The Evolution of Medicine podcast returns with a discussion of the seismic shifts reshaping healthcare – from the explosion of direct-to-consumer lab testing to the most disingenuous pharmaceutical commercial ever made. Host James Maskell unpacks how companies like Function Health, Superpower, Whoop, and Oura are democratizing health data, while practitioners must evolve or risk becoming obsolete in an increasingly consumer-driven landscape.
This episode exposes the uncomfortable truth: patients can now access comprehensive lab panels for under $200 annually, complete with longitudinal tracking and AI interpretation. Meanwhile, wearable giants are integrating lab testing to create powerful health ecosystems that compete directly with traditional practice models. The message is clear – practitioners who rely on static PDFs and sporadic appointments are heading toward irrelevance.
The episode also features the most-watched video in Functional Forum history: Dr. Izabella Wentz’s groundbreaking presentation on how thyroid dysfunction masquerades as mental illness, affecting up to 27% of the population. Her personal journey from misdiagnosis to recovery illustrates the power of root-cause medicine and why functional practitioners remain essential in an automated world.
🎙️ Tune in to learn:
- The direct-to-consumer lab revolution: How Function Health’s 200,000+ customers and Superpower’s $17/month pricing are reshaping patient expectations – and what this means for your practice model.
- Why wearable companies are your new competition: Whoop and Oura’s integration of lab testing with biometric data creates comprehensive health platforms that threaten traditional practitioner relationships.
- The data integration imperative: Why practices relying on static lab reports and infrequent check-ins will become uncompetitive against real-time, longitudinal health monitoring systems.
If you’re ready to future-proof your practice against the consumerization of healthcare while maintaining the irreplaceable human element of functional medicine, this episode provides both the wake-up call and the roadmap you need.
👉 Listen now or wherever you get your podcasts.
James Maskell:
We are going to be sharing with you what I think is maybe the worst pharmaceutical commercial of all time. And that’s a big statement, but I think it’s true, these companies are integrating lab tests because they know, with that data, plus the lab data, they’re going to have an extremely powerful understanding of your health over time. But ultimately it does say to me that for most practitioners, you need to get your act together with regard to the way that you deal with data. The synergy of lab data and other biometric data is really going to unlock a lot of understandings about how people live and how people heal. Hello and welcome to the second episode of the second season of the evolution of medicine podcast. I’m your host, James Maskell, and this week we are going to dive into some of the critical conversations happening at the future of functional, integrative and precision medicine. I’m so glad you’re here.
Later on, we are going to be sharing with you what I think is maybe the worst pharmaceutical commercial of all time, and that’s a big, big statement, but I think it’s true, and you can help me judge if you think it’s true too. And we’re also going to be showing you the most popular video in the history of the functional forum we have over 11 years of content. I went through the whole YouTube channel to see what was the most compelling, what was the most interesting, what was the most watched video of all time? And I’m super excited to share that with you a little bit later, but first we’re going to jump in to the news. And one of the biggest thing that affects the functional medicine, the integrative precision medicine community right now is the massive growth in direct to consumer lab testing.
When I started in this industry 20 years ago, the only way that you could access the kind of information that would tell you what is at the root cause of your chronic health complaint was via a practitioner, because the whole industry was essentially through the doctor, and that just mimicked the way that medicine was developed. Now, ultimately, over the last 10 years, we’ve seen the consumerization of medicine, and so consumers being able to get the care that they want directly. And ultimately, one area that this is showing up massive right now all across the industry, is in consumer based lab testing. And so what I want to do now is just share with you you know some of the organizations that are delivering this. So one that you’re probably very familiar with already is function health. And function health was created by Dr Mark Hyman, Jonathan Swerdlin and others. And ultimately, the promise of function health is to give you over 100 lab biomarkers for $499 a year. And ultimately, you know, this is something that I think is really interesting.
You know, back in 2018 or 2017 we launched a service called new health that became an alternative to health insurance. The first thing that we did was to make it easy for patients to access their own labs and to really understand some of those that basic information. So this is sort of taking that to the next level. And this is extremely popular, extremely well marketed. And I think that if there’s one thing that it can teach the whole functional medicine community is that Labs is a great top of funnel for understanding how to bring people into your practice. People want this. 200,000 people have bought it, and it doesn’t include any real medical interpretation. There’s a lot of AI interpretation, but this is something that I know when I speak to practitioners. Many practitioners are experiencing people signing up for function health, getting the information, feeling a bit confused and coming into them, and that has been the situation up until now. I would say that in the future, I think that function health will look to own the whole customer experience, and that might mean that those patients will then be choosing between function, health and your clinic. But that’s, you know, in the future, this moment, I think it’s a good way to get a lot of information for a low price.
Now, there’s another company that you should be aware of, called Superpower. And Superpower has been around a little bit less time. It’s newer, but it’s very, very similar. In fact, at the very beginning, the advertisement that you’ve probably seen all over social media was exactly the same, 100 plus biomarkers, 499, in the last month, it is now less than $200 so now they’re saying it’s only $17 a month. So what you have to understand is that this is the game of VC backed companies, right? They create an artificially low cost so that you’ll use it because they want to acquire members, and then eventually they’re going to get more of your dollars from you. And you’ve seen it with Uber. You’ve seen it with all the delivery things like GrubHub. The first thing that they do is to grab market share and then sell you more things. Superpower is very cheap. There is no way that you can that this business is making money on that first sale, right? Because for 200 bucks a year, I’m not sure if you could even organize all those labs. I’m sure you can’t. And so this is really. About using the large amount of VC money to bring in more and more members, and then ultimately, you know, to try and get lifetime engagement.
But with both of these services, you’re having, you know, long term data, you’re getting longitudinal data, and starting to see the amount of information that’s coming in. Now, there are some very new players to this space of selling lab tests that I want to make you aware of, because I think this is even bigger news for our community. So Whoop recently, and I’m sure many of you are familiar with Whoop, Whoop has just launched a new service which sells labs as well. It’s called Whoop advanced labs, and you can see here on the site, every biomarker is chosen for impact hormones, heart health, sleep, inflammation, fitness, metabolic health, nutrients, cognitive performance.
So again, Whoop, allows you to book into Quest Diagnostics. All of these companies are just really sort of a wrapper on top of either quest or LabCorp. So it allows you to schedule a test. This one is particularly with quest, so you can go in and they’re get your information. Now the reason why this is really interesting is because the synergy of lab data and other biometric data is really going to unlock a lot of understandings about how people live and how people heal, and so Whoop is really going end to end like Whoop doesn’t integrate with any other tools. It doesn’t allow its API to be used. So Whoop is really looking to create a whole health technology stack, and this is going to be in competition, one way or another, with, you know, the functional medicine clinic, because ultimately, this is doing something very similar than practitioners do, which is to gather information, to understand what’s working and to, you know, to really, to really build something that gives patients real time understanding of their health over time. And Whoop has been the leader in the sort of fitness band and now going into labs.
And one other you should know about is Oura. So Oura ring probably familiar with it. It’s been out for almost 10 years now, but now they have health panels at Oura. What does this look like? So this they’re saying Oura’s approach is accessible, personalized and integrated. So now it’s comprehensive, it’s clear there’s a personalized context, and it’s shareable to your doctor. So ultimately, again, Oura, multi billion dollar company, the Oura ring, is the sort of leading wearable, and now these companies are integrating lab tests, because they know, with that data, plus the lab data, they’re going to have an extremely powerful understanding of your health over time. And so one of the things that that I want to share is that I believe in the power of the patient practitioner relationship. You know, I came to functional medicine because I recognize that something really powerful happens with the human part of medicine, and ultimately, like, that’s why I’m here. You know, supporting the practitioner patient relationship through supporting the integrative and functional medicine community to build successful practices and to be able to help people reverse chronic illness. The state of chronic illness is so bad that I think all of these things are going to be a sort of a net positive to those people who use them. But ultimately, it does say to me that for most practitioners, you need to get your act together with regard to the way that you deal with data, because the idea that in a few years time, you would be able to do it the way you’re doing today, where you have a few PDFs and you’re looking at them, and you don’t have any idea what’s happening with people in between their appointments.
You don’t have any way to understand what’s going on, you know, how are the things that you’re recommending affecting their health in the short run, medium, long run, it’s just going to be uncompetitive in the new world. And so that’s why, you know, we have brought together, you know, mission partners, to help build this, you know, practice network of the future, because we believe that, you know, you are going to, you know, have to catch up with this. And you know, in that spirit, I wanted to mention, you know, one of the groups that we’ve been part of for a long time, Fullscript. You know, Fullscript is completely committed to the success of practitioners. That’s the only business they’re in, they only work with practitioners.
There’s 120,000 customers that use them. Ultimately, very soon, you will see that Fullscript will make it easy for you to do exactly this to, you know, to create labs, to send those labs to patients at regular intervals, and to create longitudinal data for your patients. And so we are very excited and grateful to have Fullscript as one of our mission partners, because we believe that, you know, it’s going to take B to B technology, technology that you use in your practice to make an impact and to, you know, help you compete with these kind of tools so that you can maintain market share, grow a business and have the impact of functional medicine grows significantly. So if you’re not aware of this, I just wanted to make you aware of this, and look even LabCorp is doing it lab core, which has always been sort of B to B, for business to business, and making it easy for clinics to get their lab testing done.
You can now go to LabCorp directly and order directly from LabCorp. Report, and I’ll show you the site here now as well. If you haven’t checked that out, LabCorp on demand, women’s health tests, complete blood count. You know, all of these things can be purchased with cash and executed directly.
And this is the sort of the middle of the end game of the consumerization of healthcare, in that the consumers can choose what they want, and ultimately, will they choose to want to have a functional medicine doctor? Will they choose to want to engage consistently with a clinician, or will they use some of these other tools? So those are the questions that we’re going to have to answer. So that is the news section, and I hope that you know, share this with someone. If you’ve had these kind of conversations at conferences, you think this is interesting. If you use an Oura ring or if you use a Whoop, you know, why not sign up and see what that experience is like, so that you can understand, you know, who you know, the people who are getting excited about health in your community, what are the tools and services that they are likely to use? So this has been the news.
Now we’re going to get into a segment that I’m pretty excited about, and what I think I found is the worst pharma commercial of all time, and that is a big, a big statement. So I remember watching this. It came out in 2015 what we’ll do is let’s watch a little bit of it, and then I’m going to comment on it at the end, and then we can watch a little bit again, just to see how disingenuous the whole thing is. So this is called Big bad cough. It’s put out by GlaxoSmithKline, and it was a commercial that came out in 2015 for the whooping cough vaccine. So let’s take a look. There’s something out there. It’s a highly contagious disease. It can be especially serious, even fatal, to infants. Unfortunately, many people who spread it may not know they have it. It’s called whooping cough, and the CDC recommends everyone, including those around babies, make sure their whooping cough vaccination is up to date. Understand the danger your new grandchild faces, talk to your doctor or pharmacist about you and your family getting a whooping cough vaccination today.
Okay, so few things to say. First of all, you know, I’ve been reading this book called vaccines Amen, by Aaron Siri, and through reading this, I kind of recognized, you know, some of the topics that we talked about a lot during covid, like does the vaccine stop transmission? These were conversations that were happening in a very niche audience. Pre covid and covid alerted a lot of people to this. So I’m just going to read you a section from this book. And this is essentially in June 22 of 2018 there was a consensus conference regarding Pertussis vaccine. It was organized by the World Association for infectious disease and immunological disorders. Now in a consensus paper published after the conference, authored by 16 pertussis experts, together with the World Association for infectious disease, they said, in no uncertain terms, natural infection evokes mucosal and systemic immune responses.
While these acellular pertussis vaccines induce only systemic immune response, mucosal immunity is essential to prevent colonization and transmission of B pertussis organisms. Consequently, preventive vaccine measures such as apvs do not induce a valid mucosal response and can prevent disease but not avoid infection and transmission, not avoid infection and transmission. APV pertussis vaccines do not prevent colonization, consequently, they do not reduce the circulation of B pertussis and Do not exert any herd immunity effect. End quote, contagious disease. It can be especially serious, even fatal, to infants. Unfortunately, many people who spread it may not know they have it. It’s called, okay.
Why would someone spread it and not know they have it? It’s because they’re not having symptoms. You know, if you’re like me and grandma has a bad cough. Grandma is self conscious enough to not go and cough on the INS on the infant, but if you take the Pertussis vaccine, you’re less likely to get that cough, which is the signal to society that you’re sick, so you’re more likely to spread it, and that’s why this, this, this is the most disingenuous pharma commercial of all time, because ultimately, it’s the vaccine itself that is creating the situation where it’s more likely to be spread because grandma doesn’t know that she have whooping cough. And whooping cough is pretty obvious with that with that certain cough that you get not know they have it. It’s called whooping cough, and the CDC recommends everyone, including those around babies, make sure their whooping cough vaccination is up to date.
Understand the danger your new grandchild faces. Talk to you know, for those of you listening online who can’t see this, the visuals are a wolf, like grandma as a wolf breathing, you know, in Front of the infant. And this is awful, right? And one of the reasons why I completely changed my life and moved to the country, started my own education organization with a bunch of other parents and sort of opted out of school together, is because I saw straight away in covid, that covid was being, you know, that the way that kids and the way that school was being run, it was teaching the kids that they were going to kill grandma, that they by, you know, by coming to school and by circulating viruses, they were going to kill grandma of covid. And whether or not that’s true, you know, think about the implications for the mental health of those children for the rest of their life. This is a very, very murky waters that we’re treading into if we’re going to convince kids and convince parents that their kids are a vector of illness, primarily, not a vector of love, not a vector of being together with their you know, with community not a vector of all the things that we want kids to grow up thinking they are, joy, love, engagement, participation, you know, all of these, these other things that you are primarily a vector of infectious disease.
And ultimately, all of that proved to be kind of a farce anyway, when it showed that the covid vaccines didn’t prevent transmission, and it was never tested for transmission. And so much of the languaging was all about protecting the herd herd immunity. And ultimately, what does cause her cause herd immunity is getting covid right because of the mucosal immunity. And so, you know, the reason why this commercial came down is because ICANN sued them to say, alleging, among other things, claims for consumer fraud and false advertising. They served the lawsuit and July 14, 2020, by mid September, the entire campaign were taken down.
You know, they also said you should receive a booster at least two weeks before having close contact with an infant. After filing the lawsuit, the statement was scrubbed. Classic Pharma. There’s really nothing to back up what they’re saying, but ultimately they can make a commercial show a big bad wolf scare parents into doing something that is more likely going to cause more problems than it solves. Definitely check out this book, vaccines Amen, by Aaron Siri. I think it’s required reading for anyone who really wants to understand the history of illness in America and in Europe and in developing countries, and really understand, you know, the the role of of nutrition, of sanitation and so forth. So, you know, check that out.
All right, we are going to get into the next segment. And every week, you know, we have a new segment. We have a pharma out of the week. We have innovation corner and we have clinical corner. We’re going to save the clinical corner for last, and I want to talk about innovation corner so as part of our community, we are blessed to have four mission partners.
I mentioned Fullscript before, but Big Boost Marketing was started by my partner at the Evolution of Medicine, Uli Iserloh. He was the COO for a number of years there, and he is really the best in the business at understanding how to market the functional medicine practice.
And ultimately, one of the things that we have seen as a sort of a trend in the consumerization of healthcare is that instead of searching people, searching for their conditions and their maladies on on Google, which is, you know, you you’ve heard the phrase search engine optimization, so you’ve probably done some work to search, you know, to optimize your practice for search.
If someone says, functional medicine doctor near me, does your clinic come up? That’s the kind of thing that Uli has helped with for the last 10 years. But there’s a shift in consumer behavior, for the first time in more than a decade, where a lot of people are now going to the AI services to look for to look for practitioners, to research, you know, their conditions, and then go further to find practitioners near them.
Now there are some problems with that. One is that, you know, if you look into like, I’m not exactly always sure that the information that comes from AI is accurate or useful or helpful for our community, but certainly it is something that is happening. And so, you know, it might be a good question to see like, put into ChatGPT, who is the best functional medicine doctor in your town? Or who should I go and see for functional medicine in your town and see what comes town and see what comes up? You know, I’ve certainly found that that it’s a mixed bag. Sometimes you get an answer when you put in something related to this type of care that’s really empowering and exciting, and you think, Okay, well, if someone else is putting that information in, I’d be glad for them to see this. And sometimes it doesn’t look so great.
And so ultimately, what Uli has created is some assets and some tools that can help you navigate this, because ultimately everyone is learning as we go. So he’s got a free guide that will essentially help you understand why this matters. You know, where AI tools get their data from? What are the critical factors? Right, and then answer ready content and creating trust signals that matter. So there’s a step-by-step guide, and I’m going to give you that link. If you go to goevomed.com/bigboostguide , you can download the guide, and then he’s also doing a boot camp to essentially help you get organized so that your practice can really understand you know how to optimize yourself for a I search optimization, and this is a new way. And ultimately, ulu is already seeing that many of his customers are able to get new patients from Ai.
So there’s some really exciting parts about it, but there are some things that you need to do in order to make sure that you’re showing up in the right way. So this is a cool innovation. One of the cool things about having these partners is they are creating awesome stuff that is really relevant for building the functional medicine practice of today, of the future. So check out the guide. Download the guide. It’s free to check it out, and then if you want to go into uli’s boot camp, I think it’s only $47 and you can upgrade your website with all of the tools that you need in order to be relevant. So check out all those details, and that’s innovation corner. So before we get into our next segment, this is really about looking at what was the most popular video in the history of the functional forum.
Now, obviously videos that started earlier have had more time to rack up views, but there’s one video that has had way more views than anything else. And actually was from an event that we did in February of 2017 at the eTown in Boulder. I don’t know if any of you been to eTown, but it is by far the best venue that we ever did. A functional forum in we did a bunch of functional forums. There one, lots of great practitioners in Boulder. Two, it’s just an amazing venue for doing the functional forum five cameras. These guys know how to run the whole thing. It’s just very easy to do that. So I love eTown, but in that session, we had talks from Janet Settle and Will Van DerVeer. Since then, Will Van DerVeer has become a great leader in the sort of cross section of psychiatry and psychedelics, and he has a great organization that is educating mental health professionals in the use of psychedelics and integrative psychiatry generally.
And so I love Will, and he spoke that night, but the talk that I’m referring to was by Dr. Izabella Wentz. So she is a PharmD. She was one of the first sort of functional pharmacists to become famous in our space, and she’s written a number of books. She’s made a lot of content about thyroid health. In fact, she has a new book that’s just coming out, all about IBS that’s coming out, you know, right about now, when this came out, this talk that she gave, I want to give a shout out to because, you know, I think this resonated with people. I think it, first of all, it resonated way beyond the functional medicine audience. Like, we don’t have 500,000 doctors watching this. So who is watching it? I’m sure that there’s many, many people out there who have had symptoms of mental illness, and now they recognize that there must have been a deeper cause.
And so this talk is called the misdiagnosis machine, how thyroid problems mimic the symptoms of mental illness. And I think there’s so much to learn for all practitioners here, because ultimately this speaks to the power of the root cause diagnosis, like, do you know to what degree the thyroid is having an effect on, you know, your mental health? And I think that you know this is one of the reasons why I believe that you know the integrative functional medicine, why I think that integrated medicine for mental health conference that we went to a month ago was extremely valuable, because it’s teaching mental health professionals about all of the different root causes, and there’s many, and thyroid is just one. So enjoy with me. Dr Isabella Wentz, the misdiagnosis machine, helped thyroid problems mimic the symptoms of mental illness. Enjoy.
Dr Izabella Wentz
Please welcome boulder bolt, not native, but bolt currently, Boulder citizen, Dr Izabella Wentz, so I have a confession to make. I haven’t always been interested in the thyroid gland, especially not during pharmacy school. I thought that thyroid disease was just something that everybody got once they got older and quite frankly, at the pharmacy when I was dispensing tons of thyroid hormones, I never quite understood why people kept complaining about symptoms when they were already taking medications. It wasn’t until I was diagnosed with Hashimotos thyroiditis in 2009 after almost a decade of some pretty debilitating symptoms.
So today I’m going to share with you a little bit more about thyroid disease and how we can address it, as well as how it can masquerade as mental illness. Ulrich, so I’m 18 years old. I am a coming out of my freshman year in college, and I go home for the summer. I’m a little bit beat down and a little bit depressed, and one of the reasons was because I missed my final exam in chemistry. Now this probably wasn’t that unusual that a college student would miss a final exam, except for me, that was really unusual because I was, you know, a straight A student. I was a very type a person, and I got my stuff done right yet I missed my 9am exam, and the other part of it was that I just laid down to take a nap at 3pm the day before. And so, what was at the root cause of my fatigue? Right? I go home for the summer with my tail between my legs. I’m going back to the Chicago suburbs where I’m from, and my parents just didn’t see the same Izabella again.
They said, wow, you know, you don’t really care about much of the things you used to care about. You are sleeping all the time. You are, you know, you’re forgetting stuff. What’s going on with you? And so, as any loving parents would do, they sent me to a psychiatrist, right? And I was diagnosed with severe depression, very severe depression, like they were concerned about me, and they were, you know, they they wanted to put me on suicide watch because they were so concerned with what was going on with me. Now, going back to my health history and my health timeline, what was going on before I got sick, right before I started having all these symptoms, and of course, you know, I think I had a couple of boyfriends break up with me, so that always happens in college, and I missed an exam, and that was very, very hard for me, but I also had the Epstein–Barr virus, or mono and that is a known trigger for thyroid disease, and that set me on a path of misdiagnosis for almost a decade.
I was misdiagnosed with panic attacks, I was misdiagnosed with anxiety, I was misdiagnosed with major depressive disorder, and this is what happens to people for with thyroid disease, they’re told that they’re either crazy, perhaps, that they’re lazy, like like I was, because I was sleeping all the time. And sometimes they’re just told that they’re fat, right? Because they can’t seem to pull off the weight no matter what they do. And so many times, some of the root causes of thyroid disease may actually be some of the root causes of mental health illness and mental health symptoms may actually be due to thyroid disease when we are all taught in schools, you know, if nursing school, pharmacy school, medical school, we get this picture of a woman, right? This is probably like something you’ve seen in a textbook before, where half of her is hypothyroid and the other half is hyperthyroid. And so you have this woman that is dealing with symptoms, and one half of it is, you know, hypothyroid, so you’ve got the sluggish metabolism, you’ve got the hair loss, you’ve got the brain fog, and you’ve got the weight gain, right?
And then on the other half, you have somebody who’s hyperthyroid, so you’ve got palpitations, you’ve got panic attacks, anxiety disorders, the bulging eyes, and, you know, just overall, like speeding up of things, but the truth is, usually this is an advanced stage for people. And most people who have Hashimotos, which is what I had, might have symptoms from both sides. So I not only had a sluggish brain, but I also had anxiety. I not only had weight loss, that was actually my symptom, but I also had the brain fog, and I also had the cold intolerance, and it was, you know, missed for many, many years, so I kept getting the same kind of run around. So, you know, I think it’s in your head. Maybe you need antidepressants, maybe you need anti anxiety medications. I think you’re just getting older. I was 25 at the time, though. Yeah, and and this is the message that most people get now.
When I first got diagnosed with Hashimotos, it was 2009 and my symptoms started in 2000 This is my loving husband, Michael, who’s been with me, supporting me all along the way. And when I first got home from getting my diagnosis, I go I have Hashimotos. And Michael said, that sounds like an exotic Japanese sword fighter, like what’s going on, right? But. But this condition, this autoimmune condition that happens to impact the thyroid gland, is actually quite common. So studies have shown that up to 27% of our population actually has Hashimotos when using advanced diagnostic methods. Now during those nine years when I struggled to get a diagnosis. I would go every year. I was a good girl, and I was, like, very concerned about my health. I was a pharmacy student, and, you know, I thought I had every condition, right? Because that’s what you do when you’re going through school. But I kept getting the same test done, and all of them were normal. One of the reasons is that the TSH Test is not going to be elevated until somebody’s had thyroid disease for quite some time. The other the other reason, of course, was that the interpretation of the test was lacking back in the day.
So we now know that most people feel best with a TSH between point five and two, and mine was 4.5 and I have this wonderful report that says your thyroid is normal, yet I was sleeping for 12 hours a night, right? And I was I, you know, I used to call myself, those are my sloth days, right? And we also know that this condition impacts five to eight women for every one man that’s impacted. And I have a theory about this. It’s my safety theory of of autoimmune thyroid disease, because, quite frankly, it’s not safe to be a woman in our in our world, as you know, the doctors were talking about, when you have a history of trauma and you have this, this is a potential root cause of thyroid disease. These are things that are going to set you on a cascade of abnormal thyroid hormone levels later on in life. The other thing to consider is that most people who are seeking your care are likely to have the you know, the general population statistics are 27% when you use advanced diagnostic methods like thyroid antibodies or or using a fine needle aspiration biopsy to diagnose Hashimotos, but the truth is that many of the people presenting to healthcare professionals and trying to get healthcare services, that percentage of thyroid disease is going to be much higher in them.
And one of my one of my friends, Trudy Scott, she’s a wonderful functional nutritionist, and she specializes in anxiety, and she says that anywhere from 50 to 60% of her clients with anxiety actually have thyroid antibodies. So one important thing to note with Hashimotos is that it’s not like black and white. It’s not like you just have it full blown or you don’t have it. There’s actually five stages to Hashimotos. In the first stage, for all intents and purposes, your thyroid function is normal, your immune system function is normal, and you’re not going to have any symptoms, right? This is just the genetic predisposition. The second stage is when things start to change. So we start seeing an infiltration of white blood cells right into the thyroid gland, and people can start seeing changes in thyroid antibodies. So you might see thyroglobulin antibodies or thyroid peroxidase antibodies in this stage, but the TSH will still be normal. The other interesting thing is there’s also seronegative Hashimotos, so some people don’t even have thyroid antibodies, and doing a thyroid ultrasound or a biopsy might be another way to find thyroid disease. But really, unless you biopsy every single cell within the thyroid gland, you can’t tell if there’s white blood cells in there, so it’s really not something you can necessarily exclude by doing thyroid antibody tests.
The other thing is, in this stage, there’s just beginning attack of the thyroid gland, so the thyroid tissue may still be intact, but the body’s already compensating, and this is when we start seeing symptoms. So people in this stage are going to have the panic attacks. One of the there’s multiple studies on the different types of symptoms that are correlated in this stage, obsessive compulsive disorder, panic attacks, anxiety, one of my favorite one was health, seeking behavior, hypochondria, right? And a lot of times and traveling the country the last year, so I’ve interviewed over 60 patients with thyroid disease. And through my platform, the thyroid pharmacist. I’ve have over 300,000 people that follow me online, my clients and whatnot, and they all share the same stories with me. Is like they were going to get care. They were trying to seek the help, but people were just telling them that there was, you know, you’re crazy, here’s an antidepressant. There’s, you know, you’re just fat, you have fork and mouth disease, you need to eat less.
Yeah, these are true stories, right? And then that’s stage two. Now, if you can get a person diagnosed in this stage, you can prevent a lifetime of fork to mouth disease. You can prevent a lifetime of depression. And you can also. Also prevent the need for thyroid hormones or thyroid medications, because you can, you know, while we have some technologies that can reverse and accelerate tissue healing, it’s much easier to prevent damage on a thyroid gland than it is to like, regrow new tissue. Stage three is when more progressive doctors are starting to diagnose people where a person will have subclinical hypothyroidism and they will also have slightly elevated TSH, and then they will have, you know, the thyroid antibodies or not. And at this paid point, we start seeing more and more symptoms. We know that treating people with thyroid hormones at this stage can also be helpful for pregnant women.
This is usually a must, but for in the conventional world, whenever a woman who’s not pregnant comes in with a TSH, I don’t know, six, seven or eight, she’s told to wait and watch, to wait and watch for what right for, for to get worse. And so stage four is overt hypothyroidism. This is when most people get diagnosed, right? And at this point, they are prescribed a medication. I think we all know the brand name, levothyroxine. It was the number one prescribed drug in two out of the last three years. It finally got beat out by Vicodin last year, right? And this is something that they’re getting, but many of them continue to have symptoms with this medication, and they’re told, Oh, well, your thyroid has got nothing to do with your hair loss, your thyroid has got nothing to do with your weight gain, and your thyroid has nothing to do with your depression.
And the scariest part is that this medication is not only it doesn’t really help the symptoms that it’s supposed to treat, but it also doesn’t stop the progression of the condition. So we know that Hashimoto is like every autoimmune condition is progressive, and so stage five is when we start seeing progression to other types of autoimmune conditions. I’ve talked to so many people around the world who who were good girls. They took their thyroid medications, they did everything their doctors said, and then they were diagnosed with rheumatoid arthritis or lupus or another type of autoimmune condition because the root cause, the trigger, was still there. Nobody was doing anything about it.
And so just a quick summary. So people have thyroids, people have symptoms, and a lot of times they’re misdiagnosed with mental health issues when they have thyroid antibodies. And this is going to be as you know, you might not see any changes on the TSH. You might just see these changes when you do thyroid antibody tests. And so these are some of the antibodies to do for thyroid peroxidase, thyroid globulin, TSI and TSH receptor antibodies. But So going over a lot of the symptoms, we talked about, some of the symptoms that can be caused and traditionally, people associated hypothyroidism with many of these symptoms, with some of with one set of symptoms, and hyperthyroidism with another set of symptoms. But the truth is, when you have Hashimotos, what’s happening is, as the body starts to attack the thyroid gland, we start seeing a big rush of thyroid hormones into the bloodstream. And this actually causes a transient hyperthyroidism, and so you will have a person who has symptoms of both an overactive and an underactive thyroid.
And I could tell you personally, it’s not, it’s no picnic, right? So you end up with having anxiety and panic attacks on one hand, and then you end up, once the hormone gets cleared out of your body, you might have depression, fatigue, apathy. There’s a whole bunch of different conditions that can be traced back to thyroid disease. I’m not saying that thyroid disease causes every single mental health symptom and condition. Of course, that would be ridiculous, but there’s a significant percentage of people who have, you know, postpartum postpartum thyroiditis, and that presents as postpartum depression, or they have depression that can actually be resolved when treating the thyroid gland bipolar disorder. There’s a big percentage of people with bipolar disorder who actually have thyroid antibodies. I don’t think this is really appreciated.
People don’t realize the effect of thyroid antibodies on the brain, except for in the case of Hashimotos encephalopathy. But you know, of course, this is a very extreme case as far as psychotropic medications go. Oftentimes, you know, I’ll see when I when I used to work at the pharmacy, it was like, Okay, here’s your birth control, your antidepressant and your thyroid med. It was just pretty much we had this, like, fast mover section in the pharmacy. That was like, right up front, all the medications we commonly use. And that was just like, okay, they’re all right here. I can just pull them all real quickly. Here we go, right because commonly, women will be placed. On all these different medications, and a lot of times they may actually, they may actually exacerbate some of the symptoms or even mask the condition.
So medications that affect dopamine can actually suppress TSH. And so if a person was to go was on, let’s say, well, butrin, and if they were going to get their TSH tested, it may be falsely suppressed, so you might miss a thyroid condition. Then we know with lithium, lithium has unfortunate, very unfortunate relationship with a thyroid gland, and that’s one of the really big things when you have a person on a lithium as pharmacists, we were always taught to monitor their thyroid function, because lithium can actually bring new onset thyroid disease, or can exacerbate existing thyroid disease antipsychotic medications. So I used to be a before I became the thyroid pharmacist, I was a consultant pharmacist in mental health, and one of my biggest jobs, and was actually to get people off of antipsychotic drugs because of the harmful metabolic effects they had.
And I can’t get this statistic anywhere, but there was somebody that said that, you know, like taking an antipsychotic drug is like eating three extra cheeseburgers a day, right, because of their impact on the metabolism. Now, if you give somebody a highly sedating medication that makes them gain weight and they already have thyroid disease, like you’re really not doing them much of a service. And of course, benzos and SSRIs, these are commonly given to people with thyroid disease, and they really don’t help in many cases. So studies have shown, like the sardee trial, that these medications are not super effective, and especially if you have a thyroid condition, they’re not going to be all that effective as well. So what are the helpful interventions for people with thyroid disease?
Well, obviously, thyroid hormones, right? And so, you know, in pharmacology, we call t4 and medications that need to be activated into the body, into other medications as Pro drugs. And so t4 which is levothyroxine, the most commonly prescribed drug, is actually a prodrug. So it needs to be turned into it needs to be activated in the body to work properly. And t3 is the more active version, and we see that people, oftentimes, will continue to struggle with thyroid symptoms when they’re on this medication. So one, you know, kind of crazy thing you can do is you can actually give them t3 directly, and that helps, that really helps some people resolve their symptoms. So people will say, wow, you know, like, I started taking this medication, whether it’s t3 directly in addition to the t4 or natural desiccated thyroid.
But they’ll say, wow, like I am not changing up my exercise routine, but I’m losing more weight and I feel better, and my hair is growing back, and my my skin’s nicer, and I’m not as tired anymore. Of course, it doesn’t stop there. Selenium supplements. So selenium supplement can be very, very helpful for people with thyroid disease. Selenium deficiency has been identified as a big potential root cause of thyroid disease, and anywhere from 200 to 400 micrograms of selenium methionine has been shown to reduce thyroid antibodies by about half over the course of three months. The other cool thing that happens is a lot of times, people’s anxiety goes away or reduces when they have Hashimotos and their antibodies start reducing. So this is something that can be very helpful, and it’s also helpful for for postpartum thyroiditis. It’s helpful for for Graves’ disease as well. Myo inositol is also a helpful intervention for a person who has OCD like symptoms as well as thyroid disease. They can go hand in hand. There was one study done a little while ago that showed using Myo inositol in combination with Selenium helped to reduce not just thyroid antibodies, which actually helped to put some people in their remission range, but also help range, but also helped to reduce TSH.
And I did a survey of my readers in 2015 and I asked them about some of the most helpful interventions, and I broke it down into all kinds of classes. And you know what helped most for what? And these were the actual interventions that people thought were most helpful for their mood related symptoms with thyroid disease and so balancing blood sugar, wow. Can you see some miracles when somebody eats blood sugar stable meals, right? Gluten Free or paleo diet. My mom just sent me an article the other day, and it was like people are on the gluten free diet when they shouldn’t be like this. This crazy woman said she’s on it for Hashimotos, and I was like fuming in my little shoes, because in my survey, over 2000 readers, I’m just in my work with clients, 88% of them feel better gluten free when they have Hashimotos. And what’s crazy is an. Asking them which interventions helped most and least?
And I have, you know, I don’t have time to go through all these stats with you guys, but the the gluten free diet was actually more helpful for for mood, for weight, as well as for energy, which are the top three thyroid symptoms people experience compared to thyroid medications? It’s like, wow. Paleo diet can be very, very helpful as well. And then autoimmune paleo diet is another really helpful intervention where we see nodules shrinking when we see people, you know, getting like, becoming brand new people when they when they change their nutrition, acupuncture, sauna therapy, massage therapy and adrenal adaptogens. These are some of the other things that people say. You know, this really helped my mood with thyroid disease. And so I always like to think about root causes. So sometimes, you know, mood alterations can be caused by thyroid disease, right? But then what causes thyroid disease? And I like to look at the functional medicine approach, of course, when we look at food sensitivities. So gluten, dairy and soy are the top reactive foods for people with thyroid conditions.
Nutrient depletions, selenium, thiamine, magnesium, ferritin, as well as vitamin D, are some of the common nutrient deficiencies. Chronic infections, Epstein Barr Virus, h pylori, blastocyst is hominis, various kinds of parasites, SIBO, all of these things can actually trigger thyroid disease. And in some cases, when you get a person treated for these, the person can go into remission. It’s amazing. It’s like, well, I don’t this was the cause, right? Of course, impaired stress response. So there’s a huge connection. And I think you know, as everybody in this room is aware to traumatic events and causing chronic illness and thyroid disease is no different. Things like social rejection can actually bring on thyroid disease. There’s a study of two of this like little rat study that was done in there was a little rat family, mama and papa rat in their little home with their little rat children. And scientists decided to drop an intruder rat like right in that cage and see what happened. Right?
And of course, the intruder rat immediately got attacked by Papa rat and got and was defeated. And then that didn’t feel very, very pleasant for the intruder rat, and so they decided to measure that rat’s thyroid hormones right after and guess what? They were altered, right? You know, prisoners of war have altered thyroid hormone profiles. And you know, it’s anywhere from the extreme. It could be like from a Mean Girls experience in high school, or it can be from something as extreme as having trauma, serious, very, very serious, significant trauma in your life. Of course, intestinal permeability is a common root cause, so that’s something that’s huge.
Thyroid cells are actually made from the same fetal origins as gut cells are. And a lot of times, we’ll see, when we address gut symptoms, we see thyroid symptoms improve, and then toxins, like really simple things like getting a fluoride filter can be really, really helpful for people and getting them to stop using their antibacterial soaps. So triclosan was recently banned by the FDA for having a thyroid hormone disruption. And I think about, you know, poor people with like OCD and using all of their antibacterial soaps, right? And it’s like a vicious cycle. So I’d love to get into with you guys a little bit deeper about everything related to thyroid disease, I have a few resources to offer.
So my Hashimoto is the root cause book that came out in 2013 it’s a New York Times best seller. We’ve got 1000s of patients that have now reviewed it, and this is something that you can give to them. They can take this, and they’ll be on board with functional medicine once they read this. So the best emails I get are from doctors that say, Hey, I had a patient come in with your book, and they’re actually asking me to do functional medicine testing. They’re actually asking me to do more testing and like it gets them motivated and gets them on board. My new book is coming out March 28 Hashimotos protocol, and then the thyroid secret documentary series that’s coming out March 1.
And in this series, we have nine episodes that go through misdiagnosis. They go through postpartum thyroid issues and take people back on a recovery to get their health back. Episode Two is actually focused on mental health and misdiagnosis as well. So I think you guys will be especially interested in that. That’s all I have for you guys. But if I could leave you with one closing thing, that if you have a person who is fatigued, who is sleeping a lot, you know, think about their thyroid. Don’t always say like this person. Must be depressed even, even if they are, quote, unquote, having mood alterations. Think about the thyroid.
James Maskell
All right. I hope you enjoyed that. I think there’s a lot to learn there. Hopefully you got something from it, and maybe this is useful information to send out to, you know, patients in your community, or something that you can use for for education. Ultimately, you know, the goal here with the functional forum as always to make it aspirational to be a functional medicine practitioner. I think Isabella does a great job of doing that. We’ve seen a huge growth in pharmacists being interested in functional medicine. Shout out to Lauren castle for the organization that organizes the functional medicine pharmacy community.
More and more pharmacists realizing that the best way to well, I’ll come back to that big shout out to my friend Lauren Castle, who organizes the functional pharmacist Alliance. And, you know, I think many pharmacists around the country whose businesses are closing because pharmacy is a very difficult business if you only sell drugs, are realizing that the best thing that you could have done if you were a pharmacist, an independent pharmacist, is to create health. And those pharmacists that have been creating health for the last few decades, you know, have thriving businesses because they’re not just selling drugs. And that business became very uncompetitive. And there’s a huge opportunity for pharmacists to be at the front lines of building health in their community.
They got so much trust, they got so much knowledge. And so if you’re interested in finding out more, reach out to Lauren. We’d love to hear from you. I’d also like to say, look, if you’re in the process of building a practice and you’re a bit you’d like to start a new practice, or you’d like to, you know, work on building a practice. We are now making our calls available again. So these concierge calls we started back in 2014 where we met with practitioners who were on the journey to really try and understand how you know their vision. And we must have done 1000s of those calls between 2014 and and 2025 and so we are excited to be doing those. I’m going to be making myself available for some of those calls. So if you are interested in getting on a concierge call, go to goevomed.com/concierge, and you might get on with me, you might get on someone with our team, and ultimately we’ll be able to help you find where you need to go.
I do want to mention before we leave, a couple of our mission partners. Last time you heard about freedom practice, coaching, scalability assessment, we’ve had hundreds of practitioners go through that process and find tremendous value from understanding where they are. Are they in the startup phase? Are they in the growth phase? If you make decisions that make you where you think you’re in the growth phase, but you’re in the startup phase, it will be a disaster. And so go to the scalability assessment. It’s goevomed.com/scalability, you could take that assessment. It takes 15 to 20 minutes. Highly recommend that.
And also TruNeura. So true neuro is, you know, if you were, if you were to start a practice, use true neuro and take in a patient in the same way that Isabella is talking about there, you would be able to very clearly see the thyroid hormones. Are they out of balance? Are they? Are they contributing to the dysfunction. And so if you go to trueneura.com/demo you can get a demo of that software. TruNeura really brings all these things together, everything that we’ve spoken about here today, you know, to be able to build a practice that has the technological bells and whistles that patients are going to expect from being with Oura, being with whoop, being with function health, being with superpower. You can have that superpower for your practice right now with true neuro, especially if you’re interested in building a practice around cognitive decline. So go to trueneura.com/demo, all right. So here we are. It is. This has been episode two. If you like this, please share it with your community. Please share it with other practitioners that need to hear it. We’re very excited about the relaunch of the evolution on medicine podcast. Hopefully this is valuable for you. Thanks so much for tuning in.
If you have questions concerns, we’re going to start some new email addresses so that you can get in touch with us, let us know. You know what you’d like to see in the future, who you’d like to hear from, topics you’d like to get into. We are going to go deeper into a lot of topics that we’ve only skimmed the surface of. We’re going to talk about psychosocial health. We’re going to talk about psychedelics. We’re going to talk about, do people’s symptoms serve a function for them is this something that they get? They are getting something out of and this really speaks to, you know, understanding the psychology of disease. We’re going to get into all more of that. Anything else you’d like to hear about here the evolution of medicine. Be glad to hear from you. This has been the evolution of medicine podcast Season Two. Episode Two. I’m your host. James Maskell, thank you so much for tuning in, and we’ll see you next time you.
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