Functional Medicine & Natural Healing Podcast
Functional Medicine & Natural Healing Podcast
Thyoid Q & A - Systemic Inflammation, Autoimmune Thyroid and more...
Need more help?
Reach out to Dr. Anderson or Dr. Ariciu for more info on overcoming thyroid disordes!
Dr. Gabe Ariciu - Phone Consult Book Online
Dr. Gabe Email - doc@drariciu.com
Fullscript Products Mentioned - Click Here For Fullscript
Visit Our Sponsor - www.amgnaturals.com
Ever wondered why T3 and T4 might not convert or improve when your TSH is in the normal range? Or maybe you're concerned about maintaining optimal health following thyroid or gallbladder surgeries? Join us, Dr. Houston Anderson and Dr. Gabe, as we illuminate the often murky waters of thyroid health, tackling these queries and many more. We peel back the layers of thyroid function, exploring topics like the ideal TSH range, managing health post thyroid and gallbladder operations, and, most importantly, how to determine the root cause of thyroid nodules.
But we don't stop there. We also take a deep look at the intersection of Candida and thyroid health, emphasizing the importance of addressing the root cause of autoimmune issues, not just the symptoms. We delve into the potential systemic inflammation caused by Candida, which can trigger these issues, and discuss the significance of regular check-ups. Moreover, we shed light on the implications of thyroidectomy and underscore the need to comprehend why such procedures become necessary. So, come and tap into our expertise as we navigate the intricate world of thyroid health and respond to your burning questions.
The best herbs for functional medicine practices and their chronic patients.
Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.
Looking to connect with Dr. Anderson?
https://linktr.ee/doctorhouston
Welcome to the Functional Medicine and Natural Healing Podcast, where we share the secrets to upgrade your digestion, improve your hormones, restore your immune system and detoxify your body. I'm your host, dr Houston Anderson. Now let's get started. The following discussion is for educational purposes only. It is not intended to diagnose or treat any disease or disease process. Please discuss any medical treatments or medical interventions with your personal physician. All right guys, welcome back to the podcast.
Speaker 1:I'm Dr Houston Anderson and I'm here with Dr Gabe and today we're going to answer your questions that you submitted on Instagram on essentially thyroid. So some of these are always always they get interesting. But we'll see what we can do here and we'll just jump right to it so you guys don't have to waste any time. And I think the first question is probably the most applicable to the last podcast, where we should definitely review some of those things. But the question is why does T3 and T4 not convert or is not improving when the TSH is normal? So can you give me a couple scenarios, doc, where that might be a scenario that you could see in your office?
Speaker 2:So I think that goes back to just conversion issues in general, so it has nothing to do with the thyroid itself. It's like the liver, the gut, the periphery. Something's going on there. So whether it's reverse T3 problems where I mean generally it's inflammation, things of that sort that's causing reverse T3 to be an issue or we're looking at just general conversion issues, so like need for zinc or selenium or something like that. Now, of course, there's some other things that could be affecting it, especially like what do you mean by TSH being optimal? Yeah, because I've heard like I was listening to one functional medicine doctor and he said anything above, I think 0.25 or 0.5. And I was like that's low. That's actually low. You need it above 1.8 because we forget that anything below 1.8 generally is like blood sugar or something else is messing with the thyroid and then you're going to end up with some hypothyroid type symptoms. Tsh is not jacking up and going high.
Speaker 1:That's interesting, yeah, so the only caveat I find is like when people are medicating, it seems like their TSH should be a little bit lower in order to get quote unquote the hit or the effect from the drug, because obviously we know the drug is not going to do exactly what the body does by itself. So sometimes I'll see that. Yeah, because I do tell people one to three is a solid range if you're just struggling with thyroid things Though I'm not saying it's perfectly optimal and in fact I really struggle with saying numbers exactly but I do like that you say when it gets too low, we have other problems that we're dealing with.
Speaker 2:Right, Yep, yep, and we have to ask all those questions too. It's just like we don't know for sure which one it is Right and, like you said, one to three, I'm fine with that range too, if the person is feeling okay, right and there's no other issues showing up. But, generally speaking, if I see it before low 1.8 and then they're complaining of different thyroid type symptoms and I'm like, okay, we need to investigate that.
Speaker 1:Yeah, If I look into that question and I kind of think, like what was this person trying to ask? And once again I don't even know who the questions are coming from and I actually try not to worry about who they came from. That way I give an answer that's applicable to all people. But it almost makes me wonder are we being too crazy about our T3 and T4? When the TSH is normal? So let's just say your TSH is a beautiful 2.0. And then your doctor's like, oh yeah, but your T3 is not optimal, so they might start to medicate you.
Speaker 1:So my biggest thing there and when I'm saying medicate you, these are like holistic doctors that are a little bit too into medicating for thyroid medications. And so my thought is this yeah, if your TSH is normal or in an optimal range worse, thrown out numbers like one to three, if you feel well and your T3 and T4 are off, what you're looking at is just, like you said, the periphery. Go and attack some other health problems, see if it normalizes, but don't mess with the thyroid too much. Make sure your liver feels good, Make sure your digestion is working well, Make sure that you don't have systemic inflammation, like you said, sometimes an immune disorder that we use like oh man, all my joints ache all the time or something like that no other signs or symptoms of inflammation. And then come back and retest that T3 and T4 and you'll find that if you fix those problems, usually it comes right in the range that you're looking for.
Speaker 1:So what you're saying is we should be actually holistic, yeah so yeah, we shouldn't prescribe just because we have a thyroid in our body. Okay, so cool. So let's go to the next one, because this is a pretty good question. It says how do you shrink your thyroid nodule on the right side specifically, but I think it applies to both sides. But how would you shrink a thyroid nodule, doc.
Speaker 2:So it's kind of interesting. In the last couple of weeks I've had a few Hashimoto's cases that have popped up and each of them were complaining initially of like a goiter, so just an enlarged thyroid. Okay, like knowing the history of the family and stuff like that. I was like we need to run these tests, we need to know for sure and sure enough, hashimoto's. So really we got to figure out what's going on in the first place. Do we have some inflammation, do we have something related to like Hashimoto's, or is there some other type of inflammatory mechanism going on? And then of course there's the all iodine thing. If it is true iodine deficiency and you're actually getting like a goiter type thing, that should be investigated too. But generally I'm going to get probably with a nodule. I'm going to be going after like inflammation more than anything and then trying to figure out OK, is it Hashimoto's or is it general inflammation? Is there something else going on elsewhere that's causing this to come about, that sort of thing, long before thinking something more insidious which is often overdiagnosed.
Speaker 1:Yeah. So I think I think, yeah, I think you're right. I think when we're talking about shrinking nodules, I'm first thinking immune inflammation and why is something attacking that thyroid? Is there some type of viral infection that kind of penetrated that tissue or something like that? And then, kind of going from there underlying in the question once again just me thinking about this patient, whoever this may be like is, if you're looking for a quick fix for any thyroid, anything you really shouldn't be looking into holistic. And I think then that's where a lot of people come in. They like well, my friend got on thyroid medication. I want to do it natural, so give me the natural medication. You know, I was like hold on a second here. It doesn't work that way. If you want to address your thyroid health naturally, then you need to completely like revisit the story of how did you get here. So shrinking a nodule is not just, you know, take something, but yeah, definitely things like you know, converting factors like a selenium or zinc would help Definitely. Selenium has great research on decreasing TPO antibodies.
Speaker 2:Just by itself it's glutathione, so I mean that alone can be super helpful.
Speaker 1:Correct and glutathione itself can help, but I would much prefer selenium in the thyroid in general.
Speaker 2:Yeah, no, no, no. Yeah. That's kind of what I was just meaning Like it's going to have like a double effect.
Speaker 1:Yeah, I love it, I love it so yeah, so just addressing immune inflammation is kind of like both what we're saying there. But, generally speaking, once again, find the inflammation Somewhere in the body. All right, best diet and lifestyle and we'll hit the sit in the next one. But best diet, lifestyle and support after thyroidectomy. So we don't see these patients as often, probably. But what do you think, doc? What should we do after we've had our thyroid removed?
Speaker 2:I mean generally, if I have somebody along those lines, it's they're still feeling pretty cruddy afterwards, but usually it's just like a lowectomy, not like the full thing, right. So best diet lifestyle I mean paleo, if there is like if the whole reason for it to be removed was something similar to Hashimoto's or something along those lines. Of course, looking for food intolerances, etc. As we've previously discussed with autoimmunity, but generally speaking it's eating a whole food, good paleo lifestyle and having a subsequent lifestyle kind of similar in the sense that you're outside in nature, you're cleaning up the environment, you're trying to be, you drink filtered water.
Speaker 2:You're not drinking out of glass or plastic water bottles or anything, you're drinking out of glass or metal and just doing your typical over a view of like natural health lifestyle, really like the way that I try to live, the way that you try to live, yes, an entire lifestyle change, which goes back to what you were saying earlier, that Coming to a natural doctor, coming to a holistic doctor. People do come in with this expectation that is somewhat similar to medicine, western medicine, and they just want that quick fix. And it's like you don't understand, like we don't intervene in the body processes. We work with nature and working with nature requires you to actually meet it halfway. That's not fully where you actually are working to better your lifestyle, better your diet, better everything, so that nature isn't necessarily being compounded or beat up or messed up because of Eating junk food, going McDonald's and everything, everything else.
Speaker 1:Yeah, yeah for sure. When I think about that question, I think, okay, the first thing that most people do is they have their thyroid moved and they think that it's been taken care of, and I Thought, oh yeah, like you actually still have to discover the reason why you needed a thyroid activity in the first place. The same goes for the gallbladder here. The all-time already had my gallbladder removed. How could I have a gallbladder problem?
Speaker 2:Well, you had a gallbladder.
Speaker 1:You just remove the symptom, right, you just remove that symptom and cut it out of your life, but the problem is still there, because the problem was never the thyroid in most thyroid ectomy cases. You know, like we've talked about in the previous podcast, primary thyroid disorders are very rare. Yeah, so then, so then, okay. So that's the first thing is, I would say, like you still need to figure out why you got sick in the first place. The second thing I would say is now you're on a medication for life. Usually. I mean, if you're only having a small portion removed, but say you're having, you know, a large portion of thyroid removed, you're on medication for life and you don't have as much thyroid glandular support of your natural ability.
Speaker 1:I would say pay attention to your dosages, pay attention to your conversion. So if you're just on like a level of thyroxine, you just have to work with your doctor to make sure that you're checking those regularly and you still have to support converting organs. You still have to get your liver and your gut healthy in order to do those things. You still have to have Nutrient levels intact to support the adrenals so that they can function. With your new lack of thyroid, which are gonna take a bigger toll now because the thyroid can't take the toll. So once again, I think maybe you think thyroid ectomy nothing left to do. Thyroid ectomy means now you have more to do and that's that if they communicated that before they removed the thyroid, or if they gave you those options originally instead of waiting until the time when you needed a thyroid ectomy, then maybe people would have taken more lifestyle changes. But that's kind of where we run into that problem.
Speaker 2:So, yeah, yeah, like a full hysterectomy.
Speaker 1:Yeah, I mentioned gallbladder, but the same would be with hysterectomy, right, you had thinking, because it produces hormones just as much as thyroid producing hormones.
Speaker 1:Yeah, so. So I was thinking, like you know, you get, I don't know, polycystic ovarian syndrome, pcos, or you have endometriosis, and so they go and do something, maybe even completely removed. I've seen 25 year olds with their entire uterus removed. What a shame. But point is now that that's removed, you you aren't done with your problem. You still got to go back and fix what you was wrong with in first place and you have to now babysit it more than you've ever babysitted it before and You're actually in a worse spot overall now.
Speaker 1:You may not have the symptoms, which, trust me, I know people want relief from that, but it's it's. They're stuck in a place now where they actually have to definitely take care of their health more. That was their one chance. It's gonna go to another organ if you don't take care of your health. So it's just a matter of following up on those things. I Think you covered overall good practices to maintain a healthy thyroid. Really. Diet, stress, nutrient levels yeah, female hormones, adrenal hormones and thyroid hormones. Pay attention to all three of those and you'll be pretty good. Any other thoughts on general practices for a healthy thyroid?
Speaker 2:The only other thing that pops in my mind was just thinking about iodine. I know you know there's that small risk that iodine can exacerbate a Hashimoto's case but if you've done everything to get that under control you're easy not going to have an issue with iodine but having a good liquid iodine, like I use isol For a liquid one but just doing like a small dab of it on your forearm and then watching it for six hours and if it absorbs before that you need iodine generally.
Speaker 1:All right, so review that test for them. So this is essentially an at-home thyroid test, or, sorry, I have iodine test you can do. How do you do it in your office, or do you send patients home with it? My office, just because I?
Speaker 2:have a little liquid roller and so I just put it on their arm. Of course you, you want to have like a paper towel there. If you get a little bit too much because you don't want to get it On your clothes, it'll stain your clothes, but uh yeah just a small circle.
Speaker 2:I mean we're talking about the size of the quarter, uh and then just kind of dab it so that it's not like overly wet, and then you just watch it for six hours and if it absorbs like it's completely gone in six hours Without you obviously washing it or something like that, right, um, then that's a good indication that you need iodine. And then you might just want to supplement with iodine, talk to your doctor about iodine, that sort of thing. But I mean I don't give like a high dose or anything like that. I think it's like 400 micrograms or something.
Speaker 2:I can't remember off the top of my head. I use a couple of different sources of iodine the isol I do, one drop in a glass of water. A day if they eat it. Otherwise it's like for general maintenance, like one drop every three days or something like that. But yeah, that's, that's just my two cents there. And iodine is huge, especially for females, because it's a big part of ovaries as well.
Speaker 1:Yeah. So big thing on iodine is it does competitively we talked about this in the podcast but last podcast but it does Competitively fight for spots on cells. So I like that low dose, maybe a drop every three days, pretty much for almost everyone, and then paying attention. Obviously if you feel like your throat is itchier and flamed and maybe that thyroid back there Start having difficulty swallowing. You might want to you know, work with a practitioner on that but Salt does not count. Yes, I, salt does not count, and so a lot of people do say that, hey, I add salt to my, to my food every day and honestly, that doesn't count for electrolytes either. But we'll do that in a different podcast. So, alright.
Speaker 1:So how to heal thyroid and stay off medications if diagnosed with hypothyroidism is the next question. Let me just say most I can't think of one right now the patient that came in with any reasonable level of thyroid disorder that had to go on a medication in my office on If we had enough time, meaning like three to six months. So I don't see it a lot where we have to get people on, but essentially my thing is they need to take a step into getting healthier Right away and it needs to be aggressive. They need to go all in rather than like oh well, you know, I stopped eating McDonald's, but I just eat a healthy fast food restaurants now, if that's a thing, right. So maybe that's not enough, right? If you're having thyroid problems and you really want to not be on a medication ever, you got to go pretty hardcore at it.
Speaker 2:Yeah, and I I would agree. I don't really have much else to say other than what you just said. I mean, I think that goes the next question too. It's the same type of thing. You got to get a healthy lifestyle and you got to be Some what, like you said aggressive in that approach. You got to jump on it. I mean, when we're dealing with patients like it it's still aggressive, even if it's a couple weeks, in that we're pulling things off slowly, but we're changing stuff, like you're moving to whole food, good, good quality foods, you're removing any of the things that are inflammatory generally, but then we're looking, looking for the major food intolerance, and so you got to remove all those things and you got to be Constant, like people always ask well, can I bring gluten back in it's?
Speaker 1:like, no, like. Once this is done, it's done like you're not going back.
Speaker 2:Generally speaking, like maybe three years down the road you can have some sourdough organic bread once without it going nuts, but you can't just go right back to that stuff. It's done.
Speaker 1:Yeah, it's. It's unfortunate that essentially oftentimes when our thyroid disorders develop, it does mean that we're at a point of health where it's going to take a long time to rebuild that health. And and same with energy. People come in with energy problems and, yes, while I have home run cases, it's rare that I'm going to tell someone, hey, yeah, we can get you out of your chronic fatigue in a day or two. You know, it's more like hey hope for six months and in a bad case scenario You're more like 12 months. But slowly but surely, every day you'll have a little bit more energy. The thyroid is going to be the same way. Slowly but surely your thyroid health will recover. Once you start to eliminate the antibodies, once you start to Get your lab normals in range, once your liver is clear, once your guts better, once your hormones are balanced, then your thyroid to start healing. So I think those are pretty important ones there Root causes of Hashimoto's, hypothyroidism, of non Hashimoto's, so something that's not autoimmune.
Speaker 1:So not food, not infection. What do you think, doc? So top of the list.
Speaker 2:Generally that I see is blood sugar, but estrogen is going to be up there too. So we're going to have some high estrogen issues or just hormonal what says, put it really kind of general there, hormonal problems, um, conversion issues aren't really top of the list, but I mean I do see them from time to time and then, um, stress, like kind of general stressors to the body, what is are going to cause hypothyroidism for sure, like there's definitely some other ones, like I Saw relatively recently somebody with low dopamine and so because they had a dopamine deficiency, they had hypothyroidism. That's coming one in, like the last several years.
Speaker 1:Yeah, yeah, that's pretty good.
Speaker 2:But still, um, those are some of the big ones that I would see in my office would be hormones, blood sugar and then like kind of general stress.
Speaker 1:Yeah, so you could do like a secondary I'm thinking secondary brain like uh, uh, you know more like a pituitary issue. That's not really hypothyroidism, um, real. So I guess the answer is question directly. The answer is that non Hashimoto's hypothyroidism is like Hashimoto's hypothyroidism, which is it's not really the thyroid. Um, so we can see it, it's. It's another problem.
Speaker 1:Um, when you were going through the different things that you said, it's like I think those are all accurate that I think, if you can look, go through your lifestyle and figure out what's the most chronic of those, you know, have you been, have you been eating bad for a long time? Okay, well then, it's probably that. Have you had lifestyle stress for a super long time? Maybe a really bad marriage or a horrible job? Um, if it's only been a month or six months, okay, whatever, like the body can handle some stress. But if, if you can go back in your life and say like, hey, this is really just worn me down over a long period of time, that may be the guy that's kind of, uh, the the obvious one to start doing things with. I guess is is the way.
Speaker 2:I think that's why I would put estrogen and blood sugar at the top of the list, because they're so stinking common. Yeah, you better think about them first and then start going on the other ones. And that's just common In general practice. It may not fit everyone.
Speaker 1:Well, yeah, and if you think about, like, how long as someone had insulin problems, well, how long have they been gaining weight? You know, years? Take an estrogen issue how, how many? So obviously females have more Hashimoto's and thyroid disorders, but how many of them say their periods have been bad since they were 12? Yeah, team, half of them at least. You know so. So it's like they've had that hormone imbalance. Now let's get not necessarily their fault when they're 13 years old, right, and we have a lot of girls in my office right now going through different transitions and we're trying to figure that out early, rather than when they're 35 and can't figure out their patterns, or before the doctor tells them Then they have to go in birth control to control their hormones. So that's kind of an interesting one there.
Speaker 1:All right, how to reverse Hashimoto's, I'm gonna refer back to the last podcast. So so, yeah, it's a great question because reversing Hashimoto's is important. But, generally speaking, you know all the things that he mentioned in the last question. And then, once those are all good and once your thyroid has the nutrients that it needs, you're addressing a little bit of inflammation, or immune dysregulation is a better word Almost like resetting that immune system at the end. So you have all these problems. You have fix, then reset or calm down the inflammation of the immune system, balance it out, and that's what's gonna kind of like Finally reverse the Hashimoto's, or the tendency towards it and then you just manage flare-ups from there on, like because we're all Humans and we're going to be affected by something.
Speaker 2:Yeah, I mean they're not that common, but a flare-up can't happen. So it's on the table and you just you know that's where we, as natural doctors, is like coming for a checkup periodically if you're feeling like junk coming for a checkup, otherwise, generally it's gonna be pretty good.
Speaker 1:Yeah, I mean I would say that for almost any diagnosis. If you actually have a diagnosis, you should probably be working with someone. If you're just like, hey, I have general malaise or fatigue, okay, you can go at it by yourself, go off some of our recommendations. But if you know that you have Hashimoto's, elevated antibodies, your time is limited. I mean, your thyroid is getting destroyed every day, so you might as well do something and go see a doctor so that you can find someone that can help you start getting on that story. I know it's hard to find good doctors. You can always reach out to us. We do our best to find people for you, but it is hard. I mean we can't find an excellent doctor in every city, hence why we both still offer phone consultations. Yep, all right. Last question of the day, once you divide it into three how do heavy metals, parasites and candida affect the thyroid? You want to choose any one of those doc.
Speaker 2:Let's go to candida. I Mean we see it so sticking off and I mean it's gonna kind of apply for everything. Like generally speaking, you're going to see two major avenues going towards autoimmunity in a sense, because that's what I'm gonna look at with these three. I'm gonna think autoimmune yeah, if that's on the table. Obviously, having a candida infection or any infections going to cause you to feel kind of malaise, like that fatigue, you're not gonna feel very good and your thyroid is gonna have a secondary effect they're a heavy metals, probably even to.
Speaker 2:But I'm gonna go from A autoimmune standpoint that with candida or any of these types of things, you're going to end up with most likely, whether from it or something else leaky gut, and with leaky gut you're gonna wind up with inflammation that is gonna turn systemic. And then you can run into what we've talked about before molecular mimicry, where your body is going to not mistake but broaden its search for this foreign substance, so Candida, so this fungi, and then it's going to end up attacking the thyroid in the process of trying to get rid of this issue. And with that then you got some autoimmune issue stemming from a fungus that needs to be eradicated. Once it's eradicated, immune systems bounce, things go back to normal and like you see that with other infections, like I wrote an article on my website about H pylori a case study on H pylori causing alopecia ariata so an autoimmune that causes you to lose your hair and I think that's gonna probably apply to the other ones too. What you wanna say about it?
Speaker 1:Yeah, no, I think you covered them in general. I mean, we're not gonna do a whole podcast on heavy metals and parasites right now or on yeast infections, but I think when it goes to that autoimmune disease, one thing for people need to know is it does include all tissue destruction. It's not just your thyroid that's getting damaged. Your thyroid is your screamer, it's the guy that's talking the loudest in the room, and that's why I like to actually lab test for thyroid so often.
Speaker 1:Even if you don't have a thyroid problem, if it starts to get mildly off, I can say, hey, there's some some type of inflammation or other system that's going wrong and we wanna make sure that that whole system is good. If you've got like I said, if you're like 45 years old and think you have arthritis, I mean you probably have tissue destruction everywhere. If you're 35 years old, a female, and have Hashimoto's, it's not just your thyroid that's getting damaged. There's a lot of inflammation in the system, now more towards the thyroid. But the old saying in different autoimmune courses that we've probably both taken is simply that you get one autoimmune disease, you get three autoimmune diseases, and so it's. And so, while I like that statement because it brings the awareness to patients. The reality is you only get three if you don't take care of the first one.
Speaker 2:Correct, so take your thyroid. I was liking it If I wanted to scare somebody to like a pack of wolves, and each wolf represents a different autoimmune, so it's only a matter of time.
Speaker 1:Yeah, but obviously if you take care of the leader or the wolf or the pack, the leader of the pack, the wolf kind of pack kind of dissipates or goes somewhere else or feels, in that analogy feels intimidated.
Speaker 1:But yeah, that's the story is like. If your thyroid antibodies are high and you get those to go down and you feel great, it's not like you need to develop a new autoimmune disease every week if you feel great, but it's when you don't feel great and you let that perpetuate that your health goes downhill. So, once again, just my encouragement for you to go and take care of your health those listening to the podcast and make sure that they are finding a doctor they can work with. That is truly holistic, not just someone that will write you a script. I get that phone call every day. I probably get that call five times a week. Hey, I need to refill my prescription. Will you guys do that for me?
Speaker 1:I saw that you treat thyroid in your office and it's like, oh, actually we won't do that for you and we don't want to do that for you, though we do realize that some people are on their medications already. In fact, probably 50% of women listening to this podcast are gonna be on a medication and, as I said in last podcast, the goal one is to feel good on your medication. Then we can decide if you can work with a practitioner and get off your medication. That's a whole different process than getting you to where you're functioning well and then once again getting off of. It depends on how long you've been taking that drug. All right. Any final thoughts on the thyroid today, doc?
Speaker 2:I don't know. I think we wrapped it up pretty well. I mean, this is the thyroid. It's important to deal with it. It's important to live healthy, good lifestyle. So that's just gonna be a general course of action that we're gonna take with everyone coming in.
Speaker 1:Great. So, like I said, both Dr Gabe andI are offering phone consultations right now and then you can find us on Instagram and that's where we got all these questions from. So we'll do these podcasts every couple of weeks and we are gonna ask you guys what questions do you have? The harder the question, the better, because those are the ones that don't get answered. We don't want to regurgitate the information that's online there and hopefully we said something today that irritates you, aggravates you or, even better, makes you think a little bit about your thyroid and makes you take some action to get healthier. But we will see you guys next week on the next podcast and find us on Instagram to ask some more questions. Thanks, doc Yep take care.