WB40 episode 803 – McCall McPherson – Transcript

JJ Virgin
McCall McPherson, welcome to the show.

McCall McPherson
I am so excited to be here. Thank you so much. JJ, for having me. actually

JJ Virgin
I can’t believe you haven’t been on before. So that’s ridiculous, and this whole thing happened because at the Mindshare Summit this year, we did a panel totally selfish. I did the panel for me on GLP-1s because I’m just so interested in all of the amazing side benefits they have, and yet people are still missing the point with them. I feel like everyone’s missing the point. They’re looking at them for weight loss, and I think that’s like the least exciting thing about them. I’d love to just start there with you. You’ve been doing thyroid for so long. How did you start to focus on because GLP-1s now seem like a real big part of your practice.

McCall McPherson
Yeah, absolutely. So sadly, you can give a woman back her vitality, her energy, her clarity, her motivation, her libido, but if you can’t help her lose weight and feel like herself and her body, you don’t, you’re not really giving them their full life back. And that’s where I found myself for years at modern thyroid clinic. I would perfect all of these women’s thyroid function and help them in so many aspects of their life, and they still couldn’t lose weight, and it was incredibly frustrating. As much as we don’t want how we feel about our body to dominate the landscape of our lives, sometimes it does, and it’s hard to get around that and work through it.

So I have worked. I’ve looked at all the progressive ways of working through this problem. And when GLPs came out for the weight loss sector, I dug, I dove in completely, and started harnessing them in my practice, and took women with literally a perfect lifestyle that worked out four or five, six days a week, eight. I remember a woman telling me, I’ve been whole 30 since 2018 still couldn’t lose weight. Seen multiple nutritionists, and it allowed them to begin the process of losing weight with appropriate amounts of effort and then ultimately come off of them and continue that success story. And so I just went all in on this, and have been collecting a massive amount of data. I think I probably, honestly have the largest data set of any thyroid population in the world for GLPs. So it’s been a fascinating and honestly, like a sacred journey for us at modern thyroid clinic, and now we’re soon launching our sister company, modern weight loss. So very exciting.

JJ Virgin
So you said something, and it just brought me back to the whole idea of weight loss resistance that I finally hear people saying now, and for so long, it was just poo pooed that, you know, you just need to eat less. You must be cheating. And I remember early, early on in my career, like literally, 35 years ago. I thought that too, and then I was just fortunate to take a group of women away. One of them had this amazing ranch in Santa, Barbara, so I controlled everything, uh huh, and I mean, everything. There was nothing they could do. They couldn’t they couldn’t eat more than what I was giving them. They had to exercise with what I was doing.

And I’m watching, and I’m like, This is so interesting. Some of them lost weight. Some of them stayed the same, some of them gained weight. And I’m like, Okay, well, there you can’t deny thermogenics, they, of course, have a role. It’s not the only thing. And yet, there’s so many people in the weight loss world that just I remember hearing Jillian Michaels screaming as she does at a even at me, at a guy on The Biggest Loser going, it’s calories in, calories out. And I’m like, okay, that’s part, but that’s not the whole story. So it sounds like that’s what you were seeing with this

McCall McPherson
absolutely, and I value you standing with women so much on this, because we have to believe women when they tell us that they’re doing all the things. We have to believe them that they are and they’re not getting the result. And especially with thyroid people, the effort going in does not lead to the appropriate outcome, and ultimately, that’s what I want. I don’t want people to magically be able to lose weight forever, but I want them to be able to appropriately influence their weight. And so many people you’re right still are not believing women and calories in versus calories out is such an antiquated. Outdated, simplistic view of this that just we have to get beyond it, right?

JJ Virgin
So what else do you have? You found to be a play,

McCall McPherson
yeah, so certainly hypothyroid people, but this translates to the better portion of the population as well. Has insulin resistance, right? We have leptin resistance. We have elevations in blood sugar. Basically, we start to, especially with Aurand problem, lose our metabolic potency over time, and I think that translates to us as we age as well. Our system simply does not run as efficiently as it used to, and we can influence that by building muscle mass and doing these things to raise our basal metabolic rate, but when you have a decade of metabolic dysfunction from hypothyroidism, a loss of insulin sensitivity, a loss of leptin sensitivity, we just are prone to storing fat, and we have to back our physiology out of that mechanism in a pretty controlled and intentional way.

JJ Virgin
So you said, you know, when you have a decade of this, like, what is the typical time from the outset of hypothyroidism or the onset of hypothyroidism to actually getting diagnosed? Because I will tell you personally, for me, it was about a month like I could feel it well, because I used to teach this course called overcoming weight loss resistance, so I would go through all the signs of subclinical hypothyroidism, and all of a sudden I’m like, Oh, wow, bing, bing, bing. It’s like, so, so I didn’t suffer. But you made it sound like this could go on for a decade, absolutely.

McCall McPherson
And I don’t want to go, I know we’re not. This isn’t about thyroid only, but sadly, medicine is devolving in the world of thyroid. We are considering, we were considering, really overt hypothyroidism, and then we moved it to subclinical, meaning we don’t want to treat these people. They’re subclinical. Now we’re trying to recategorize, or research as subclinical hypothyroidism into normal thyroid function. Oh, absolutely, absolutely, so medicine is advocating for people not to be treated until their TSH is over 10 or even 20.

JJ Virgin
Yes, what? I got symptoms at 2.5

McCall McPherson
a men. JJ, I think people get symptoms above 1.8 and women can’t show up to their doctor’s office and get treated for 2.5 TSH, anymore. It simply will not happen. So it can take a decade to get a true diagnosis, and by that point, these people are pre diabetic, they have cholesterol issues, they have heart disease. I was reading a study this morning about subclinical hypothyroidism causing insulin resistance, and a separate one causing heart disease. So it’s devastating for our physiology to let that go on.

JJ Virgin
Manned, I did not know this. McCall, I thought that they were actually making the norms I you know, to me, it’s like you want a one. TSH, you want your notes. Like I thought that they were tightening up those norms and taking it down to more like point five to two.

McCall McPherson
They were in like, 2018 and then we took a hard turn after a study, and then it’s just been devolving. And this is what I’m releasing, a book in 2027 on this exact topic, trying to reverse medicine out of this terrible, terrible thing that’s happening for these women.

JJ Virgin
Well, fortunately, they can come to you so, so then you started getting into GLP-1s. What? And I know we were talking offline about this, to me, the most exciting thing about GLP-1s is not the weight loss. And even this morning, I was talking to a friend who said I opted not to use them. I was going to use this very low dose of Tricia Aurand. I opted not to because I realized I could do it with diet. I go improve insulin sensitivity and reduce inflammation quickly, really, you know. So I’d love to hear what your you know, where your enthusiasm is with GLP-1s, and how you’re looking at them.

McCall McPherson
I look at them in a similar way as you and a similar way as our patients. So initially, most people get on them for weight loss, and weight loss quickly becomes a very minor positive side effect of these medications, because, as you said, the benefits of them are far, far reaching outside of weight loss. So I’ve been collecting data specifically even on inflammation, with HS CRP, which is an inflammatory marker also risk stratifies people for their likelihood of a heart attack stroke, which obviously we know is the number one killer of men and women in the world.

After one injection, I have measured people’s CRP, and I’ve seen it reduce over 50% on a micro dose of GLP. So another study came out last week that talked about the anti inflammatory benefits of GLPs, specifically in the Tara. Time before people actually lose weight. So there are so many benefits of these. And we can go deeper on the inflammation topic, because I’ve uncovered so much fascinating stuff in the in the literature. But anti inflammation, I see people’s auto immune numbers drop. Hashimotos antibodies plummet. They’ve been studied for MS and shown every clinical marker, as well as the progression of Mrs. On an MS on an MRI is slowed and reduced on a GLP. Psoriasis, psoriatic arthritis, Alzheimer’s dementia, cancer, 13% reduction in breast cancer risk.

What is so sad is the media is talking and spreading all of this fear based propaganda, honestly, if we can call it that, and creating a lot of anxiety around these side effects of these medications in a medication that has the lowest side effect profile of any Medicine I’ve ever seen, especially when it’s used in micro doses. And we’re not talking about all these extra benefits of these meds that increase longevity. People’s chance even of dying is reduced by 20 to 30% on GLPs

JJ Virgin
theory. Tell me total conspiracy theory. I want to know it’s a total conspiracy theory and and full disclosure, like we are using low dose, I started using it a couple years ago because I was at a medical conference, and Dr William Sears, no, what’s his name. It’s, it’s will seeds. Dr will seeds was William seeds was talking, and he was talking about them, and talking about neurodegenerative disease. And, you know, I’ve got a son with a traumatic brain injury, with neurodegenerative disease now, and I was like, okay, turned him around. Yeah, holy smokes. So then I’m like, looking more into it, and I’ve got a husband with, you know, high risk cardiovascular profile with elevated APO B dropped it. So I’m just like, going, you know me, I’ve got a little autoimmune thing.

Stopped it. So it’s like, Okay, wow. And so my theory on all of this is, is, and I love the argument, oh, but you’ll have to be on it forever. I’m thinking, Okay, wait a minute. There’s no side effects. There’s only side benefits. The only side effect is, if you dose it incorrectly, you get noxious or, you know, gastroparesis, or you lose muscle. But you’d lose muscle with any bad diet. But if you do use it, you could get off your statins, your blood pressure medications, you know, you reduce your risk of cancer. Now you don’t go into that big industry. That’s a Tricia Aurand, so my conspiracy theory on all this, I know I’m gonna get flat for this, but I don’t care anymore, is that big pharma hates it because it’s gonna get them off of all the other drugs. That’s my conspiracy theory. There it

McCall McPherson
is. You know, mine because I asked myself years ago, I’m like, how? How do these meds have all of this potential to create health and healing, like true healing, but all we are doing is recycling various narratives in the media that create fear, like, who is driving this conversation? And I was talking actually with a patient about it, and she’s like, I think it’s the insurance companies. And I was like, oh my god, I think you’re right. They don’t want to spend $20,000 a year on millions of people for the every year, for the rest of their lives. So they are propagating, I mean, I have no idea, but I would say it’s highly likely that they could be the ones that are creating all of this conversation and fear. Because honestly, I can’t find another reason why.

JJ Virgin
Yeah, here’s the big takeaway for all of it, for everybody listening, I think that we’ve discovered over the last five years that the media is ridiculous. Like, I remember back when I went to college, we I was in communications for a bit, and we studied the media, and there was all this stuff about how you had to fair reporting and everything else that’s gone out the window. And window. So, you know, like, don’t get your information there and go look at the research, because the research is incredible. And what’s amazing now is you can just get on chat GPT, get the consensus, you know that I love, I’m obsessed with consensus on chat, GPT, and you can get all the studies. And it’s very clear that this is like amazing, but not used at the dosing the way that you know this that not for a weight loss thing, for an overall health span thing. And you know, as far as the muscle mass goes, as far as I can tell, it seems to be good for muscle mass and lower myostatin and help you build muscle. So I’m the whole thing’s confusing.

McCall McPherson
Yeah, there are inherently muscle protective mechanisms and bone protective mechanisms in GLPs, but kind of like you touched on earlier, a great way to lose muscle. Mass is to starve your body and not give yourself protein and micronutrients or move your body. Doesn’t matter if you’re on a GLP or not, you will lose muscle mass in those situations. So the opposite is also true if you’re on a GLP in a low enough dose that you can get enough protein, get enough micronutrients, move your body, lift weights. You can easily, easily build muscle on these meds. They are not magically evaporating muscle.

JJ Virgin
So walk me through someone who wants to use this. Would you who are the who are the use cases you’re looking at with your patients for using these and then, how are you going about putting them on them?

McCall McPherson
Yeah, so for me, and our approach, honestly, is, I mean, the reality is, is outside of, like a clinical practice, people are like, Well, who do you think makes a good candidate for GLPs? And to be honest, I’m like, everyone, everyone, but my favorite people to put on them are women who simply cannot lose weight with effort, despite great effort being put in. And so I My goal is always to rehabilitate that ability for the effort that they put in to create the outcome that they’re working for. And so I don’t care if a woman needs to lose 10 or 15 pounds, or 50 or 60 pounds, if they have dieted, exercised, gone through all the things obviously optimized their thyroid and hormones and they can’t lose weight. I think they make an incredible candidate. Now, you know, when we first started our program, we started at standard doses, and we started creating data and analyzing feedback and really going deep, and before the word microdosing was ever even applied to GLPs, we were doing it in our practice and slowly reducing doses and seeing outcomes, and obviously now microdosing is like a very common household name for GLPs, but we find that at low doses, we start standard at No more than a quarter of this starting dose, often even an eighth. I have

JJ Virgin
gotten Tricia Aurand, which

McCall McPherson
Good question. So I like to start most people on semaglutide. And the reason is because Tricia petite, in my opinion, is almost too potent, like it tends to bomb out people’s appetite. And my goal is always, I want you to get enough calories, like enough nutrients, enough protein. If you can’t do that, we’re going to fail long term. And so I think almost Tricia Aurand is overly potent. So often I’ll start people on semaglutide Quarter to an eighth of the dose, and only increase them when it loses efficacy. If they’re trying to lose weight, people don’t need to one be on diabetic doses of medication when they’re non diabetic, right? So we are applying systemically diabetes based dosing to the general population, which doesn’t work for a lot of reasons, and then secondarily to that we are determined to increase the dose of this medication on a monthly basis, despite it continuing to work at lower doses. And again, people are losing too much weight. They’re losing it too fast. They’re having side effects, et cetera. It’s just unnecessary. I think the future is in micro dosing, tailored dosing, unique dosing protocols that are much, much more conservative than what we have available at this point in a injectable pen, dose and method,

JJ Virgin
from what I hear in Europe, they have pens that you can dial like what is up With us here. You know, with what we have available to us, not only have I heard that’s like $100 there, yeah, by pharmacy, here you go to a compounding pharmacy, but that you could actually dial your pens to get the dose that you want, as opposed to what we have here, which I’m just wondering why the pharmaceutical suitical companies haven’t caught on to that.

McCall McPherson
Here they will. They absolutely it’s going to be consumer demanded. It is only a matter of time people are too from the concept of microdosing that we had. I mean, it wasn’t called microdosing, but in our practice, to where we are now, this has wildly gotten to be almost normal in the conversation about these medications. So I think very, very quickly, if they’re not already doing studies looking at micro dosing and more Tara dosing, it will happen. But yes, there are certain pens that are clickable. You can count the clicks. The downside is, you’re really not supposed to use the same needle to re inject, so we still need to come up with a better solution, in my opinion, that’s certainly compounded.

JJ Virgin
Mets, yeah. So what is happening here? Because I heard all this fear I was like, going, do I need to stockpile that we weren’t going to have access to these what is going on with that? And as a second part of that question, what is up. With all of this attack on compounding pharmacists, I’ve been, I’ve had so many compounding pharmacy friends over the years, and what always stands out with me, with my compounding pharmacy friends, is their compounding pharmacies can get raided at any time. They are under so much scrutiny, so they act like they’re out there, like mixing, I know, cocktails in their bathroom. They are like they, you know, it has to be a sterile environment. They have so many things they have to hold to, and they can be evaluated at any time with no warning. So why do they have such get such a bad rap?

McCall McPherson
Yeah, well, you know, I think the time that we are in right now is we are, in my opinion, in the greatest medical advancement that will happen in my lifetime, which is GLPs. I think GLPs will change medicine forever. They are certainly equivalent to the discovery of antibiotics 100 years ago. So not only are they such an enormous advancement, they are incredibly lucrative for Big Pharma. And big pharma makes, like you had kind of mentioned, the majority of their medication back on us, on Americans, these drugs are much cheaper, available in other places. And so guess what? The next thing that happens is, is they want to really, potentially, not allow other people to manufacture these meds. And then if they are allowed to manufacture them, they would like other people to not trust and buy them, right? And so I think there is a very intentional situation happening right now.

And the dynamic that is happening that honestly evolves on a weekly basis is, you know, the makers of tirzepatide are really working hard to take away the possibility for us to have access to compounded tirzepatide. They have gone really above and beyond and are getting quite litigious in an effort to stop compounding pharmacies from making these medications and even threatening. You know, clinicians who are prescribing them, unfortunately, we have not succeeded in overturning their desire to halt our ability to access them, and so things are progressing on a weekly basis at this point. But I think that’s why we hear a lot about these compounding pharmacies not being good or unsafe, et cetera.

The reality is exactly what you said. It takes basically four years to get a license to make these medications, and it is incredibly rigorous the standards that are held to create injectable, sterile medications, it’s insane. Like these pharmacies have very specific standards that are tightly regulated. And I think what, where I think that rhetoric came from, is there are, like black market or gray market GLPs that you can buy online, that are research for research purposes only, not for human consumption. And I wouldn’t do that myself, like I think that’s a little risky, and I would never trust those compounding pharmacies. But those are not regulated pharmacies. They are just peptides made in China or Russia, and then they’re shipped over here for people that can’t access them otherwise. And I do think that’s risky. I find zero risk in regular, regulated 503 A and 503, B compounding pharmacies, which is what any real licensed medical provider would be prescribing.

JJ Virgin
Yeah, I think that is so important for everybody understand. Because I hear it. I hear this all the time, and I hear medical doctors saying this, and, you know, I think they’ve been told by the pharmaceutical companies and haven’t looked outside, yeah, to see. Oh, that actually isn’t the case. I hear the same thing in the supplement industry, of like, they’re not regulated. I go, have you been to a supplement manufacturing plant where they can come in at any time and investigate, and you have to have every single bit of your paperwork completely, you know? It’s like, it is, it is no joke. And so you hear that there too, and I’m like, I don’t know what you’re talking about, but like, I have been in the manufacturing of supplements for 30 years, and that’s not the way it works at all. So I just want to make sure everybody is aware of that. So you mentioned that you’re having people come on these and then you’re having people come off of them. But I just wonder, like I look at and I go, why would we want to come off of them? If they have all of these benefits, what do you maintain by getting off of them? Like, why would you want to do that versus just do a cycling low dose?

McCall McPherson
Agreed, if it were up to me, I mean, people would be on them forever, right? I think there is so much still fear based propaganda about, oh my gosh, you’re going to have to be on this forever, and people don’t want to commit to that. Also, it’s not the cheapest. And so sometimes finances come, you know, get in the way. Yeah. Of people being able to access them on a permanent basis. But I think, and people are like, are they safe to be on forever? I’m like, Look, these meds are studied for people to be on them forever. Like, Well,

JJ Virgin
we haven’t studied past 10 years, have we? We’re at 20 now. We’re at 20. What 20 with? Like, what Lyra, gluten, or, I know some exactly your ones, yeah. And when you think about it, I just wonder, like it would seem to me, that we have really damaged a couple things. We’ve damaged our L cells. We’re not able to produce GLP one like we used to. We’re probably not able to hear it like we used to, yeah. So I don’t know how much we can rehab all of that, but I also just wonder if maybe we used to produce more of it in our like, 1000 years ago or something. But, you know, it seems like a wonder compound for what it can do to the body. Have you found anything like what is your thought on us, potentially not producing it like we used to, or being resistant to it?

McCall McPherson
Yeah, I think I haven’t found it in the literature, but I can easily, sort of extrapolate the idea that physiologically, when we are leptin resistant, when and that’s a measurable thing when we’re insulin resistant, that’s a black and white data point. Certainly I would expect for us to also be GLP resistant, right? Like our body can’t hear that message as loud as it used to. And so I would imagine those things just correlate with one another in parallel, and so trying to override and retrain that mechanism is part of the healing process. But yeah, no, I absolutely believe that we as a society are GLP resistant, and that can easily, I think, be equated to, you know, bad food, processed food, all the things that are involved in the standard American lifestyle.

JJ Virgin
Yeah, there’s a lot of post tissue, muscle, fat, exactly things. What do you think about some of the non peptide alternatives. I’m excited about this idea of the Aurand. I think we’re going to have some different things that are going to help us raise GLP-1s. I know that there is a supplement I met this woman at IHS from New Zealand called Calleros, supposed to raise GLP one for a couple hours after taking it. And I also was talking to Dr Jeff bland, and he said, Well, Himalayan Tartary buckwheat does this too, that these bitters. Do these things? Have you looked at any of this to see if any of that would have like could be used in conjunction, or maybe to help people be able to use less of it or to taper off of it if they didn’t want to spend the money anymore.

McCall McPherson
You know, I haven’t, I mean, I’ve had a bottle of caller in my, you know, pantry for for years, I think at this point. And so I’d have to do some beta testing right now. I’m, I’m doing beta testing on true oral formulations of these medications, and not finding the same impact, sadly, thus far, but I’m cycling through several of them with a population of patients.

JJ Virgin
What are you noticing? Or do they work at all? Or no?

McCall McPherson
So I haven’t, don’t have enough data on the inflammatory aspect, but certainly there is little to no appetite suppression, sadly, which I fear could correlate with the anti inflammatory impact. I think potentially, we’re losing too much of the absorption in the Aurand mucosa pathway, but I’ll have to report back. I’m a few weeks in at this point, so there’s so much data to still be collected. But yeah, I mean, the one thing that I do to transition off, speaking to that, and I do think it’s valuable to explore this and other GLP one stimulants. I have one right here, yerba mate, right? That’s another one that stimulates GLP one. I use Metformin to wean people off and transition off a little more smoothly. It’s another medication, but it also has a lot of longevity benefits, and still can continue on that influence of reducing leptin resistance, insulin resistance and elevations in blood sugar.

JJ Virgin
Now with metformin, I’ve always been concerned with metformin and what it does with mitochondria and exercise and reducing exercise capacity. Do you have any issues with that? Do you see that as a problem?

McCall McPherson
I definitely think it can be, and I think it should be cycled on and off and low doses. So I don’t think people need a lot. I think I’m an advocate for 500 milligrams, extended release once a day, even just a few days a week. So like skipping it leading up to exercise or post exercise, I think is is a good idea, especially for people who are very, very weight lifting centric in their lifestyle,

JJ Virgin
which I hope is everybody, me too. So what are some of the big things that you’ve seen with patients? And especially like one I’d love to address is, I think food, noise is a big issue just because of the way, first of all, even in the perfect world. Old. We’re not going to get away from processed food like we’re just not. I mean, I like to think of myself as a really clean eater, and I still eat some processed food, yeah, so, you know, we’re still going to have some of that, and that still creates, the minute you eat them, you’re like, Ooh, yeah. Like, I love this. This cereal called Catalina, crunch, uh huh. Have you tried that? Absolutely okay. So cereal is, like, my thing. So I have to weigh in, like, I have to literally measure this stuff. Otherwise I’d be like, snarfing out a bag of it. Like, literally, we’ll have food noise. So that’s one of the big things I see with this, is it helps shutting down some of the food noise, craving, stuff that our whole lifestyles engineered us to do. What are some of the big things that you’re seeing as benefits from taking these

McCall McPherson
I’ll tell you my most unexpected one that I feel like for my women and my practice has been pretty life changing. It almost rehabilitates their relationship with food, because I’ve take them through this cycle of years of thyroid dysfunction. And I think this applies outside of thyroid dysfunction as well. And it’s I can’t lose weight. I’ve got to restrain, restrain, restrain, control, control, control. Oh, of course, inevitably I fail, and I give in to Catalina crunch, and then I feel guilty and ashamed, and then, you know, it rinse and repeat that cycle, and I gain five pounds of inflammation and water weight, and then I beat myself up, and it really quickly spirals out of control. And then I think that neural pathway gets strengthened in our mind, and then we feel guilty when we eat food, which should not be the case.

Food should be fuel. And what this does, and what I’ve seen it do, is break that cycle. It’s Oh, they’re able to eat well in a very balanced way, have their Catalina crunch and not suffer severe rebound, inflammation, water, weight, inappropriate weight gain. And so slowly over time, that mechanism of guilt and shame associated with food gets broken and food becomes fuel and healthy and good and not evil. And it has been truly one of the most sacred experiences in my medical career to see women go through this transformation is incredibly powerful. So that’s a little bit of it an abstract concept, but cannot be understated.

JJ Virgin
So right, yeah, yeah, I totally appreciate that. I’d love to just switch gears. Just since you do have the modern thyroid clinic, and you know you initially were in this world, you got known for thyroid I think I’d be remiss to not just talk a little bit, just so someone listening, because when you you talked about how long it could be before someone got diagnosed, and especially with them increasing the range, not decreasing it, I would love for you just to talk through what hypothyroidism really looks like, how someone might know what they should look for in their lab tests. So that, and you do have a virtual your practice is virtual, right? So, yeah, virtual and nationwide, yay. So, you know, so that’s because I, I just hate the idea of people suffering. I mean, I had a cousin who, like, her first sign of her hypothyroidism was breaking her hip. Wow, yeah. I was like, when was the last time you went to a doctor, you know. But you know, people don’t realize what low thyroid function can do, plucked unchecked.

McCall McPherson
Yeah, yeah. And, you know, it’s one of those things where it’s so important for women to know that they can’t go to their doctor with a bunch of thyroid symptoms, which I’ll cover in a second, and expect to get an actual answer from their clinician. The likelihood that you have a thyroid issue you show up to your clinician and they diagnose you and treat you with it properly is like, less than 2% like, that’s just not going to happen for years and years. Oh, women are dismissed, rejected, told to eat less, exercise more, all day, every day. So you know, it’s it, and it’s minimized in medicine, the severity of the symptoms involved with hypothyroidism and it’s devastating, it’s life altering.

So first of all, some of the symptoms that women should be looking for are fatigue, brain fog, weight gain, hair loss, dry skin, brittle nails, brittle hair, constipation, low sex drive, elevations in your blood sugar, elevations in your cholesterol that lead to weight gain, even loss of the outer portions of your eyebrows. Medicine says, Oh, those are very non specific symptoms. Just because you have a constellation of them doesn’t mean you have a thyroid problem. It could be anything. In fact, I believe in fine, if you’ve got five or six of those, you probably have a thyroid issue.

JJ Virgin
Wow, yeah, yeah, because outer third of the eyebrows so classic for so many things, yeah, right, exactly.

McCall McPherson
And it’s like, when you have a lot of them, if it looks like a duck. Quacks like a duck. It walks like a duck. It’s honestly probably a duck, right? And so often, women will go to their clinician and they’ll say, Well, I have all these symptoms. I think I have a thyroid problem. Will you please check me? And medicine will only check one, maybe two markers, neither of which are even remotely able to screen for thyroid dysfunction. They will check your TSH and your t4 I was literally reading a study before we hopped on this call that so your most important thyroid hormone is called your free t3 it’s your active hormone.

It’s what regulates all of those symptoms that we just talked about. No one ever checks free t3 and I was reading a study that said less than t3 has the impact on TSH and t4 in labs less than 1% of the time, meaning less than 1% of the time is your t3 appropriately reflected in your TSH. So wow, if no one’s checking that, you won’t know. The same study also showed, I thought, I thought you might find this interesting. Higher levels of t3 are correlated with longer life. Higher levels of t4 which are is the medicine that everyone’s being put on, levothyroxine, Synthroid, T resin, having higher levels equal increased mortality. So medicine has this completely backwards and upside down. So women really, really need to be advocating for a full and complete thyroid panel, which is TSH, free t4, free t3, reverse t3 as well as antibodies, TPO and thyroglobulin antibodies, and then look for optimal, not normal ranges. And I’m happy to share my thyroid lab guide with you. JJ, it’s free, and

JJ Virgin
that’d be great. Let’s we’re going to get your your GLP-1s, decoded guide, your lab, your thyroid lab guide, but just give us a little idea there. Because again, you know, I know for me, a 2.5 was like, lost the outer third. My eyebrows constipated. I wasn’t sweating anymore, which was awesome, but Right? That’s another symptom. Yes, it was like kind of good, but not good, right?

McCall McPherson
Totally. You can’t detox that way. Yeah. So I want people’s TSH less than 1.8 which you know medicine is beginning the the concept of not treating people unless their TSH is above 10 and 20 in a lot of cases

JJ Virgin
that like, I cannot believe that it’s

McCall McPherson
devastating, and it was based on one study that started this catapult years ago that said, Look, people actually aren’t getting better if their TSH is less than 10 with treatment, so let’s just not treat them, because they’re not getting better anyway. In reality, what that study should have looked at is the efficacy of the one medication that we’re offering these people, and saying, Synthroid, yeah, levothyroxine, yeah. And saying, hey, if all these people aren’t getting well until they’re so severe, maybe we need to look at a different treatment. But that’s, in fact, not what we did.

JJ Virgin
It wasn’t fixing t3 so there, so there’s still, were probably low in

McCall McPherson
t3 Right? Exactly. They were low in t3 so TSH should be less than 1.8 t4 should be between point nine and 1.2 free t3, should be between 3.6 and 4.2 reverse t3, should be between about eight and 15. So you guys can write those down, but obviously you guide to go get the guy too.

JJ Virgin
Well, I’m just flabbergasted by the 10 thing,

McCall McPherson
it’s in real time. JJ, thyroid care is devolving, and it is devolving rapidly, despite other research coming out that showing the exact, exact opposite. One fascinating thing that I think applies so much to your people. Came out in April of this year and said people with higher fat to muscle race ratios, their TSH is not valid. So basically, anyone with Aurand problem,

JJ Virgin
wait, wait, wait. So people with higher body fat or sarcopenic Maybe if they were skinny fat, right? Yep. What do we know what that range is? I like, I’m the other thing I’m amazed at McCall is, like, what I learned in, I spent one whole semester in in doctoral school on body composition testing and norms, and what we were taught the norms were then and what the norms are now are entirely different. I’m like, wait a minute, we were taught that, you know, at 27% you need to start worrying about metabolic sleep back then, and now, that’s healthy.

McCall McPherson
They’re worse, they’re not better. You know, it’s crazy. How can we be getting worse and not better? And the answer is, because we are basing those norms on averages of people in our population. That’s also what happens with labs. It’s it’s horrible. It’s why we have one of the worst health outcome countries in the world.

JJ Virgin
So can we with thyroid disease? I don’t know how prevalent is low thyroid function, the. What’s really low thyroid function, not the BS 10 or 20, like, you know, the thyroid function of what you’re talking about.

McCall McPherson
In my opinion, if you are a woman, especially if you are a woman with children, at some point in your in your life, it’s you will have thyroid dysfunction. It is not a matter of if, but when. And why is that? Yeah, I think it’s a lot of reasons. So I think we have massive inflammatory lifestyles that drive Hashimotos, which is the autoimmune condition that then creates, in many cases, hypothyroidism. We are in a society that primes us for autoimmune disease. In addition to that, I think we are also in a society that is filled with hormone disruptors. So in the same way that our estrogen, our testosterone, our progesterone, is being influenced by our environment.

Our thyroid is also and then lastly, what medicine does not account for is women’s hormones decline as we age. And that is not just our reproductive hormones, our organs, our hormone producing organs, like a car, like anything else in the world that gets used over time, doesn’t function as well, and I find so commonly outside of Hashimotos, women’s thyroid production hormones, just they decrease slowly over our lifetime. And so it’s a whole system of reasons, but it is profound and will impact someone’s quality of life Aurand their long term health outcomes in massive, massive ways, if that problem is not solved.

JJ Virgin
So at what age do you find like, you know, perimenopause? We know this one. That’s an obvious one, but I think this one, a lot of these things are not as clear. I’m glad you talked about some of the symptoms. I know I had a client who was depressed, and, you know, like psychiatrist I go, did you check your thyroid? Sure enough. So there’s so many different things. What age do you is there? Is there an age that’s that’s common for this to start out?

McCall McPherson
Yeah, you know, I think a couple things. I think, especially if you have a strong family history. I mean, I see kids with thyroid dysfunction, with massive and severe Hashimotos. So I think if you’re going to the

JJ Virgin
doctor, culture, processed food totally and toxins playing its role here,

McCall McPherson
absolutely. I mean, even, like athletes that play on turf or swimmers, like I have a lot of those kids too.

JJ Virgin
Reverse that, or is that done?

McCall McPherson
No, you can. You can certainly reverse Hashimotos in kids. It’s a little harder, because it’s hard to manage, like what they eat at school and at their friend’s house, and they can’t not do swim all summer, you know. But part of it is like developing these tools to try to combat the severity of the flares, but, you know? And then I think the other dynamic is women, we push through. We are people that just deal with how we feel, and we grind it out, and it becomes our new normal. And so if we’re not being

JJ Virgin
hysterical, absolutely right? I mean, that’s yeah.

McCall McPherson
And then we’re told by our doctors, it’s not your thyroid, it’s actually all in your head. It’s your fault. Go eat less, exercise more, right? So we need objective data to be monitoring every time you go to the doctor, get a full thyroid panel. Get it on your own. If your doctor won’t order it. There’s a million ways like exactly function health and health, I mean, and they do a full thyroid panel,

JJ Virgin
they do. And I’m just thinking so I was just fortunate early on, like 25 years ago, I met this doctor, Dr Diana Schwartz, fine. She was a thyroid fellow. She actually was the one who was treating Suzanne summers for hormones. But she I was like, we need to do certification courses. So I actually outlined the business plan of it. And I was, I was teaching the nutrition part, and she was teaching all of this. And so I got to learn so much from her. And one thing she always said is, if your thyroid is not functioning well, you will not be able to balance your hormones. Like, absolutely not be able to go and balance estrogen without good thyroid. I know, with your thyroids not working well, you’re not gonna be able to build muscle well, you’re gonna have more bone loss. So, you know, things you may not think about. I think we tend to think of thyroid and weight, but it’s the master regulator. Like, if it’s not working, well, nothing is working exactly, and it’s hugely problematic. Just like you said, devastating for your health.

McCall McPherson
It really is. And I get, you know, these people who are like, I don’t want to be on a thyroid medication forever. And my answer is always, you know, okay, but if you’re not on a thyroid medication, you’re going to end up on a diabetes medication and cholesterol medication and hormones that all come from exactly so it’s like you can fix this core issue that’s going to protect so many aspects of your health, or you can try to ignore it and then deal with the real consequences that sometimes are not reversible too late in the game,

JJ Virgin
well, you look at it and go, What if we were working with things that are natural in the body, and just. Helping them come back to where they’re supposed to be, versus doing an external drug that’s not like it makes so much more sense. Absolutely amazing. Well, wow, this has been a master class. I know we’ve gone all over the place, but I was like, I can’t have you here the thyroid, the thyroid queen, without talking that too. So you’re going to do both the GLP-1s decoded guide and the thyroid lab guide, and we will put those at JJ virgin.com, forward slash McCall, m, c, c, a, l, l, and, wow, this has been great, worth the wait. Thank you so

McCall McPherson
much. Thank you so much for having me. This was delightful, and thank you for all of your work supporting and empowering women. JJ

JJ Virgin
Okay, we are talking all things GLP-1s and thyroid. Today, I started out this conversation thinking we’re just going to go deep into GLP-1s, but I have such an amazing thyroid expert with me too that I couldn’t not address that. I’m speaking today with McCall McPherson. She is a pioneering Physician Associate and entrepreneur in the world of thyroids, hormones and metabolic health. She founded the modern thyroid clinic and the modern weight loss clinic, and she also owns thyroid nation, where she combines medical expertise with personal experience to offer innovative solutions as well as a unique and balanced approach to wellness. She’s a TEDx speaker. She was honored as the top 200 faster growing health companies in 2024 Inc, 5000 list.

She’s a top 500 Inc, female founder and the host of the podcast modern thyroid and wellness. And honestly, this conversation, I think you’re going to have your jaw dropping with some of the information that she is sharing, as well as some of the very actionable takeaways, which I will be back at the end to remind you of a couple of those too. We are putting two really important guides that she’s created at JJ virgin.com, forward slash, McCall MC c, a, l, l, and I will be right back with McCall McPherson. Stay with me. All right. I want to give you a couple action items after this, and I think the most important action item, kind of obvious, is to get your thyroid tested completely. Now we’ll put a link to function health to be able to skip the line, because I know they have a huge waiting list, so I have that for you. And I really love function health. Shout out to my buddy, Dr Mark Hyman, for creating this, because it’s $499 a year, and you get massive twice a year. You do a massive panel that literally, if you were going to your doc, you’d end up having to pay out of pocket for a lot of this stuff, and they do a complete thyroid panel, so you’ll be able to see, and that’s how I was able to identify that I actually needed to supplement with straight t3 that what I was doing wasn’t enough. So it’s very, very helpful.

So that is the first one is make sure that you’re really looking at the whole picture there, and if you’ve got other issues, like inflammation, insulin resistance, auto immune disease, neurodegenerative issues, cardiovascular things, this might be a time to explore, looking at using a very low dose of GLP. One. It’s not just for weight loss. And again, I started looking at it a couple years ago. Started using it with my son for brain health. Major shift. I worked with my buddy, Dr Tina Moore, on just ideas around which ones were the better ones, because Tricia Aurand semaglutide there, and she’s also got a really nice GLP one. Course, if that’s of interest, we’ll post that in the show notes too, so you can really learn everything. You know, it’s like, that’s the greatest thing that we have now, is we have democratized information, so that when you go to your healthcare practitioner, you can come in well informed, with the right questions to ask, and if you’re not getting the right answers, you know, there’s a lot of really amazing virtual clinics, like McCall’s, that you are available to you as well. So that’s the big thing, I would tell you, is get your labs done, get become aware of what these things are, and know that you have a lot of options out there. And if someone tells you that it’s all in your head, run away fast. All right, I will see you in the next show. You.

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