Exercise. If you’re my patient you may have wondered why I haven’t emphasized this more. Well the truth is, it’s because a long time ago I committed to never recommending to patients, something I wasn’t willing or doing myself. I vividly remember sitting across from a fat physician who was telling me about healthy dietary habits because my cholesterol was slightly elevated. Never mind his recommendation was to stop using olive oil and incorporate more canola oil into my diet, and the fact that my cholesterol was elevated because of a poorly managed thyroid problem.

Beside the point but I couldn’t resist.

What I mean is, I’m not down to sit back and hand out advice like candy at a parade, for something I’m not committed to myself.

I used to work out 6 days a week. It changed my life. My mood, my energy, vitality, and the way I viewed life was on point, but during my second pregnancy everything changed. Despite having worked out full throttle my with my first pregnancy, the next one wouldn’t even allow me to stand on my feet in one position for 5 minutes. When I was 6 months pregnant and flew across the country with my toddler to meet my husband on tour (the music kind not the war kind, thankfully), I had to take a wheelchair through the Austin airport. If you know how small the Austin airport is, you’ll know how bad off I was. My body couldn’t even handle the metabolic requirements for daily living, much less exercise. And don’t even go there, this was not a will power thing, believe me. So during the entirety of my pregnancy I deteriorated physically and since the birth of our Baby Rose, I haven’t tried to reset. I could give a million excuses as to why, many are super legitimate but ultimately, I would try to regroup on an exercise program and would fail miserably. If I’m being super honest “failing” would mean I ended up rushing to the bathroom to vomit, followed by a solid 20 minutes of bathroom floor bonding while flat on my back with my feet comfortably resting on a seat- at times even a toilet seat. My body has a hard time figuring out what to do with exercise. It always has. So its difficult for me to determine how hard to push myself in a workout, and it honestly just became so discouraging. But I knew I had come to a Y in the road: either I would continue down this path of health in so many aspects of my life, while still being unable to comfortably hike up a hill with my daughters, or I would need to find a program that would give me the tools to change my path.

I did. I decided to join the “Transformation” program at a place called Body by Frame. They have a long-standing reputation for success in changing people’s exercise game in Austin (and actually Dallas now as well). The “Transformation Program” is the most intense that they offer and it lasts for three months. I mean, why not dive in fully, McCall? I was scared out of my mind walking in on day one, three weeks ago, but I began feeling and seeing the effects within the first week. Their method of support and accountability is a game changer. I essentially have a personal trainer for each structured workout to assist, teach and modify each exercise according to my needs and abilities. They have several there but I have the same one each day because I go at the same times. His name is Anthony. Seriously, he’s amazing. He makes a person who is extremely uncomfortable in a gym type environment, feel completely at ease. He is the perfect balance of 100% encouraging and also delicately nudges me to push myself. I’m not sure what the other trainers are like, but if they are 1/8th as good as Anthony, Frame is better for it. My diet is also closely monitored and accounted for so that I can get the best results possible. For those of you who know me personally or professionally, my diet knowledge is on point already, but this takes it to the next level to facilitate a balance of fat loss and muscle building. The diet component is again, part of the Transformation Program and not a component of the general gym membership. Thus far, I’m halfway to my goal and literally feel stronger almost by the day. I’m also using some Xymogen supplement products that have helped increase my workout potential and muscle building but I will save that for another blog. If you’re anxious to get your hands on them, you can email info@modernmedicineaustin.com and I’ll get you the deets.

So long story short, I encourage you to find your own system of successful exercise. I know for me, mine is working wonders and I can’t wait to see how strong I’ll be at the end of the program. If you’d like to join me, or Body By Frame, they have so generously offered a discount to my readers and patients of 20% off of any form of membership for their Austin location. Simply give them the code #YEAROFSTRONG. Find out more at http://bodybyframe.com/. Join me on my #yearofstrong. I’d love to see you and see some familiar faces at Frame and my hilarious lack of coordination should be incentive enough to join in on the fun.

Be well and be strong,

McCall

Every year I'm hoping medicine will catch up, that health care providers all over the country will get the news "YOU NEED TO CHANGE THE WAY YOU DIAGNOSE AND TREAT HYPOTHYROID!" It's December and this year isn't looking good. So I want to take some time to talk about the basics, so that you in turn can know what to discuss with your doctor, PA, or NP.

Let's talk thyroid signs and symptoms and you see if these sound familiar: fatigue, dry skin, depression, brain fog, brittle nails, hair loss, constipation, decreased sex drive, always being cold, weight gain or difficulty losing weight, thinning at the edges of your eyebrows, brain fog (did you catch that?). The incidence of hypothyroid also goes up post-pregnancy.

Ok, this can get a little dense but do your best to get through it. There are 3 major players in thyroid function: TSH, free T3 and free T4. Thyroid stimulating hormone (TSH) sends out the message for need of some T3 and free T4. It is like the gas pedal, the harder we push on the pedal the harder the car is going to work, and the higher the number of TSH will be. When the thyroid received TSH it begins releasing hormones. The majority of what is released from the thyroid is T4, which unfortunately doesn't do us a lot good until it's converted into T3, which a small percentage is. Once finally reaching T3 things can go 2 ways: either free T3 (yay) or reverse T3 (boo). Free T3 is the active form of thyroid and is what carries the effect of our thyroid throughout our bodies (the MOST important). You can think of reverse T3 as free T3 competition. It can bind to the same receptor site taking up the parking spot (why not continue this car analogy?) of our beloved T3. Reverse T3 is often high when our body is under stress or significant inflammation which means we get even less free T3 activity. So what our body really uses is the T3, but this is the least monitored out of the 3. I have no idea how that ending up happening. Often, the only thing being checked is the patient's TSH. Complicating things further is the fact that the "normal range" most used by providers, are grossly inadequate for all three of these hormones, but most dramatically TSH-making even the potential initiation of a hypothyroid diagnosis extraordinarily sparse. In practice, I simply use the TSH value to tell me how hard the thyroid is working to get the output of the patient's T3 and T4. Besides, it's not uncommon for it to be low if a patient is on thyroid medication. This renders it even more useless and problematic, as it is often still the only thing checked for patients being treated. Oh TSH, the problems you cause us.

*There are some other labs that can be useful but we will save for a later post.*

Let me recant my hypothyroid experience at my primary care doctor's office a few years ago. Bear in mind I had been on thyroid medication for years and am obviously familiar with with the symptomology associated with hypothyroid on both a professional and personal level. It went something like this:

Me: "I am having symptoms of x, y, z (really more like a-z), I think I need to increase my thyroid med."

Doctor: "Let's get some lab work."

Me: "Ok."

Lab work returns.

Doctor: "Oh it looks like we need to decrease your thyroid medicine."

Me: "WHAT? (almost jumping across table) Can I see that? (almost ripping it out of his hands) Oh, well you only the checked the TSH.

Doctor: "Ya..."

Me: "You can't decrease my thyroid medication based on this, this isn't even the right lab work. If you want to order my Free T3 and Free T4 then we can talk, if you'll still want to decrease my thyroid meds after that I will have someone else manage my thyroid."

I returned a week or two later.

Doctor: "Your free T3 and free T4 look ok but your TSH is still too low and I think we need to decrease your meds. Oh and by the way, I looked up the labs to run and I was right-TSH."

Needless to say, I went elsewhere. On my thyroid screening questionnaire I filled out at my intake, I checked off each every single thyroid symptom. Every single one. The doctor looked at the same lab results as the previous doctor and thought my free T3 looked low and it was not wonder I was having so many problems.. I have a hard time admitting this to people but for two months leading up to that appointment I was almost bed bound. I literally went to work every day, got off in the afternoon and went to bed by 3pm until the next morning. I remember telling my husband in the car at one point that I think he may need to just take me to the hospital, that I was just too tired and I just didn't feel like I could push myself any more.

That second doctor gave me my life back. He thinks I'm silly when I tell him but he gave me my life back because it's something so simple. The coolest thing is that sometimes I get to give people their life back. They come to me for depression but they don't need an antidepressant at all-they simply have a thyroid problem their doctor missed by only checking their TSH.

Some good internet resources for information pertaining to thyroid are the websites of Stop the Thyroid Madness and that of Dr. Amy Myers out of Austin, Texas.