094: Why We All Need To Be Talking About Hypothyroidism w/ Elle Russ

094: Why We All Need To Be Talking About Hypothyroidism w/ Elle Russ

by Dr. Anna Cabeca July 14, 2019

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If you’ve been struggling with your weight, feeling sluggish, and getting no luck with a doctor’s diagnosis, you could still have thyroid disease. Unfortunately, most doctors don’t have all the answers when it comes to correctly diagnosing hypothyroidism. Today’s guest, Elle Russ, has taken her thyroid health into her own hands and now helps other women do the same. 

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Elle has developed and written The Paleo-Thyroid Solution after years of undiagnosed thyroid issues. She has been through it all with the medical system, including being patronized by doctors who are uneducated about thyroid disease. She is a regular on The Primal Blueprint podcast where she discusses thyroid health and the paleo diet.

An extraordinary amount of people have to figure out their thyroid problems on their own. Becoming your own thyroid advocate might be the only solution to your health problems. Therefore having a solid knowledge of what tests you should and shouldn’t take is essential.

Thyroid issues can be caused by a number of different lifestyle influences, some of which you may never have even considered. American diets are designed in a way that makes your body sugar-burning, which usually has a detrimental impact on your health. Optimizing your body to be fat-adapted, which takes at least a month, can already solve a number of health and thyroid issues.

Undiagnosed thyroid disease can have an impact on your mental health, and not just hormonal and chemical reasons. But there are other people out there who have solved their own hormone issues. Finding online communities and reading books, like The Paleo-Thyroid Solution and The Hormone Fix, can help exponentially.

How long can you go without food? Have you repeatedly been to the doctor without receiving any kind of diagnosis? Do you feel like you can’t go more than four hours without food?

In This Episode:

  • How the paleo-primal diet works to treat thyroid disease
  • What tests you should and shouldn’t take to diagnose thyroid disease
  • What type of influences can cause thyroid problems
  • How stress can affect your thyroid and hormones
  • Why there is more to thyroid treatment than taking medication
  • Why you need to take your health into your own hands and educate yourself
  • How your mental health can suffer when dealing with undiagnosed thyroid problems
  • What the difference is between a sugar-burning and fat-adapted body is
  • Why you need to deal with your hypothyroidism before becoming fat-adapted
  • How following your intuition when it comes to food can have a positive impact on your body

Subscribe to Couch Talk w/ Dr. Anna Cabeca on Youtube

Quotes:

“I didn’t realize I was basically eating and exercising my way into a Type 2 insulin-resistant situation.” (13:51)

“People sometimes get all of the tests they should, except the Reverse T3, and it’s just not comprehensive enough.” (25:06)

“Perseverance pays, no matter what. I wouldn’t be here right now if I was unwilling to accept this state of being.” (31:15)

“This is a feeling of not being able to live in your own skin. Every minute of the day sucks. And all you can do is wait to go to bed so you don’t have to exist.” (32:28)

Links

Get your free Thyroid Health Guide

Find Elle Russ Online 

Follow Elle Russ on Facebook |Instagram |Twitter 

Pick up your copy of The Paleo-Thyroid Solution

Book your Ulta Lab Tests

Join the KetoGreen Community on Facebook

Buy The Hormone Fix

 

Transcript:

Elle Russ:
One thing that people don't understand about hypothyroidism is that it's not that we're sad because our hair's falling out and we're getting fat. When a normal person just gets fat because they ate or whatever and they had a two-week vacation and they blew it, we all understand that feeling. This is a feeling of not being able to live in your own skin. Every minute of the day sucks and all you can do is wait to go to bed so that you don't have to exist. Honestly, I, like, tear up every time I talk about it, Dr. Anna, because there are days when I'm still so grateful that I don't feel as horrible as I did.

Dr. Anna Cabeca:
Hello, everyone. Dr. Anna Cabeca here. We have a really special episode of Catch Talk today. We are going into the paleo thyroid solution with Elle Russ. Let me tell you, we hit some really key points. Don't you want to know what testing you absolutely have to get for your thyroid? If you've been struggling on getting keto-adapted or checking on ketones or still having hunger and cravings, well we're going to hit on those issues too as well as the sad point of undiagnosed thyroid issues. We also go into the root causes. What is causing some of these symptoms like feeling cold, sluggish, the weight gain, the hair loss, the acne, the hormone imbalance symptoms with irregular cycles even?

Dr. Anna Cabeca:
Certainly, we're going deep in today. We hit some really great conversation pieces. I want to introduce to you today Elle Russ. I met her through Mark Sisson indirectly with The Daily Apple and the Primal Blueprint. I've been on the Primal Blueprint podcast and just love, love, love this woman. She is actually the fifth person in the world certified in ancestral health and is the leading voice of thyroid health in the paleo-primal and evolutionary health movements. She is the author of the bestselling book, the Paleo Thyroid Solution and writer of the award-winning documentary, Head Hunt Revisited, and much more. She lives and plays in Malibu, California. You can learn more about her and her work at ElleRuss.com. At the end, we have a special thyroid guide to give you guys. Thank you for listening and enjoy. Let me introduce you to Elle Russ. Welcome, Elle. Great to have you on my podcast.

Elle Russ:
Oh, I'm so happy to be here. You were so great on ours and we got so much great feedback from the show we did together. I love the product you sent me. I'm a fan of the matcha green powder. I love the taste. I put it in my shake up bottle when I'm going swimming and it's just delicious. I wouldn't say that if I didn't mean it.

Dr. Anna Cabeca:
Oh, no. Thank you so much. I appreciate it that and I know. I'm like, "Ah, I love your stuff too." We're going to get into that and I really want to draw in on your story and how you came to write this book, that's amazing the Paleo Thyroid Solution. Let's talk about what we're getting right in the common medical space and what we're getting really wrong so that we can stop the suffering. You yourself are a living, breathing, walking testimonial to getting it right.

Elle Russ:
It was a very lonely world for me. I don't have a medical degree. I'm not a doctor. I don't have a biology background. I live in Los Angeles, which is one of the best cities for doctors no matter where you are in the world. I could not find, over a decade and two sufferings through hypothyroidism, one was regular hypothyroidism, another one was a reverse T3 problem. Both times I could not get any doctor to test me correctly, diagnose me properly, and then the second issue didn't know how to treat and fix the problem. The reason I wrote a book and I became a subject expert is that I did it myself. I shouldn't have had to do that, but I had to order my thyroid hormones by myself. I used doctors for blood work and I dosed myself and became my own doctor.

Elle Russ:
Not something I recommend, but thousands and millions of patients all over the world have had to do this because they're in areas where they just cannot move forward with a doctor. It's a very scary place to be. When you are in this situation, and you feel left in the dust by the medical community or the medical community, in my situation, in certain instances, was telling me that I might kill myself or that I'd give myself a heart attack and all of these false fears that were unfounded. Anyway, I went through this journey. I suffered through two bouts of hypothyroidism over 10 years. Solved both of them on my own. Left in the dust by doctors. All on my own. When I say all on my own, I mean I spent $15,000 I didn't have at the time. I have a PPO. I had really great insurance. If I had to do that and get no answers ...

Elle Russ:
In fact, a lot of doctors screwed me up. I was misdiagnosed with polycystic ovarian syndrome. Now, someone says, "Well, how would you be misdiagnosed with that? I mean, you know, what kind of idiot doctor ..." No, no, no. If you were the doctor and you did the ultrasound you would have also said, "She has polycystic ovarian syndrome." I would have made the diagnosis too. However, the proper question that should have been asked after that is why is a 30 year old with no gynecological crappy history, perfect periods, suddenly having problems? Instead of patching up PCOS, they didn't look here. Once this once fixed, I have never had a gynecological problem since. As a result of not being tested correctly, being misdiagnosed and undiagnosed for two years, I developed a polyp and a fibroid in my uterus.

Elle Russ:
The fibroid, I was able to have a Chinese doctor, with acupuncture, get it out of my body. The polyp had to be surgically removed. I didn't have to go through all of that had my doctor in the beginning just not used 40-year-old outdated thyroid testing protocols. Again, I'm the victim of uninformed doctors. They're not all bad, but a lot of them are steeped in ego and entrenched in what they learned 30, 40 years ago. The ones like you and other people that are DOs, functional medicine doctors, integrative physicians, they're keeping up with the latest. When a patient keeps coming to them on Synthroid and says, "I'm still feeling horrible. I'm still feeling horrible," they don't say, "Well, not your thyroid."

Elle Russ:
My doctor on my book and other doctors should, in the spirit of geekiness over medicine say, "Let me try to figure this out. I'm getting a lot of patients on Synthroid here still complaining of hypothyroidism symptoms. Maybe there's something I should look into." Those are the doctors that found the answers. Those are the doctors that led to things like 3T3 and reverse T3 being tested. We can get into that. I'm happy to explain how the thyroid works. That's really my story and it shouldn't have had to happen to me. The other bestselling books that I love are written by thyroid patients for a reason. We've been through it. We struggled. Unfortunately, some of us have to experiment with dosing to get it right and then thankfully then educate some doctors to get it right. There's a lot of great doctors out there. Unfortunately, the majority of them are still uninformed.

Dr. Anna Cabeca:
Yeah. It's disappointing, right? Years and years of struggle. Being undiagnosed. Being told, "Well, you look healthy," or, "This is to be expected," or, "Maybe there's just a lot of stress." Hitting the underlying like, "This is how we test your thyroid. This is what we need to look at," and also the key parts of you pioneering the lifestyle and nutrition aspects to get you back in control of your health.

Elle Russ:
You know, Paleo Primal can absolutely correct a thyroid problem. I have literally seen people turn around Hashimoto's in six weeks. Now, when I say turn it around, do I mean that they're never in threat of having antibodies get high in their life? No. But I mean someone who's bloated, miserable, brain fog, all the hypo symptoms, was eating a bunch of gluten, just wasn't good diet, super bloated and fat, had a come to Jesus with me, one of my friends, got them optimized on some nutrients. Literally six weeks later this person was deflated like 10 pounds, hair gorgeous, eyes bright. Just that paleo effect. Where we met, primal health coach came up to me and said, "You know what? My thyroid was so off after having a baby," which happens often.

Elle Russ:
She just got it together with the diet and that's the only part of my book she needed to use to get better. Sometimes that's all you need. One of the things I want to explain here is when people see the Paleo Thyroid Solution they think, "Oh, I get it. You were hypothyroid. You got really fat. Then you used paleo to lose the weight." That is part of it because most hypothyroid patients often become insulin resistant just based on this horrible metabolic inefficiency. Then they kind of get towards type two, which is what I did. You get pre-diabetic. Then once you fix the thyroid, let's say, with hormone replacement, for example. Then where are you? If you're still following the same diet carbohydrate dependency program, those thyroid hormones are not going to get metabolized properly.

Elle Russ:
Paleo Primal Ancestral is not a gimmick about, "Oh, this is the way you lose weight." That is part of it. The other part that people don't really understand, here's the connection that this book made and why I decided to write it, because there was nothing out there making this connection, is Paleo Primal Ancestral, or being fat-adapted, or even keto, is the most incredible and it's the most efficient when it comes to glucose efficiency and also adrenal efficiency. Adrenals and glucose, cortisol, thyroid, they all go together. This is about if you're taking exogenous thyroid hormones like me every day, to not be hypothyroid, or you kick your own back into gear and get it working right, however, the thyroid hormones are being delivered. Through your own thyroid because you're good or because I'm taking them, they need to get to where they need to go.

Elle Russ:
Without proper ferritin, which is iron storage, without proper vitamin D and B and other levels, it just can't get to where it needs to go. You can give a patient all the thyroid hormones you want and then they keep going back to the doctor and they go, "I don't feel well," and the doctor goes, "Well, I don't know what to tell you. Your thyroid looks fine." Well, it doesn't.

Dr. Anna Cabeca:
Right. Not just where it needs to go, but converting properly.

Elle Russ:
[crosstalk 00:09:38] Yeah. I have a conversion issue.

Dr. Anna Cabeca:
Oh, you do?

Elle Russ:
I mean, I've had a conversion issue for eight years.

Dr. Anna Cabeca:
That's where you look at a TSH and a 3T4, even, and you're like, "Oh, well it looks good, but what's the 3T3? What's the reverse T3? What's going with thyroid antibodies? Let's go back. I want to jump back into your story a little bit. You were 30 experiencing problems. All of a sudden, healthy, healthy and then 30 experiencing problems because you modeled and you did all kinds of amazing stuff, right?

Elle Russ:
Yeah, so 30 years old. This is where it often manifests itself with women, gynecologically. Infertility, miscarriages, anything down there that's off. I started to get my period all the time. I wasn't on the birth control pill. I got it every two weeks. I just chalked it up to, "Okay, that's a fluke." Then it kept happening. The moment I went into the doctor, all he did was take my TSH, the absolute insanely wrong test to solely ... You never use TSH to solely diagnose a thyroid problem but that's a 1973 test. The doctor kept testing my TSH. He says, "You're absolutely fine. Work out more and eat less." I said, "I'm working out two hours a day and I'm eating 800 calories. I'm gaining weight. My hair's falling out." I had horrible, horrible acne. I also had horrific blood clots that kept falling out of me because of this bleeding situation.

Elle Russ:
Again, developed a fibroid and a polyp. He put me on three different levels of birth control pills and I kept bleeding through. First of all, the birth control pill robs you of testosterone in your thyroid anyway, so not really a great idea anyway. Because he was using a 1973 outdated test and he was an uninformed doctor, he kept patching up a problem that was not to be patched. It was to be solved from the root, which is right here. The thyroid gland is the master gland. It is involved in the production and regulation of all of your sex hormones. If you're out there and you're like, "Oh, my hormones are off," and some doctor wants to give you exogenous hormones, check the thyroid first. Same with any mental issues. Depression. We have more T3 receptors in our brain than anywhere else.

Elle Russ:
You can even treat depression with T3. If someone's depressed or feeling bipolar or ups and downs, you can get on a Prozac with your doctor and it won't work three months later because you never got to the root. Same with the guy who walks in with low testosterone. Doctor fails to check his thyroid properly, just puts him on testosterone. Let's not introduce exogenous hormones and shut down feedback loops unless it's absolutely necessary. We want our body to work in the way that it's endocrinely meant to be. I'll let you go from there. I could go on forever.

Dr. Anna Cabeca:
I know, I know. I love it too because you're making very, very solid points. Okay, this is the symptom. What's the cause of the symptom versus how do we treat the symptom? We want to go it at both ways. I also want to get to the cause of your thyroid disorder. Was it heavy metal toxicity? Amalgams? Was it a high amount of stress? Was it supplementation? Was it mold toxicity? What do you think triggered? Because you were fine until 30. What triggered it then? What do you think built up or triggered it?

Elle Russ:
I can't say for sure. No one in my family has thyroid problems so it's clearly not something that was hereditary. I was following the anti-ancestral paradigm. I was going against everything Mark Sisson ever says. I was doing chronic cardio. I was doing a low carb, low-fat zone situation. Keep the insulin steady, which is basically a sugar burner. Basically, carbohydrate dependent. Now again, to my credit, I'm 45 now, back then couldn't have even Googled Paleo Primal. The only thing close to it was Atkins and I tried that and I got super fat. Again, we can talk about this later, but with high-fat diets, if they don't work you got to check your metabolic baseline, such as thyroid. Moving down this road, when I looked back there were a few things that were off.

Elle Russ:
I did have a selenium deficiency, it turns out, and CoQ10. Now, did my overexercising, crappy diet, lack of cholesterol and fat possibly lead to that? Sure. We don't know which came first. I also used to be a cigarette smoker. Okay, some people say that can affect TSH. I'm not anymore, but I was, so there's that. I worked out a lot and I under ate, but again I thought that this was the paradigm you should follow because that's what was out there. I didn't realize I basically was eating and exercising my way into a type two insulin resistant situation. Did that storm. Again, euthyroid thyroid sick syndrome because starving oneself, whether you think you are or not, but we can be starving yourself by not getting the proper macros, that can lead to low TSH, low 3T3, low 3T4.

Elle Russ:
I will say this though. Growing up, and this could have been diet dependent, I'm from Chicago. We ate a lot of cheese and bread, stuff like that, growing up there was a doctor who looked at my thyroid and looked at me and said, "Have you ever had your thyroid checked?" It never went beyond there. But when I look back, I wonder. I see some years where I'd be really puffy and exhausted and thyroid-y and then other times when I wasn't. I'm wondering, was that food dependent then? Do we know? I didn't know anything about grains. I didn't know about dairy effecting me or being inflammatory. I can't say what brought it on, but I can say that for sure it was compounded by that lifestyle. I really didn't have a lot of stress at that time at all, other than just exercise stress and eating stress.

Elle Russ:
When things all fell apart, and this is where we can eventually go into keto, but when things fell apart I thought, "Oh my God. I'm getting so fat and bloated. No one says it's my thyroid. They say keep working out." I try Atkins, which again, high fat, low carb, moderate protein, keto type of diet. But it doesn't distinguish between quality food so I was eating a lot of cheese and a lot of dairy in there. I kept getting fatter and fatter, which to everyone listening, if you try any kind of dietary paradigm, or keto, or low carb/high fat and you start getting fatter and fatter, you're either doing it significantly wrong or you do have an issue at the baseline. A lot of people go to keto as a last resort because nothing works. Nothing works. But that also won't work if your thyroid's not in order. I get this question almost every day from people. They're like, "I went keto and I just keep getting fatter." Let's check the -

Dr. Anna Cabeca:
Or you're eating a food sensitivity, right? Because of that dairy, that food sensitivity, the exogenous hormones from dairy too affecting thyroid and if there is that chronic inflammatory messaging going on, your thyroid's going to want to protect you, put you into some hibernative state.

Elle Russ:
Yeah and that includes even like chemicals we put in our body and also I swam every day, in chlorine, every day leading up to that. Did the chlorine antagonize my thyroid along with all the things I was doing? Possibly.

Dr. Anna Cabeca:
Well, that's a key thing to mention because chlorine competes with the iodine receptors, the same as bromine, that has been in our food. Chlorine directly competes with iodine. I've had several patients that were swimmers and hypothyroid and tried to switch to saltwater swimming, just change it up, and then again replacing iodine. That's a key toxin.

Elle Russ:
Yeah, I had to stop swimming. Well, here's the thing. I still swim. I try to rub coconut oil all over my body first to protect it because about after half an hour probably the people at my gym aren't happy about that move. I do that. I swim less because I don't want to be ... Then also afterward I do make sure to scrub off and steam and sauna and do my best. If I do swim, I might take some modified citrus pectin or do some kind of hack that would be like ... Also, too, I did have a mouthful of silver fillings at some point. They were all replaced though way before I got hypothyroidism. It's been -

Dr. Anna Cabeca:
How long before?

Elle Russ:
Gosh, I mean, at least 10 years, if not more, before. But here's the thing, I had one left in the back of my mouth, a big one, that I didn't find out until about a year and a half ago. And I did have heavy metals. I'm a lifetime sushi tuna eater and then who knows during what periods I might have been hypo or, again, not nutritionally efficient and probably not detoxing, whatever. I had to go through about five months, a little bit longer, or a natural coalition, doing sauna. That is absolutely a factor in reverse T3, mitochondrial function, weight loss. It's the first question I ask everyone I talk to. Hey, do you still have silver fillings in your mouth? You know, you learn this over time and there's only so much you can do with the money you have. You've got to start somewhere.

Elle Russ:
You can still get on thyroid hormone if you had to while having all these issues. Then the goal is you get un-hypo like me and then you solve all of these issues in the background and then you can decide what to do with medication at that point, particularly in a reverse T3 situation where you have to take T3 only. For example, I've had no T4 in my body, roughly, for seven years. My TSH has been suppressed for over 15. In that situation, T3's not ideal. It's the last resort. We can get into that later. It's really not optimal. However, it is the only shot I had to become un-hypo and then work on the underlying things. Now I can go back and try to attempt to wean off T3 when we get back on a T4/T3 combo if I wanted to. Whether I do or not, I'm not sure.

Elle Russ:
I've tried a couple of times getting off T3 and there's still some sort of issue there. I might attempt it at some point but again, each time I go through these attempts there is a possibility your brain and things don't work as well, so you got to time it right in life for what you're working on. I didn't want to do any of these experiments when I was writing a book, so I waited 'til afterward. I've tried to get off the thyroid hormone a couple of different times in my life and it's always failed. On that note, though I used to be on a very high amount of medication and now I am on much less. Which is cheaper, it's easier and when we talk about thyroid hormones, I clearly mean minimum effective dose. This is Goldilocks. You don't want to overshoot it. I've been hyper. That is not good. It feels awful.

Elle Russ:
It's also inflammatory and bloating. You can't get into keto when you're hyper and you can't get into keto when you're hypo. It's almost impossible on both ends because of the way it affects cortisol and blood glucose with the T3. Plus, too much T3 is catabolic. The game here is really to become metabolically efficient as possible through a paleo-primal ancestral paradigm of some kind. Then as you become metabolically efficient, you become calorically efficient, as Mark Sisson talks about. We then need fewer calories to function. In that process then you become what I have coined and called T3 efficiency, where you ultimately then will need less T3 to function than you did before.

Elle Russ:
In the keto world, there are people that say, "Oh my God, I went keto and my T3 moved down." My question is, "Are you hypo? Do you have symptoms? How are your temps?" Because you just might be T3 efficient. There's a guy, Paleo FX, I'm not sure if you met him at the speaker dinner, his name's Tony Federico. He used to be the host for Paleo Magazine. He's written a book. He's been in our industry awhile. He had his thyroid removed a long time ago. He takes natural desiccated thyroid in the form of Armour. His 3T3 is a couple of points below the mid-range, which is very rare for people optimized on NDT. They are often mid-range or above the mid-range. I asked him, I said, "How are you feeling? How are your temps because you have room for more if you need it?" He goes, "I feel great. Everything's awesome."

Elle Russ:
Then it dawned on me. That's because Tony is T3 efficient. This guy is so dialed in with his health and his anti-inflammatory situation that for him, he can run on a little than even Mark Sisson without taking thyroid hormones, who might need to be at a 3.1 of a 3T3. Again, just because something has lowered on a test does not mean a diagnosis. Just as someone with a higher 3T3 is not hyperthyroid just because of the lab. There are overstimulation symptoms to be checked. I know people that have to be at the very top of the range of 3T3 in order to actually do well. I know people that have to take five grains a day of thyroid and then I know people who are huge dudes that get away with one grain of thyroid hormone. It's not about size. It's not about the amount. It's about what do you need? If I literally hear another doctor go, "Oh, that's kind of too much," no. It's not about the amount of pills in your hand, it's what is that doing to the person? Again, sticking -

Dr. Anna Cabeca:
As long as we're addressing the underlying issues, so that we're looking at, "Okay, is this too much temporarily because we've got to create some metabolic efficiency?" That's really a key point that you brought up. I want to just stop for a minute and go into this testing. As a physician, one thing that we're told is that, okay, initially TSH, that's what you use to look at thyroid. We look at TSH in pregnancy. As I learned, well TSH is just also a symptom, and it's one of a bucket of thyroid hormones and we need to look at that. Guys listening, write this down, this is key. This is an important thing to remember. We're talking hormones here but it takes more than hormones to fix your hormones. Like Elle has put into place with her Paleo Thyroid Solution, I mean there is more to it than taking a hormone for this part of the picture and always asking, "What's the cause?" Eventually, we got to get to the cause too.

Elle Russ:
[crosstalk 00:22:48] I just want to clarify one thing. TSH is actually not a thyroid hormone. It's a pituitary signal. It's the only biologically active thyroid hormones is T3, actually. Everything else is in support of that or around it. That's where it gets tricky because some people think that that's actually a thyroid hormone. Again, thyroid stimulating hormone, that's what it's called, but essentially we need to consider it as a wake-up call, a signal from the pituitary. Anyway, go ahead, I can explain ...

Dr. Anna Cabeca:
Yes. Above that, there's a thyrotropin-releasing hormone. We typically don't measure that at all, but something to take into consideration. We look at TSH. Want to look at that to see what's going on. Looking at 3T4, 3T3. Look at reverse T3, thyroid antibodies, so thyroid peroxidase antibodies and antithyroglobulin antibodies. That's pretty much the core. When we think of what's the basic thyroid profile? That's your basic thyroid profile. That's the basic.

Elle Russ:
That's right. That's the basic. That's where you start.

Dr. Anna Cabeca:
It's where you start.

Elle Russ:
By the way, anyone listening, if you've been on Synthroid for a long time, or you keep complaining about stuff, I bet you a million dollars, go back to your test. I bet you your endocrinologist only tested your TSH and your T4 for the past decade. That happens often. People need to hear what you just said. Those six tests are the primary, let's start there and we can see. Now there's peripherals. Like of course ferritin is critical to get and B12 and vitamin D. There's some other ones, of course, as you know. Like you said, those are the basics and that's where you have to start.

Elle Russ:
If you're missing a reverse T3 test and someone tries to put you on medication, whoa. You might be taking five steps backward and you need to get that reverse T3 test. Now, there's been a little bit of disagreement in the thyroid community, some people. We always used to do a ratio between the 3T3 and the reverse T3. There's an online calculator for that. Usually, a ratio of 20 and higher is best. If it's 18, okay, they can take some selenium, it might get better. But if it was like me and your ratio's 11, you're in big trouble and you need a different form of thyroid hormone replacement treatment. If you don't and your doctor just puts you on a T4 containing medication, you have a reverse T3 problem, you are going to get horrifically worse. People sometimes get all of those tests except the reverse T3 and it's just not comprehensive to miss out.

Dr. Anna Cabeca:
We may get it right because we're going to supplement with T4/T3, so we may get it right because we're giving T3, but still, you want to look at that, want to look at that reverse T3. I just want to let you know because Elle, as you've done your work, again it's going to take 20 years. We typically say for a standard of medicine to change and especially with big pharma and insurance companies dictating what physicians can and can't do. Physicians will have to pay out of pocket for tests that the insurance companies don't ... The insurance company doesn't believe is warranted for you. They will come back and collect money. This has happened time and time again. Ultimately, I want to empower each and every one of you to be in charge.

Dr. Anna Cabeca:
You can order tests yourself. I think that's really key. I'll give the link right now, put it in the show notes, but ultalabtests.com/dr.annacabeca and you'll see that panel. But you can order tests yourself. You're investigating, you're hitting a wall. You've got to take your own health. I don't care what kind of insurance you have because they're not ... Not my experience that they're looking out for your best interest and most functional medicine doctors are concierge practices, are very high end, very expensive. That's because we know what it's like to have to fight for a patient and get denied from an insurance company. Your physician doesn't want to do that either. We just can't deal with the insurance companies dictating what's best for you as a patient, as a woman, as a man, as a child.

Elle Russ:
I just want to highlight that. Here's the thing though. This is what I talk about. I've had lots of really interesting doctor experiences, but I'll give you one that really is an example of being patronized by the doctor and feeling uncomfortable to speak up. I went into an endocrinologist with a woman who worked for our company who didn't speak very good English. I suspected she had a reverse T3 problem. She had been on Synthroid for three years. They wanted to put her on blood medication, statins, side note, you've got a bad lipid panel? Thyroid. Check it. I also had a bad lipid panel when I was hypothyroid. You fix the thyroid problem, your body starts metabolizing fat just fine. You don't need to go on a statin for that. Blood pressure, same thing. Blood pressure you -

Dr. Anna Cabeca:
With the high cholesterol, abnormal lipids, there's the triad. There's the heavy metals, candida, and thyroid. Those three, if you've got high cholesterol, thyroid issue and/or candida, that triad, you know you've got heavy metals. Thinking what's causing it? Again, what's causing it? It's a good point.

Elle Russ:
Going back to the root of this, anyway, we go to this doctor. Aside from statins, blood pressure, high blood pressure usually equals insulin resistance and that's also screwed up by lack of thyroid hormone metabolism and optimization. Again, if anyone tries to prescribe you a pill, you go right here first to discount because this is the root. Anyway, I go into this endocrinologist and I really suspected that the patient had a reverse T3 issue. She was not converting this T4 she'd been taking. She was feeling miserable, crying all the time. I take her in there and the endocrinologist didn't even look her in the eye or ask her one question about her symptoms.

Elle Russ:
Then I said to the endocrinologist, "Hey, listen, I'd really like you to test this patient's reverse T3." She looked at me and in the crappiest, most patronizing way, said, "Uh, yeah. We don't test that. That's old school." I said, "Well, hold on a minute. I just got over a very serious reverse T3 problem so that seems pretty F-ing new school to me. All I'm asking is that you just please take a reverse T3 test." This was her response, "Fine but I don't know how to evaluate it." Then I said to her, "Did you just patronize me about asking you for a test that now we finding out you don't even know what it is?" Dr. Anna, there are people listening right now that understand, this is horrible to be there, having to fight. Now I already had the emotional wherewithal because I was un-hypo. This poor patient sobbing, sitting there. This doctor didn't ... She goes, "Fine." Guess what? She tested the reverse T3. What do you think the result was?

Dr. Anna Cabeca:
Really bad.

Elle Russ:
Of course, she had a reverse T3 problem. Then I begged her to give her a little bit of T3 with the Synthroid. I was like, "Can you give her at least five? I mean anything." She wasn't willing to do ...

Dr. Anna Cabeca:
[crosstalk 00:29:29] Five micrograms.

Elle Russ:
It was just so sad. We walked out of there bawling our eyes out. I was just so angry, again, again, again. You see as you're listening to how horrible this is for a patient to go in and get discounted like that. What if I weren't a strong personality that could speak up like that or had that level of logic and articulation to explain that to her? She knew she was busted at that moment because that's an insane thing to say. If you called me today and was like, "Do not go see the new Avengers movie." I'd be like, "Oh why, did you hate it?" If your answer was, "I didn't even see it." Are you kidding me?

Dr. Anna Cabeca:
There's no validity there. I think that's really -

Elle Russ:
This is really awful. I want to explain that to people. This is hard to deal with. You're dealing with egos. You're dealing with some stuff here that's tough.

Dr. Anna Cabeca:
You're dealing with a broken medical system because again, endocrinologists have been some of the hardest people that I've had to deal with as a gynecologist and obstetrician advocate for my patients. It's been like, "Okay, well you know what? I'm just going to manage your thyroid. I'm just going to manage your diabetes. I'm going to manage your endocrine issues." They weren't getting well managed. It's something to consider. There's more to the picture. There's more to the picture than what's been taught. It's very sad. It's absolutely very sad. Everyone listening, taking a deep breath, just take a deep breath and just know that look, you guys, you are empowered.

Dr. Anna Cabeca:
You're being empowered every day even just by listening to this podcast right now, for sure, but getting books that help educate you and starting to take your power back. Don't give it away. Learn everything that you can do. If you're hitting a wall with medical care, keep looking because there's other ones out there that know this, that we're bringing to you. There's so much that you can do on your own, even, that's truly life-saving.

Elle Russ:
Perseverance pays no matter what. I wouldn't be here right now if I was unwilling to accept this state of being. While I am happy and look normal to you and have hair and everything, I was riddled with acne. My hair was falling out. I had gained, I'm now about 118 pounds, I'm 5'2", I was 160 with working out and trying my best. Again, the gynecological issues, what it did to my brain, my skin. It was two years of misery. And then again, further misery with the reverse T3 problem. Clearly, I was meant to go through this to help people but I will tell you this. I've never been suicidal but I as I was going through this, two years of undiagnosed and kept falling apart, I really did have the thought because I went to over two dozen endocrinologists and doctors. Nobody helped me.

Elle Russ:
They failed me or hurt me. I remember sitting in my place being like, "If I don't start to find an answer to this, I'm going to have to start thinking about thinking about killing myself." One thing that people don't understand about hypothyroidism is that it's not that we're sad because our hair's falling out and we're getting fat. When a normal person just gets fat because they ate or whatever and they had a two-week vacation and they blew it, we all understand that feeling. This is a feeling of not being able to live in your own skin. Every minute of the day sucks and all you can do is wait to go to bed so you don't have to exist. Honestly, I tear up every time I talk about it, Dr. Anna, because there are days when I'm still so grateful that I don't feel as horrible as I did. When people call me or come up to me crying at Paleo FX, I understand this on a deep level.

Elle Russ:
It is demoralizing. It's embarrassing. It's horrible. You don't know what's happening to you. Doctors are telling you you're wrong. You don't have a thyroid problem. People think you're crazy. I once had a, mentioned it in the book, I had a family member that yelled at me and said, "You know, one of these days you're just going to have to listen to one of these doctors." You know what? I'm glad I didn't or I'd probably dead by now. Again, you have to have faith in yourself. It was very scary. I thankfully had the help of other patients and authors. Janie Bowthorpe who wrote Stop the Thyroid Madness, she saved my life. Before that book came out, in 2006, she had a natural thyroid hormones Yahoo Group. Free group, still available, where you can post labs, talk to fellow patients.

Elle Russ:
You have to take stuff at face value there, of course, but at the end of the day, it was other patients that helped me get to where I needed to go. If it weren't for them, I'd probably be dead now. Now here I am paying it forward, as a patient advocate and someone who, here's the bottom line, doesn't matter what you're experiencing in terms of symptoms. If you've been diagnosed with something please don't put it in the hands of a doctor completely. You have to learn about this. You have to become your own expert. You might be able to help your doctor help you. It's not to say that every doctor you go to is going to be ignorant. Then what if the doctor that's awesome retires? Okay, now what?

Elle Russ:
99% of the people that take thyroid hormones cannot explain to me how the thyroid works or what they're doing into their body. That is dumb city. We have to step up. I was that dumb patient too. My doctor said hit my gym shoes and said, "Work out more and eat less. Everything's fine," after just looking at a TSH and I believed him. I'll tell you this, years later I saw him in a pharmacy. I walked in and I saw that doctor. I literally just started bawling crying and ran out. I had to go to my car and I just sobbed. Because I was looking at this doctor who kept me sick because of his uninformed not willing to go further, and just being uninformed. Then also doing all these things with me, the pills, all this stuff, discounting me.

Elle Russ:
At the end of the day, I had to do a lot of work to forgive doctors, realizing they are where they're at with their learning curve. This is why you have to step up as a patient. Also, too, what we've seen is when you're more compliant, you're on it, you're taking records, you're detailing symptoms, a doctor is more willing to practice medicine with you. I suggest everyone, you've got to write out on a separate piece of paper. There's not enough room on the intake form. Type it out. What are you taking, what time of day? Do your temps. Show that you are going to fix this. That doctor's probably more willing to trust you if you suggest something that might be out of their realm.

Dr. Anna Cabeca:
For me, way back in 1999, someone brought me a book, written by Christiane Northrup, Women's Bodies, Women's Wisdom. I suggest you all listening too, get your doctor this book. This is awesome, the Paleo Thyroid Solution and The Hormone Fix. It is written to ...

Elle Russ:
My book.

Dr. Anna Cabeca:
... empower you individually but also to inform outside the box. I know Elle agrees. I say this all the time. I would never want anyone else to take the journey that I've been on to learn what I know. Take it from us. We've got to work as a team and as a community to help inspire and also change the medical system. Elle, let's go into let's fix this. Let's talk about the Paleo Thyroid Solution. What do we do? We're listening and we're getting our thyroids tested because we're doing that ourselves because we're empowering our health.

Dr. Anna Cabeca:
We're going to be our own detective and watch things even more frequently than what we do in medicine. Maybe it's every six weeks we're checking as opposed to every six months, or three months. We're going to follow our labs, follow our temps, free to do that, follow your temps. We're going to solve this issue. Where we're digging on the root and now we're going to take action. What can we do right now?

Elle Russ:
The first thing you have to understand is that if you're hypothyroid, whether you can turn around naturally or not, but if you're in that state it is a state of pretty much no metabolism or very crappy metabolism, very crappy fat burning abilities. In order to start to move towards fixing that, which could in and of itself fix the thyroid problem, but if not you're doing what you need to do to prepare your body for thyroid hormones in the event that that's the choice that has to be made. That's what's in the book. Everyone should follow the natural protocol because again, it could either fix it entirely or then you've just prepped your body to really receive the last choice, which is, "Okay, not I have to go on thyroid hormones." What does that mean? That means getting off of becoming a sugar burner. In the paleo-primal world, we talk about sugar burner and fat burner.

Elle Russ:
Most of the world is a sugar burner. How do we know? Because of type two diabetes. We know because of all the glucose-regulating medication and commercials we see on television. Our standard American Diet Food Pyramid, issued by the government, is a diabetes making diet. It suggests basically like three to 400 plus grams of carbs a day. You'll eventually get insulin resistant with that kind of things. That's not what our DNA as humans expect of us or dictates of us. It actually prefers fat as a primary fuel. It also uses glucose and we need that, but not as much as people think. How do you know if you're a sugar burner? It's so easy. Can you go right now for the next 12 hours and not have a hangry meltdown in either mental energy, mood, physical, headache, whatever, brain hurting, I really want to eat? I can. I can because I'm fat adapted.

Elle Russ:
Because if I don't eat for the next two days, I'm fine. There might be one uncomfortable moment where I'm a little hungry but I won't suffer anywhere else. I won't catabolize muscle. I won't suffer. I won't have a drop in energy because I'm fat adapted and my body goes, "Oh, she doesn't have fuel. We'll use the fat off of her thighs right now to get her going." When you are a sugar burner you have made yourself dependent on carbohydrates. If you don't eat every four hours, and this is where people on a plane flight, four or three hours in, have to have the Pringles, have to have the ... They eat the Pringles and they feel better and they go, "Oh, well then this is how that goes."

Elle Russ:
My doctor in my book would say, "Well, the same thing happens when you do heroin and you're coming down off of heroin. If you do a little heroin, yeah you're going to feel better. That doesn't make it good." Our ancestors, and in general this is the model of our DNA, are really meant to be in a fluid metabolic flexibility state were low carb, mostly keto, our ancestors were. Being able to go in and out of that comfortably, but it requires getting fat adapted. That can take a month. We've got to clean out the cupboard. We've got to get rid of the industrial seed oils. Anyone can Google Paleo Primal. You can go to ThePrimalBlueprint.com, Mark's Daily Apple, free food plans, things like that, to give you an idea of what that means.

Elle Russ:
That means you're switching the oatmeal in the morning and the cereal and all that kind of junk with maybe an egg omelet or half an avocado or nothing, eventually, moving to an intermittent fasting eating window that most of us naturally gravitate to when we become low carb. It's not something that happens right away but you find out as a sugar burner, as you get more fat adapted, you start to wake up and you're not hungry like you used to be. Why is being a sugar burner bad other than what it ... Okay, so every time you're having a drop of glucose, you're on the plane and three and a half hours hit and now you're getting hangry, you're moody, you're exhausted and you need to eat the Pringles, okay, when it drops cortisol, your adrenals, it doesn't like that.

Elle Russ:
It will respond and send cortisol out. It doesn't like the highs and the lows. Every time that happens you're really interfering with all of your workouts. You're interfering with thyroid hormone metabolism and basically every metabolic process in your body. To be Paleo Primal is the ultimate in glucose management and adrenal management. It's the ultimate in steadiness that allows your body to then, whether it's autophagy because of fasting, or whether it's now you're optimizing thyroid hormones and also the minimum effective dose. I used to be on 100 micrograms of T3. I'm now on about 15 a day. That is a huge drop. It's not to say I was on too much then.

Elle Russ:
I was just so metabolically wrong and off at that point and such a pre-diabetic sugar burner that it probably took that much to even effect and get into cells and do its job. Whereas now that I have become more efficient over these years, cleaned everything up, I need a lower dose, which by the way is a lot cheaper. It doesn't matter how much you have to be on, but it is a lot cheaper, so thank God for that. We want to move towards this but I will say this. People who are hypothyroid can't totally get fat adapted. Here's the thing. If you're hypothyroid because you destroyed yourself with food or whatever, then yes, moving to a Paleo-Primal will reverse that, make you insulin sensitive and you should be fine. Hence, obesity, obesity and type two and thyroid get hand in hand. If you get to that point, your thyroid's usually off as well.

Elle Russ:
That can happen. You can correct that. If you didn't get there that way, then sometimes in that situation that can work, where you reduce the calories. I wanted to say that some people get very frustrated because until they fix their hypo, hypo is a state of no metabolism so sometimes it's hard to get the appetite under control. In the Paleo-Primal world, when we talk about getting fat adapted and the appetite suppression that happens, we're talking about that being a platform on a normal body with normal metabolism that can get into that state. I just tell patients, you have to just be a little bit patient. You start to clean out the cupboard. You still may crave carbs because your adrenals are suffering because you don't have enough T3 and your body's looking for energy.

Elle Russ:
You can still be in a state of food obsession and extreme willpower as you're getting better, that's kind of normal because until that T3 level gets to where it needs to be, or you get un-hypo in whatever way that is, then you can actually fully get fat adapted where all of these things apply, where you don't think about food, da, da, da, da, da, da, da. I hope that makes sense because I don't want people to lose hope. Sometimes you just can't get fully fat adapted, but you want to try because that could reverse the hypo. Then if it doesn't, at least you've gotten there and you've prepared yourself and optimized your nutrients so that if you have to take thyroid hormone eight weeks later or however long you decide to try, they will be received in the most optimal way. Did that make sense?

Dr. Anna Cabeca:
Yeah, no, that's great. I think just explaining sugar burning versus fat burning, fat adapted. That's critical. Especially as we hit midlife, 35 and on, 40 and on, using ketones for fuel in the brain, that's the ideal fuel source. We need to do that periodically, intermittently, chronically. We just need to really get that feeling and consistently get our body so that we become more insulin sensitive and we're able to use ketones for fuel. Of course, thyroid and insulin go hand in hand. It goes, again, back to the key thinking, underlying, underlying, the health of the receptor sites for our hormones. Cleaning that up. Let's talk. We're going to move to the fat adapted and how does this work? How does this work in your world?

Elle Russ:
You mean like what my schedule of life is?

Dr. Anna Cabeca:
Yes.

Elle Russ:
When I first started, I made a whole bunch of mistakes. I didn't understand what was going on. I ate way too many nuts. I overate fat. I overate protein. I did all of the mistakes you can imagine. Then finally, okay, I figured it out. Being a Primal health coach helped with that, obviously. It really depends. I'm very much in the camps of once you clean stuff up, you move to a place where you're intuitive. If I feel like eating an apple, I'd eat an apple. I don't worry about whether it's in my macros or what my day was like, I eat the apple. I'm at a point though where I trust that intuition. That intuition cannot be trust from a metabolic crappy platform. You know what I'm saying? Because then your adrenals are just telling you, you need donuts, right? It's not very intuitive.

Elle Russ:
I wake up and I have fasted. I might have a cup of coffee or so. It's rare that I eat before a workout. However, sometimes to take a B12 or something else, I might have a spoonful of coconut butter. I might have a quarter of an avocado. I might have a bone broth latte, which if you didn't try them at Paleo FX, basically it's chicken bone broth heated and you put it in a blender with a little coconut oil, a little turmeric, and a little ghee. It is this delicious almost meal replacement of a drink. Then I usually go workout at some point in the morning and I work out fasted. After my workout -

Dr. Anna Cabeca:
Wait. You got to slow down.

Elle Russ:
Sorry.

Dr. Anna Cabeca:
I've got to write this down too. So chicken broth heated.

Elle Russ:
Yeah. So basically you use 16 ounces of chicken broth heated. This will make two servings. Then one tablespoon of coconut oil, one tablespoon of ghee and a quarter teaspoon of ground turmeric and a pinch of salt and a little squeeze of lemon. You just put all those things, other than the bone broth, in the blender. When the bone broth is hot, you pour it in the blender. Blend it up. It's this frothy, creamy, foamy, delicious bone broth latte that Bonafide Bone Broth was making at Paleo FX last year. That could be a really yummy winter time or great meal replacement that's yummy and different. I mean, I may grab other protein and fat. I usually don't eat carbs in the morning.

Elle Russ:
Again, there's a little bit of carbs in coconut butter. It's a little bit. Then after my workout, I usually steam or sauna or something at my gym and I will have a green drink. I'll either have yours with ice mixed also with more greens from Organify. I will also sometimes throw a scoop of Primal Kitchen unflavored Collagen in there with your greens. Shake it up. I just drink that, mostly because I like it and I want to get that stuff in me, not intentionally because after a workout I feel that that's a thing. I have an eating window of like one or two to six or seven. I don't really even like to eat before two. However, this is where intuition comes in. I live in an area with wild peacocks, which is really cute.

Elle Russ:
It's springtime and they're all mating and one of them was honking underneath my bedroom window at like four in the morning. I got up early this day and I'm all off with my thing. I was actually really hungry around 10:30. I'm not normally. I don't even like eating at that time. I was resisting this intuition to eat at that time. I was really craving eggs and sausage and some fatty meats. I honored it. It threw off my day. I didn't like it because I'm a creature of habit and discipline and things like that that I like, my thing. I did it because the overwhelming intuition told me, "No. Your body is telling you to do this. Do it whether you want to or not." I really did want to wait four more hours to eat. I didn't like the way that threw off my day, but I did it. You have to follow intuition at some point. Essentially, I like the idea of a six to eight eating window and that means like -

Dr. Anna Cabeca:
Now, you worked up to this. This has been a process of years of working up to this and healing thyroid and cleaning up your receptors and doing all these other things. This has been a process to work up to. I typically tell clients, "We're going to start at 13 to 15. Let's start there. Let's work on getting our hormones balanced. We're eating, not snacking in between meals." Those concepts. Going to 16 to 18-hour fasting, don't do that right off.

Elle Russ:
Nope.

Dr. Anna Cabeca:
You're detoxing a lot.

Elle Russ:
[crosstalk 00:48:30] The other reason not to do it is if your cortisol and adrenals are suffering, it's just not ... Again, you're trying to put a normal metabolism person platform onto a body that is not operating correctly, so it's not really going to work. I don't suggest people do intermittent fasting almost at all until they are at a better road here. Again, you're going to have these cravings. Like I said, if you're still hypo and you have thyroid and issues, then eat. Never force yourself into an intermittent fasting situation or an eating window. You gradually get there. You gradually get there. I absolutely agree with you. Never from the start do you try this. It's going to be painful. Same thing with keto. This is what I love about your book, I love about Mark Sisson's book, The Keto Reset, is you have to graduate there.

Elle Russ:
In his book, you have to take a test to even earn the right to become keto. I agree with that. You have to become fat adapted first. It is going to be painful, not worthwhile and not metabolically efficient to try to go from a sugar burner to ketosis unless you're epileptic, you've got cancer, some doctor has said, "You got a traumatic brain injury," unless you have to go there for a therapeutic medical reason immediately, you need to graduate. It usually takes four weeks or so to really turn around these genes. You have been telling your body that expects fat as a fuel, you've been switching it over to a glucose fueled state. Now you need to switch it back. That takes a little bit of time for these genetic switches to be fired. That is about 21 days.

Elle Russ:
We do, at the Primal Blueprint, we call it the 21 Day Total Body Transformation, but it can take four to six weeks. You have to get used to, as well, this way of being. Now I will say this though. Assuming your metabolic platform is okay and you're not hypothyroid, let's say, this is very quickly achieved. Meaning, if you do it right, willpower will not need to be exerted beyond that month. Once you get fat adapted it's, "Ah-ha-ha."

Dr. Anna Cabeca:
Yes.

Elle Russ:
If you stay there, you're good to go. That's the thing that I want to impress upon everyone, thyroid problems or not. It doesn't matter if you're 400 pounds. You don't ever have to lift a finger. You don't have to go to the gym. All you need to do is exert willpower for one month. One month of your life. The people that are like, "I don't have time to work out." Cop out. You don't even need to get off the couch to get fat adapted. Seriously, that is the truth. Now, you will eventually want to. Your energy will eventually move you to stand and move. You'll naturally feel that way. I'm telling you right now, you can actually get to that point without doing much physically and changing your life. You just have to change the food. I would just ask people, "Wouldn't you rather do that than have to go join a gym?" Some people are like, "I'm not going to exercise."

Elle Russ:
You don't have to. You'll want to eventually, but you don't have to. One month of your life is nothing in the grand scheme to turn around an eating disorder, to turn around a sugar addiction. I was completely addicted to sugar. Almost my whole life, probably, but probably teenage years and on, where you're really ... The 80s, bagels, cheese, all the low-fat thing. Gosh, I thought something was wrong with me. I was so food obsessed, I thought, "Is everybody else obsessed too and they're not talking about it? Do I have an inherent problem as me?" What I realized is I've been on the wrong paradigm the whole time. The moment I switched over, it's like I have a new life. I never think about food. When I do, it's just slowly and awesome. There's no stress about it. This is the success story we get every Friday on Mark's Daily Apple.

Dr. Anna Cabeca:
I love it.

Elle Russ:
It doesn't matter if someone cured their cancer or lost 100 pounds. The biggest revelation is, "Oh my God. I don't think about food anymore. I'm not obsessed." Food obsession takes over your life. It doesn't matter if you're 400 pounds or you're skinny. It is horrific. I remember eating and still thinking and bargaining with myself about the next meal, opening the refrigerator every two hours. Really, really calculating everything in my head about my day of food and what it was going to be. Now I barely think about it. The other thing, too, I want to consider and I'm not sure if you break it down this way, for women in keto there are some nuances and I think it's important to be open with adjusting carbs and things like that.

Elle Russ:
Leanne Vogel in her new book talks about day one through five and what you can do. You might need to add some starchy vegetables towards the end and lower the fat. I'm not about hard and fast rules. Again, you've got to learn what carbs are in what. Take a look at macros to start. Then you got to just become intuitive and natural about it. Once you're beyond the hump of one month of being in this high fat, moderate protein, low carb paradigm, not even keto, just standard low carb primal, you will get fat adapted and you will see that this is just ... It's such a game changer in terms of appetite and your life. You have a whole new life that opens up. The friends who have done it because of me call me all the time. "Oh my God. Thank God I'm fat adapted. I got to the airport. Then I took a five-hour flight. It's been eight hours. I'm not even hungry. Everyone on the plane was eating Cheez-Its." These are the kind of calls I get all the time because that is such a sense of freedom, isn't it?

Dr. Anna Cabeca:
Yes. I think that's so key. I remember going to bed thinking about food, waking up thinking about food. That just shifts completely. It's really crucial. Elle, I want to thank you so much for being with us. You have given us so much information. I've taken lots of good notes. Tell our listeners where they can go to find more of you. You have that free download on the thyroid.

Elle Russ:
I do. You can go to ElleRuss.com and click, "Free Thyroid Guide." It tells you all the tests she just mentioned plus some peripheral ones, how to find a doctor in your state or country, how to call a doctor's office and ask them questions to see if they're in the know or if you're going to waste your money. That's for everybody at ElleRuss.com. You can find my book, The Paleo Thyroid Solution, at every Barnes and Nobles, Amazon, anywhere else. You can hear me every Monday on Mark Sisson's Primal Blueprint podcast where we interview superstars, like you ...

Dr. Anna Cabeca:
I love it.

Elle Russ:
... on the health industry and mind, body.

Dr. Anna Cabeca:
I thank you so much for being with us. Thanks to all our listeners as well. This has been just such a treat to have Elle Russ on here from the Primal Blueprint and to also be sharing this great information with you guys and so much more. Go to ElleRuss.com for her thyroid guide as well as her book, Paleo Thyroid Solution. You guys, get that. Get this and a copy of The Hormone Fix. Take them to your doctors. We appreciate it. As a physician, I appreciate when a patient comes informed and willing to make some lifestyle changes and willing to do what it takes versus just take a prescription or a pill. I definitely appreciate that.

Dr. Anna Cabeca:
I want to thank you guys for listening today. I am so grateful for your reviews that I've been getting here on my podcast. Whether you're listening on Podcast Addicts, Stitcher, iTunes, thank you for those reviews. Keep them coming and please share this episode. You know so many people in your life that need to hear this. Thank you and I'll see you on the next episode of Catch Talk.

Dr. Anna Cabeca
Dr. Anna Cabeca

Dr. Anna is a Triple Board Certified OB/GYN, Anti-Aging Medicine expert, and author of the best selling book, The Hormone Fix.

Dr. Anna helps women heal the 9 most dreadful symptoms of menopause with natural, safe solutions. Follow her for content on hormonal imbalances, vaginal dryness, menopause (and more) that are medically backed, and created to empower women — not just treat them.