Pamela: Hi, this is Pamela from the Encourage Your Wellness podcast, and today I have Dr. Heather Stone. She's one of the top functional medicine practitioners in the world. She has over 20 years of clinical experience in private practice. During that time, she has successfully helped thousands of women overcome symptoms of hypothyroidism and Hashimoto's, and her Thyroid Transformation Blueprint has been used by hundreds of doctors. Thank you so much for being here, and I can't wait to learn more about thyroid health and how we take care of this. It seems like many of my friends go through this and are not sure what to do next.
Dr. Heather Stone: Yes, it is very common. There are millions of ladies who really suffer from this and really suffer needlessly.
Pamela: So, how do you know when you've potentially got a thyroid problem? Then, what do you do, who do you see, and what do you do next?
Dr. Heather Stone: Yeah, so typically the symptoms that we have when dealing with low thyroid include weight gain, low energy or fatigue, and difficulty sleeping at night, whether it's hard to fall asleep or stay asleep. Ladies may experience constipation, diarrhea, or IBS symptoms of any kind, and they may even have anxiety and depression. That combination of symptoms, if you Googled them, would probably indicate you need to check your thyroid. These symptoms are pretty classic for someone experiencing low thyroid or an underfunctioning thyroid.
Pamela: So you suspect that it's a thyroid issue. Do you immediately have to go on medication, or what sort of tests can you potentially run to see if there might be something else going on that might be causing it? How would you typically help somebody navigate this?
Dr. Heather Stone: Well, traditionally in medicine, they run one marker called TSH. If you're lucky, they will do a TSH with a thyroid panel, which includes three additional markers to see if you have hypothyroid. Hypothyroid means that you have underfunctioning or low thyroid hormones. In traditional medicine, they will immediately put you on thyroid medication to get those thyroid hormones normal. Typically, they tell you all your symptoms will go away in a couple of weeks, you'll feel amazing, and to come back and see them in six months or even a year to see if they've balanced out these thyroid hormones.
Unfortunately, when you're dealing with the thyroid gland, it's not usually that easy. Some ladies do experience results after taking the thyroid medication and don't have to deal with all of those symptoms anymore, but that's really few and far between. Most of us who have low thyroid have a lot of other things going on underneath the surface that aren't addressed. In addition to just making sure that your thyroid hormones are normal, there are at least 11 or 12 different markers that really complete a full thyroid panel that should be run. There are many different combinations of imbalances that can be going on with the thyroid, but traditionally they're just looking to see if you have primary hypothyroid and then apply hormone replacement therapy, which you will essentially be on for the rest of your life.
If you still have symptoms after you're on that thyroid medication, they start medicating all the other symptoms. If you can't sleep, they'll give you sleeping pills. If you have anxiety or depression, they'll give you psychotropic drugs, and on and on. But in the functional world, we know that your body gives you symptoms because something is not right, because there is some kind of underlying imbalance. The goal is not just to suppress the symptom but to really understand what's causing the symptom, where the underlying imbalance is, and then address that to help the body actually move forward and heal so that the symptom goes away.
There are many different imbalances that we deal with in the thyroid, and one of the most common imbalances is an underlying autoimmune condition called Hashimoto's. Most of the time, that's not even checked for. The reason they don't check for that is because it doesn't really change their treatment approach. Essentially, if someone has Hashimoto's in the traditional model, they're still put on thyroid hormones, and that's the extent of the solutions they have for dealing with these issues. But we know when you're dealing with an underlying autoimmune condition, there are so many other imbalances, triggers, and components to helping someone truly resolve these symptoms.
Pamela : Yes, so when my son had autoimmune encephalitis, I learned how to do a deep dive into inflammation and what in the world is causing it. It could be a million different things, but really understanding how to put a microscope on your life and say, "Okay, so what is inflammation, what causes it, and what's potentially in my environment?" Tell us a little bit about how you help get to the bottom of this and find out what symptoms could really be exasperating it. From our experience, it wasn't just one thing; there are a number of things that layer in and create a situation where your body says, "Okay, enough." How do you take a look at that?
Dr. Heather Stone : I think it’s really important to understand that the body works together. One of the biggest mistakes we make is taking a myopic approach, focusing only on the thyroid. If you have an autoimmune condition, you tend to zero in on the organ system or gland that’s not functioning properly. In reality, with any autoimmune condition, you have to balance out the immune system.
For example, with thyroid issues, the immune system is attacking and killing the thyroid. Everyone focuses on the thyroid and the thyroid hormones—checking if TSH is normal and adjusting medication dosages. But if we step back and look at the bigger picture, the real problem is the immune system. It's recognizing the thyroid as something foreign or damaged.
This perspective applies to any autoimmune condition, whether it’s the joints (like RA), lupus, the brain, or any other area. The immune system needs to be balanced. We then need to ask a deeper question: What’s triggering the immune system to attack the body?
There are many layers and triggers, and each individual may have different combinations of them. Big triggers include blood sugar and insulin resistance. Foods like bread, pasta, rice, potatoes, cookies, cakes, candy, and soda cause blood sugar and insulin surges. These surges can trigger the immune system to attack the body, creating a cycle of inflammation and immune response.
Adrenal function and how well your glands adapt to stress are also significant. Stress levels play a huge role. Estrogen and testosterone surges, mold toxins, Lyme disease, heavy metals, environmental toxins, food sensitivities, and leaky gut are other layers of triggers.
Many people with autoimmune conditions are frustrated because the conventional approach is to shut down the immune system with biologics. With Hashimoto’s, they don’t do that because the side effects are often worse than the condition itself, so they just put you on thyroid hormones and hope for the best. If another autoimmune condition or thyroid cancer develops, they address it then.
It’s a convoluted way of understanding health, focusing on disease management rather than striving for optimal health. When dealing with autoimmunity, you can’t focus on just one trigger; you have to address multiple triggers simultaneously. Inflammation is a huge trigger, but taking anti-inflammatories like ibuprofen or even natural ones like curcumin doesn't solve the underlying cause.
To effectively deal with autoimmunity, you need comprehensive testing to understand all the triggers and address them concurrently to make noticeable progress.
Pamela: Yes, it's overwhelming for most people going through this. I found it really important to take notes, track your symptoms, and write down what you're doing and not doing because everyone will ask what you’ve been doing, and it’s hard to remember. When you're starting to get help, do you find that all of it is blood tests, or do you also use saliva, urine, or stool tests? I think a lot of people are afraid of blood work, and some doctors won’t even order it because they say it’s too expensive or not needed. What do you do?
Dr. Heather Stone: Well, for me personally as a practitioner, I do all kinds of testing, not on every patient every time, but I always do comprehensive testing when someone starts. We go as deep as we need to go to really understand the complexity and cause of each person's issues. Yes, I do very extensive blood work.
When you're dealing with insurance, it becomes tricky because insurance companies want an ICD-10 code or a diagnosis code to justify the testing. They might say, "The diagnosis codes you listed don't justify running a test like homocysteine," and then the patient gets a bill for $250 for that one marker. Clinicians also get nasty letters from insurance companies threatening to sue or impose repercussions for ordering extensive tests because they don't want to pay for them.
Clinicians are in a difficult situation because they have to play within the insurance system. On my side, I am a member of a co-op where doctors get together to buy down the cost of blood work, going the cash route. Normally, my comprehensive testing would be about $3,500 through insurance, but our testing costs about $360, around 10% of what gets billed to insurance. Isn’t that crazy? Going through insurance makes blood work almost cost prohibitive for most patients, but if you are with a doctor who is part of a co-op, it becomes affordable.
This approach gives us flexibility to run saliva, urine, and stool tests. We do blood, urine, and saliva tests on every patient. The urine test is usually a DUTCH test to look at adrenal function and hormones. We also do very extensive blood and stool testing to see what’s going on. From there, we might do toxicity testing for mold toxins, heavy metals, and environmental toxins.
Finding someone to add to your team is crucial. There is a time and place for Western medicine, but if you're really looking to optimize health and address underlying issues, not just diagnose diseases and apply medication or surgery, you need to take a different approach. Most frustration comes from trying to go the Western medicine route while expecting the results of a functional medicine route.
Pamela : Yeah, when people are looking for a doctor, it's definitely a great idea to have a regular doctor in your corner and also look for a functional or integrative doctor. I liken health and wellness now to doing a major project on your house—you'd probably shop around a bit. It's really important if you have a challenging symptom or diagnosis to do a lot of research and talk to different doctors. Unfortunately, with so much information and potential education out there, it's difficult to ensure you're getting the best individualized treatment plan for you.
Dr. Heather Stone: Yeah, and I think it's important because now we're in a place where we can be—and need to be—our own advocate. You have to take control over your own health, and you can't expect someone else to care more about your health than you do. With access to all the information we have, the more research we do, the more empowered we become. This allows us to be selective about the people we work with. Just like when you're building a house, you don't have one person doing everything; you have an electrician, an architect, and all kinds of people helping you with this masterpiece. Your health should really be no different.
Pamela: Yeah well and If people want to learn more about thyroid health, Hashimoto's, and autoimmune conditions, how can they find you and where should they potentially look?
Dr. Heather Stone: So, the best place to find me is on Facebook. I have a Facebook group called 'Happy Healthy and Lean'. You can search for that group; we have about 30,000 ladies there right now. It's such a great group—everyone is so supportive on their health journey. We have people who are just beginning their journey and others who have been on it for decades. It's a great support system.
The other place you can find me is I wrote a book, 'The Thyroid Transformation Blueprint', which is available on Amazon. I have a link where you can get two free chapters online. I'll make sure you have all that information.
Pamela: That's super and for any doctors listening, what type of cooperative group did you find and join?
Dr. Heather Stone: We use Evexia Diagnostic. We've been with Evexia for decades now. They're a really great group and excellent to work with for doctors.
Pamela:That's super! Well, thank you so much, Dr. Stone. We really, really appreciate having you on.
Dr. Heather Stone: All right, thank you for having me. It's been a pleasure.