GLP-1s, Microdosing and Thyroid Inflammation: What Hashimoto’s Patients Need to Know with McCall McPherson, PA

Starts at 1:35 (so minus appox. 90 seconds to these times)

00:06

McCall, I am so excited to have you. Welcome, welcome.  Thank you so much for having me. I’m so excited to chat with you. I feel like we’re like long lost thyroid sisters. So every time we catch up, it’s always a treat.  Absolutely, yes. And what I really am excited about is to pick your brain  on so many things that my audience really wants to know more about and learn about. And I want to start with GLP-1 medications. They are so popular right now.

00:36

But oh my goodness, there’s so many different narratives, right? Some people swear by them and say that they are the best thing ever. And then there’s also all this negative about it. But  how do we know what’s really true? And there’s a lot of talk about them not being good for thyroid health, though that’s not necessarily correct. So I’d love for you to set us straight on all of this, because it’s something that I think can be really beneficial, but there’s just  very confusing information out there. So why don’t we start with what are GLP-1s?

01:05

Yeah. So  GLP-1s are uh now a medication  that is actually a peptide. So a peptide is just like a chain of amino acids we produce endogenously, naturally,  GLP-1s. And they help us regulate blood sugar. They help us regulate cravings, feelings of satiety, just  metabolic function. And  a lot of people, as we age, what I think people don’t really realize is we become GLP-resistant.

01:33

as we metabolically decompensate, especially thyroid people have these struggles, right? You guys can do me too, all the things right, eat well, exercise, and you can’t lose weight because we’re so metabolically decompensated.  So  these medications supplement you with higher concentrations  of a bio-identical similar form of a GLP that we produce naturally,  and they influence our physiology in  ways that promote weight loss.

02:03

which is amazing, but in so many other ways that I know we’ll talk about today that do things for longevity, for our long-term health outcomes that go so much deeper than weight loss. So I always love to have this conversation, especially in the context of thyroid, because thyroid people need to know, I feel like it’s most misunderstood for us. Yeah, yeah, absolutely. So why don’t we start with why is there a narrative that people with thyroid issues,

02:29

and any history of potential thyroid cancer in the family  cannot use them. Yeah, it’s sad. I I hear people tell me, well, I have hypothyroidism. So my doctor told me I can’t use them. I have Hashimoto’s.  I can’t use them. Oh, my mom had a history of papillary thyroid cancer. I can’t use them.  The reality is  it kind of multifaceted. Number one,

02:54

there is a black box warning specifically for medullary thyroid carcinoma on these medications. And the reason is because  in studies done on rats  which have incredibly dense GLP receptors on their thyroid gland,  and these rats were given anywhere from about 20 to a hundred times the human equivalent dosage. And that combined with those dense GLP receptors on their thyroid,

03:22

triggered an increase in the incidence of medullary thyroid carcinoma. Okay, so the FDA went ahead and put a black box warning on these medications  and that has carried through  to  people assume that it carries the same risk for humans.  Lots of studies have been done on this. There was a study that came out about six months ago that was multi-continental. It looked at so many people over about four years and looked at the incidence.

03:50

of medullary thyroid carcinoma and any other cancer  in the realm of thyroid. And there was  absolutely no statistically significant risk. Other studies have been done that show, hey, like insulin carries a higher risk for medullary thyroid carcinoma  than  GLPs do. And there is no warning on insulin. There is no concern for MTC with that. you I want people to be empowered with that. And I also want to delineate, there are very few and specific

04:20

People who aren’t eligible for these medications, people who should not take them. And if you have a history of medullary thyroid carcinoma, even though that risk didn’t translate to human studies, I probably wouldn’t recommend taking it, right? If you have multiple endocrine neoplasia, the same, but  all of these other categories, Hashimoto’s, hypothyroidism, who again, so often need these medications to rehabilitate their metabolism once everything else has failed, um or Hashimoto’s.

04:47

All of these people are eligible. There is no contraindication.  And I want to dig into this later, but we’re so paranoid about them causing cancer. But in fact, they do the opposite. And there are studies to back that up.  so I’m so glad we get to talk about this today because we actually get to share the truth, right? Yeah, absolutely. And that’s so good to know because it’s every other day.

05:09

people ask me, oh, I’m thinking about this. I’m speaking with my doctor, but I have Hashimoto’s, like you said, so I can’t. And it’s like, well, hold on a second.  Let’s wait and let’s look at it.  So that’s really, really, really helpful to know.  So there’s also a lot of different ways that we can use them. And I think as they’ve been out and more popular over the last couple of years, there’s been a lot of different protocols that are talked about. So  can you tell us a little bit about how people usually use them and then some of the other things we can do to maybe make them even more effective?

05:38

um Well, let’s talk about that. And then I have follow-up questions to that. I’m like, I don’t want to vomit all my questions out. No, I love it.  I might just be like, tell me the question again. No. uh So,  you know, I think  where  the pitfalls of these medications lie  is  in the standardized dosing. So what medicine has done is we have lots of data on these drugs for over two decades.

06:07

mainly they’ve been studied in the diabetic population because that’s what they were originally created for before they were sort of rebranded and repurposed for weight loss.  So what we’ve done in medicine is we have taken diabetic dosage  and we’ve just transitioned it to people for weight loss. And the reality is, that most people that need these drugs  or peptides to lose weight do not need the equivalent dose of a diabetic person. And if I was to be candid, would say,

06:36

there’s a good chance even that dosing is too high for diabetic patients as well.  And so what ends up happening,  and the reason we hear about all these,  know,  nightmares in the media all the time, every couple of weeks, there’s a new thing that’s in  vogue to talk about, is because people are not eating food. So their appetite is so  overly suppressed that they do not get enough macronutrients, protein, they do not get enough micronutrients.

07:04

They are surviving on two to 500 calories, often like carbs because they feel nauseous.  And guess what? That leads to muscle wasting. That leads to hair loss. That leads to collagen loss. It increases our risk of developing gallbladder issues, which increase our risk for pancreatitis. Like  almost  all  of the side effects people hear about in the media and are afraid of are literally due to over-medication. So…

07:31

If we can shift that and we’ve been doing what’s called microdosing in our practice since before microdosing was a word that was applied to these medications.  And slowly we were like, look, I don’t think people need this much. What happens if we reduce the dose? What happens if we split the dose and do a small amount the early part of the week and a small amount later in the week  and kind of make the peak and trough a little more or less volatile really. And it is a completely different experience for people.

08:01

not only do they not feel nauseous, they don’t feel  GI upset, they don’t feel exhausted, they can eat food, they can nourish their bodies, which is such a key component in the long-term outcomes of the success of this, but also just like long-term health outcomes in general, we need food to fuel our body. So  it’s important that we eat. Yeah, that makes a lot of sense. Now, what about  stomach paralysis? Because that’s another thing that people hear about is that also I’m assuming because of just

08:29

these giant doses that people are given in their overdose? I would say yes. mean, my  thinking physiologically of how this works, yes. Now they haven’t done studies on microdosing to see if that particular side effect is less common, less prevalent.  But even when people have the early stages of too sluggish of paralysis or peristalsis, excuse me, uh meaning the movement of your gut to move things along and make its way out.

08:58

you have to pull back that dose,  allow them to like  start the function of their  lumen, their muscles in their intestine to start functioning again. And it’s a great way to prevent that from happening. But that’s kind of a second concept is this idea of tailoring doses for each person, right? Like  starting really low, going slow and not applying this one size fits all dose increase to people. they’re having

09:26

a lot of constipation, we need to back off, not just push through, not keep going. Because again, that is when things like stomach paralysis happen. And they can be avoided in a huge percentage of the population almost, know, there I say ubiquitously. Yeah, that’s  really, really helpful to know too, because  one of the things that I get asked all the time is,  well, I’m on this medication, I’m doing really well. It’s been a year, but I heard…

09:52

that you can’t be on it for more than a year or more than a year and a half or more than two years or whatever it is. And along with that, the dosages, like you said, it’s very standard. You start at 250 and then you go to 500 and then you actually work your way to the 2.4 grams, which is like the recommended dose, even though we’re having symptoms or people will get a plateau. And they’ll go, oh, well, go up, you’re plateauing. And the plateau for so many people is like,

10:21

Well, I only lost one pound the last two weeks. It’s like, yeah, that’s not a plateau. That’s great. That’s what we’re aiming for. We don’t want to lose two, three, four pounds every week. That’s not healthy. uh And so, yeah, I I’m hoping that medicine is headed that way. I think it’s undeniable that that’s what people need to truly create success  long term with these medications. uh And even we started out doing standardized dosing.  And I’ll tell you, I probably wrote eight.

10:49

zo-fran scripts every day for nausea. I’ve written one in the last two years. Like it just completely changes everything when you shift that approach. And I’m so glad it’s becoming more well-known and more utilized. Yeah.  Now,  how are the results, you if someone is doing a standard dose versus microdosing,  is it that the results come a little bit slower  or is it that, you know, there’s less, but it still happens within a certain period of time? Good question.

11:19

Definitely they lose weight slower. That’s honestly my goal, right? Like I think  rapid weight loss is what’s driving so much of these side effects. Like that is what’s driving muscle loss. It is what’s driving hair loss and pancreatitis- gallbladder issues. And gallbladder issues.  all of those things are tied to rapid weight loss, nutrient depletion. They’re not tied to the medication itself.  And so  I think people are losing weight too quickly. I truly do. And so-

11:48

It’s longer, it’s slower, but gosh, it’s so much more sustainable, it’s so much healthier. And I think the outcomes long-term are much, much better and they’re not this massive rebound effect. Yes, that was my next question, right? You lose weight fast and then what happens if you stop or is the plan to never stop but at such high dosages, is that really sustainable? So then with microdosing, is the plan then to continue for a specific period of time or indefinitely or how do you typically do that?

12:18

Good question.  you these studies are, I mean, excuse me, these meds are studied for life. Like they were created to put people on them forever. They were created for diabetics who are going to be diabetic. And so when people ask, can I be on this forever? Well, technically, I mean, these meds were made for people to be on them forever. We’re about 20 years into data right now. So we’ve got, you know, some solid data on safety long-term, what I would consider that to be. uh

12:47

Most of our people are thyroid patients, especially women.  You probably see this too. I can perfect their hormones.  I can get everything down to a T in very, very tightly controlled ranges. And these women still cannot lose weight. They’ve had so much insulin resistance, leptin resistance, blood sugar dysregulation that has accumulated and kind of created metabolic dysregulation over the years.

13:14

They can’t lose weight even with effort. Like I’m talking about, you I always go to one of my patients who’s like, yeah, no, I eat well. I’ve been on whole 30 since 2017. And I’m like, what? That’s not okay. uh But they exercise, they invest in their health  and they’re not able to lose weight. So when these medications came out, I  went really deep in the literature, really ran so much data on our patients and found them to be massively effective in this community of people specifically.

13:44

And I see people lose weight when they couldn’t before, but I also see their metabolic dysfunction reverse.  And so our goal  is to get people back off of these medications. And we kind of have an algorithm that’s pretty successful where we’re looking for specific numbers in terms of blood sugar, insulin, leptin, metabolic numbers that I don’t quite share. It’s like the one thing I keep kind of  private, but- As you said.

14:09

That’s what you do.  That’s what they get when they come to see you, right?  Totally, totally. And I normally share everything so openly, but it’s the one piece that we  kind of keep back.  But we find when people come off of them,  when their numbers are where they’re supposed to be, they have incredible amounts of success to maintain their weight with normal effort, not over restricting,  not over exercising.  And some of them, honestly,  they’re able to continue to lose weight with effort.

14:38

despite being off the meds. And then other people, they just have so many benefits from these medications that have nothing to do with weight loss. So a lot of Yeah, talk about that because I don’t think people realize, you know, they think GLP-1, weight loss, they don’t realize the other things, but it’s kind of like with thyroid. We don’t realize all the different things that the thyroid does and it’s so much, right? Totally. Yeah.

15:02

So people that get those benefits, like to stay on a microdose. And one of the most profound benefits that I didn’t  really expect so early on, but I captured in our data was inflammatory reduction. Like  the reduction in inflammation is  like nothing I’ve ever seen.  And I get people on social media that respond and they’re like, well, why don’t they just go gluten-free and eat well, go paleo? And I’m like, look,

15:32

Diet is a way that we can influence our inflammation. It is powerfully in our control. So I love that. And that’s something I talk about with my patients every day, but not all inflammation comes from food. Like our biology creates inflammation as a by-product for some people like me. It’s a lot of inflammation for other people like my husband, God bless him. He never has known what a day in his life, what it feels like to be inflamed.  So there’s things that we can’t control.

16:01

And these medications, one of the first things people say when they start them is, I feel less inflamed, whether that’s puffy, whether it’s joint pain, whatever their manifestation of that  is  clear. And then it also shows up in the data. So I found four pathways  in research where GLPs influence inflammation. The one that we measure in our program is HSCRP, which is a general inflammatory marker. also kind of tells you about your risk.

16:30

for having a future heart attack, a future stroke.  And  I saw this shift in people that I’ve worked with for  seven years and I couldn’t get their CRP down in a matter of initially three months. And then I started pulling back the clock. I’ve got to tell you this, I checked one person on one microdose  after  one week.  And her  HSCRP went from nine to just below four.

17:00

Oh my goodness. Wow.  That’s amazing. That is amazing. And for everyone listening, HSCRP is something  that measures overall inflammation. It’s not something that doctors will typically look at at a regular physical, but it’s a number that you really want to try to request  because it gives us so much information.  there’s so many different ways, like you said, McCall, where inflammation happens, right? And for some people, food can bring them down. And I’ve seen people.

17:27

have this number decrease with food, but there are people and more than just some, there is a good amount, like a lot of people where it’s like, okay, it’s still coming from somewhere. I I know cases where I’m like, okay,  we fixed the food, we’ve done all the anti-inflammatory nutrients, we’ve looked at  hidden infections in the gut, we’ve looked at hidden infections  dentally because there’s so much with root canals and things. mean, literally everything and it’s like, it won’t budge from seven.

17:53

that is so good to know that it can influence those pathways. Because again, that’s not something that people speak about. think it’s weight loss or negative stuff, but people don’t talk about  all of these amazing positives. So that’s great. So that’s  one of the inflammatory markers that you mentioned. There’s a few, are there others that you look at? I don’t look at them mainly because they’re so expensive, but I found them in the research. So CRP is like affordable, it’s easy to check, but there are a few others that uh are

18:22

just more costly to run and rerun all the time.  I’ll tell you about one other patient that I had that was so fascinating.  She was in our thyroid practice  and thriving. Like we fixed her thyroid, addressed her hormones, just on top of the world. She went to Mexico  and  got an infection there, came home  and went from thriving to taking an hour and a half to get out of bed every morning. She had intense joint pain all over her entire body, went to every high.

18:51

quality medical institution, including Stanford, could not get answers except put her on methotrexate is what they wanted to do. I’m like, well, let’s just try a microdose. Let’s see what happens. She emailed me 24 hours after she took her first microdose and said 95 % of my joint pain, my inflammation is gone. And it’s just mind blowing and inflammation in turn, like it’s about your quality of life, but it’s so tied to our long-term health outcomes, to cancer, to so-

19:21

much that if we can influence that, you know this, it can change the trajectory of our health truly. Wow. That’s amazing. That’s so good to know.  In addition to inflammation, I know there’s other benefits too. What are some other things that people see from? And by the way, too, I’m assuming you’re saying  the benefits are from the microdosing, not  general dosing, right? Or is it from any GLP ones? Any GLP dose will reduce inflammation. In fact, I was wondering more if it would still

19:49

occur with a microdose  and it does, like undisputable. So  some other benefits specifically in like thyroid people, that’s really cool. Did not expect this,  literally just showed up in the data.  I see it almost a hundred percent of the time reduce Hashimoto’s antibodies  in a very big way. And it makes sense,  right?  You reduce inflammation, you reduce autoimmunity in a lot of aspects. It’s been shown to…

20:16

reduce the progression of MS on MRI by like 13%. Wow, that’s significant. Right, another autoimmune disease, psoriatic arthritis in terms of autoimmune disease. So what’s cool is I think this is like inching medicine maybe towards understanding that we can actually influence autoimmune disease, that it’s not like the reverse lottery and, you have this thing and it’s random. There’s nothing you can do about it. So it’s cool to see that evolve in real time. Yeah. Yeah.

20:46

That’s amazing.  Now, when you do microdosing, so you mentioned typically it’s once a week that someone would do an injection. So with a microdose, it’s a smaller dose.  And is it done more often or is it just a smaller dose once a week or is it depending on the person? You know what? It should be, in my opinion, it should be tailored to the person. So you can do it once a week. Some people can do it every 10 to 14 days and still feel the effects. ah

21:14

Other people need it twice a week. Like they need to split their dose, especially people who are really sensitive to side effects.  They can split the dose because generally side effects peak 24 to 48 hours after the injection. So  it is, it’s unique for everyone. And that’s the beauty of it is that you can partner with someone to help you find what works uniquely for you  and then adjust it along the way if needed. That’s great. Sorry. em

21:42

No, the one thing I wanted to also chat about is cancer, like cancer reductions with GLPs. Okay. I know. I, there are so many studies that look into this, but I pulled some stats specifically for this conversation that I thought people would be interested in. Like I’ve heard, I’ve had social media followers ask me, doesn’t GLPs increase the risk of breast cancer? Like there’s just all of this false narrative that cycles around.

22:11

So I wanted to pull some stats for common kind of or significant cancers, breast cancer. There’s a risk reduction of 13%. Lung cancer, a risk reduction of 19%. Prostate 17, colorectal 16, pancreatic six. So while everyone’s saying, oh, it increases your chance of pancreatic cancer, it actually reduces your risk of pancreatic cancer  by 6%. And it also  improves mortality.

22:40

for people who have already had cancer. So there’s a risk reduction. can’t remember the exact amount, but it um reduces their risk of um significantly. So pretty cool. That is  very, very cool. And this is the stuff that you don’t hear about because all you hear about is…

23:01

negatives or people losing way too quickly or having these things. And it almost reminds me of how, when everything started with even bioidentical hormones, right? Where it’s like, well, you use it for  the least amount needed in the lowest dose possible for five years or less or else, you know, and then it just, it didn’t even still after all of the research is out, it’s still, people are still talking about that. And it just takes, it takes a while.

23:26

Um, but I’m so glad that you and your practice are doing this and are educating people about it.  And it’s just amazing that in addition to losing weight, which is so hard for so many people  that they’re getting all of these other benefits. So  that’s really great. It really is. And I think specifically, I mean,  for people that can’t lose weight with effort, it’s such an incredible tool.

23:51

because there truly are those people. I I wish it was as simple as calories in versus calories out, but  that’s not science and that’s not our physiology. So we need to have something to help those people that can’t be helped with their own efforts alone. Yeah, exactly. Now, what about working out? So one of the things that we talked about was that you can  lose muscle or possibly bone, which you explained so eloquently that it really has to do with the dose and just someone not eating.

24:18

But if someone is doing a healthy microdose for their body and it’s tailored to them,  is it still important  that  they lift weights and that they help to support their muscle and they eat a certain amount of calories? Absolutely. So  I view these meds  as something that should never be used in isolation. Like they should accompany a strong lifestyle, right? And  so many of us going in,

24:45

to needing those medications is because we have a very low metabolic rate  and we can’t keep up with our daily intake of calories, even if it’s low.  And a big way to combat that is building muscle mass, right? Like if we can increase our lean muscle mass, we burn more calories, even if we’re sitting around all day than we do if we don’t have that muscle mass. So  I think while you’re on a GLP, it is an incredibly good, time.

25:13

to start solidifying your lifestyle. So definitely exercise. I recommend our patients lift weights.  I say, look, like let your heart rate come down in between sets so you’re not taxing your adrenals too much.  Be sure you eat a great meal before you go,  but lift weights so that in the future, if you want to successfully come off of these medications, that is gonna increase your likelihood of successfully transitioning off substantially.  I also love walking, like just…

25:42

Low intensity sustained training is an underrated tool.  so combining those two things is incredibly powerful. And I think, you know, because  from a nutrition standpoint, these people struggle sometimes to get in enough food. So getting very strategic in ways  to get good quality food in works. Like I always talk about what I call the food flow formula.

26:10

where I have people start with protein. Like let’s just solidify that you get enough protein in, then move to like micronutrients that are very  dense, fibrous foods, not carbs.  Save those for either the last part of your meal or for the evening so that you have all this room for the nutrition that your body is craving  and that you need as fuel. And it works for most people for sure. That’s great. Now what about-

26:37

if someone is a vegan or a vegetarian and they have trouble losing weight and they want to go on this and they want to do the microdosing with you. Naturally, mean, of course they could do and should do protein powders, but you know, it’s a different type of protein and it is harder to get the amount of protein that we need in those cases. So can they be candidates for this and is it something that can create issues for them if they’re not getting enough protein?

27:03

Yeah, I mean, I think you starve your body of some of the essential nutrients and it’ll pull it from somewhere else, right? And so I think they’re candidates, but they need to be strategic  and also just be very careful about their dose. know, vegan people tend to eat in an ideal scenario,  a lot of vegetables, a lot of fibrous, dense foods that are going to fill up your stomach more quickly.  so

27:28

maybe perhaps lowering their dose a little bit, allowing them to eat more food, eating more frequently throughout the day. And I always discourage people honestly from tracking food. I think that my goal on a GLP for people is that they create more food freedom for themselves and not so much fear around food.  Cause most of these people have  reduced their caloric intake for so long. They almost view food as bad and a failure if they eat.

27:56

But in the case of vegan people, especially, I think they almost need to track their protein to understand, am I getting enough? Do I need to reduce my dose  and do it from a scientific way? Yeah, that makes sense for sure. Now, speaking about inflammation, another question that I get asked about all the time  is  LDN, low dose naltrexone. It’s a different medication, but it has such a positive effect on modulating the immune system and helping inflammation.

28:24

And so I’d love to chat with you more about that because as a prescribing provider, you you use medications all the time and I think you can speak to this so much more  than others who kind of speak to it more in theory  rather than like seeing it in practice. What are your thoughts about LDN  and you know, is it something that could be beneficial and can you use it together with GLP once? Sorry, that’s too many questions.  That’s great. No.

28:49

I love LDN. I use it with my patients literally every day. I take it myself. I put my husband on it.  It is a medication that is thought to work by lowering opioids. So reducing a little bit of your accessible opioids that you circulate because naltrexone is an opioid antagonist. It blocks them.  When we have a little bit less, our body says…

29:13

hey, I think we need more. And so we actually up-regulate our production of opioids and instead of walking around like in this deficit, we end up walking around with a little bit of extra  and that reduces inflammation. It’s a powerful way at reducing severity of autoimmune disease as well.  It even has some benefits in cancer because it suppresses inflammation without reducing immune function. It actually improves our immune function while suppressing inflammation, which is…

29:43

different than most drugs in that class, right? Yeah.  Like steroids, like they’re great. They reduce inflammation. They also reduce your immune system. Right.  And this is not that.  so especially 100 % of my Graves patients are on low dose naltrexone. It is  so incredibly powerful in that population of people,  Hashimoto’s people, especially with significant amounts of antibodies. It’s an amazing way to get a leg up.

30:10

and get this started to reduce that inflammatory response,  it’s extremely well tolerated. I’ve never had a single patient have something serious from it. Most people have vivid dreams. That’s kind of the extent of it.  So tons of really great benefits,  especially from a longevity standpoint.  We kind of mentioned even with GLPs, inflammation’s the driver of disease. It’s what drives the breakdown of our body over time. It’s what drives aging. So if we can just…

30:39

turn the volume down on that a little bit. It’s a powerful way to influence our health span and lifespan. And I get asked the question if you can take it with the GLP-1 literally  every day, multiple times a day, and absolutely you can.  We have so many people  that do both.  Of  the pathways of inflammation that I have seen GLPs work on in research,  it is not the same pathway as LDN. There are so many inflammatory pathways and…

31:07

hey, the more we can disrupt and interrupt, the better off we’re going to be, in my opinion. So they can be a powerful combination.  Yeah.  And dosing-wise, is that something because usually people recommend starting slower and then working up to not a higher dose, it’s a low dose, but to the higher dose of the low dose.  Is that something you recommend as well,  or are you utilizing that microdosing theory with that as well? Interesting.

31:35

Ultimately, generally speaking, titrate people up to the standard low dose of 4.5 milligrams.  I don’t do it very slowly. Like I know a lot of people will do it in half milligram increases. So there’s like nine increases or so.  I don’t recommend that. feel like people that have side effects from LDN, which again is like vivid dreams, waking up maybe a little groggy when they first start taking it, those side effects last for a few days at each dose increase.

32:04

and I usually increase them at 1.5. So they have, you know, maybe five days total of feeling like that because we increase it twice. uh If you increase people in those microdoses, they usually have that same experience if they’re going to have it, but now it’s drawn out like  for weeks and months. And so I always think it’s better after toying with both to go a little bit more aggressive, aggressive is relative because it’s ultimately still a microdose of naltrexone.

32:34

I find that to be the most beneficial. That’s really interesting. Yeah. I wasn’t familiar with that. So that’s really good to know for anyone that may be considering it, that if there are side effects, they’re not long-term, they’re temporary side effects and then they subside. So that’s great to know.  And the nice thing with LDN is that, you know, it’s that immune system modulation in addition to the inflammation. So with Hashimoto’s,  Graves, right? mean, any autoimmunity, it’s,  it’s just so crucial.  And,  you know, I think

33:02

that we have these tools and then we have, of course, our food and our lifestyle and the toxins and all the things that we’re doing. And if we kind of use the lifestyle and use the tools together, it’s like, oh, like the best of both worlds. Yeah, you’re not going to  now treks up your way out of a poor diet and all of these other things that need to be addressed. That’s just not the way that  it works.  It’s best used again as an adjunctive in addition to

33:31

to the lifestyle piece. agree. Yeah.  And I think it’s really important for people to hear that. And I know I say this a lot, you say this a lot, and we’re repeating it here.  Because they think, OK, well, I’m just going to do this because it’s easy and everything else. I’ll just be on the side.  And I think people may see changes at first, but long term, that’s not really what we want. ah Now with LDN, is that something that people stay on indefinitely?

34:00

And once they’re on a full dose and they feel good with it? I mean, I would advocate that pretty much everyone should be on LDN indefinitely.  think the benefits from a longevity standpoint are so powerful.  honestly, I tell my patients, look, when you get on LDN, don’t even look for symptomatic improvement. That’s not why I’m giving it to you. If you feel better, great. Amazing.  But really, we are looking for more resilience to inflammation, reduction in antibodies, and long-term health outcome benefits.

34:31

Yeah, that’s great to know. mean, that’s obviously the root  of all autoimmunity. So that’s great. That’s actually something I’m considering for my son as well. He’s nine now and he has pandas. I know you and I chatted about that before and  we’re doing so many different things for inflammation and he’s doing the hyperbaric oxygen chamber  every morning now. He eats his breakfast in there. It’s super cute. He has this routine, but that’s one of the things his doctor was considering. And I think I was nervous just because

34:58

I don’t want anything to interrupt his sleep, but that’s so good to know that it’s a temporary thing and it doesn’t even happen to everyone. Oh yeah. I mean, I have had maybe two people ever stop LDN for sleep issues out of like thousands. I mean, really multiple thousands.  I’ve had less than five people ever stop it from side effects. Like it is extraordinarily well tolerated. Most people honestly say it helps them sleep more deeply, more restfully.  And I want to put Rosie on it too. So I’m right in your boat. think  it has.

35:28

tremendous benefits in our little kids subset of the population. Yeah. Yeah. Well, we’ll have to continue that conversation.  So I’d love to know, and I know that everyone watching and listening this will want to know too,  you have Hashimoto’s, right? You’ve had Hashimoto’s for a long time.  And  I mean, you look amazing. You’re doing so many things. You are running a huge practice. You’re helping so many people.

35:53

What does your routine look like? What do you typically do? What do you focus on? How are you doing what you’re doing? Because you’re doing amazing. Well, thank you. My life would look very different if I hadn’t gotten the help that I got a long, long time ago. And thankfully, now I’ve actually been in remission for my Hashi for over a decade. So I’m very grateful for that. Still absolutely have hypothyroidism. But part of what

36:21

makes me so motivated to  manage my health is because unfortunately, if I don’t, I don’t feel well. Like I struggle  and it impacts me.  Whereas again, like other people, not so much. Like my husband can kind of eat what he wants. He doesn’t, it’s all fine for him.  It’s not like that for me. So I have to be productive to show up in the way that I need to show up at work and home with my kids. I have to feel well.  And so a lot of my lifestyle is centered around inflammation.

36:51

So I’m a very inflamed person. That’s why I talk about it so much on social. And so some things that I do for myself for inflammation, definitely supplements for sure, but  I intermittent fast for me, that is,  I don’t think I could do life without that. Like I think I would just really struggle and I only do it four or five days a week. I kind of listen to my body. what hours do you do when you do the 16 eight? I try and do the 16 eight basically where I eat in an eight hour window. uh

37:19

uh And again, like I don’t, think the beauty of intermittent fasting that’s missed so much of the time is this can be a relaxed thing. It doesn’t need to be like really rigid, really dogmatic. If I wake up and I’m hungry, I was, ate breakfast this morning. I’ll probably finish my eating window early or I just won’t fast today.  You know, I just want to listen to my body and it works  really, really powerfully for me.  I also.

37:45

kind of order my food in the food flow formula that we kind of talked about a few minutes ago, where I really focus on keeping my blood sugar low in the early part of the day. It fuels me to feel well and be productive and reduce inflammation. I drink a ton of green juice,  flood my body with micronutrients, eat a lot of healthy veggies and color rich foods. And I exercise, you know, it’s  nothing magical.  I probably do take quite a bit of supplements just to be extra productive during my work week, but.

38:15

uh But yeah, no, I mean, I just, but I keep focusing on it and I’m pretty consistent because it impacts how I feel really quickly. Yeah. Yeah. That’s great. Now, are there any self-care practices that are really big for you? Yeah. Great question.  So, uh you know, working out for me is like a form of self-care, especially yoga, like something like that. Walks are one of my favorite things that I do. I take my daughter Rosie and we just go for a walk most days.

38:44

lymphatic massage is a big one for me. Like I’m a puffy girl. And so moving all that lymph makes me feel physically so much better. Same with the sauna. So I do like our normal biohacking things. Red light’s another one that I love. And I’ve kind of built my home to be a little bit of a self-care sanctuary. So when I have a few minutes, I can dip into something and just put it on my list as something that I did for myself for the day. That’s great. I love it.

39:13

That’s right. And it’s so important. And I think it’s  really inspiring for people to see,  you know, someone with Hashimoto’s who is in remission, who is doing all of these things and is so successful and so beautiful and,  know, just  is able to really enjoy their life because that’s really the goal. Right. I you and I, like, that’s what we focus on for  our clients and patients is, you know, how they can get there too. And I just, I love people  to, to  really like know that and get that into.

39:42

see the example in others that they can do that and they can have that too. And it doesn’t have to be that hard. you know, tying that back to GLPs is that like,  there’s a way, and again, it’s not that we take shortcuts, right? We do all of the things, but then there’s these other things that can help when put together with, with everything else. Now you mentioned you still have hypothyroidism, which of course makes sense after prolonged hosumodos. So you are on thyroid medicine, right? I am. So I’m on renthiroid and a little bit of cytomel as well.  And just

40:12

tailored to a perfection and I  feel so great. And I do think, think it’s so important that people know their life does not have to be miserable because they have a thyroid problem. Because I think sometimes it’s hard to find that in medicine. think people just are written off and told, well, you have a thyroid problem. This is kind of what life looks like. you’re so right. It doesn’t have to and it shouldn’t. And we want more for our people than that. Yeah, definitely. Oh, my gosh. This is so inspirational and so.

40:41

informative. So for people who want to connect with you, who want to find out more, who want to contact you, where can they find you and learn more? Yeah. So I have two,  two nationwide practices. One is modern thyroid clinic where we specialize obviously thyroid hormones, adrenals.  We take a progressive functional medicine approach and it’s just, I wanted to create a safe place where women could go to actually get healing and get their lives back. And I feel like we’ve done that. It’s just my passion project for the last 10 years.

41:10

The other one is Modern Weight Loss, which is a newly launched GLP, tailored dosing, microdosing,  nationwide practice as well. So you can find us at modernthighweightclinic.com, modernweightloss.com. And then you can find me on social. I love just hanging out on Instagram at McCall McPherson PA and on TikTok at McCall McPherson. So I’d love to see you around. Amazing. We’ll post all of these in the show notes too. Well, thank you so much for being here. This was…

41:37

So, so helpful. know so many people are going to find it really informative  and I’m excited to get this out there. Thank you so much for having me and thank you so much for your work and dedication to these people, these women, because truly they need it and it’s invaluable. Thank you.