that whole inflammatory response of the body goes down and the thyroid works better. The thyroid is going to work better when all of your other functions in your body are better, when your sex hormones are better. The thyroid is going to work better, when you’re not inflamed, when it’s not getting beat up by those antibodies on a daily basis. It is going to work better. 

So, yes, we can absolutely say that through that pathway, creatine is beneficial to the thyroid. And then there’s just the other benefits of creatine improving nutrient absorption. Like we said earlier, shuttling those nutrients into the muscle cell. You’ve talked so much about it. I need to go down some more rabbit holes of creatine, because I just mainly recommend it and I just tell people, “Start on this. Here’s the benefits.” But I know that you’ve even dove into antiaging benefits of creatine, brain benefits of creatine, right? 

Cynthia Thurlow: Yeah. And even mood and cognition. The thing that’s been interesting, so I think it’s important to get real life testimonials. The things that I always find amazing is people saying to me, “I’ve had long term depression. I’m on medication. Within three days of taking creatine, I feel like my mood is lifted.” And I always say, “Don’t stop anything you’re doing. Talk to your doctor.” I’m always like, “Don’t change anything.” But I think that’s wonderful. I think it really speaks to mitochondrial health. It really speaks to ATP production. It really speaks to all of these cellular mechanisms that people can tangentially, they’re like, “Okay, I lift heavier in the gym. I’m sleeping better. It can help with sleep architecture. My mood is better.” And so, people focus in on that. But I always say it always comes down to the same things. Mitochondrial efficiency, ATP production, getting down to the cellular level, all those things are so important. 

I think in a sea of the supplement industry that in many ways, I think is well intentioned, let me just be really clear, well intentioned, because I come from a glass half full kind of person. But I think in many ways, if you really go down those rabbit holes and really spend time, like I know you have with your own supplement line, that things can be very, very helpful. I’m like, “Let’s simplify things. Let’s not be on 50 supplements. Let’s be on a curated amount of supplements that we know are very helpful.” My entire family actually takes creatine, which I think is hilarious because people will say, “Is it safe for teenagers?” And I was like, “I have two very athletic teen boys.” You would ask my 15-year-old. He’s at a university doing a program right now. He took it with him. He’s like, “I stick it in my water and I carry around in my water bottle and I get to take it.” And so, I love that we both have this shared appreciation for creatine monohydrate. What are you working on now? Anything new? I know you’ve got these burgeoning like supplement lines, which I’ve loved learning more about. Tell us what you’re working on now. 

Amie Hornaman: Well, what I’m working on now, coming out soon, is actually a good tasting beef protein. 

Cynthia Thurlow: Oh. [crosstalk]

Amie Hornaman: So, that’s exciting. Because sometimes, you can really struggle with the taste of protein. I tell my ladies, “Please don’t go out and just get some plant-based– Don’t get it from Sam’s Club.” Just because it says protein on the label, you don’t know what it’s going to do inside your body. And personally, anytime that I’ve tried a beef protein, I’ve struggled a little bit. It’s not something that I look forward to doing every single day. And plant-based proteins bloat me. I always get the angry belly with them. So, I have developed and found, I’m super excited, this should be coming out within the next week or two, a beef protein that tastes good, I actually look forward to doing it every day, and that you can make it into a mousse, you can make it into an ice cream. So, that’s pretty cool. So, that’s next up in the line of the fixer supplements.

But really just focusing on– I love getting out the message of T2, because I do call it the forgotten thyroid hormone. Just really educating listeners, people everywhere, practitioners even, on the benefits of how you can use it. You don’t have to worry about your patient or your client having an elevated heart rate or yourself having an elevated heart rate. You don’t have to worry about their numbers looking all wonky and looking hyper. This is a tool that can– You pair T2 with creatine. My gosh, you’re a mitochondria powerhouse. Now you have that ATP production, you have steady energy through the day. No more crashes, no more looking at the couch at 02:00 PM going, “Oh, man, if I could just lay down and close my eyes.” That’s not how we were built. We were built to go through the day. We sleep at night when it gets dark, melatonin production, all of that. We weren’t designed to be so damn tired at 02:00 PM that we need a nap. That’s not right. So, just continuing to focus on T2 education and getting the word out. 

Cynthia Thurlow: Well, thank you. As always, a great conversation. I know it’s first of many. Have a great rest of your day.

Amie Hornaman: Thank you. You too. 

Cynthia Thurlow: If you love this podcast episode, please leave a rating and review, subscribe, and tell a friend.