277: Rethinking Thyroid Problems (And What They Mean) w/ Dr. Eric BalcavageBrought to you by Quell

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As anyone who has worked with me in my clinical practice may know, I feel very strongly about monitoring thyroid function and trying to optimize it. Plus, I get questions ALL the time surrounding it. Because of that, I am so excited to have an expert on the thyroid, Dr. Eric Balcavage, on this episode to talk about this important topic.

Dr. Eric Balcavage is a functional medicine practitioner, chiropractor, host of the Thyroid Answers Podcast, and the co-author of the book, The Thyroid Debacle. The book co-written by Kelly Halderman MD, addresses the problems with current allopathic and functional medicine approaches to hypothyroidism as well as the solutions to restoring thyroid physiology.

Dr. Balcavage is also the owner and founder of Rejuvagen, a functional medicine clinic in Chadds Ford, PA. As a Certified Functional Medicine Practitioner and being Board Certified in Integrative Medicine, he is a nationally recognized speaker and educator on various health related topics including thyroid physiology, bile physiology, detoxification, oxidative stress, methylation and chronic illness. He has made it his mission to change the way medicine looks at hypothyroidism.

If you're suffering with a skin condition, have you checked into thyroid function? Were you surprised by it? Let me know in the comments below!

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In this episode:

  • What does it mean if your thyroid function is NOT optimal?
  • Cell danger response: What is it + how does it affect cellular function?
  • The difference between thyroid dysfunction vs. an adaptive/protective response
  • Dr. Balcavage's thoughts on Hashimoto's Thyroiditis
  • Thyroid issues NOT related to antibodies
  • Strategies to modulate + reduce your body's stress response to support skin + thyroid health
  • Which diet is best for thyroid issues? (It's probably not what you think!)


“If we have a population that's about 50% overweight or obese and if about 50% of the population has some type of blood sugar regulation issues going on, then the number of people that struggle with problems with thyroid signal physiology and tissue or cellular hypothyroidism is probably closer to 50 or 60%.” [05:17]

“What's the biggest organ to dump stuff out if you have a bad gut, bad liver, and bad gallbladder? Skin is one of the best places to dump it out. If you have an immune inflammatory issue, you're producing a bunch of inflammatory chemicals that are going to have an impact on the skin.” [18:36]


Find Dr. Eric online at his Rejuvagen clinic

Follow Dr. Eric on Youtube | Facebook | Instagram

Get Dr. Balcavage's book The Thyroid Debacle

Healthy Skin Show ep. 101: Psoriasis-Thyroid Connection

Healthy Skin Show ep. 023: How Low Thyroid Plays A Role In Skin Rashes w/ Dr. Izabella Wentz

Thyroid Skin Rashes: The Hidden Connection No One Talks About


277: Rethinking Thyroid Problems (And What They Mean) w/ Dr. Eric Balcavage FULL TRANSCRIPT

Jennifer Fugo: Dr. Eric, thank you so much for being on the show today. I'm so excited that we could make this work and get you this time to be able to share your work on thyroid dysfunction because I know that this is a topic my audience really wants to hear about. It's something that I feel very strongly about monitoring thyroid function and trying to optimize it. So I'm so grateful that you were able to make the time to be here today.

Dr. Eric Balcavage: Well, thanks for having me. I appreciate being here. It's good to see you again.

Jennifer: I know. So I think we should just dive right into this concept of thyroid dysfunction and also the term hypothyroidism. Can you describe to us what is that? What does it mean for your thyroid to not be working the way that it should? What does it mean for you to develop something called hypothyroidism?

Dr. Balcavage: Yeah. So when you think about classically how traditional medicine looks at hypothyroid, it's a condition where the thyroid gland is losing its production of the two primary hormones, T4, which is the primary hormone, and then T3. So as the thyroid gland becomes damaged or dysfunctional. It doesn't produce as much. T4 is the primary. It does produce a little bit of T3, and that results in less available thyroid hormone in the bloodstream, and then less available thyroid hormone to make it into the cells. If there's not enough thyroid hormone in the cells, then you develop the signs and symptoms of slowed metabolism or low thyroid function, which encompasses almost everything.

So thyroid hormone has receptors and kind of regulates our metabolism. It regulates our liver function, energy production, hormone regulation, cholesterol regulation, skin health as an example. So thyroid hormone plays a critical role. But that's the traditional kind of thought process and definition that it's thyroid gland that can't produce enough thyroid hormone. I think we need to redefine that definition a little bit to hypothyroidism is a lack of thyroid hormone inside the cells, which can be the result of thyroid gland compromise or reduced production. But it could also be just the result of reduced thyroid hormone inside the cell and that can occur for various reasons.

What we refer to that, and it's referred to in the literature, is tissue hypothyroidism. In the book that Kelly and I wrote, we call that cellular or tissue hypothyroidism. Then because you can have hypothyroid signs and symptoms, despite having a perfectly functioning thyroid gland, despite having a perfectly normal TSH and T4, despite having enough T4 and T3 in the bloodstream, you can still have hypothyroid symptoms because the individual cells and tissues get to regulate what happens to the thyroid hormone. So if a cell is reducing the amount of T4 that's converted to T3 inside the cell, you're going to have hypothyroid signs and symptoms.

Jennifer: Can I ask why would a cell slow that process down?

Dr. Balcavage: Yeah. I think, again, from a traditional standpoint, they would say it's dysfunction. Something's causing it to be resisted from coming in. I think we have to, again, take another look at what's going on and say, “Is this a mistake of our cells and tissues and our immune system altogether? Or is this maybe an adaptive response to some type of excessive stress response?” So cells typically operate from one of two modes. They're either in low stress manufacturing mode where they're making peptides and proteins and hormones and neurotransmitters and burning energy, which makes us feel good, right? Primary manufacturing mode.

Or they're in cell defense mode, so cells feel threatened for various reasons, toxins, organisms, thoughts, hypoxia, different types of stressors will cause a cell to perceive danger. When a cell perceives danger, it says, “Hey, we need to slow down the manufacturing process and we need to shift time and attention towards cell defense.” I think that it's more of an adaptive response at the cell level, and I believe it's even more of an adaptive response at the gland level as well.

Jennifer: Can I ask before we dive deeper, how common is, I mean, I would say just thyroid dysfunction in general, but do you have some stats that you could share on how common this is?

Dr. Balcavage: Well, hypothyroid, it's thought about 10% of the population has a thyroid condition anytime during their lifetime. Do I think it's more than that? Absolutely. I think if we take a look at the role thyroid hormone plays in our physiology, the number, if we have a population that's about 50% is overweight or obese, if about 50% of the population has some type of blood sugar regulation issues going on, then the number of people that struggle with problems with thyroid signal physiology and tissue or cellular hypothyroidism is probably closer to 50 or 60%.

Jennifer: Wow. That's a lot of people.

Dr. Balcavage: Yeah. Sometimes people would give pushback like there's not that many people that are on thyroid medication. Right. There's not that people with high TSH. Right. Because when we're identifying hypothyroidism traditionally, the thyroid gland has lost 90% of its function. So we're not assessing what's going on at the cell and tissue level. We're assessing when the thyroid gland has lost 90% of its function. That's when you get an elevated TSH and a low free T4.

So if you're not evaluating the tissue level, you don't see it. What we see is insulin resistance, and we assume that it's because the person ate too much carbs and doesn't exercise enough, right? If somebody's got high cholesterol, we assume it's because of their diet and their lifestyle. But if we take a deeper dive into the science and the literature, and I think we got into that pretty heavy in the book-

Jennifer: We did.

Dr. Balcavage: You realize that the down regulation of glucose transport, insulin transport, thyroid hormone plays a role there. When you see elevated lipids in the bloodstream, it's an indication that we've got a tissue hypothyroid state. Now the question becomes is that a dysfunction or is that an adaptive response, and I think it's an adaptive response, which I think is a big distinction. Because if you think it's just dysfunction, then I think what happens even in the functional model is let's just give more thyroid hormones since the body's not making it, right? Well, the medical community's only concerned about T4 and TSH. In a functional community, we're worried about T3. They're not converting T4 to T3, so we'll just give it.

If you think it's a broken model or broken physiology, then that might make sense. If you look at it from an adaptive perspective, you'd say, “Well, if the body doesn't want T4 to convert to T3, why would I want to give more T3? Why would I want to do that?” It's a temporary boost. It's not fixing the underlying issue. What we should be doing in functional medicine is, in my perspective, is addressing the root issues. I don't think trying to force something into the body that it doesn't want is probably a good idea long term.

Jennifer: Does this have any relationship to antibody? Because a lot of times too, there's like, oh, we want to test for the TPO antibodies or the thyroglobulin antibodies. Is this tied to that? Or is the autoimmune version of hypothyroidism also more commonly called Hashimoto's thyroiditis when it's low thyroid state? Is that connected to this or is that really a different process?

Dr. Balcavage: No. It's all part of the same process, in my opinion. Almost all hypothyroidism, especially in the U.S., is immune driven, okay? So now the question becomes whether it's hyperthyroidism or hypothyroidism, is it dysfunction or is an adaptive response, right? I think it could be a mix of both. But I think for a lot of people, especially those with Hashimoto's, that it's initially an adaptive response. If I'm a cell in danger, then what I want to do is I want to slow down the manufacturing process and ramp up defense.

So the dimmer switch inside the cell to either turn on the metabolism or turn it down is the amount of T3 inside the cell. So as a cell, I say, “Listen, I'm going to bring less thyroid hormone in and I'm going to deactivate that thyroid hormone to a greater degree than activate it.” Okay? So why is that beneficial? Well, if there's less T3 in the cell, I have less T3 to bind to receptors to turn on the manufacturing process. So the manufacturing process goes down, and I have less T3 inside the cells to turn off the cell defense mechanisms. So with less T3 binding to those receptors, now those cell defense mechanisms turn on. So at the cell level, the cells are deactivating it and reducing the state.

Cells in danger also can release what we call signaling molecules that go out into the bloodstream. We call them DAMPs and PAMPs, damage associated molecular peptides, pathogen associated molecular peptides. So if it's a bacteria or a virus or an organism that's creating a threat, the immune system and the cell takes little pieces of it and throws it out into the bloodstream, and then the immune system can come along go, “Oh, this is the thing that's causing the problem. Let me go tell the antibody side of the system and the T-cells and B-cell side of the system what they're looking for and they can go find this thing and get rid of it.”

Then there's also damaged pieces of the cells themselves that go out into the bloodstream to also signal to the immune system like, “Hey, I'm the person that's getting damaged and attacked here. Come help me.” So now the immune system say, “Hey, we got to go to the liver. Hey, we got to go here and help out.” It's not just the immune cells that have receptors for these danger particles. The thyroid cells themselves have what they call pattern recognition receptors on them. These DAMPs and PAMPs as they float around in the bloodstream, as they get to the thyroid gland, they can bind to these receptors. When they do, it initiates thyroid cell damage, okay?

So it's not the antibodies coming in like little Pac-Men and eating away the gland, it's when the thyroid cells get these danger signals, they almost self destruct. They actually become immune-like, release a bunch of inflammatory and signaling chemicals and that attracts all the white blood cells, these T-cells and immune cells into the thyroid gland and that creates more inflammation in the thyroiditis.

So I'm looking at this. So you could say, “Well, that's the immune system out of control.” Is it? Or is that a perfectly choreographed response to some type of cell danger? If I have to down-regulate the metabolism in one cell, why not just turn off the metabolism or turn down the metabolism in one cell? If it's one tissue, just turn it down in one tissue. But if I had to do it globally for an extended period of time, why wouldn't I just turn off the thing I don't need at the source?

So we see that in conditions where there's famine and where there's not enough food. People start to develop thyroiditis. Because why would I want my metabolism to speed up? So they have thyroiditis. When they come in and try and fix it with more thyroid hormone medication, they actually make the people worse. Why? Because now you're trying to rev up their metabolism and they don't have food. So they continue to have the kind of more attack on the tissue.

So I think there are other mechanisms involved, but the literature's pretty clear that the antibodies, which everybody kind of associates with the little Pac-Man eating away the gland, that doesn't really happen. Thyroglobulin antibodies don't cause any damage. TPO antibodies cause very little damage. Almost everybody who has hypothyroidism, the reason for it is some type of immune-driven process.

So when somebody says, “Well, I have thyroiditis but I don't have Hashimoto's.” Yes you do. Your antibodies haven't shown up. Hypothyroidism or thyroiditis often starts off as a Th1 dominant disorder. When you're Th1 dominant, you're not making a lot of antibodies. It's over time that typically there's a shift to the Th2 antibody side of the immune system.

Jennifer: Okay. Now, for somebody who's listening to this and they have just skin problems right now, right? So a lot of people listen to this show and they're like, “Hey, I have eczema or psoriasis or whatever.” Then they're saying like, “Well, I don't understand why are we having this conversation about thyroid issues in relation to skin.” So would you mind just sharing a little bit how can thyroid imbalances impact skin?

Dr. Balcavage: So it's pretty clear in the literature there's a tie between thyroid physiology and the health of your skin cells. Skin cells also need T4 and T3 to help regulate the function of physiology. But TSH also is thought to potentially regulate the conversion of T4 to T3 inside those skin cells. So if you have a state, especially people who are put on thyroid medication and have their TSH driven too low, that could definitely impact the state of T3 inside the skin cells and really create some problems.

There are other mechanisms that are often at play as well. So if you have a hypothyroid state that's just because there's not enough thyroid hormone in the system, that too can cause a down-regulation of the health skin cells and cause them to start to fade. Often when we have thyroiditis going on, there's an inflammatory process. When you have inflammatory process, we get up-regulation of something called histamine, and histamine can create a lot of the irritation and other things that we see along with the skin. So those are just a couple of the mechanisms.

But again, when you see most of what's going on with the immune system when there's a thyroid issue, we've got a thyroiditis, we've got an immune system up-regulation, we've got inflammatory issues, and we often start to see a cascade of immune conditions. The reason for that is we oftentimes are having a cascade of tissue damage. So it's not unheard of that if you have one immune-based condition, you might have another immune-based condition. A lot of the immune-based stuff stems from gut type issues.

So when we consider that chronic inflammation, immune issues, damage to some of the stuff that's going on inside the cell and the potential kind of link to tissue transglutaminase and their skin tissue transglutaminases, this all becomes one big soup of problems. So I wouldn't expect it to be unheard of for somebody who's got thyroid issues to have skin issues, or somebody who has skin issues to have down-regulation of thyroid physiology.

Jennifer: Yeah. I'll just throw this out there because when I was at the Integrative Dermatology Symposium, so in 2022, there was a number of doctors and actually dermatologists who shared the importance when someone has vitiligo, as well as psoriasis, to check thyroid function in those patients because there tends to be thyroid problems that creep up, and obviously you want to keep an eye on it. This was coming from more conventionally minded dermatologists. So just for anybody listening, there is a connection.

I also have had a guest who was a client of mine who had psoriasis and her thyroid was a mess and no one had bothered to look. I think this is an important conversation as part of that reminder that skin problems are so much more than skin problems and that a lot of times they're driven by other things going wrong inside the system. But I appreciate you sharing all of this because I get questions a lot, and actually I wanted to ask you, we've talked a bit about hypothyroidism. Is there any connection to any of this with hyperthyroidism or Graves' disease at all?

Dr. Balcavage: Absolutely. I mean, at the end of the day, we're talking about hypo or hyper, what we've got is some type of stress response that's causing an immune system to be up-regulated. So whether based on genetics and in other factors, whether you develop hyperthyroidism, whether you develop Hashimoto's, thyroiditis, whether you have a combination of those two conditions going on, at the end of the day it's not the thyroid problem. That's the problem that we have to take into consideration. We've got it an immune system up-regulation that's being triggered by some type of cell stress response.

I'm not a skin expert, but I would tell you, most of the time when you see a skin issue, the primary issue is not just treating the skin itself. It's the effect that's happening. Many times, especially if we've got immune inflammatory issues, we're going to have down-regulation of detoxification pathways. What's the biggest organ to dump stuff out if you have a bad gut and bad liver and bad gallbladder? Skin is one of the best places to dump it out. If you have an immune inflammatory issue, you're producing a bunch of inflammatory chemicals that are going to have an impact on the skin.

So when we look at people who have immune issues or skin issues, I think we should expect, you should actually anticipate ahead of time, they're going to have some down-regulation of their thyroid physiology because there's a stress response that caused the skin issue. The stress response is going to have an impact on other systems as well. Most people aren't walking around with one inflammatory condition. I just have eczema. Well, no you don't. You probably have a gut issue. You probably have a down-regulation of your metabolism. You probably have an up-regulation of your inflammatory issue.

I wouldn't be surprised if your blood sugar's starting to become dysregulated. I think most people, we'd like to look at things as a singular condition. I think that's a medical model and medical lens to look through. I think we need to take a broader look at the physiology often and say, “What is causing the body to respond and present this way?” When we do that, we stop maybe treating the thing we see and we start addressing the roots.

Jennifer: I agree. So let's talk a little bit, you've mentioned the cell kind of danger response, which I've read about in literature. So what, in your opinion, can cause a cell to go into this kind of almost like a panic mode?

Dr. Balcavage: Yeah. I mean, at the end of the day, like I said, cells operate in… They need a certain amount of energy to run the system, okay? When there's a drop in that energy, the cells start to go, “Whoa, what's going on here?” So maybe it's a drop in oxygen is resulting in less energy production. Maybe there's an organism inside the cell that's stealing energy. Maybe the cell is perceiving getting inflammatory or danger signals from other surrounding cells. So at the root of what causes a cell to go from manufacturing to cell defense is an excessive level of stress.

Everybody says, “Well, everybody gets stress.” Right, we all get a bit of stress and we all have a threshold for a certain amount of stress that we can manage. Physical stress, chemical stress, emotional stress, microbial stress, respiratory stress, disrupted sleep patterns, right? So all of these things, chemicals, toxins, can all have an impact on the system. But we have a threshold for how much we can tolerate. It's not about the stress itself, it's about the load that we put on the system usually. Have I exceeded my capacity? If I've exceeded my capacity to manage the stress, now I'm in danger mode, right?

Somebody's trying to break into my home, I can manage it. It's a 12 year old kid, I got this, right? But if it's yo, six guys with guns, whoa, I'm calling in the reserves, right? I think about the cells the same way. They can adapt to a certain amount of stress. What are we doing when we're working out and lifting, right? We are stressing the physiology so that we can break the tissue down, trigger a little bit of inflammatory process so we can rebuild, regenerate, and then we have bigger, stronger muscles later. But when we have constant ongoing stress without a rest or recovery period, at some point in time that load actually starts to just shift us into danger.

So for my clients, I usually try and explain the excessive stress response like I've got two cinder blocks with a board going across and all the stressors we go through in life are like weights, right? So I do a stress, I put five pound weights on. I get a new job, that's a 10 pound weight, right? So we're putting weights on and we're putting weights off. But if I'm putting stuff on and I'm never taking the weights off, at some point I'm going to come to the capacity of the board and I'm going to exceed the capacity and the board's going to break.

That's our danger physiology. I can do that slowly and incrementally over 20 years and I don't even know what caused it or I could drop a 50 pound weight on that board, it breaks. I know exactly what did it and now how do I fix it? That's the problem, right? So the cell danger responses, there's about nine different hypotheses, but Dr. Robert Naviaux put those things all together and said, “Hey, all these hypotheses really are talking about the same thing. Here's all the things that happen when a cell's in excessive danger.”

So this is not broken physiology, but adaptive physiology. I think when you look at health through that lens of adaptive physiology, the cell danger response, it changes our perspective of how we want to go about addressing it and how we're going to help somebody heal and recover.

Jennifer: Yeah. May I also ask, nutrients obviously are very important for the thyroid, does that play a role having any deficiencies in terms of the cell becoming overly stressed or is that sort of a different process?

Dr. Balcavage: You know what, we talk about that like, hey, you need zinc and you need selenium and you need all these things, and it's a deficiency. I don't think for most people it's a deficiency at the root. Because if it was, then every magic supplement formula that people… That prescribe, everybody's got one, “Hey, this is my thyroid blend, this fixes it.” It doesn't fix it, right? Most people, when you start looking at their new micronutrients, they're not really that deficient.

If you think about what Naviaux says in his paper, he says under stress conditions, under under manufacturing conditions, we take in those micronutrients and use them for this healthy manufacturing process, but under stress conditions, we take those same nutrients and use them to support the immune inflammatory cell defense mechanisms. So is it just deficiencies? It could be, especially if there's gut issues, if there's a terrible diet, right? All those things are important, but most people aren't fixed by just taking selenium. That's not going to do it, right?

Jennifer: That is true, yeah, and I agree with that. I think you can see some improvement sometimes, but a lot of times, especially with clients who have really complicated cases and they've been sick for a long time, a lot of times the nutrients aren't going to be… It'll make some improvement, but it's not going to be enough to say, “Oh, now there's not an issue.”

Dr. Balcavage: Yeah. So if we just say, “Oh, I'm deficient in B9, B12, zinc, selenium, so we're just going to give you a multivitamin.” Okay. But that's not any different model than what the allopathic philosophy's doing. They're saying, “Oh, it's just a deficiency.” If it's a deficiency and we're in functional medicine, then we should say, “Okay, what's the food quality you're eating? Maybe we need to get you better quality food. Oh, you're eating good quality food. Maybe we've got a problem with stomach acid, digestive enzymes, bile flow, dysbiosis in the gut malabsorption, right?”

“Maybe we've got a stress response going on that's causing you to divert that B6 to do something that supports the inflammatory system. It doesn't make you feel good. Maybe that B12 is being diverted or metabolized and it's not doing what you want it to do, but it's going down a different pathway.” That's functional medicine. If it's just about filling up the potholes with supplements, that can be beneficial. But I don't think at the core, that's what functional medicine's all about. I've been only doing this 28 years at this point. So in 28 years I've found that only healthy sick people, you just give them a multivitamin, everything is better, but that's not who I see.

Jennifer: Right. Well, so for these people who are dealing with this sort of adaptive immune system overdrive essentially, their immune system is like, “Let's see if we can shut things down and try and cool things off.” What do you look for and what could listeners… I mean, obviously your book is an amazing resource, which I would highly recommend, and I actually shared with Dr. Eric before the show that I wish that I had read this in grad school because it very clearly lays out so many different pieces to thyroid dysfunction in a way that was not discussed in my grad school program.

Which I realize, with time we evolve the information and knowledge that we know and the way that we approach things. So I do think that the book, The Thyroid Debacle, is an amazing resource. But what are some things that people could start to consider taking action on or even looking at their health from a different perspective, knowing now that maybe the thyroid is a bigger piece to the puzzle even though TSH looks normal?

Dr. Balcavage: So in the book, especially in part three, obviously, if you've got a chance to look through that, there's no supplement recommendations in there, right? Because the reason is when people get a book, they want to go to the back and find out what supplements they can add to their list of supplements they're already taking. Then they show up in an office like mine taking 30 supplements a day and they have pill fatigue and they're not doing any better. So the foundational things I think are really important.

Look at your diet. What are you eating, right? That's a good place to start. It's free to just assess, am I eating more healthy whole foods or am I eating more processed foods? If it's that simple. I think you should be eating more healthy whole food like the way it came off the tree, out of the ground, out of the water, right? But most of us are probably eating more processed food. So stop doing that, right? Most of the not so good stuff is in the processed food.

You don't even have to have the argument organic, not organic yet. Just eat more healthy whole food. Two, don't worry about the argument as to what diet is better. Keto, carnivore, vegan, vegetarian, paleo, who cares. The focus that I think in the functional medicine industry is on the wrong thing. We're arguing with ourselves about which whole food healthy diet is better and demeaning the other ones, instead of saying, “Hey, let's circle the wagons and shoot out at the processed food industry that's creating a host of issues.” We've circled the wagons and we're shooting in at each other. So improve your diet, right?

You don't have to be perfect. I think that creates food fear and fright and that's not good either. 80% of the time, eat healthy whole food. 15 to 20% of the time, enjoy yourself a little bit. But what I find is most people when they get consistent eating healthy whole food, they don't want to eat a bunch of that crap because it doesn't make them feel good. I think we need to think about sleep. Am I protecting my sleep? That's when we heal, that's when we repair. So are you staying up too late? Is it hard to get up in the morning? You're waking up through the night? What's your sleep habits? What's your sleep behaviors? Start there. It's free, right? Get to bed early, turn the cell phone off. Don't stare at that thing in right before you go to bed. It's going to change your physiology.

How about respiration? Do you have healthy breathing? I don't know. Well, how about something simple? Tape your mouth shut at night. Most people, especially if they have immune inflammatory issues going on, they mouth breath at night. Why not tape your mouth shut? It's nearly free. That can reduce the stress. It can reduce hypoxia, which can create a stress response. So look at your daily habits. What do you do on a daily basis? Are those habits that you're doing primarily healthy or unhealthy? Make changes to those. Do you exercise every day? No, I don't have time. Okay, well then make it a priority. Start with two minutes a day and build up.

But look at your diet. Look at your lifestyle. That's really the purpose of part three in the book is to not say, “Hey, you need to pay somebody a lot of money to help you fix this.” But start doing the low hanging fruit things that you can do first so you're not jumping over the dollar bills to pick up pennies, right? You are doing the things that you should be doing anyway if you want to have a healthy life and lifestyle. Do those things first.

Then if you're still struggling, then I think it's a perfect time to come see somebody in a functional medicine world and say, “Hey, I eat whole food. I've got great sleeping habits. I protect my sleep. I got great respiratory habits. I have limited screen time. My emotional fitness is really good. I've got that managed, right? I work on my breathing exercises every day and it improves my HRV, but I still have my skin issue. I still have my gut issue. I still have this.”

That's the time when we as physicians can come in, look at a health history, look at a health timeline, look at a comprehensive blood chemistry panel and say, “Look, here's what's going on. You still have a cellular issue, you still have multiple inflammatory issues. It looks like it's coming from your gut. Maybe we should do some type of GI test to see what's going on there.” Maybe there's a hormone issue. Maybe it's an adrenal issue, I don't know. But that's when you need the expertise. But you really don't need the expertise, if I'm honest, to say,” I'm going to eat more healthy whole food initially.”

Jennifer: That is very true. Yeah, I agree with you on that. I always tell people, I'm like, “This is the first thing I'm going to tell you to do so just do this now. This is your free advice. This is the easiest thing to do is to start cleaning up different aspects of your life that don't necessarily cost you anything, just making different choices.” So I just want to make sure for everybody who is listening and watching, The Thyroid Debacle, it is a really thick book. It's a great book and I will definitely link up to it in the show notes. That way, we can make sure to get everybody access to the book if they're interested in it. It's excellent.

Dr. Balcavage: Yeah, so my website is rejuvagencenter.com. So that's my practice website. Then I have a podcast called Thyroid Answers Podcast. So if you wanted some deeper dives into thyroid physiology and how it relates to different conditions, we're always having different topics, and matter of fact, we'd love to have you come on the podcast and talk about skin because it's such a huge issue. I guess I have an Instagram page I guess that's where I went from zero to where I'm at now with just posting informational posts. So I'm on YouTube, Instagram. Instagram's probably where I put most stuff through and the website and the podcast. So those are probably the places to get ahold of me.

Jennifer: Perfect. Well, that's what we'll link up in the show notes for everyone to easily connect with you. Thank you so much for being on the show. I really appreciate it.

Dr. Balcavage: Thanks for having me on.

“If we have a population that's about 50% overweight or obese and if about 50% of the population has some type of blood sugar regulation issues going on, then the number of people that struggle with problems with thyroid signal physiology and tissue or cellular hypothyroidism is probably closer to 50 or 60%."