Breaking Out of The Traditional Healthcare System to Heal Thyroid Issues from The Root Cause with Dr. Dana Gibbs

Dr. Jessica Drummond 00:00:03 Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis, or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Hi, and welcome back to the Integrative Women’s Health Podcast. I’m your host, doctor Jessica Drummond, founder and CEO of the Integrative Women’s Health Institute. Today we are going to get nerdy about the thyroid. We’re going to talk about why so many women fall through the cracks of conventional medicine. Because thyroid health issues so commonly involve various factors of the endocrine system the metabolic system, the immune system that are not covered by just one subspecialty.

Dr. Jessica Drummond 00:01:37 You are going to love my guest, doctor Dana Gibbs. She is a physician practicing in North Texas. She was trained as an ENT with a subspecialty working in allergies, but she had gone to an allergy conference one too many times and got bored listening to the main speakers. So she went and listened to some of the alternative health lectures. That was a great day because it completely changed the course of her life, of her healing journey, of her practice, the healing journey she didn’t even honestly know she needed. You are going to hear her amazing story of feeling not, well, literally her entire life. Never once having anyone diagnosed her. She ultimately having to figure this out for herself after years of conventional medical training, surgical training, surgical practice, lots of skillful work as an EMT, and then realizing that one of the pieces of the root cause for her issues was her thyroid. And it is for so many others. So listen to her story. I think one of the things I want you to think about, and we’ll talk about on the other side, is as a health or wellness professional.

Dr. Jessica Drummond 00:02:56 Our journey gives us confidence, gives us insight and we have to keep trying to prove ourselves wrong, trying to prove ourselves right, looking at the research, talking with other colleagues, listening to podcasts like these to both try to confirm our suspicions but also try to contradict them. We don’t want to be in a bubble of confirmation bias, and that can happen when we’ve felt such healing in our own bodies through a certain path. That’s not always the right path for someone else. So our story is a fire that ignites our passion for healing others, but it’s not enough to safely support the healing of others without collaboration, without further education. This is why we need many, many people practicing with this wide lens, reading the literature, sharing our stories, sharing our cases, learning from each other so that we can better serve our clients who are falling through the cracks of a system that is too hyper specialized. All right, let’s dive into it. I’ll see you on the other side, and we’ll talk about some specific ways you can take this information right back to your practice.

Dr. Jessica Drummond 00:04:24 Hi there, Doctor Gibbs, welcome back to our podcast. First of all, let’s dive right in talking about what was the first challenge, I guess, in your practice as a traditionally trained physician that began your journey of exploration outside of the more conventional model?

Dr. Dana Gibbs 00:04:49 Oh, wow, that’s a biggie. Well, anyway, thank you for having me. I’m so excited to be here. As you mentioned, I’m an otolaryngologist by training, and I was also very quickly interested in allergy as an ear, nose and throat specialist. And this is technically part of the core training for ear, nose and throat. Even though a lot of Ents don’t do it, they get bored with it or whatever. But what I found when I really first started was that everybody that I saw couldn’t be fixed by surgery and medications, and when I would send out to the general allergist, the patient would come back with a prescription. And I’m like, you know, no, you need to go deeper than that. You’ve got food sensitivities, you’ve got this allergy, you need to be on shots, you have mold sensitivities, blah, blah, blah.

Dr. Dana Gibbs 00:05:40 And so, you know, even 1 or 2 years into my private practice, I was looking for kind of out of the box solutions for my patients. And I was also, you know, ent part of cor ent is that we remove people’s thyroid and I would get people in and oh, you have this nodule, we have to take it out, blah, blah blah. 90% of the time that pathology would come back as benign adenoma, Toid nodule, goiter, nodule. And I’m like, what can we do? Can we do something about this? Do we have to be doing these surgeries on these people? You know, they don’t want surgery, you know, is it really necessary? And so I started looking into can I use thyroid hormone to suppress the growth of a thyroid nodule? I didn’t know at the time much about Hashimoto’s. As a matter of fact, it kind of wasn’t on my radar. Barely at all. But I started seeing the pathology would say lymphocytic thyroiditis. And so I’m like, what is that? Oh well, okay, that’s Hashimoto’s disease.

Dr. Dana Gibbs 00:06:49 Well, what do you do about Hashimoto’s disease? And was like, well, nothing. And I’m like, well that’s not helpful.

Dr. Jessica Drummond 00:06:56 Sure. Absolutely.

Dr. Dana Gibbs 00:06:58 That is not helpful. But the thing that was the really big kicker and this was about, I don’t know, 4 or 5 years into my private practice, I was at an allergy conference and it was the same allergy conference I went to every year. And so I’d already heard the main lectures in the main lecture hall. So I went to this secondary alternative set of lectures, and it was about hormones. And I’m like, oh, I think I’ll learn something new today. And the guy started in on thyroid physiology and what are all the symptoms of low thyroid. And by the time he finished with that list, I was having to pick my jaw up off the floor because I was like, Holy cow, he’s talking about me. He’s talking about me. And my basic training about thyroid was, well, you have to be tired and fat and have a big neck to have hypothyroidism.

Dr. Dana Gibbs 00:07:51 I found out very quickly that that’s not at all true. I was never overweight. As a matter of fact, my response to being exhausted was that I wasn’t hungry. I’d rather sleep than eat, and so I was never overweight. But when I went to that guy and I said, okay, I believe you, I think I have this, what do I do? And he said, here, take this, take this, do this, do that. And it was like this miracle because looking back on my life, I don’t know when I felt normal, you know, until I felt normal. I had no idea what normal felt like. Does that make any sense? Yeah, absolutely. I had always been exhausted. I had always been cold. I had always had trouble sleeping. I’d always woken up in the night with sweats, constipated, dry skin, thin hair, you name it. I had all those symptoms. I didn’t even have eyebrows. I mean, you know, I had all those symptoms and it was just like this pop on the face, you know, I was like, oh my gosh.

Dr. Dana Gibbs 00:08:51 And once you see that list of symptoms and once you know what that list of symptoms looks like, you can’t unsee it. And so I started recognizing it in all these patients that would come through the door and all those patients that had their recurrent sinusitis. And I’m like, you know, yeah you need this sinus surgery. But let me look at your thyroid some and let’s see what we can figure out. And the funny thing was the first time somebody came back six months later and said, oh, you know, that sinus surgery we were going to do, I don’t need it anymore. My sinus problems are gone. I just need a refill on that thyroid medicine you were given me. That was another one. It was like, Holy cow, I’m really onto something here. You know, the more I knew, the more I wanted to know. The more I realized, oh, my God, I really don’t know what I need to know here. And so I went looking for the education and I went looking for the explanation.

Dr. Dana Gibbs 00:09:47 Why are so many people who are already on thyroid medicine not feeling well? Why are so many people who look like they have hypothyroidism not even diagnosed? It was a process, not only an education process for me, but a learning process for, you know, it’s okay for me to experiment on me doing something that I don’t really understand. But I’m a classically trained physician. I first do no harm, don’t experiment on people. And so until I really had an explanation for why what I was going to do was going to help them, I didn’t feel comfortable. But then once I had that, it was like, okay, I know you’re here for your allergies, but I see that you’ve had four miscarriages. Let’s try this. And the next thing I know, they’ve got a baby. And I’m like, whoa. And that went on and on. And you know, the funny thing is, is my reputation for. Oh, she can keep you from needing thyroid surgery. She can fix you to where you feel better, blah blah, blah.

Dr. Dana Gibbs 00:10:47 The more of those people came into my practice, and the more of those people came into my practice, the fuller my practice got and the pretty soon I was just like, why do I need to keep doing surgery? I got to practice for all of these people. And so I realized that I did not need the high overhead group practice insurance model anymore, and I could actually do a better job for people outside of that. And Covid really kicked that along just because people basically stopped wanting to have surgery. And so by three years into Covid, I was like, okay, I’m done. Let’s move on. And so here we are.

Dr. Jessica Drummond 00:11:29 So now you have a private practice. We’ll talk about the details of that in just a moment. So many of our listeners are Traditionally trained health and wellness professionals who are kind of in the corporate health care model, and they want to make a transition out of that model. And I think what you’re saying, it was very organic in your circumstance. It was actually turning the mirror on your own healing first.

Dr. Jessica Drummond 00:12:00 So if a practitioner feeling symptomatic, that might be a really interesting them to start seeking other models of healing.

Dr. Dana Gibbs 00:12:15 Yeah. And that story comes around over and over and over again. So like I have a friend who treats mold illness. She was a pediatrician. She would have never gotten into mold illness, except for somebody in her family got extremely sick from the mold that they had contamination in their house after Superstorm Sandy a while back and did not get relief in the traditional setting. And so she was the same way. She’s like, okay, I have to go learn this. I have to figure this out. And now that’s all of what she does.

Dr. Jessica Drummond 00:12:50 Yeah. So I think that passion is really a valuable part of the transition. What do you say.

Dr. Dana Gibbs 00:12:56 In it’s passion but it’s also necessity? I have no idea where I would be right now if I had not figured out. I mean, I never had abnormal TSH. I had all the symptoms, but I diagnosed me. Nobody diagnosed me.

Dr. Dana Gibbs 00:13:12 During the course of my searching for answers, I finally found another person. He’s an ENT doctor like me, and he basically had a very similar story. He burned out of one specialty and then picked up another specialty. And it’s kind of like the further along you get, the further down this rabbit hole you get and you realize that the base of it is all this hormone stuff. And he figured out many, many years later, oh, I have Hashimoto’s disease. And I’m like, oh, well, that tells me why you’re interested in this. And so I almost think it takes some kind of personal experience, some kind of personal epiphany to get you out of this. I have to stay in my box. I am a pediatrician or I am a whatever, and I can’t step beyond that. Well, the truth of the matter is, and I’m speaking about physicians because that’s the world I know. But physicians are trained in critical thinking. One of the things that we learn to do is learn.

Dr. Dana Gibbs 00:14:21 And so who’s to say learning has to stop the minute you walk across the stage? And, you know, that’s silly.

Dr. Jessica Drummond 00:14:29 Of course. Yeah, there’s a sense I think to, you know, in my experience and and that of many of my colleagues who have transitioned into a more integrative model, is that breaking out of the box is challenging because you’re having to not necessarily unlearn things, but layer you’re learning in a different way. Read new research that you weren’t originally trained with. Keep up with research evolution. Look at other you know, look at other things that you didn’t learn in school. But then doing that, I think the personal story can be so important because when you’ve actually experienced it in your own body, you have this confidence that you’re right, even if it’s not what you were taught.

Dr. Dana Gibbs 00:15:19 Yes. And also I mean like I said, for me, I really was not going to experiment on people. I had to find data that backed up what I figured out, which was basically that not paying attention to reverse T3 and to the balance of the different hormones and the interaction of thyroid with adrenal, with insulin, with your immune system, with everything else that ignoring that and, you know, siloing those things into different boxes where each of those different things is handled by a different specialist, and never the twain shall meet, is something that is wrong with medicine today.

Dr. Dana Gibbs 00:16:05 Yeah. And it prevents us from seeing a person as a whole person.

Dr. Jessica Drummond 00:16:12 Yeah, I absolutely agree. And I think that’s so hard because the entire system is set up in subspecialties, and it’s challenging enough to keep up with the research in the field that you’re focused on in the lens that you have that pulling together multiple sources of education and information, you know. You know, even thinking from ENT to allergy to immune health to that being integrated with endocrine health is four different subspecialties in a traditional model. It’s true because it is hard to learn all of that. So but I do think you’re exactly right that obviously the more that we look at sort of root causes, rather than just here’s a prescription for antihistamines or something to sort of quiet the symptoms or hormonal birth control can often be a hormonal mask. You know, we do have these sort of pharmaceutical symptom management tools. But if you’re going to go deeper, your practice has to evolve more integrative. So now you have broken out of the model.

Dr. Jessica Drummond 00:17:26 You have created your own integrative practice in Texas, right? You’re in Dallas, Texas. Yeah, yeah. And so talk about you now work with those patients who also fall through the cracks between the different specialties. What is the kind of patient what is she or he dealing with where they’re not finding the answers that they make them the perfect client for you.

Dr. Dana Gibbs 00:17:55 Oh gosh. Okay, so my perfect client has several off that list of symptoms that I started with. And they’ve been to their doctor sometimes they’ve been to a bunch of doctors and bid told, oh, everything’s fine. You’re all good. You don’t need or. Here, take this levothyroxine. It’ll make you feel better. And it doesn’t. They’re kind of in one of those two silos. They’ve been told that nothing’s wrong with them, which, you know, it’s gaslighting, whatever you want to call it, it’s gaslighting. You know, it’s dismissive. It’s, you know, your symptoms aren’t real. I mean, and women get that everywhere, not just with thyroid, but it’s hard to be taken seriously as a woman with symptoms.

Dr. Dana Gibbs 00:18:44 And it’s hard enough. But then when you have something that doesn’t show on the standard test, then it’s worse. And so those are the folks that I want, and they’ve done research. Now, Europeans are better at doing this kind of research than we are here in the US. But when people are given the choice between taking levothyroxine and taking a different combination thyroid product to replace their thyroid when the mainstream thinks it’s necessary, mind you, a good 30% of those people prefer the combination therapy. but the mainstream docs have not figured out why that is. They haven’t figured out how to structure it so that it’s safe, that it’s helpful so that they can follow it with something that makes sense. And that’s a big part of what I do. But when you look at those people and not all of them have Hashimoto’s disease, but autoimmune disease is a big, big hunk of that. And of course, that’s 80, 90% women. As it is, there are genetic overlaps between inability to produce T3 hormone, which we can go into more what that is in a minute if you want to.

Dr. Dana Gibbs 00:20:08 Inability to produce enough T3 hormone in your body and insulin resistance for example. And what is insulin resistance? Well, that’s the genetic defect that makes you end up having diabetes but causes all kinds of problems between. I’m 17 and I feel great. And diabetes when you’re 45 or whatever.

Dr. Jessica Drummond 00:20:31 So there’s that genetic vulnerability, but it’s not expressed often for decades.

Dr. Dana Gibbs 00:20:37 It is expressed, but your body is still strong enough to overcome it. And so you don’t realize until you’ve got the neuropathy, until you’ve got the kidney damage, until you’ve got, I mean, people when they are diagnosed with diabetes, many, many, many of them already have eye damage, kidney damage, neuropathy, obesity, all these things. Then it’s like if it was recognized right away and taken care of. And how do you take care of it with what you eat? Hello. If it was taken care of at the first and you developed, this is the way I need to eat for my body, then you would never get those side effects and some of those are not reversible once you have them and you don’t wait until the day you have diabetes to start getting those, but that overlaps with thyroid problems a ton in a genetic way, but also in other ways that are more complicated and not as well understood.

Dr. Jessica Drummond 00:21:36 So let’s talk about some of the nerdy details of the thyroid. Okay, so. So if you have a client who comes in with that generalized fatigue, cold heat intolerance, night sweats, hair loss, eyebrow loss, skin fragility, all of the different common and not so common symptoms of thyroid dysfunction, weight loss, weight gain just depends on how it manifests. What are some of the things you’re looking for to first of all tests so more clinically and nerdy. And then what are some of the drivers of those things at a deeper level?

Dr. Dana Gibbs 00:22:22 Oh, wow. That’s a lot of stuff. Okay. Well, so the first thing I’m going to do is I’m going to take a really complete history and I want to know stuff all the way back to I was premature, I had a new record. I was sick a lot with strep when I was four years old and had to have my tonsils out and tubes in my ears. My parents got divorced, I witnessed domestic violence, I was abused, you know, there are so many things that play into how your hormones work in the present that have to do with what happened to you in the past.

Dr. Dana Gibbs 00:22:59 I think there are viruses that can trigger the start of that. I think there’s this idea that, you know, you can continue to have an active infection in your body, and that’s causing Hashimoto’s disease. I think that’s kind of wrong. I think those viruses may be part of what triggers the disease in the first place, but it’s not the only reason. The other things I’m looking for are how do you handle stress today? What are the other symptoms you have? Do you have menstrual problems? Have you had a miscarriage? Have you had a bunch of miscarriages? How healthy were your parents? How healthy are your brothers and sisters? How healthier your kids? There’s so many different things to look at. And then are you a menopausal age? Could you also be into perimenopause, which is a problem in people with thyroid imbalance? They will in their early mid 30s sometimes become a maniac. Hello. You know, is that really perimenopause or is your thyroid just so messed up that that’s what it’s doing to you? So I need to know all of that.

Dr. Dana Gibbs 00:24:08 And then when I head into doing the testing, there are several different categories of tests that I go to. So I do a complete set of thyroid and we can talk about what that means. But I’m also looking at okay, do you make enough cortisol. Do you make enough cortisol. But your signal molecules for cortisol are off the charts. Do you make not enough cortisol. Do you make it at the wrong time of the day? Do you have enough vitamin D in your body? And here’s the thing. Vitamin D is not a vitamin. It’s a hormone. It has a huge effect on your immune system whether you’re going to get cancer or not. Whether you’re going to get an autoimmune disease or not is dependent on your vitamin D status. How much time you spend in the sun or whether you take a pill or not. I look at insulin levels and I look at other signals that could tell me there’s not a great test for insulin resistance, unfortunately. I wish there was. Here’s a quick yes or no.

Dr. Dana Gibbs 00:25:11 You have insulin resistance, but there’s not, unfortunately. So I’m looking at things like the fasting insulin level of fasting glucose level, looking at your uric acid. I’m looking at your sex hormones, and I want to know them on a specific day of the month within your cycle. So that I can tell, are you at an average level for where you ought to be at your age, or are you higher or are you lower? So kind of those are the four. So we’ve got cortisol, we got thyroid, we got insulin and then we got sex hormones and then vitamin D and other supplements. And there’s things like there’s a genetic inability to process folic acid. And so that can create anemia and B vitamin deficiencies that are not good for your, you know, your mitochondria and other things that are, you know, cellular processes that are kind of indirectly related to hormones. But anyway, so I have a whole lot of real basic stuff that I kind of look at. And then one at a time, we start fixing what we see.

Dr. Dana Gibbs 00:26:20 And I do want to know if they’ve never had an autoimmune test for Hashimoto’s disease or for graves disease. I want to do that too, just because it plays a role in how your body processes and metabolizes thyroid hormone, whether or not you have enough, right?

Dr. Jessica Drummond 00:26:37 Then how does your immune system interact with that?

Dr. Dana Gibbs 00:26:41 And then how is your immune system interacting with that and so on. Yeah.

Dr. Jessica Drummond 00:26:45 And so you for Hashimoto’s or Graves, you’re testing things like antibodies. Correct.

Dr. Dana Gibbs 00:26:51 There’s a set of antibodies that I test. And if somebody comes in and says, I already had these tests, then I’m like, okay, cool, we know you have Hashimoto’s. Let’s work on some other stuff first and get you a little bit of energy and then start working on, okay, can we get those antibody levels to drop? You know, and I’m using them as a marker for inflammation in your body because we don’t really know what turns antibodies on, what turns antibodies off in specific. There are a lot of people who get diagnosed with Hashimoto’s.

Dr. Dana Gibbs 00:27:26 And then it just goes away. And we don’t know why. It’s like, why does one person have it come and then go in another person? It comes in and then it gets worse, and then it worse and worse and worse and gradually destroys your thyroid gland. We don’t know why.

Dr. Jessica Drummond 00:27:40 Yeah, that’s very interesting. And so as you mentioned earlier, your TSH, which is the standard one thyroid marker that’s measured in primary care and even a lot of endocrinology practices. What is your complete thyroid panel even if someone’s TSH is normal.

Dr. Dana Gibbs 00:28:00 Sure. So I always test the free hormone levels. So the free T3 and free T4 And within the quote unquote normal range, there is an ideal range that I really look for and go for on those two. But I also test total T3 and then reverse T3. So general endocrinologists ignore the effect of reverse T3. And they say it’s an inactive molecule. It doesn’t matter. It doesn’t do anything. I really, really don’t believe that because I measure that total T3 and that reverse T3.

Dr. Dana Gibbs 00:28:37 And the reason I have to have the total T3 is because reverse T3 is also a protein bound number. And maybe I need to step back and explain what that means a little bit. So TSH is a brain hormone. It’s a trophic hormone. It comes from your pituitary gland. You know the more of it there is it’s like it’s driving your thyroid. Make more, make more, make more. And it’s a little bit paradoxical because the lower the TSH is, the less thyroid hormone is driven to be produced, and the higher it is, the more thyroid hormone is driven to be produced. But the higher that number is means your thyroid gland is sicker. It’s like it’s unable to produce more.

Dr. Jessica Drummond 00:29:25 So the brain is saying produce more, produce more, produce more, which is why we need more. That’s why the TSH will look high, so it may not look high. I think the other thing to note for people is that the range for TSH, which is that hormone that’s produced by the brain, the normal range on a standard lab test is often much higher than the research, even from back in 2015 states as more optimal, which is, say, two versus five.

Dr. Dana Gibbs 00:29:56 Yeah, I could talk all day about that because I think there’s a political issue with it. The way they chose the reference range for TSH is just. I mean, if they chose it the way that they choose the reference range for other lab tests, then 50 million more people would be diagnosed with hypothyroidism just like that.

Dr. Jessica Drummond 00:30:15 interesting. What’s the difference between that and how normally it’s chosen?

Dr. Dana Gibbs 00:30:19 Well, okay. So for example, here’s how they choose what a reference ranges. They take a whole bunch of people. If we’re talking about LabCorp and I’m just using them as an example.

Dr. Jessica Drummond 00:30:30 Sure. Just a standard.

Dr. Dana Gibbs 00:30:31 Lab. Then we say, okay, LabCorp, go out and find 5000 people to test. And so they pick all their employees and they say, okay, you employees, you’re going to take a questionnaire. And every one of you who’s normal, we’re going to test your TSH, and we’re going to put you guys all in a giant bucket and stratify you out from low to high.

Dr. Dana Gibbs 00:30:52 We’re going to cut off 2.5% of you at the top end, 2.5% of you at the bottom end. And then halfway in between there is what we’re going to say is the mid mid-range. And what happened when they did that was that they got one and a half. That was the median number one and a half, 1.5. And so when they cut off their top and their bottom there, you know, so that they’re they’ve got now a 95% confidence interval, that’s what they call that. Then it went from 0.5 to 2.5. So 1.5 is in the middle. But they said oh well but that leaves too many people abnormal. So we’re going to put it up to 4.5 instead for some arbitrary Lord only knows reason that it’s just like, why did they do that?

Dr. Jessica Drummond 00:31:39 Yeah, yeah, as you know, I’m sure like we have actual data that also shows the more optimal ranges around that same number 1.9 to 2.5. Yeah.

Dr. Dana Gibbs 00:31:50 Yeah, around one and a half. And that’s about where it probably ought to be for most people who aren’t taking thyroid medicine.

Dr. Dana Gibbs 00:31:56 But anyway.

Dr. Jessica Drummond 00:31:58 Okay. So as it is the numbers a little bit wrong, but the idea is the same TSH gets released release. If it’s very high, it’s just working hard by the brain to trigger the thyroid to release.

Dr. Dana Gibbs 00:32:09 Flailing your poor old dying horse of a thyroid gland is basically what’s happening. But anyway, so your thyroid gland produces T3 and T4. Those are the two main thyroid hormone molecules. T4 has four iodine molecules on it. T3 has had one of the iodine knocked off and that becomes important in a minute. So 90, ten, 90% T4, 10% T3 is spit out of your thyroid gland into your bloodstream. And if your thyroid is normal, that’s a nice steady. It happens, it’s nice and steady, and it’s pretty much the same all the time. If you have Hashimoto’s disease, what you get is up, down, up, down, up, down, up, down, because your body’s fighting those antibodies and sometimes it’s being damaged and it releases a whole bunch, and then it’s like trying to recover and it doesn’t release much of on any.

Dr. Dana Gibbs 00:33:04 And then up, down, up, down. And those fluctuations are important. Those fluctuations and those hormone levels are important. But anyway so we’ve got T4, we’ve got T3. Well the 10% of T3 that your thyroid hormone releases is only about 20% of what your whole body needs of active T3, because T3 is the active hormone, the one that actually stimulates your cells to produce energy, to produce heat, to create new cells, to create new proteins, new antibodies new this, new that. So your cells have to make their own T3 out of the T4 that’s circulating around in your body. Those two hormones circulate through your blood bound to different proteins. And the reason they have to be bound to different proteins is because it’s a little bit like oil and water. So your blood is watery and thyroid hormone is oily. And it wouldn’t mix in your blood, right, if it didn’t have those proteins to make it dissolvable. So we’ve got the total amount which is bound and not bound. And then we got the free.

Dr. Dana Gibbs 00:34:14 We measure the free because that’s kind of more accurate at the cellular level.

Dr. Jessica Drummond 00:34:20 Okay. That makes sense.

Dr. Dana Gibbs 00:34:22 But the reverse T3 here’s the deal about reverse T3. You guys are getting a big science education today. Reverse T3 is the other version of T3 that’s made from T4. And reverse T3 is almost exactly like T3, except that the wrong iodine molecule got knocked off.

Dr. Jessica Drummond 00:34:43 okay.

Dr. Dana Gibbs 00:34:43 So it’s like a key that you went to the hardware store and got made a new key for your front door, and you put it in the lock and it fits in the lock, but it’s not quite right, so it doesn’t turn. And that’s reverse T3. So if your body makes reverse T3 and there are several reasons why it would do that. And the reverse T3 gets in your cell and gets on that receptor to do the thing it’s supposed to do, it sits there on the receptor, but it doesn’t do anything. It’s blocking the T3. And so the more reverse T3 you have in relation to the T3.

Dr. Dana Gibbs 00:35:22 So if you’ve got a lot of one and a little of the other, you’re okay. But the closer they get together, the more the activity of the T3 gets blocked. So you can measure that and reverse. T3 is ordinarily such a tiny, tiny amount that the test for reverse T3 is only done as total. There’s no free reverse T3 test, and so we have to have something to compare it with, which is why I get the total T3.

Dr. Jessica Drummond 00:35:51 That makes sense. And then you can essentially pull out the others.

Dr. Dana Gibbs 00:35:54 Yeah, they’re not exact, but they’re comparable enough to be useful. Rather than me measuring all the different kinds of protein levels and trying to do a calculation. It’s just easier to just get the total T3. And then that gives me a very simple ratio. So like if the T3 to R3 ratio is 10 to 1, then that’s pretty good. The ideal is about 12 up to about 14. So between 10 and 14 is pretty good. But on average I would say my patients come in at a level of five four.

Dr. Dana Gibbs 00:36:33 I’ve even seen as low as two and a half. And those patients feel terrible. They feel awful. They really do.

Dr. Jessica Drummond 00:36:41 Now you talked about your own health journey and that you ask your clients sort of as young as even premature Mature birth or common childhood illnesses. And you said even when you were a teenager you, like, never felt well, you never really felt good until after you had treatment. What are some of the root kind of foundational things that people can do if their, you know, their whole lives they haven’t felt well, what are some of the basics that essentially are our common environment is missing?

Dr. Dana Gibbs 00:37:19 Well, okay. So one of the things, and this is actually the one that I suspect is me, is that there is a common genetic I don’t want to call it a defect. Exactly. But there’s a genetic variant, a snip that is present. And I’ve seen different studies that say it’s only 10% of people, up to like 32% of people, depending on your nationality and your descent.

Dr. Dana Gibbs 00:37:42 That makes your body not convert T4 to T3 as efficiently. And if you have that genetic variant, then not only do you not convert T4 to T3 as efficiently, but you make a lot more of that reverse T3. Then the other things that trigger elevated levels of reverse T3 are stress, high cortisol, high insulin, and fluctuations in thyroid hormone, which is what we just talked about is wrong with people with Hashimoto’s disease. So it’s like, okay, so what of those things are preventable? Well, you can manage your stress sometimes.

Dr. Jessica Drummond 00:38:22 Yeah.

Dr. Dana Gibbs 00:38:22 Sometimes most. I mean and it’s funny because people are like, oh, well, but my life is my life. And I’m like, yeah, but you can manage your perception of your circumstances. And that’s, you know, mind body medicine that’s there’s so much there. Once again, I could talk all week about that, but there’s some other really, really simple things to do with nutrition that you can do. You can make sure you’re getting enough iodine and selenium in your diet.

Dr. Dana Gibbs 00:38:49 Those are two really, really important minerals for thyroid production. We do things, you know, as a society that we think are really good ideas at the time that turn out maybe not to be such a good idea, like fluoridated water, for example, fluoride displaces iodine in your thyroid gland. Hello. So then it’s not as efficient at making thyroid hormone.

Dr. Jessica Drummond 00:39:15 Because you need those four molecules of iodine. And then you need selenium to convert and to convert.

Dr. Dana Gibbs 00:39:21 Exactly. And there’s other nutritional things. You know, there’s other minerals that you need. They’re zinc. There’s magnesium and protein. And I don’t know nutrition is complex. And we could talk about that all month if you wanted to.

Dr. Jessica Drummond 00:39:34 Well, and so for many of your clients, there probably are some of those foundational nutritional things that they need to at least try to give some attention to, even though.

Dr. Dana Gibbs 00:39:44 Yeah, Absolutely.

Dr. Jessica Drummond 00:39:45 Certainly our food is less mineralized than it used to be. Our water has to be filtered so much that it’s less mineralized or it’s somewhat toxic.

Dr. Dana Gibbs 00:39:56 Yes.

Dr. Jessica Drummond 00:39:57 You know, you kind of have the choice of more toxins or not enough minerals. And so these are sort of general environmental issues that people need to have some awareness of so that they can change how they’re hydrating, clean the fluoride out of their water or. And so when you think about, like the most common client in your practice, would you say there are like three things they could start doing right now that would start to turn the needle until they actually were getting like a good clinical diagnosis.

Dr. Dana Gibbs 00:40:34 Take vitamin D3 so simple, so cheap, so easy. Here’s this. Here’s a myth. People have this misunderstanding about autoimmune diseases. And they’re like, I can cure my autoimmune disease. And there are doctors on the internet that are telling people that they can cure their autoimmune disease. It’s not really true. I mean, you can put an autoimmune disease into remission. You can take it down to where there’s no detectable antibodies in your system. But it’s not a cure. That’s not something we can say.

Dr. Dana Gibbs 00:41:08 Once you have an autoimmune disease. It’s like type one diabetes. That’s actually a very, very common autoimmune disease that happens. You can’t turn that off once it’s turned on. And you can’t always undo the damage that that disease has done, even if you can turn it off. People need to realize that, first of all. But if you have kids and you have an autoimmune disease, you should be doing every damn thing possible to prevent your kid from getting that autoimmune disease. And, you know, the last statistic I saw was that 70% of children are vitamin D deficient. Not just not enough, but deficient. And I was like, Holy moly, that’s crazy. You know? And thinking about my own kid, she doesn’t go play outside. You know, when I was 12 I still ran outside every day after school. I rode my bike around, you know, I was out getting sunburned pretty much every day.

Dr. Jessica Drummond 00:42:11 And. True. Yeah.

Dr. Dana Gibbs 00:42:12 No, my my daughter gets in. She sits in her room, she’s on the computer.

Dr. Dana Gibbs 00:42:17 She’s doing her homework. She doesn’t get any sun. She doesn’t get any fresh air. She get any sun, and there’s not enough. You know, people are like, oh, well, my kid drinks vitamin D milk. Well, there’s all kinds of things wrong with that. besides the fact that the amount of vitamin D in vitamin D milk is very, very insufficient to do anything but maybe prevent rickets.

Dr. Dana Gibbs 00:42:40 Right.

Dr. Jessica Drummond 00:42:42 But a lot of.

Dr. Dana Gibbs 00:42:42 The people that I see coming in, they’ll have a vitamin D level of 712 you know, and 32 is the minimum. Now I think they finally decided 32 is the minimum that’s considered sufficient. I like it up a lot higher than that. I like to see it above 65. Yeah. You’re not just preventing autoimmune disease, you’re preventing cancer. So there’s a lot of reasons to do that. And I think it does help people get their energy back. I think it helps them with bone pain. Muscle pain is a common presentation of low thyroid.

Dr. Dana Gibbs 00:43:19 And a lot of times if you get the person on the vitamin D, a lot of that will clear up. So it’s like, wow, that’s really crazy.

Dr. Jessica Drummond 00:43:27 Really nice.

Dr. Dana Gibbs 00:43:28 Yeah.

Dr. Dana Gibbs 00:43:29 Getting enough sleep. You know, here’s the dilemma. You know, somebody with hypothyroidism may have as much trouble sleeping as I did. I had a terrible time sleeping before I got on thyroid medicine.

Dr. Jessica Drummond 00:43:42 Right, so that might be more of a chicken egg issue. It’s going to you can do the behavioral things to help yourself turn your light your screens off a few hours before bed, eat earlier all of that. But it may not be effective enough until your thyroid hormones are in better shape.

Dr. Dana Gibbs 00:43:58 Are a little.

Dr. Dana Gibbs 00:43:59 More balanced. Yeah, exactly. And you know, some of the stuff that helps people manage cortisol that are really, really simple, like exercise, just get out and walk in the morning, go outside in the morning and in the evening and let unfiltered sun hit your eyeballs without sunglasses. There’s research on that.

Dr. Dana Gibbs 00:44:19 Now that that’s super, super important for regulating your cortisol. And if your cortisol is high, then your thyroid and your reverse T3 in particular will be high and your thyroid will be unbalanced just because of the cortisol.

Dr. Jessica Drummond 00:44:37 Yeah, I think so many people don’t understand that interaction between stress, physiologic stress, including circadian rhythms and all of that and thyroid, you can’t just like we talked about how we can’t isolate everything in medicine. You can’t really isolate the thyroid outside of the rest of the endocrine system.

Dr. Dana Gibbs 00:44:56 Yeah, that’s absolutely true. So yeah. Sleep what you eat. Mineral supplements, vitamin D, those are the biggies.

Dr. Jessica Drummond 00:45:05 Yeah. And those are great. I think sometimes when people just recognize that like there are a few basic things you can do. And then once you. How long did you feel like it took for you to feel, well, for the first time in your life after you began to implement all of these changes?

Dr. Dana Gibbs 00:45:26 So I have to be honest, when I first started doing thyroid hormone, I didn’t know to do all those other things.

Dr. Dana Gibbs 00:45:39 You know, I just heard, oh, if you get your thyroid hormone balanced, you’ll feel better. And it was literally like flipping a switch for me. I mean, within a week it was like, oh, I didn’t sweat all night. Oh, I didn’t go to bed freezing because I used to lay in bed. And this is the God’s honest truth. I would lay in bed with my feet so cold that I couldn’t fall asleep for like an hour.

Dr. Dana Gibbs 00:46:04 Oh my gosh. Yeah.

Dr. Dana Gibbs 00:46:06 Very frequently I would have to get up, go in the bathroom, run a hot bath tub, sit in the hot bath tub and let my feet warm up, and then race back to bed before I got cold again. And then I could fall asleep. But then I would wake up drenched in sweat and and, you know. So my sleep was terrible.

Dr. Jessica Drummond 00:46:25 It’s almost like for you and I think probably a lot of your clients, that while the entire healing can take a few months to a few years.

Dr. Jessica Drummond 00:46:35 There can be some initial shifts that then start what we call in our practice an upward spiral of healing, right? So once you were able, you got the thyroid medication on board and then you were able to sleep, then that’s another layer of improvement. Then you have the energy to maybe change some of your nutritional habits. You know, it’s like one little baby step after the other. It’s the hard parts getting started.

Dr. Dana Gibbs 00:47:03 Yes. Yeah. And truthfully, that’s a lot of what I see is if somebody comes in and I find something that’s really egregious wrong with their labs or, you know, I think it’s egregious. You know, even though every other doctor in the world would go, oh, those are normal, right?

Dr. Dana Gibbs 00:47:20 Right.

Dr. Dana Gibbs 00:47:21 And I can give them a quick win, then they have the energy to turn around and say, oh, well, you know what? I’m going to go for a ten minute walk every morning. The minute they start doing that, then it helps their circadian rhythm and then they start, you know, noticing that they’re sleeping a little bit better and they have a little more energy.

Dr. Dana Gibbs 00:47:39 And, oh, I think I’ll prepare a home cooked meal instead of ordering out. Yeah, you’re right. It just builds gradually. There are some people where it’s like a slot machine. You put a quarter in, you put another quarter and you put another quarter in, and then all of a sudden you’re changing dee dee dee, you know, and all of a sudden it comes. And then there are other people where it’s very gradual, where it’s like a teeny little win and, you know, and they build, like you were saying, they build up on each other. But every now and then I will get a win. That’s just like it’s almost instantaneous. Like I’m seeing a patient from last week and she’s one of these. I’ve got chronic thyroid. She’s been on levothyroxine for a long time. And I said, okay, before I do your tests, I’d like you to do one thing. I’d like you to break your pill in half and take half of it in the morning, and half of it in the evening.

Dr. Dana Gibbs 00:48:34 And she texted me two days later and says, I already feel so much better. And I’m like.

Dr. Dana Gibbs 00:48:40 Wow. That’s so.

Dr. Dana Gibbs 00:48:43 Great. Because what I did was I knocked off the high and low variability in her thyroid supplementation, which does what it reduces the amount of reverse T3 that you make. Before she even went to the lab, she got a win. I was like, dang, that’s great.

Dr. Jessica Drummond 00:48:59 Yeah, I think that’s so encouraging for people. And then on the flip side, I’m sure you work with patients long enough, having a sort of chronic practice. One of the biggest challenges among my students, nutrition and health coaching students is that when we’re working a long time with people that have chronic illness and need to kind of maintain a relatively committed, let’s say, level of lifestyle behaviors, you know, getting outside every day, eating well most of the time. Getting to bed early enough. You know those habits while on paper as a little checklist. They’re not really that hard. It’s kind of it’s not that difficult.

Dr. Jessica Drummond 00:49:38 It makes sense. But in the environment of social pressures and work schedules and all of that, three months into it, even though they’re then feeling better addictive devices.

Dr. Dana Gibbs 00:49:51 Hello.

Dr. Dana Gibbs 00:49:51 Yeah, right.

Dr. Jessica Drummond 00:49:53 I saw that study where like if you’re if your phone is like a certain distance from your thyroid, it’s really not good. You have to keep it much further away.

Dr. Dana Gibbs 00:50:01 I don’t know about that, but I’m just saying just being on it all the time, it’s is raises your level of anxiety and it’s just like.

Dr. Dana Gibbs 00:50:08 Okay.

Dr. Jessica Drummond 00:50:08 Yeah, I’ll turn it off.

Dr. Dana Gibbs 00:50:10 Stop watching.

Dr. Jessica Drummond 00:50:11 So, you know, all of that detail, I think while it’s sort of easy for us to be like, oh, just stop doing this, just change this, just do that. And then people do it initially, especially those first 2 or 3 months when they’re feeling better, they’re like, oh my gosh, this works. I’m going to keep doing it. And then, you know, the holidays come around or they go on summer vacation or something.

Dr. Jessica Drummond 00:50:34 What’s your number one tip to help people navigate when it gets hard?

Dr. Dana Gibbs 00:50:42 Oh, wow.

Dr. Dana Gibbs 00:50:43 Well, self-compassion is huge. That’s the first one is if you don’t do all the things. Don’t beat yourself up for not doing all the things you know. Really have a little compassion. It’s like, look, life is complicated. Life is hard. Oh, that’s you know, that’s so understandable. It, you know, it makes sense that your brain would offer you this. I don’t have time. I don’t have the energy, I don’t blah, blah, blah. You know, it makes sense. And so that’s that’s number one is self-compassion. And then the second one is to get a coach to help you change how you think about what’s going on with you. Because, you know, I see a lot I really a lot of this victim mentality, where somebody like, I’m a Hashimoto’s patient, I identify as someone who’s sick. but you don’t have to, you know, you can change over time.

Dr. Dana Gibbs 00:51:54 And I’m not saying it’s like flipping a switch. It’s not sure you can change your view of yourself to. I am a person who’s committed to working out at the gym every, every week, twice a week. Or I am a person who doesn’t drink alcohol. because I know that it’s horrible for my body and makes me sleep like crap. I am a person who prioritizes my health, you know, and therefore I don’t choose. I choose the egg sandwich instead of the donut or, you know, the chia seed smoothie instead of the the, you know, special K with milk on top or I, you know, I don’t know.

Dr. Dana Gibbs 00:52:46 But sure.

Dr. Jessica Drummond 00:52:47 Just that shift in identity that once you have a diagnosis, I think we we talk about this a lot in our, in our trainings because there’s some real benefit to the community of that diagnosis initially, especially when you’ve been through a lot of the dismissal from all of the other physicians and you’re like, finally getting some validation and some understanding. But then unless that is coached in an appropriate way, that then opens up like hold space for that healing, compassion, support, acknowledgment, and then allows for the possibility that this diagnosis doesn’t have to become an identity.

Dr. Dana Gibbs 00:53:32 Yes, exactly. No, you’re exactly right. That’s exactly what I was getting at.

Dr. Dana Gibbs 00:53:37 Yeah, yeah.

Dr. Jessica Drummond 00:53:38 And and I think acknowledging that it is hard in our culture because the culture’s driving value is productivity. And if you have a energy limiting, you know, physical challenge, disease state or not, it’s hard to keep up with the culture of productivity.

Dr. Dana Gibbs 00:53:58 Yeah. No, that’s exactly right.

Dr. Dana Gibbs 00:54:01 And you know, my my personal story, which, is out on the internet. I talked to a talk in episode one of my new podcasts. I talk about that, I really had a terrible opinion of myself for years because, you know, I’d been to doctors and they said, you’re fine, go away. Take these antidepressants. Everything’s all good. and so I had this horrible opinion of myself as a lazy human being. And when I wasn’t anymore, you know, and I can have somebody point out usually it’s a coach who points out to me, you know what, you work a lot of hours, you focus really you’re doing this and you’re, you know, and pointing out to me from an observer, you know, an outside viewer’s viewpoint of what I do and how I’ve accomplished it.

Dr. Dana Gibbs 00:54:59 My self idea was so messed up for years, even after I wasn’t having the problems anymore.

Dr. Dana Gibbs 00:55:14 Yeah.

Dr. Jessica Drummond 00:55:15 Yeah. Really sticks.

Dr. Dana Gibbs 00:55:17 It really sticks.

Dr. Dana Gibbs 00:55:18 And and I, I’m not sure how successful a person would be if they tried to just push that under the rug and get over it by themselves. I think that really just adds to your stress.

Dr. Dana Gibbs 00:55:32 Yeah, yeah.

Dr. Jessica Drummond 00:55:34 So having the coaching to just help you even notice where that’s affecting you, because I think that’s something that’s pretty universal amongst anyone who’s had, you know, had this kind of an illness even at any point in their lives.

Dr. Dana Gibbs 00:55:49 Yeah.

Dr. Jessica Drummond 00:55:49 Well, thank you so much for sharing your story and getting nerdy with us into the science. And, what is your new podcast? And then where else can our listeners find you?

Dr. Dana Gibbs 00:56:04 Sure. So my new podcast is Beyond the Thyroid, and it’s going to be very nerdy for a while because I’m really kind of trying to present the basic science of thyroid in a way that’s digestible and understandable to someone who’s not science trained.

Dr. Dana Gibbs 00:56:22 Nice. but I’m also going to get in there and tell stories of coaches and other providers and practitioners. And so I’m really I’m really enjoying it so far. We’re we’re working on episode ten right now. So getting there.

Dr. Dana Gibbs 00:56:39 Nice.

Dr. Dana Gibbs 00:56:40 But as far as the rest of where you can find me, my website is Dana Gibbs, MD. Com I’m on Instagram. Dana Gibbs, MD, Facebook I am, consultants and metabolism is my business page. And then I’m actually Dana Gibbs Clark on Facebook. So, you can find me there as well.

Dr. Jessica Drummond 00:57:02 Well, thank you so much, Doctor Gibbs. Thank you for sharing your story. Thank you for inspiring anyone who feels trapped and like they’ve been gaslit and dropped through the cracks of the the very siloed traditional system. And hopefully they can find their way to come and see you.

Dr. Dana Gibbs 00:57:23 That’s awesome. Thank you so much. This has been really fun and I hope we get to talk again soon.

Dr. Dana Gibbs 00:57:29 Excellent.

Dr. Jessica Drummond 00:57:29 Have a wonderful day everyone. Thanks for joining.

Dr. Dana Gibbs 00:57:31 Us. Thank you.

Dr. Jessica Drummond 00:59:46 Thank you so much for listening to my conversation with Doctor Gibbs. We actually met before. This was our second conversation. but we had some tech issues initially with the first interview. And what was so fascinating about this interview, for me, it was so different. So in our first interview, we talked quite a bit about why physicians have a really challenging time breaking out of the system. There are they are trapped by the heavy debt of their education, the heavy time commitment to heavy resource, commitment of their education, the heavy energy commitment, some of which leads to challenging chronic illness in physicians. To be able to get out of that system is truly a testament to how much of a priority Doctor Gibbs sees the work that she’s doing. So I want you to have that as background, because I think her story is so common to so many of us in the integrative medicine space. It’s not that we want to throw away our training or conventional training. It’s not that we don’t value the skill set of as she was talking about learning how to learn, and it’s one of your superpowers.

Dr. Jessica Drummond 01:01:05 Keep learning. Keep collaborating. Keep listening to podcasts like this one. And then these case stories, and our own included, are such valuable wisdom because we can see pattern recognition. We can also see things that are surprising in different cases. We can learn to apply the literature as it grows and expands, and we also begin to see where some of the cracks are in some of the conventional assumptions we were taught. I loved that story, how she explained how, you know, conventional labs came up with why TSH can go as high as 4 or 5 in some cases and still be considered normal. That is not evidence based. But, you know, it was just there weren’t enough people if you kept it tight. And why are so many people having these thyroid issues? That’s the question that’s so hard to answer in a system in an environment that is increasingly physiologically stressful. So I love the tips that Doctor Gibbs ended that conversation with, because I think they’re so actionable. So many of our clients have low vitamin D, so many of our clients don’t have the capacity to prioritize even their behavioral sleep, changes their behavioral sleep habits, habits, and when they are doing all of the right things, they’re eating well.

Dr. Jessica Drummond 01:02:34 They’re getting the sleep that they need, and yet they are not feeling well. Sometimes they need specific medical support that has to be looked at by a clinician who has this level of training in lab review in biochemistry. You know, we want to be collaborating with our physician nurse practitioner, physician assistant, naturopathic physician. All of our colleagues in a wide variety of subspecialties can really add value. And sometimes you get this quick win that can help people make those more challenging day to day habit change. And that’s where she circled back and said, you know what? What we need there is coaching and we do. So I hope you enjoyed getting a little more nerdy learning about the thyroid biochemistry and how that can help your clients feel so much better so that they can make the changes that they need to heal their complete endocrine system, not just patch it up with hormones, only with thyroid medications only, with thyroid hormone only. That’s an important first step, but it’s not the whole journey. I’ll see you next week.

Dr. Jessica Drummond 01:03:56 Thanks so much for joining us. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast. Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.