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The Melanie Avalon Biohacking Podcast Episode #184 - Elle Russ

Elle Russ is a #1 bestselling author and thought leader on confidence, self- esteem, and intention. She is also a world-renowned thyroid health expert. Elle is the author of Confident As Fu*k and The Paleo Thyroid Solution – a book which has helped thousands of people around the world reclaim their health.

She is also a TV-Film writer and the screenwriter of the award-winning documentary film Headhunt Revisited. Elle has written for Entrepreneur and has been featured in Success, HuffPost, Podcasting Magazine, Mind Body Green, Prevention, and more. For a decade Elle has been coaching people all over the world in a variety of areas. Visit ElleRuss.com to learn more about her virtual courses and free masterclasses.

Elle has a degree in Philosophy from The University of California at Santa Cruz. She lives and plays in the mountains above Malibu, California. She is an avid reader, hiker, swimmer, stand up paddler, and comedy binger.



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The Melanie Avalon Biohacking Podcast Episode #12 - Elle Russ

The Melanie Avalon Biohacking Podcast Episode #28 - Elle Russ

The Elle Russ Show Episode #64: Melanie Avalon

11:35 - the problem with modern thyroid diagnostics

17:30 - melanie's experience

22:00 - hyperthyroidism

24:10 - Suppressed TSH

28:00 - LOMI: Turn Your Kitchen Scraps Into Dirt, To Reduce Waste, Add Carbon Back To The Soil, And Support Sustainability! Get $50 Off Lomi At Lomi.Com/Melanieavalon With The Code MELANIEAVALON!

31:00 - t4 conversion to t3

35"30 - hyperthyroidism

35:45 - graves' disease

40:15 - how to dose thyroid meds

42:00 - unoptimized doses

44:15 - thyroid medication history

48:00 - seeing a functional medicine doctor

50:15 - a blood draw after exercise and fasting

52:10 - endocrine mimickry

53:30 - t3 only patients

56:45 - fine tuning the dose and timing t3 only

1:00:10 - intolerance to t4

1:03:45 - free t3 and free t4 testing

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1:09:10 - optimizing testing

1:16:10 - the combining medicine and supplements

1:19:45 - taking the course and learning to read your labs

1:26:40 - creating the course

1:32:00 - doctors skipping or missing labs

1:35:05 - the issues with Natural Desiccated Thyroid

1:39:00 - the issues with compounded medication

1:40:50 - the free 2 hour masterclass

1:48:25 - natural ways to correct thyroid function

Go To melanieavalon.com/ultimatethyroidcourse And Use The Coupon Code MELANIE For 15% Off The Ultimate Thyroid Course!


Melanie Avalon: Hi friends. Welcome back to the show. I am so excited about the conversation that I'm about to have. It is with one of my favorite people in the universe and I actually mean that and a crowd favorite, listeners love this woman. I've actually had her on the show twice before, so this is her third appearance. 

I am back here with Elle Russ. I feel like this woman needs no introduction, but I will introduce her anyways. I originally had her on for her book, The Paleo Thyroid Solution. Elle has just an incredible story with her own hypothyroidism and taking it into her own hands and finding answers and not only addressing her own health issues with hypothyroidism, but just figuring out everything that is behind that and giving people agency to fix themselves as well. And then I had her back on a second time for her book Confident As Fu*k. What is the subtitle to that book, Elle? 

Elle Russ: It's like, How To Ditch Bad Vibes, Clean Up Your Past, and Cultivate Confidence in Order To Make Your Dreams a Reality.

Melanie Avalon: Yes, that. 

Elle Russ: I sort of paraphrase it. [laughs]

Melanie Avalon: That was an amazing episode as well. I remember getting a lot of amazing feedback about how just incredibly inspiring it was. I can just say from the bottom of my heart that Elle, just as a person, knowing her as a friend, really embodies all of that. Just inspiring, giving you, like I said, agency to take charge of your life and solve your health issues. At the top of that, just have confidence in everything that you're doing. We are bringing Elle back on the show because she recently released a new thyroid course called The Ultimate Thyroid Course. I think that this is such a valuable resource for people. The book that Elle had is amazing. The podcast she's done is amazing. But now there's something very mechanical and applicable that people can actually do to take charge of everything when they're struggling with hyperthyroidism. There are so many different directions that we can go with this. But, Elle, thank you so much for being here. 

Elle Russ: Oh, what a lovely intro. One of my favorites as well. I have known you think kind of like since the beginning of when we wrote the books and started to get out there. You might have published yours a little bit after me or I'm not sure, but I remember how we connected and of course we have really fun, great catch ups just like for two hours, [laughs] like hanging out, talking, not about health just about life. 

Melanie Avalon: Boys. 

Elle Russ: Boys, some other biohacking stuff. Yeah, Melanie has a great episode on my podcast, The Elle Russ Show recently and of course I've interviewed her in the past for a while. I have courses on both and everyone listening can get a discount on both of my courses. You mentioned my book Confident as F and so I now have developed courses for both of these, the most important really being I mean, they're both great, but my gosh, the thyroid course. I took everything that I've not only learned in my own struggle and journey and success in correcting my own hypothyroidism when no doctors could help me. But then also just all of the years of coaching other people, all over the world with their thyroid health, evaluating their thyroid labs, literally being the conduit between them and their doctor, helping their doctors help practice medicine with them because 99% of the doctors out there are completely uninformed on this topic because they're steeped in 40-year-old outdated protocols for thyroid treatment.

Just off the bat, to get everyone know how huge of an issue this is and I bet everyone listening knows someone who's like on thyroid hormone medication, [chuckles] there are 200 million plus people in the world suffering. There are 25 plus million Americans who are already documented as having a thyroid problem but 60% go undiagnosed. 

Let me just give you a little run down here. So, you're like, “Wow, 60% go undiagnosed?” Yes. And then what does that mean? That means the doctors are not taking the correct test to even I was on diet. I had a doctor take the wrong test from 1973 who kept saying, you're fine, you're fine. Here, work out more and eat less. You're fine. Here, we'll put you on the pill for that crazy abnormal uterine bleeding you're having when you're 30 years old. [laughs] Not only is the 60% are undiagnosed because of that, but then how many more are mistreated, because even if a doctor tests the correct test, they often don't know how to assess them. If you're assessing them correctly, even though are you dosing and correcting it properly? So, there's like all steps along the way where uninformed doctors get it wrong. That's why my book is, since 2016, still a number one best-selling book. 

It's just consistently successful because it gives answers. But I couldn't do all that I could do in a 30-hour online course. It would have been a 900,000-page book or something [laughs] You know what I'm saying? So, I went deeper now, even though I coached people for years one on one. At this point, you have to take the course to have access to thyroid coaching with me, which I still keep at a very modest price for half an hour because if you've taken the course and you've spent the money “Hey, and I don't know how long I'll be doing that, but for as long as I am doing it.” I give people that option. But you have to take the course first because what I've realized is I've repeated myself a million times all over the world and I was able to encapsulate it. 

So, for example, my book may have a few lab examples, but in the course, it's a two-hour thing of me on video with different labs of men, women of all ages, shapes and sizes going through so that you get to learn because, Melanie, as you mentioned, I fixed myself. No one else did. Look, now, I had to go order my thyroid medication from other countries. I don't want people to have to do that, that sucks. But I had to take my health into my own hands and do it. It worked. And so, I can't deny [laughs] that. But also, “I don't trust you, Jack, Joe or Sally, on how you're going to assess it. I took my own health risks by doing that, but it ends up that I was right.” I don't want people to have to do that. But if you have to do that, and/or more importantly, educating and working with your doctor. 

If you are so educated and you know what's up, A, you're going to find the right people, but B, you're going to be able to really kind of maybe convince your doctor to read that Q&A in the back of my book with Dr. Foresman or experiment a little bit. You've got to step up and become educated because the only reason people are still suffering. I get emails still to this day, they're like, I have been struggling for 15 years with thyroid issues. Okay. This is the only thing you gather [chuckles] from this podcast, the only reason anyone suffers that long is only because of two reasons. 

Number one, you have a dummy, uninformed doctor who has no clue how to assess, treat, gauge a thyroid problem. They can't fix you. They don't know what they're talking about. Number two, and/or you don't know what you're talking about. Now, you shouldn't, right? The doctor should know you're an endocrinologist. You should be an expert in all things, thyroid. But they're not. In fact, they are probably the worst doctors to go to for thyroid help. 

Anytime anyone says, “Well, I should go find a good endocrinologist,” I go, “Don't you dare for thyroid. It's the worst doctor you could ever go to for thyroid in the world,” but they should be the experts. What happens is people eventually find me or a book or do what I did because they're suffering for 10, 15 years. This is one of the easiest problems to manage, fix, correct. So, you and I had a conversation. Do you want to talk about your doctor and what she said that one time? 

Melanie Avalon: I was just thinking about that because I, as well have had my own hypothyroid journey, and I've been working with various doctors for years, and you've been such a valuable resource throughout all of that. And even when I have found a doctor, because the doctor I'm working with now and maybe we can backtrack a little bit in a bit and talk about the basic tests that doctors test versus what they should test. But even, like, for example, the doctor I'm working with right now, I was working or am working with her because she's under my insurance, [chuckles] which is hard to find. Meeting her in the beginning, she was very open to testing everything like, reverse T3, free T3, T4, like, all of the things. I was like, “Okay, this is good.” She even wanted to test fasting insulin. I was like, “Okay, this is nice.” But then we had an experience where I was texting Elle about it. I'm trying to remember exactly what it was. 

Elle Russ: I know exactly what it was about, the TSH. Your doctor freaked out about something on your blood test that she should not have. And I can go into details in a minute, but I'll give the overall. Her freak out is based on an outdated thing from, like, 40 years ago. It would be like me being afraid of saber-tooth tigers. It's like they don’t exist-- It's not--

Melanie Avalon: The suppressed TSH. 

Elle Russ: The suppressed TSH. What does that mean? And we'll get into the test in a minute, but just for right now, so people, don't worry. We'll clear it all up. I'll make sure we do a comprehensive talk about the tests. 

The TSH is a 1973 test that just measures the signal from your pituitary to your thyroid. That signal is just a wake-up call signal. It's a signal that your brain makes. You can consider the TSH, which stands for thyroid stimulating hormone. You can look at it like the pituitary is sort of a sensor. When it senses that your body is low in thyroid hormones and this is for anybody out there, we all run on thyroid. When it senses that your body is low in thyroid hormones, it sends out a signal called the thyroid stimulating hormone, TSH. The signal goes to your thyroid and goes, “Hey, hey, wake up. Time to do your job.” And then there's a whole cascade. I'll get into that later if you want to talk about the whole feedback loop. But just back to the conversation about your test. 

So, when people are on a specific combination of thyroid hormones, their TSH result will be 0.01 versus, like 2. Let's say the range is 0 to 5. It's roughly 0.45 to 5. Let's just say 0 to 5 is the reference range of a TSH test. So, normal people in this road will have no thyroid problems, assuming the other labs we'll talk about later are normal. The way they used to gauge thyroid was just by gauging this signal. This test is from 1973. That's 49 years ago. So, this test is just the signal. If the signal wake-up call is sent to the thyroid and the thyroid doesn't do its job, then we'll never know because you didn't take the test to see if the package was delivered, if it actually did the job. So, the TSH is only measuring the wake-up call. It's like if you ordered something from Amazon and then you never received it, you're not going to keep ordering it. You're going to look into tracking and like, where'd the package go? [laughs] Did it get there? And then also, can you open it once it gets there? And also, is it broken? 

Melanie Avalon: Is it the package? 

Elle Russ: Yeah. The thing that happens is, all right, so TSH in this world might be like 2 or 2.2 on a scale of 0 to 5 for normal people, assuming everything else is right. We never, ever gauge someone's thyroid health by just the TSH alone, based on what I just told you. However, when people are on a specific combination of thyroid hormones, which is either T3 only or T4/T3, and again just throwing out overalls here, we can dig deeper later, then their TSH gets suppressed, meaning it ends up looking on a lab test like 0.01, which would have an ‘L’ next to it as low. Okay, so that test from 1973, just gauging the signal will be low. Why would it be suppressed at 0.1, like, “Hey, ‘Elle why would the TSH go down?” Here's why. 

Because if the person-- because suppressed TSH, you would be a horribly red flag in someone not on thyroid hormone medication combinations I'm talking about. If you were a person in this world and you just had a suppressed TSH out of nowhere, that would actually be a sign of hyperthyroidism, overactive. Why? Because I'll do a whole 180 on it or 360. Okay, so the TSH is 0.1. If someone's on a T4/T3 combination of thyroid hormones in decent amounts and also they're taking over their thyroid. They're saying, “I'm introducing exogenous hormones because my shit does not work.” We're going to overhaul it and replace it. Just like a 60-year-old man would replace lack of testosterone. You're just giving your body what it needs or can use, especially a thyroid. You have to have it to survive. So, you're just giving yourself what you need. So, when you give yourself what you need, the brain goes, “Oh, they got it.” Your thyroid hormones don't ever go so low that the TSH needs to be a positive number. So, the brain shuts up. The shutting up of the brain, the shutting up of the pituitary is the TSH being 0.01. So, what do we find? 

We find that most people who are optimized on thyroid hormone replacement with a T4/T3 combo and/or T3 only, and I'm very specific about that because it only applies to those people. It does not apply to people on T4 only. Forget getting into the weeds on that. Let's just go back to this problem with your doctor. So, your doctor saw the 0.01, but you were on a T4/T3 combo in amounts that would make it so where you're overhauling your system. So, of course, it was going to be 0.01. There's nothing wrong with that. In fact, that's actually how it works. Now, you don't dose to target a suppressed TSH. It just so happens that when people are on the right levels of the other hormones like free T3, free T4, they have a suppressed TSH. Okay, so, why do doctors freak out on this? 

Melanie Avalon: I'll just make one little quick question to further exacerbated the issue was-- so that happened and then she wanted to adjust my thyroid medication accordingly, but the adjustment because I'm on a combination of NDT and just T3. She wanted to give me more T3, but lower my NDT, so lower my T4/T3 combo so that I wouldn't get further to suppress. But then the overall effect of that was a net loss of T3 because she was lowering, literally, it made no sense. It made no sense. I was so frustrated. So, thank you, Elle, for being here. 

Elle Russ: Well, this happens so much. Basically, people on NDT like you or NDT plus T3 or T3 only. When doctors see the suppressed TSH on labs, they freak out immediately and reduce the patient's dose. This is one of the biggest issues with uninformed doctors. It keeps so many people sick. So let me explain why. Like, “Why don't they know this? Why are they worried? Why did your doctor freak out that you had to suppress TSH? Why do all of these uninformed doctors freak out on this?” Here's why. 

There were studies from over two decades ago that indicated suppressed TSH might be an issue. Here is where this came into play. What they used to do more than 25, 30 years ago, was that when someone had thyroid gland nodules, like little benign, but like little kind of tumors kind of on the thyroid, they did this experiment and they don't do this anymore. But what they used to do is they used to give these people high doses of T4 only or Synthroid or levothyroxine to patients with the intention of suppressing their TSH in order to strengthen the thyroid gland nodules. They figured like, “Okay, well, if we kind of shutdown some of the signals or something, let's just give these people.” 

This was a horribly flawed protocol. They don't do anymore. But this is where this fear comes from. At the time they used such high doses of T4, they were making people chronically hyperthyroid. And they were seeing bone loss, arrhythmias, all sorts of things. The medical community stopped implementing that practice because of those outcomes. However, because of the result of that antiquated practice, there are still doctors that think a suppressed TSH is dangerous. Now, you should never give someone a ton of T4 that would suppress their TSH. 

That's why what I'm talking about is when someone has a suppressed TSH on a T4/T3 combo, like, natural desiccated thyroid of any kind or T4/T3 synthetic, or T3 only, then they are going to get a suppressed TSH. Why? Because this is a little deep and clear up anything later. T3 is the biologically active hormone. T4 is just sort of a build-up, slow release, storage kind of situation. That's why the free T3 test always corresponds with how the person feels usually, If you suppress a TSH with T4 only, you're just giving the storage hormone, and you will get the problems that they experience with this protocol, you will. Then cut to all of the studies in the last few decades indicate that TSH suppression has no association with these fear results like osteoporosis or whatever.

So, with my doctor, Dr. Foresman, who's on the course and the doctor on my book and is my doctor, the patients with the lowest TSH values actually have the best bone density scores. He has patients that move to another state. Their doctor refuses to prescribe desiccated or compound or T3 only. And then as soon as the doctor sees the suppressed TSH, they freak out and lower the patient's thyroid medication not understanding the nuance. You never want to ever see a suppressed TSH unless there's some really random in-depth experiment with thyroid cancer or something people would do. For the most part, you never want to see a suppressed TSH. That's not the goal when you are giving someone T4 only. 

In fact, when someone takes T4 only as a thyroid hormone, their labs should look like kind of normal people. Those labs are completely different looking. If you're taking T3 directly, which is what is in Armour and T3 only. So, for example, just to go a step further, if someone's on T3 only and they have none of the storage hormone, which I was for, like, I still pretty much am, but I was for 13 years. Then their labs, the doctors really freak out because it's not only a suppressed TSH, it's also a suppressed T4. They freak out because they don't understand. But here's the thing. Go back to the Amazon example. The signal gets sent to the thyroid. The thyroid releases a lot of T4 and a little T3. Throughout the day, the T4 will convert into T3 as needed. There's another element here, reverse T3. I won't get into it right now. Brain goes, “Hey, Melanie's low in thyroid hormone,” or Joe, Joe has non-thyroid hormone medication. He's just a normal person in this world. The brain says, “Hey, yo, thyroid, wake up. We sense that John has low thyroid hormones.” Then the thyroid goes, if it does his job, it goes, “Okay, thanks.” It pumps out, like, 80% T4 and like 20% T3. And then throughout the days, you need it because it's this elegant, wonderful feedback loop of doing the gauging for you. The T4 converts into the active, fat burning, energy, brain life-giving hormone of T3. So, if you're just giving people, so a lot of endocrinologists will only test TSH and/or they'll only test TSH and T4. This is just the first part of the feedback. This is just part of how it works. 

So, if you're only testing the storage hormone, then again, you're only just continually ordering or looking at the order, you're not looking at, did it convert into the package that's T3? Did it convert into the thing that is the only biological, there's only one biologically active thyroid hormone that's T3. And then people go, “Well, what the hell is T4 there for?” If you can see it as, like, T3 is like gasoline on a fire. It's quick acting, quick dissipating. It's energy. Bodybuilders jam themselves with T3, not smart, to try to burn as much fat before a body competition. Like, they've been abusing T3 for years. Now they have to do other things to offset it because there's things about T3 that are metabolically not good. You do not want to put yourself in a hyper state. We are Goldilocks. not too hot, not too cold. You can make someone hyperthyroid if you suppress their TSH with all this T4, which is what they were doing. 

And what does hyperthyroidism lead to? Heart arrhythmias, bone loss. Those are the symptoms of hyperthyroidism overactive. They didn't know what they were doing. But the studies of the last few decades have said there's no association here. Basically, it's an antiquated belief system based on decades old history of using suppressive thyroid hormone T4 to try to shrink these nodules. So, doctors are still afraid of having a suppressing TSH, even though the literature has shown for decades now that you can suppress the TSH with no metabolic consequences whatsoever. 

A suppressed TSH does not lead to heart failure, it doesn't lead to arrhythmia, and it doesn't cause osteoporosis. Again, all the things I just said with the suppressed TSH are really only applicable to people on a T4/T3 combination of hormones, whether that's NDT, compounded or Synthroid and Cytomel, levothyroxine and liothyronine sodium or T3 only, and not for people on T4 only. 

If someone came to me, it's happened, someone has come to me and been like, the doctor keeps giving me T4, which is levothyroxine or Synthroid, that's by the way every single uninformed doctor does that. They had a suppressed TSH, and immediately it was like five-alarm fire. It was like, “Oh my God, you are going to have hyperthyroid problems. You could have a heart attack. This is not safe.” That would be weird if a doctor still to this day didn't know that part at least, because you'd think they'd be afraid of a TSH if they were giving someone T4 but I've seen that happen. But for the most part, they freak out again when a TSH is suppressed because of what I just told you. It's not just because of these old things, it's the way they did it.

Why would it be okay that you could have a suppressed TSH if you were on T3 only or NDT or whatever. It is because that T3 is direct. You're taking direct T3, so it's in your bloodstream, which means the brain goes, “Oh, she's got it.” So, they don't send a signal and the signal is 0.01 because they're like, “Oh, she's got it. I can shut up. Oh, my neighbor got an alarm clock. I don't need to wake them up every morning anymore. Oh, they're good,” because you're taking over the system by giving yourself thyroid hormone replacement. 

So, when someone's on-- now, again, if someone came to me and was never on thyroid hormones and had a suppressed TSH, you immediately go hyperthyroidism because it's like their own body's alarm going, “Oh my God, I can't send the signal. It's the pituitary gland. Oh my God, I need to be suppressed. I can't send the signal. They're getting too much.” What does that equal? "Oh my God, diarrhea, high heart rate. You could have a heart attack. Hyperthyroidism is extremely dangerous." It's rarer, though much rarer. 

So, you see things like called Graves’ disease. It's usually what ignites hyperthyroidism. There's a lot of commercials on TV in the evening for, like, thyroid eye disease. I've been seeing this and I'm like, “Oh my God, Graves must be on the rise then,” because why would there be a paid ad on a primetime show for thyroid eye disease, which only happens with people who are hyperthyroid. Could it be the increase of autoimmune issues in our society, etc. So, perhaps hyperthyroidism is maybe on the rise because thyroid eye disease comes from hyperthyroidism, not hypo. So, there's that. 

It's okay if someone's taking direct T3, which would be in, natural desiccated thyroid or a T4/T3 combo, or T3 only. They're taking T3 and ingesting it. So, again, it's in the blood and the brain goes, “Ah, they're good.” It's okay to have the suppressed TSH. If you're just giving someone T4 and you suppress their TSH like they did in this old stupid protocol that they don't do anymore, then you will make the person hyper. So, I hope that all made sense, and I'm happy to clarify anything along the way. I know this is maybe someone's just coming to this. That's why your doctor is a dumb-dumbs, because she wanted to reduce your medication. 

This happened to a friend of mine, a colleague of ours who used to work for Paleo Magazine years ago. He has no thyroid gland. So, it's like extra important that his thyroid is optimized. When you have your thyroid gland removed, you have to be on thyroid hormone replacement, or you're dead, period. You're just dead. So, he was on Armour Thyroid, which is natural desiccated thyroid. It's a combination of T4 and T3. He's on it for years. He sent me his labs. His labs looked good. He said, my doctor wants to lower my medication, though, because of this TSH. I get this 25,000 times a month. This is like the number one. It's so much so that, by the way, all that I said to you guys out there listening when you click Melanie's link for my thyroid course, that page just if you want to scroll right down to the bottom and right down to the bottom, you're going to have a whole section that just says for those of you that have a doctor who freaks out about a suppressed TSH. Everything I pretty much said to you is a quote from Dr. Foresman of middlepathmedicine.com. But Dr. Foresman, who's been practiced for 30 years, so they're hearing it from a doctor. 

It's also taken directly out of the Q&A in the back of my book, The Paleo Thyroid Solution. If you just need that at any time, go there, maybe just that alone. Copy and paste it, text it to yourself so that you have it, show it to your doctor. That is why they freak out about it. What I said is really only applicable to people on T4/T3 combos with a suppressed TSH. You don't want to suppress a TSH when someone's on T4 only, but because when they did, look what happened and they weren't doing it right, but they don't do it anymore, and all the studies show that it's no problem. I've had a suppressed TSH for 15 years. 

Melanie Avalon: Well. Around what you were saying like 0.1? 

Elle Russ: 0.01 is classic. It could be even more suppressed, but that's like, “Hey, nothing's happening.” The scale of TSH is usually the reference range. Almost everywhere is 0.45 to 5.0, something like that. That's why I just gave the 0 to 5 as a range. A suppressed would be like 0.01 or 0.08 or whatever. You could have a more suppressed thyroid, but that's kind of generally how it looks. That's how yours looked. That's how most people who are optimized on thyroid hormone replacement, what it looks like. And again, it's not that you target that because there are people that sometimes just need a little sprinkle of thyroid hormone replacement. 

I've met many of those where their thyroid is, like, pretty good. But yeah, they could use a little leg up but do they need to overhaul the whole thing? No. And they just take a little. Now, that's not most people that I deal with. Most people have to take an amount like you and I do, that would suppress a TSH. That would make our numbers look like someone on thyroid hormone. I can tell by looking at almost anyone's lab work whether they're on thyroid hormone or not. I'm really talking about the people that need to take it in amounts that are like standard thyroid hormone replacement versus someone who might just wake up and take 5 micrograms of T3 a day, but everything else is good. Their labs are going to look way different. That's not going to cause a suppressed TSH. 5 micrograms of T3 won't do that. So just want to make those clarifications. This is why, [laughs] in my course, like, these are the detailed things I go through including how to dose this stuff. 

Nobody, you can't find a book or anything out there that is going to go through detailed, like, how do you dose natural desiccated thyroid? How do you dose T3 only? What are all of the variety of protocols and things that you can do? Because it's individual, a lot of it. But you can get enough to know what you should try with your doctor and at least you're educated enough to go, “Hey, let's try this.” You know what I'm saying? Let's try this dosing. I've also seen crazy dosing things from doctors. Like, people will be like, “My doctor told me to take this T4 every Monday, but then every three days increase this to that.” 

Melanie Avalon: Yeah, that's what she wanted me to do. 

Elle Russ: There you go. That's right. I'm not saying that's not wrong, but it's like it kind of tells me they might be uninformed. 

Melanie Avalon: What was crazy was she thought she was raising my T3 and lowering my T4. That was her intention, which I don't even think should have been the intention, but that was her intention. That wasn't actually the dosage adjustments she was recommending weren't doing that. It just made me realize if I wasn't looking at it myself, just how often is this happening to people. 

Elle Russ: All around the world, it's no different. I talk to people, literally the only people I haven't been able to talk to is just because they're limited in how they can speak with me is like Saudi Arabia. They're not allowed to use WhatsApp or all these different things outside the country. But other than that, I have spoken to people in literally almost every country from Sweden to Brazil to Australia. It doesn't really matter. India, everywhere it's the same exact problem. And this is keeping patients sick. And so, now you can see, Jeez, no wonder 60% are undiagnosed. How many more are actually struggling? Who are mistreated? What's the percentage of people that are on thyroid hormone already that are mistreated? 

So many people come to me that are already on thyroid hormone replacement. And so, this is what happens. So, then they are not optimized. And then the doctors are like, well, and then they come in and they go complain like, “I have depression. I have this.” They go, “Well, it's not your thyroid,” because, again, they're gauging it completely wrong. Then they're giving the person Prozac or doing this over here or patching up symptoms that are actually coming from hypothyroidism. 

You can be hypothyroid and be on thyroid hormone replacement if you are not optimized on those thyroid hormones. It's like someone needing, let's say someone really needs testosterone or any hormone, and you just give them a little bit. Okay, well, but did it make them their symptoms go away. And so, if it doesn't, you just go, “Oh, well, we'll give you other stuff. We'll do other things. It must be in your mind, you need to see a therapist or you need to work out more,” whatever it is. “We'll give you a weight loss drug.” So, that's why people stay sick and struggling because they've gone to three, four uninformed doctors because it's very hard to find informed. 

To this day, I don't know many other than mine and maybe a couple of others that I could probably work with if I had to. But other than that, I don't know many. That's sad because I've been doing this a long time and I'm like a thyroid expert, and I talk to people all over the world. There are doctors who have implemented what I do and who use my book. I had a doctor email me recently. I put in my testimonials where he's like, “I just got to tell you I'm an MD and I recommend you to everyone, but I tell them that you're not a doctor, but that you know more than most doctors including myself.” He goes, “I've watched your interviews, like 50 times.” He's like, “Hey, so how and then he asked me a specific question about dosing,” and I was like, “Take my course or like, I can't go like, now it's going to be like a two hour. You want to pay me for a two-hour constitution I'll tell you.” 

So, even doctors and by the way, I love that doctor. That doctor is not trenched in ego, is he? Because he's willing to admit he didn't learn everything in medical school. He's willing to admit and understand that there's a problem here. So, how did the doctors that know what's up? How did they get there? Well, the way that my doctor describes it, he's like, “Look, were taught what we taught, like, 35 years ago in medical school, and it teaches us the standard.” Even if you went to the endocrinologist website, Association of American Endocrinologists, they're like, we want to see everyone's T3 here. There're no nuances. They don't understand. They're going to push T4 and why is that? Let's go back in history. In the late 1800s, there're people that had goiters, which are like, enlarged thyroid glands. One could even be the size of basketball or a melon or tennis ball. There're these lumps in the throat. This brilliant British physician in the late 1800s, I don't know how he came up with the idea, but he extracted sheep thyroid gland from sheep and he injected it into humans and it worked. Thus, came natural desiccated thyroid, which is from now, pigs mostly, not sheep. People were put on that and helped their thyroid problem.

Then, 1950s, pharmaceutical companies on the rise, and they could not patent natural desiccated thyroid. It's been around forever. Just a thing comes out of an animal. They came up with T4 only. They came up with levothyroxine. They came up with Synthroid. They came up with that as a treatment. What they did is they put out a bunch of propaganda against this stupid sheep stuff and pigs and not meant for humans, and they got every endocrinologist on board and sold to and then endocrinologists became T4 militants. So, then what happened is, like, so that happened in the 50s, then about, I would say, probably 20 years ago, is when things really started to turn around, where people were like, “I'm sick. I'm suffering. This T4 is not working. It's not working.” 

Thank God some geeky doctors did some investigation and they went back to the 100 plus year old NDT and people were getting out of the wheelchairs and like, “Oh, my God, thank God, they got off the stuff.” But still, that's touted today is the one size fits all. If you go to most doctors, they just don't get it. I have a functional medicine doctor that I pay out of pocket for, and then I have the dummy uninformed doctor down the street that you just go to because it's on your insurance. You get your blood work from that doctor. And she's not only obese, so that is concerning. She knows I wrote a book about this. She just doesn't understand the way my thyroid labs look. It doesn't matter how much I explain it to her. She's indoctrinated. She just can't see outside of this. So, the doctors that know what's up, how do they know, it's because patients kept coming to them, and they were like, still went back to their geeky, awesome investigative medical school self, and they decided to go, well, hold on a minute, let me look into this. They looked into it and they thought, maybe we should go back to NDT. This doesn't make sense. That's what happened with Dr. Foresman. He'll admit to this day that he mistreated probably a lot of people back in the day on thyroid because that's all they knew. 

But you want a doctor who's willing to challenge things, who's willing to also see a pattern in patients that goes, this doesn't sound right. If you are mistreated on thyroid hormone, meaning you're not optimized, you'll still have hypo symptoms, and then when you go complain to the doctor about it, they will put you on Prozac or do something else, and they'll go, “Oh, well, yeah, of course you're depressed because it's a hypothyroid symptom.” Now, that's an insane comment because you wouldn't have the symptom if you weren't hypothyroid. I'm on thyroid hormone replacement in the proper amounts that make me un-hypothyroid. I have to take thyroid hormone for that every day and you take it too, but it makes me not hypo. But if I lowered my dose significantly or did something else, it could make me hypo. So, these doctors will just pass off like, “Oh, well, it's a symptom of hypothyroidism,” and like, “No idiot, hypothyroidism is fixable, so you just haven't fixed it.” That's an extra dumb, dumb doctor who would say something like that. 

It's the awesome doctors like mine and the other functional medicine doctors out there, and the people and it's probably a few endocrinologists that are willing to learn, that are willing to look at these things and go above and beyond. Now, the doctor down the street has 15 minutes. They're not going to read a book or a Q&A. They're not going to talk to you. They're not going to measure your insulin and blood levels and Hb. I mean, they're not going to do all of this stuff that you and I do and you talk about. That's usually why we have to go above and beyond financially and get someone who is not under insurance, who is not beholden to insurance companies, who spends hours with you, who does in depth testing. 

Now, you don't need that to correct thyroid. That would be more applicable to someone who had, like, right, mold and mercury toxicity plus Lyme disease, plus they're going through menopause like, okay, yeah, see a functional integrated physician for that because that's a one stop shop. But they're looking at the whole body. They're spending time with you because they are not beholden to anyone else or dictated by some medical group that says you need to see 50 patients a day. So, when you go into a regular doctor, the solution is, “Oh, your thyroid is off. Let's give you T4.” 

But let me give you a couple of great examples of where that also has been wrong. Mark Sisson, who you've interviewed and is my mentor of 10 years, wrote the Primal Blueprint, founded Primal Kitchen, he and also, this has happened to many people who have called me. What they do is they'll wake up, they'll go to the gym fasted, and then they go in for their blood work at 9:30, 10:00 AM, for their annual blood work. The doctor is only testing the TSH. Then the doctor says and a doctor actually said this to Mark Sisson. He goes, so the TSH, 0 to 5 is the range. It was like 3.5. The doctor is like, “Oh, my God, I think you have a thyroid problem. I think you have a thyroid problem.” Mark's like, “I've never had a hypothyroid symptom in my life. My weight is amazing.” If you look at Mark Sisson, you're like, the guy is, like, ripped. He has no symptoms whatsoever of hypothyroidism at all. 

Melanie Avalon: He's like, the most un-hypothyroid person I've ever met. [chuckles] 

Elle Russ: Exactly. So, here's why. Now maybe it'll make sense earlier. They saw the TSH elevated. So, they were freaked out because, again, they're using only that measure. They didn't test the other tests. They're just using this measure and they go, “Oh, my God, it's elevated. I'm worried, here's some T4 or you need to think about thyroid hormone.” But here's why it was elevated, because, like, I told you about it being a sensor kind of. All right, so Mark went woke up, had coffee or whatever, water, goes to the gym, works out fasting. Now he's going into get the blood draw. The needle is going into his arm, and the brain is going, “Oh, he just worked out and did all this stuff and has been up for hours. He's low in thyroid hormones. Hey, let me send the wake-up call.” So, the signal goes up to 3.5. It's just a snapshot. Do you see what I'm saying? It's a freaking snapshot when it's in that situation. 

And so, no one should ever in the history of ever be put on thyroid hormone replacement if the doctor has only tested TSH or the doctor has only tested TSH and T4. Now, I have lots of audio testimonials on the sales page for the thyroid course that you could literally you could probably even solve your thyroid problem by literally just going and clicking on Melanie's link and, like, playing the testimonials from these people.

But Kara, is a great example on there. Kara was on T4 only for years. No one tested her for Hashimoto's, which is an autoimmune form of hypothyroidism, and she was struggling, had miscarriages, all sorts of stuff. Long story short, because everyone can go listen to this 30-minute story of hers. Her story is also in the back of my book. When I went to her house at that time I said, “Hold on a second. Let's pull up the tests from your endocrinologist, the original doctor that diagnosed you, that put you on Synthroid T4 only. Let's look at these tests, because I'm willing to bet that he didn't test T3 or anything else.” 

We looked at 10 years of tests, and he only tested TSH and T4. He never tested the fact, is the T4 converting to T3. And so, she remained sick, had miscarriages she didn't have to have, bald, curled up into-- she had allergies, to get allergy shots three times a week. Because, again, no one was addressing not only your thyroid problem correctly, but this is what happens to people on T4 only. Sometimes you can be on Synthroid and be great for the rest of your life, but it often fails people because it's not endocrine mimicry because let's go back to what I said before. When the pituitary sends the TSH signal to the thyroid. Thyroid does its job. When it's doing its job, it's also pumping out direct T3. It's not just pumping out T4 only. And then also, even if that would work for someone, if someone has a Synthroid, you still have to test and go, well, is the T4 converting into the thing that matters, which is T3. 

Melanie Avalon: Yeah. So, well first of all, that is fascinating, the history about the patents with T4, because, I mean, it's really frustrating to step back because I think people who are not that familiar with hyperthyroidism or what these mean and all of these hormones. If they do see anything like we've talked about doctors usually test TSH and T4 which now we've clarified, super clarified that TSH is not a thyroid signal, it's a pituitary signal. 

Elle Russ: Yeah. It's not a hormone. Even though it says thyroid stimulating hormone, it's actually not a thyroid hormone. It's just like a signal. Yeah. 

Melanie Avalon: It's from the pituitary speaking to the thyroid, right? 

Elle Russ: Exactly. 

Melanie Avalon: And then T4, which is the storage form, not even the active form of thyroid hormone. I'm just trying to recap.

Elle Russ: You could live your whole life without T4 in your body, which is applicable to the people who have to take T3 only. That's another discussion. That's the last resort choice of thyroid hormone replacement. But people who take T3 only, their labs, like I mentioned, will have a suppressed TSH and a suppressed T4. And then the doctor really has a meltdown because they're like, “Oh, my God, you need T4.” You're like, “No, you don't,” because I'm not converting, and I don't want to confuse the listeners. We can get into reverse T3 later. But T3 only, which is something that I was on and still pretty much I'm on for over 13 years now. I'm getting the direct-- I'm overhauling that whole feedback loop. I don't need the T4 to spill up and convert. I don't need anything. Just I'm giving myself the direct stuff, which is, again, not the most optimal, it's not the most endocrine mimicry. 

But for people that cannot tolerate T4 or can't convert it, then what do they do? Well, give them the direct shit, which is what you do. So, when a doctor is going to be extra freaked out because they're like they just don't understand. So, you can live. I've lived. I lived for 13 years with, like, no T4 in my body. It doesn't it doesn't matter. T4 is useless unless it converts to T3. That's really the important message out of this feedback loop discussion. T4 is fricking useless. Now we don't have to get into the weeds on this now, but it's all in my course. Never it's like, well, what causes conversion problems? 

I'll give one example. There's a fellow thyroid author named Paul Robinson, out of the UK who self-published a book called Recovering with T3. He's been on T3 only for over a decade. He is a guy that literally, his whole life, they tried to treat his hypothyroidism with T4 only, and it never worked until one day he took his shit into his own hands like I did, and he dosed himself with T3 and he got better. So, in his situation, he talks about it. He lost like, his relationship with his family was terrible because hypothyroidism causes so many issues. You're sick, you are exhausted, you can't participate, you're not fun to be around, you're a mess. It's not life. 

He's still kind of bitter about the fact that hypothyroidism F'ed him up so bad. Then later, genetic testing came out. It's like $600. No one would go and do this particular thing. He went, there're two enzymes, D1 and D2 that are responsible for the conversion from T4 to T3. Finally, the test came out a couple of years ago and he got tested and turns out he has, like, whatever mutations they're nonexistent, which means it makes sense why he couldn't convert T4. 

So, thank God he found T3. Thank God I found T3 because my T4 that I was taking in the Armour that I was taking initially, would not convert into T3, would convert into the inactive form, which is reverse T3. And then in that case, I'm still hypothyroid even though I'm on thyroid hormone replacement. And so, T3 only saved my life too because I don't have to rely on conversion at all, whether I'm swallowing it? There are people that have conversion problems who aren't even on thyroid hormone medication. The T4 that their own thyroid pumps out doesn't do the right thing. There're lots of stages along the way as to, like, what causes a conversion problem or why people couldn't tolerate it. 

For the most part, across the board, people can get optimized on a T4/T3 combination in natural desiccated like you're talking about, or Synthroid and Cytomel or compounded T4 and T3, any combination of T4/T3. Now you're a candidate too that has a nuance where you take T4 and T3 and the combination of NDT, but you add a little T3 to it. Again, I don't even know how thoroughly we went through it after discussion with your doctor, but we can always offline have another discussion about your labs or if you need to add more T3 or whatever. And then dosing time is important. Some doctors will just give, like, here's a bunch of NDT in the morning and it's just too much, it's overload. Most people on a T4/T3 combo do better when they multidose, like twice a day. 

If someone's on T3 only, I mean, they're dosing three to five times a day. I dose three times a day, sometimes I dose two, it depends. Again, that's a nuance with T3 only. T3 only is the most volatile last choice of thyroid hormone replacement, but it is a lifesaver when all of these problems happen. Just it's very rare to find a doctor that understands reverse T3 or understands T3 only dosing. It's extremely rare. You mentioned in the story that I took my health in my own hands. I had to do it twice in 10 years. The first time I got on NDT, I was on Armour and I was doing well, my labs looked good, I put them in the book, they're in the course, they look great. Then the T4 started to not convert and it started to convert into the inactive form and I started to become hypo again, even though I was on thyroid hormone replacement. That's when I learned about this. 

Then I was on my own again a second time in a decade going, oh my God, no one knows about this. Even less people know about this problem. I had to go dose myself again. I did it twice. I never had a doctor help me ever dose my thyroid hormones. I'll get his advice and stuff, I'll be like, “Oh, hey, I'm thinking about this. What do you think?” But for the most part, I'm kind of an expert in it and I can gauge it, but I bounce it off of them if I'm going to make a change. Like, for example, I was on T3 only for like 13 years and I noticed that I felt like I had to kind of adjust my dose more than seemed right because again it's volatile. You're giving the direct T3. You want this thing to work with T4 and T3. You want your body to make the decisions as it's supposed to about when to convert T4 when not to. It's a really elegant feedback loop. It's like a safety mechanism. So, now when you take T3 only, you are a person now who's like in a human brain trying to gauge what you need cellularly. So, it would be lovely if T4 could work for everybody, but it doesn't. That's not to say other people don't have that problem. There're people that have been on the same dose of T3 for 10 years and they're fine. I noticed personally that I felt like, I was always tinkering with it and it kind of was a pain in the ass. 

So, I called Dr. Foresman and I go, “What do you think of me adding a little bit of T4 in the morning, just a little bit? Would that help at all? Would you think that would make the day smoother?” And he said, “Yeah, try 12.5 micrograms.” That's like the lowest dose on planet Earth of T4 anyone has ever taken. It is like very little, but not enough to maybe cause a reverse T3 problem. So, I added a little bit of T4 to my morning, and sure enough, it actually does make things steadier. Why? Because for me, at least that T4 is there. It's not too much where it's going to convert into the inactive reverse T3, but in the event of a drop or whatever, it could pick up and kind of smooth it out if that makes sense. Now, there are some people that cannot even tolerate 12 micrograms of T3 at all. I mean, T4, they can't even tolerate any of it, like Paul Robinson or other people, even Amie Hornaman, thyroid expert, she can't tolerate any T4, she's tried. 

Melanie Avalon: By not tolerating it turns to reverse T3? 

Elle Russ: That and/or they feel horrible, they gain weight even if they don't have the diagnostics to prove it, but it's all off, something's wrong, they don't feel right. Same with Paul Robinson. Now, with me it worked, it does feel right. And I've taken tests since, and again, it's a little bit enough. It actually did the thing we thought it could do. If it didn't, I would have gone off it and not taken it. So, I take a little T4 in the morning with T3, and then I take T3 only the rest of the day. I mean, not like all day later in the day. So, I'm mostly on T3 only. I'm on more T3 than I am for this little minor dose. So, there are lots of nuances like that or sometimes people are on Armour like you or other NDT or T4/T3 combos and they need to just add some T3 to it.

There's, like, a lot of variables here. And again, the course is 30 hours. That's like a semester in school. I go through all of this, like, every nuance that you can imagine. Now still, it's a personal, individual endeavor in a lot of ways, whether you're, of course, working with a doctor or not it's an individual thing. Some people, Amie is a great example. Amie Hornaman, she's a great example because she takes 75 micrograms in the morning and 75 micrograms in the afternoon of T3. That's a lot of T3 to take in one dose for most people's standards. Now, that works for her but that would give me a heart attack.

Like, if I just tomorrow decided to do that, literally I would be in the hospital from a heart attack. But she needs it. So, what can we test? We can test the keys, but not the locks. We can't test to see what's going on in the cell and how much. So, some people it's like hormones. There are people in menopause where they might have testosterone that's high, higher at the top of the range on a blood lab, but they still need testosterone. Do you see what I mean? 

So C.J. Hunt is a great example. C.J. Hunt is an awesome paleo, writer, director, investigative reporter. He did one of the best documentary on paleo nutrition called The Perfect Human Diet, also has a book. I've talked with him public about it. He had a thyroid problem. He was not able tolerate T4/T3 combos, was so sick. He has to take 150 micrograms a day, too. He wakes up, takes 50, then takes 25. He has to take a lot. Again, because that's right for him because that's what get hence the labs, where if I took that, it'd give me a heart attack, make me hyper and blow me off the grid on the blood labs. So, it's all spectrum. Some people just need a little sprinkle. Most people need a standard thyroid hormone replacement. We can kind of go, all right, it might between these micrograms. 

And there's people like Amie and C.J., that need high amounts because why, well, for whatever reason, that's what it takes to affect them in the right way, to make them un-hypothyroid. When a doctor says something like, “Oh, well, that's too much,” you'd be like, “Yeah, well, why though, are you looking at a number?” Because most doctors would go, “Oh, my God, C.J., no one should be on 175 micrograms a day. By the way, C.J., also has a heart issue, he's had since he was 18. So, a lot of doctors, because of that old TSH bullshit about thinking it caused heart arrhythmias, they will freak out about the T3 only because it's bad for your heart. You need T3 for your heart. 

Melanie Avalon: So, you were saying earlier that even the TSH is like a snapshot moment in time. How does that apply to when we are testing T3 and T4? Is that just a snapshot moment in time? How telling is that?

Elle Russ: Well, the tests are free T3 and free T4. What does that mean? Free means what is unbound and available in the system, not what just. So, if you are on any thyroid hormone replacement that contains T3, whether it's T3 only, Armour, any T4/T3, if you're taking any T3 directly. Anything other than T4 only, you never want to take your morning dose before the test and you always want to get tested two hours after waking. We even talked about that with your schedule because you're a night owl. I was like, “All right, well, you're not going to go to the lab at 09:00 AM,” but whatever time you wake up, try to go within two hours. You do not take your dose. Why?

Because if you swallowed your Armour or T3 only and you went into the lab a couple hours later, it's going to be peaking at that moment. That's not what's free and unbound. That's what you just sent coursing through your veins. So, then that's the problem too. Doctors will say, make sure you take your dose before you go in there. They're mistreated or their dose is lowered or whatever because the free T3 will look higher than it should. So, free T3 and free T4 are not really just a snapshot. It's pretty accurate as to what's free, unbound and available and what's in there. Now, when someone's on T4 only, it matters less if they take their dose before they go in there. I always say just don't do it. But they can. 

You never want, I've had a lot of clients who've made that mistake. I look at their labs and I go, “Did you take your Armour before the test?” And they're like, “Oh shit, I did.” You're like, “Well, you have false results. You have to get them again.” Those are falsely elevated results, completely false. That's another way that doctors keep patients sick is by telling them to do that. So, this is what you do is you just take it right after the needle gets on your arm and you walk out of the lab, you just bring your dose with you. It's okay that it's a few hours late that morning. So, that's the way to get accurate labs, morning, fasting. You don't have to do lipid panel fasting. You can have water, tea, black coffee, just no food, supplements, everything else, and you go in within two hours of waking up without taking any of your thyroid hormone replacement. Those are going to be very accurate labs. 

Melanie Avalon: So, I've thought a lot about this and I actually had on Dr. Peter Kozlowski recently, and we were talking about this, and he had a slightly different opinion. But by not taking it, are you not getting the flipside, like a false negative in a way? 

Elle Russ: No. I've done the experiment before where in one day I woke up, took my thyroid hormone and then went in two hours later because T3 will peak within two hours, roughly. So, I went in, actually didn't take the thyroid hormone. I've done it both ways. Where I don't take it, I've taken it. I've seen where the level is that it's peaking. Now, it's okay if it's high when it's peaking, again that's the snapshot of its peak. A doctor will see something, “Oh my God, your free T3 is too high.” You know what I'm saying? It's like, “Yeah, well, because I just swallowed 25 micrograms two hours ago and it's at its peak.” We are looking for free T3 and free T4. What's unbound and available again it is really an uninformed doctor that would ever tell anyone to take their thyroid hormone before a test unless they were doing the experiment that I did. 

So, a free T3 lab, for example, is like the reference range is usually 2.0 to 4.0. Okay, there're some nuances like 2.2 to 4.2. Let's just make it easy for everyone listening and say a free T3 range is like 2.0 to 4.0. Now, it'll be different in Canada, it might be like 2.0 to 6 whatever. Normal people are in the middle of the range, meaning normal people who aren't taking thyroid hormone, who feel great, the Mark Sissons of the world, their T3 could be lower than the middle, but usually normal people that are standard American diets, people out there that are just fine, it's about in the middle. It would be like 3.0, 3.1 in a scale of 2.0 to 4.0. There are nuances in what it should be for someone on T4 only. It'll kind of still look like middle of the range. But for people on T3 only, it might be at the top of the range or above it, which will really freak people out because they'll claim you're hyper if it's above the range, again another reason never to take it before the test. 

If a doctor saw my free T3 when it was peaking, when I took my medication and then got tested two hours later to specifically see what the level would be when it was peaking on a range of 2.0 to 4.0, it was like 6, which most people would totally freak out at. And I called Dr. Foresman, just to confirm, even though I knew the answer was I said, “Well”, he goes, “I don't care when it's peaking it's not what's free, unbound and available. That's just the moment that it's peaking. I'm not even worried about it's not a problem.” And by the way, I was fine. I felt great. It wasn't like I did it as an experiment. So, a doctor would totally freak out. So that happens. You take your medication, you go in two hours later, and then the free T3 is elevated more than it should be. Or they go, it doesn't have to be over like mine was. It could be, “You're on enough medication when the person needs more,” so you don't want to take it. 

Let's say someone's last if someone multi-doses T3 sorry, NDT, usually their second dose is like between 02:00 and 04:00 PM. If they're people on a normal waking schedule. It's like a roughly, 08:00. Let's say you wake up between 07:00 and 08:00. If a person's multi-dosing NDT, their second dose would be anywhere between 02:00 and 05:00. You don't do anything and you wait until the next morning, it's peaked or whatever, it's dissipated. It's going to show what's free, unbound, and available. That's why there're tests like T3 uptake or total T3. We can tell little bit by total T3, but you really want free T3 and free T4. That's the other mistake, too.

Patients are like, “Hey, can you test free T3, free T4,” and then the doctor tests T3 uptake, all these other things. That, again, it's not that they're not there for a reason or don't exist, but it's almost like, for example, I talked about Amie or C.J. C.J. is on 175 micrograms of T3. We never have to test his TSH. We know what it's going to be. It's going to be suppressed. We don't even need to see that number anyway. It doesn't even matter anymore. But we do need to see his free T3 and it will correspond with how he is. So, some people need a free T3 over the range, even when they're on NDT.

Kara being another example, who I mentioned, who's got a 30 minutes testimonial experience if you go to the link through Melanie for the thyroid course, but also in my book. She usually has to be at the top of the range of free T3 to feel well. So, on a range of 2.0 to 4.0, she needs to be at like 3.9. Another doctor might go, “Ah, because they want you to be in the middle because they're comparing your results with normal people that are not on thyroid hormone. We cannot do that. You're not accounting for conversion. You're not accounting for all these things.” What we find is that people who are optimized on a T4/T3 combo usually have a free T3 above the mid-range and even towards the top of the range and that's fine. That doesn't make them hyper. 

Now, let's go to Mark Sisson, Ben Greenfield, people that are like beasts of fitness. Their free T3 is actually going to be lower than the mid-range. Is that a problem? No, unless they have symptoms. Why would it be lower, though, than most normal human beings that aren't on thyroid hormone replacement? Why would they have a lower free T3 and not feel hypothyroid? Like, let's say their free T3 was like 2.5, and it's a scale of 2 to 4, or now a doctor might go, “Uh oh.” But guess what. They are so metabolically efficient that they're what I call ‘T3 efficient.’

Sometimes you do see that Brad Kearns is a perfect example of that. He got his thyroid labs done. He passed him by me. He has no hypothyroid symptoms whatsoever. But some medical outfits suggested that they're like, “Well, we want to optimize your thyroid, so we want to see, we want to give you thyroid hormone replacement, and we want to make sure that your free T3 goes up to the top of the range.” Now, I don't know who the fuck these people are, but I literally was like, “Thank God you called me, Brad. No, you don't need any thyroid hormone replacement at all like what the fuck.” So that's the problem you don't target a number. What are they doing? Who are these people? I mean, it's like medical malpractice guys. Sometimes people can have a lower free T3, be doing well. But again, do they have no symptoms of their temperatures good, or are they doing great? Usually that person is kind of an athlete with low body fat or keto. They're so efficient that they do need less T3 to run on, and that's okay too. But for the most part, normal people in this world who don't have any thyroid symptoms, just normal people that aren't badass athletes, their free T3 is like 3.1 in a range of 2.0 to 3.0. 

By the way, just real quick, someone who's out there who's not on thyroid hormone replacements goes in and gets a test. Let's say their free T3 on a scale of 2 to 4 is like and it should be 3.1 or 3.0, let's say it's 2.8. They could be discounted as well because it's still within the range. They might need a leg up. That might be a scenario for a sprinkle of thyroid hormone replacement. 

Melanie Avalon: So, often doctors just treat the labs and not the patients and their symptoms. I'm just realizing even more and more how valuable your course will be for people to get to the bottom of their own thyroid issues. So, it sounds like there are a lot of potential manifestations that people's labs can present as. For all of the different manifestations, is there in general, probably one ideal supplementation route, or is there still wiggle room within that? Like, for example, compounded T3, T4 versus NDT, natural desiccated thyroid, or a combination like me where I'm adding T3. Is there one answer for everybody or there are multiple answers? 

Elle Russ: Multiple answers. But let me elaborate on the compounded. Okay, so NDT, natural dedicated thyroid, the brand names in the United States are Armour, Nature Throid, NP. In Canada, it's ERFA. In Thailand, it's like Thyroid-S whatever. They're all from pigs. Each 60-milligram pill has the same amount of T4 and T3 in it. Now there are fillers in these pills. Some have gluten. The reason to go to compounded is two reasons. Number one, you have an issue with the fillers that are in these things. Let's say has corn starch in it or whatever it is. If someone's very sensitive to fillers that's where why you go compounded, because they remove all of that. The other reason to go compounded is, so in 160-milligram pill of natural desiccated thyroid, regardless of what brand, regardless of the world, there is 38 micrograms of T4 and 9 micrograms of T3. That's it. 

You can't separate it, meaning you can break them apart and do that and you can add to it if you want like you're doing, but you can't. So, with compounded you can culture it down to the microgram if someone really just needs an extra 2.5 or they can make it exactly in the way that they want and again it avoids any reactions to potential fillers. No one needs to go to compounded unless they do have an issue with the fillers. The other reason is it's from pigs. If you have a religious objection, then you could go to compounded and/or you could just go to Synthroid and Cytomel. Synthroid is the brand name for T4 in the States. Cytomel is a brand name. You don't have to do a brand name, but it's levothyroxine is T4, liothyronine sodium is T3.

You could do a combination of that because then it's not from a pig. Whatever your religious beliefs or let's say you're a vegan and you just don't want to contribute to killing pigs. Look, I've had to treat vegans and people that are in this scenario. So those are the options there. Now there was one scenario where a Jewish client of mine objected to doing pigs. Of course, they don't eat pigs. It's totally fine. It turned out that compounded T4/T3 was cheaper than doing like levothyroxine and liothyronine sodium, Synthroid, Cytomel, like synthetic T4/T3. They chose compounded because it was like $30 cheaper. Sometimes it's more expensive depending on where you live. Again, you can make those decisions too. So then also, too, there are nuances like, I talked to someone recently. They were on NDT. Labs were good, but their T4 was kind of already good. They don't need to add any more T3, but there T3 needed to be raised. In that situation, we added T3 to that. Just like you might need to add something. Sometimes people need to add a little bit T4 to it too. It's fine. It could go either way. But usually, for the most part, people can get optimized on just NDT or those classic ratios of T4 to T3. So, if one 60-milligram pill of NDT has 38 T4, 9 T3, then how do you match that with Synthroid, Cytomel. Well, it could be 50 T4, 10 T3, it could be 25 T4, 10 T3. You can get it kind of close. That's kind of how you do that. 

Melanie Avalon: So, when people are taking your course, how does it work for them analyzing their own labs? Will they basically be able to see how their labs present what they learn in the course, they'll be able to match it? 

Elle Russ: They'll be absolutely able to go, “Oh, I know now how only to evaluate mine, and I know what the possible answers are.” Even if you start one of those answers, like you have to start thyroid hormone replacement, you'll know how to gauge the labs from it and also determine what you might need to do with a nuance. I talk about, I have an entire module just on NDT dosing. An entire module just on-- Not only that, I go through 25 examples of a variety of labs and scenarios of how you can look at these things including Hashimoto's antibodies, including low ferritin and iron. So, everything related to the thyroid picture, again, it's 30 hours I've got. Dr. Foresman has an exclusive hour on thyroid in there, plus an entire hour on detox and two hours on digestion. Brad Kearns is on there and exclusive talking about paleo, primal, keto, everything having to do with metabolic efficiency and caloric efficiency when it comes to diet. 

Then there's Palmer Kippola on there. She wrote Beat Autoimmune. She cured herself of MS everybody. It took her 20 years to figure it all out. She did and it was kind of easy at the end of the day, had she just known the information that she writes about now. So, she talks about that she not only cured herself of MS, but she also happens to be on Armour Thyroid. Sometimes there's dual immunity. She doesn't have Hashimoto's though, but she has MS. But now, if you tested her blood, she has no MS. She's not positive for it at all. She's amazing. Everyone should look her up. If you have MS or know anyone with MS and so she's on there as well with an exclusive module. I have double certified health coach who talks about paleo, primal, how to do it, what it means to you. Again, it's 30 hours. It's a lot. 

But here's the thing, you get lifetime access, a minimum of two years. I imagine I'll be running the course forever, but I don't know. Let's say I die or I don't know. Okay, we'll still probably get it. I'll give it to everybody. Just here you go in your inbox or for most part, you have lifetime access, which kind of is a false thing to offer people in general because people go, “Well, what is that?” But as long as this course is going on, you have lifetime access. Why? Because you could be like me. Where you see this course, you get optimized on NDT, and then a couple of years later, you got a reverse T3 problem. Now you got to go back to my course and figure out how to do T3 only. So, it's completely comprehensive.

And also, it comes with a copy of my book, a PDF of my book, The Paleo Thyroid Solution. I don't read the book in the course. I read some sections, but for example, I don't have a whole module on, like, “How the adrenal glands work?” Because it's in my book and you have my book. But I'm giving you the direct straight out of my mouth, like, “How do you solve this?” Aside from just an introductory, like, you could come off the street and know nothing about hypothyroidism, and the course will take you through, like, “What is it? What's the deal? How do I evaluate labs? What labs should look like for normal people, what lab should look like if you're on Synthroid or T4 only, what your labs should look like, what are the nuances?” Because these nuances are the most important thing now. 

Could I cover every nuance on planet Earth? No, because there're millions of people out there. For the most part, I covered all of the ones because that's my goal. Like I said, I allow once you buy the course, you do have access to a low-cost half-an-hour sessions with me. Who knows how long I'll be doing that, though? I mean, I hope forever, but I may not. In that case, this is the legacy I want to leave for doctors to take it. Doctors and health coaches could really benefit from this. Otherwise, they're evaluating everything incorrectly. But that's what this is meant to. Now there's no other thyroid course out there at all. There's only one other and it's really not comprehensive. There're no thyroid courses out there. This is literally the only one. It's the most in depth. Even some other thyroid authors and experts don't have it. They just have, again, their books and their books are great. Like my book, I show you a few things. I give you an example, but I couldn't cover all of these nuances that I could cover and hours of recording and showing labs on a video and talking about what this looks like. Someone is bound to look at these things and go, “Wait, my labs look that way.” Wait, I've covered all of the ways labs, can look all of the problems and the associated issues. 

Like, I've had men come to me who have low testosterone and the doctor just gives them testosterone. But the precursor to your sex hormones are your thyroid hormones. They are responsible for the production and regulation of your sex hormones. The fail on an uninformed doctor would to be not test the thyroid first and rule it out and just give someone testosterone, which is what they do. Then the person goes, “Well, I don't really feel any better.” That's happened a couple of times where I've had men come to me who were just given testosterone, and it turns out they had a thyroid problem. You correct the thyroid problem, you get rid of the testosterone, their body starts making it again. Granted, age is the factor, but I'm talking about men who are between like 25, 35, 45. If you're 70 and you come to me and you have low testosterone, I'm not sure that thyroid hormones are going to bring that back at that point. You might have to supplement with it. But that's the move. 

So, it happens with women, too. Women, because it's the precursor. It can cause miscarriages, infertility, polycystic ovarian syndrome, which is like temporary. I was misdiagnosed with that. I don't have it. I temporarily had it. It was induced by a thyroid problem. Gynecologically, it manifests itself a lot with women. So, again, the doctors are dumb-dumbs. They take the TSH, they go, “Oh, it's in within range. See you later.” Not going to look at anything else. And then they give the person progesterone or estrogen or whatever. And that wasn't the problem. It happened with the 25-year-old. He had a very serious reverse T3 problem. He was on testosterone for like a year. Nothing happened. Why a doctor would give a 25-year-old testosterone without looking at the backend of what could cause that is insane and that's what happened. That's what we worked on. He got on the right amount of thyroid hormones and got off the testosterone, and then his testosterone went back up to 25-year-old levels. All he needed was the proper thyroid hormone levels to create that in him. 

Melanie Avalon: Especially with the reverse T3 thing, I had my own experience with that where I had really high reverse T3, which was a problem in and of itself. But then my doctor at the time, who was more holistic and was not a conventional doctor, she switched me. I was on a T4/T3 combo. I think I was on NDT at the time and she just switched me to just T3 compounded to try to reduce my reverse T3. I literally thought I was dying. It was the worst experience. There're just so many potential issues and problems out there. So, I think people are really going to be able to make massive changes in their health with this. So, I can't thank you enough. Creating this course, what was the experience like, creating it? How long did you want to create it? When you actually sat down, I remember us talking on the phone when you were working on it for so long. How was that experience? 

Elle Russ: Well, I wanted to do it for so long and then I kind of just then when I finally was like, “Okay, I'm doing it.” What took longer was working on the web, like, what format, what platform I was going to use, how all the backends of how it would work to purchase and do the course and write the copy for all of that actually took a little bit longer. The information was already in my brain. So, it was just like getting together lab results, interviewing people, and seeing, like, how am I going to structure this. And then once I sat down to do it was just on the hours that you hear, because I have had it. It's all been in here forever, which is why I wanted to just spit it out and give it to everybody because what I have found too, is there's a lot of people that come to me pretty educated. 

But again, this has been like my game for years nonstop. I don't expect that anyone is going to be as involved. But then the ones that come to me that don't know anything, see that's the bummer. It's like, no, here's why. You need to learn about this whether you have a good doctor or not, they might retire, they might do something that's not cool. You have a disease, learn about it. I don't care what it is. You can't put your health in the hands of a doctor. I was hurt by them. I was misdiagnosed by them. I'm here to tell you it's not the game you want to play. Those are the people that suffer for 15 years and then they're finally contacting me or they're finally taking my course because they realize, “Oh, I guess I need to know about this problem that I have.” 

Because they entrusted that a doctor would understand and fix it because they should, but they don't. They should know, but they don't. I remember one time, years ago it's another class example. It has nothing to do with thyroid. Some time I had not been dating anyone or been sexually active for a period of time. This wasn't as a result of that, but I had a pH balance off in my private. This is weird. I go to the gynecologist like, “Oh, yeah, you have an imbalance. You need to take this antibiotic.” And I was like, “Mmm and I looked up this antibiotic,” and it had just horrible side effects and all this kind of stuff, and I thought what, I called Dr. Foresman. He goes, “Oh, my God, let me call you into the compounding pharmacy, uric acid pills, shove them up there once a day for 12 days and you're done.” It fixed it.

Melanie Avalon: It was just the boric acid or uric acid? 

Elle Russ: Sorry, boric acid, not uric acid. Sorry, uric acid is when you have gout, sorry. Sorry. Thank you for correcting on that. Sorry. I don't know why I threw that out there. Yeah, sorry, boric acid. Again, it was $40 versus the $100 antibiotic. God knows what would have done. And often my doctor goes, “Oh, you can do that. It could come back. It could come back again.” It's just not the way to go. That's a perfect example of a functional integrated physician versus your standard care classic doctor that just goes by what they learned 40 years ago. I was like, “Well, what could have caused this? I'm not having sex. I'm not washing underwear. It's like, I don't know what,” and they're like, “Look, it could happen from, like, you got soap in there or accidentally fecal matter got in there,” and like, “We don't know. We're just like, this is what happens. This is what you have to do.” 

They were talking to me as if my vagina was going to explode. This is dangerous and all this stuff. And then meanwhile, Dr. Foresman is like, “Go get a--. This is the dumbest thing ever.” And it completely was fine. My God, look at the two scenarios there. So, most people get the first scenario. That's all they know and they trust the doctor. The doctor is a gynecologist. The doctor telling them they could die, their vagina was going to explode. [gibberish] So I was like, “Oh, my God.” I was just like, “Yeah, there's got to be another way.” And there was, there's another way. Turns out it was easier and $60 cheaper. 

Melanie Avalon: I had a recent experience with the gynecologist, and she did a hormone panel, which was normal, but based on the results, she wanted to put me on just this high dose of a hormone. I was like, “But I don't need that.” And then I went and did a second opinion with another doctor. They were like, “Yeah, you don't need to be on that.” 

Elle Russ: Second opinions and third opinions are important, unfortunately with thyroid, they go through several doctors, but if they're staying in the conventional route, they're just going to get here, take Synthroid. They're not going to get the right test. Another thing I want to mention this happens all the time. I mentioned in my book. I mentioned in my course. I had clients cry to me over it. So, they ask their doctor, “Hi, can you take this panel,” that I suggest they take rightly. “Hi can you take this panel?” And the doctor goes, “Yeah, sure.” They go into the lab, and then somehow three of those tests are missing. 

Melanie Avalon: Mm-hmm, this happens all the time. [laughs] 

Elle Russ: Yeah, and I say, "Here's the thing. You have to check their work. Is the checked past the phlebotomist." If it's not, don't waste a blood draw because now they're crying, and they've got to go in next week to get the reverse T3 or whatever. Let me tell you something, which sucks about this. First of all, it's literally no different than you being like, “Oh, hey, can you pay me back that $100?” And I'm like, “Here's 50.” And you're like, “Where's the other 50? You didn't tell me you couldn't pay the other 50. You just gave me 50, you'd think I would have said, "Where's 50? I'd give you the other 50.” 

So, they don't even tell you. They don't call you and say, “Hey, I disagree with your list.” There's just fucking assholes who go, this patient doesn't know what they're talking about. I'm not ordering this. And they don't tell you. They don't go, “Oh, hey, I'm not willing to order this.” Now that I've looked at it, they don't even give you a chance to argue with that. They just don't check it off again. This is so funny. This is another classic one. Everyone's like, “Oh, yeah, yeah, yeah, my doctor tested. My thyroid is fine.” I'm like, “Well, I need to see the labs now.” 99% of the time, they're not fine. I talked to one woman who's been on thyroid hormone replacement for years and she was a friend who my friend invited on a Hike with us, and she's talking to us about this. And I said, “Well, did your doctor test the free T3 or reverse T3?” She goes, “I'm sure they tested the free T3.” And I go, “All right. Well, I'm suspicious. I'd like you to go, you shouldn't be suffering if they know what they're doing, so tell me.” 

They wrote back, they're like, “Oh, my God. They only tested the TSH and T4. Turns out she had a horrible reverse T3 problem, and she had to go on different-- and corrected it. She had been literally in this game for 10 years and went through early menopause at 40. Not a shocker, but how much time wasted because you just trust that your doctor knows what's up because you think they should be the expert in the thing because they have a degree. They don't. I shouldn't know more than doctors. I shouldn't have an MD write me and go, you know more than most-- that shouldn't happen, Melanie. That's wrong, isn't it? But this is the way it is. 

Melanie Avalon: Sometimes they just I think, honestly, leave it off by accident. But I've experienced that a lot. So, I really, really encourage people when they're getting the labs drawn or have the lab slip to double check, because that's happened to me so many times. 

Elle Russ: Yeah, and it's with anything. You could be like, “Hey, I'm starting to date someone. I want to get an STD panel.” You give them a list, and they go, “You only need these three things.” And you're like, “Oh, really I don't need HIV and the other thing like, what?” Because in their standard of care, they're like, well, unless you have symptoms or there's a problem, we don't test it. Well, you could have told me before I went into the lab. This happens with almost everything. You have to double check even if you say your doctor, “Hey, look, I need you to tell me, I don't want to go into the lab and have you not check these, can you take all of these tests?” 

Now, another story is I went to the dumb-dumbs obese insurance doctor down the street for whatever to get the Pap smear and the order for the mammogram or whatever, like the local, get a panel. I went into her and I told her who I was and I said, “Listen, I work with a functional doctor who doesn't take insurance. These are the tests that he wants me to get.” I handed her list, and I said, “Are you okay with testing these for me so that they can be covered under insurance?” She takes a few minutes to look it over and she says, “Sure, I'm happy to order these all for you, but I don't know what some of them mean.” Okay, number one, glad she admitted it. Number two, do you think that mofo went home that night and said, “What are these tests I don't know about? Maybe I should look into it.” I guarantee you she didn't. Guarantee it. That's a dumbass way to be a doctor. But I guarantee you she did not. She should have. She should be like, “What are these other tests this doctor is ordering that I have no idea about? Maybe I should look into this. What's that? What's that?” They don't have time to geek out. They don't have time to do that. They're just like cookie cutter, put through the mill, standard of care, whatever the endocrinologist's association is, T4 is the only answer. They'll still say things like, “Oh, Armours for pigs, not humans.” I've heard that a million times. That's not true. It's USP. It's completely-- Now, I will say some of the NDT companies have had issues in the past couple of years that don't make that look good for that false impression of doctors because a couple of the companies have had issues where they formulated it incorrectly and fucked up and put too much T3 in something or not enough. So, there have been a couple of manufacturing issues, Armour, Nature-Throid, and NP have all gone through it. 

As of right now at the time of this recording, Armour is fine, Nature-Throid is little bit hard to come by, NP is great. So again, they're all usually good. But yes, there has been some blips, but that doesn't mean they're for pigs, not humans. It means there was a manufacturing dumbass issue with the pharmaceutical company. It didn't make it any better for the people trying to say NDT is good for them to have done that. So, those got resolved. There were a couple of recalls that happened as a result of that. People started to get a little hypo because their medication was less when they were on Nature-Throid when that happened with that company and then it happened with NP for a while where they put too much. So, is that an argument for doing synthetic T4, T3, or compounded? Maybe, because you'd always ensure that there's not going to be that issue. Again, that was a blip in time for the most part. I would still recommend NDT to people. It's kind of the easiest and cheapest way to go. Again, considering like, religious objections or anything vegan or you don't want to kill pigs and okay, there're other options. 

Melanie Avalon: I've also heard on the flipside some people say that compounded has more of a potential for dosage issues because it's less stringently regulated. Like it's just up to basically the compounding pharmacy and so if they screw up. 

Elle Russ: Yeah, you know what? Dr. Foresman, has an example that he gave once. Usually, they're reliable. You get a good compounding pharmacy, they're reliable. But you are correct that that could happen. He had a situation one time where a compounding pharmacy effed up and put like a shit load of T3 in there and the patient called with like, a crazy elevated heart rate, had to be put on beta blockers and rushed to the emergency room. So, now the patient didn't blame my doctor for that. It was a horrible thing. He talks about what an awful thing. But in general, it's reliable. Still, if you were afraid of that, then yes, if you were afraid of that plus potential NDT manufacturing issues, then you go to Synthroid, you go to levothyroxine, although I will say this about levothyroxine, and my doctor says it in my book, he's been a doctor for 35 years. Of all the things he prescribes, he prescribes a lot of stuff to people. He has no problems with pharmaceuticals. He's still an integrative functional physician and takes the natural route as much as possible. He will not prescribe the generic Synthroid. So, Synthroid is the brand name. I take Synthroid, I will not take levothyroxine generically. He has found that in patients and labs, it can mess up like liver panels. It can be wonky. So, if you have now generic Cytomel, generic liothyronine sodium, is just fine. I take generic T3. But as far as T4 goes, if you're taking synthetic T4, which is levothyroxine, you want to try to get the US brand name, which is Synthroid. 

Melanie Avalon: If you go to the landing page for Elle's course, which I made a redirect, so if you go to melanieavalon.com/ultimatethyroidcourse and the code MELANIE will get you 15% off of that. So, Elle, thank you so much for that. You can watch, it's like a two-hour video on the landing page. 

Elle Russ: Yeah. If you go to the landing page, there's a little like two to three-minute video, but in there I say, “Hey, if you don't know who I am and you want to learn more about this before investing in the course, click on the button below here, which will take you to the free two-hour master class, where it's just me talking and kind of shoring up a lot of what we said, maybe in a more linear order.” It has free downloads, it has a free meditation. It's got a free Paleo Primal Guide in there. So, again, if you're unsure, there is a two-hour free master class and that in and of itself might be able to help you. But if that's not enough, then, yeah, you'll want to take the course and go back to that. 

Also on the sales page in the course landing page, man I mean, there's a clip from Dr. Foresman, from Palmer talking about curing her MS. There're little clips. There's a clip of Brad, that's four minutes. Then there's a couple testimonials that are like one person was on T3 only. It's her testimonial, Debbie, she's like 63 years old. There's Carrie, who's on there. She is the founder of the website Clean Eating Kitchen. Carrie Forrest. She had her thyroid removed due to thyroid cancer. So, she was really sick being on Synthroid only, meaning being on T4 only. In fact, if you are missing a thyroid gland. I had someone sidenote. I had someone who was I don't know, they called me because they knew a friend of mine and they had gotten through thyroid cancer, and they were like, “Oh, they're thinking about writing a book about their experience with thyroid cancer. They want to talk to you.” Because they were a friend of a friend, I was like, “All right.” 

I get on the phone with this guy, and he's like, “I'm thinking about writing a book about my experience with thyroid cancer and helping people with thyroid issues.” And I go, “Great. Do you know what reverse T3 is?” He said, “I have no idea what you're talking about.” I go, “Then please don't write another useless thyroid book. No, really, don't, dude you need to learn everything I know and more if you're going to write anything that's going to contribute to space because I've read every thyroid book out there. They're garbage.” The only two other ones that I recommend other than my book, The Paleo Thyroid Solution, is Stop the Thyroid Madness by Janie Bowthorpe and Paul Robinson's book, Recovering with T3, because it is the definitive only book that is solely on if you needed to go on T3 only. Those are the only two authors I ever recommend. That's does sound like hardcore, but sorry, don't contribute to the misunderstandings anymore. He just had gotten through and he felt triumphant, and they put him on thyroid hormone replacement, and he still doesn't know any of the things we just talked about. So, he realized, he took it well. I presented it a little bit more diplomatically, but he took it well and he appreciated it. 

On the landing page 2, is Carrie who is a thyroid cancer survivor. They do not usually do well on T4 only because some of the conversion does happen in the thyroid gland. When you're missing one, often you really need to be in a T4/T3 combo. You'll hear her talk about this, but let me give you her dosage, for example, just so you can be like, “Oh, this is what this person doses it. She takes 100 micrograms of T4 in the morning with 25 micrograms of T3. Then four or five hours later, she takes 10 micrograms of T3. Then about 4 hours after that, she takes another 10 micrograms of T3. Most doctors would be absolutely like, their minds would explode hearing that [unintelligible [01:26:26] schedule. But her doctor is also Dr. Foresman, and she found me because she heard an interview that I had done when the book first came out, and she realized Dr. Foresman was in her neighborhood and she could barely stand. She was passing out. She has no thyroid gland. It is of the utmost importance. And then her life has been changed since then and she's been on that dose for a while. So, you can hear her testimonial about going through thyroid cancer. Then there's a T3 only Debbie, on there. There's Kara who has Hashimoto's and she talks about her experience, which I mentioned about here. 

You literally can go directly just to the landing page and listen to these people talk, and there might be something in there that makes you, I've had people write me and go, “Hey, I heard you on an interview. Thank God you talked about A, B, and C. I went and got tested, and I fixed my shit, and I'm doing great.” Awesome. Everyone wants to sell books and courses, but that's why I put all that information on there, so that you might be able to just get enough information to go fix it. People would go, “Oh, that's dumb. You should try to sell courses.” No, because I'm trying to change a fricking horrible global problem. 

Melanie Avalon: Which you are doing and so few people are. I really, really encourage listeners who are struggling with hypothyroidism, get the course. It will really, really help. If you're on the fence at all, definitely go to that landing page and click the link to get the two-hour video that Elle has because it's overwhelmingly helpful. At the end, when you're crying, I was almost crying. I was like, this is so intense. 

Elle Russ: Oh, the two-hour master class. Yeah, it's emotional. It's like because I think about my old self that had to do this on my own that was so sad and hating it and crying and bloated and fat and just fricking hair falling out and miserable and bleeding and like, what. And so, it sometimes comes bad. It comes up in me where it's more about me feeling so sad for my old helpless feeling self. But I'm here to tell you, I have a philosophy degree, and I know more about this. This is not impossible to learn. I did not excel in math and science. If you asked me what 10% of 100 was, I can kind of tell you what it but I'd kind of be like, let me get the calculator. I hate math. I hate science. 

And I remember back in grade school my science teacher was like, if you don't learn science and math, you're going to end up sweeping the floors at an amusement park. I remember being like, “Ha ha you like me now,” but just clearly didn't need to because I think people have grasped a little of this in our conversation. Most of this you can understand philosophically and theoretically. Now, granted, do I really know? Like, if someone were like, explain a cell and an atom to me, and I'd be like, “Not the person to ask. I don't know.” Clearly, I don't know more about human biology maybe than someone who went to medical school. But you don't need to to understand how to fix this and grasp it. Even if you're someone out there, it makes sense once it's explained right. 

Melanie Avalon: It's not that hard to understand once you understand the really basic concepts. Like, it's not rocket science. 

Elle Russ: And I think if anyone-- I know you know this, but people listening probably are also like, she's explaining stuff in a way that I can understand. Yeah, because I was a dumb dumbs with math and science. I didn't know. That's how I explained it to people. And there is repetition in the course. Like, you don't just hear about the feedback loop once, you hear it a couple of times, it has to be reminded. You have to keep getting the hang of it. Got to keep learning.

Melanie Avalon: Slightly different ways. 

Elle Russ: That's right, that’s right. But it is really just the landing page alone and/or the two-hour master class, and it's honestly, people were like, “You should be charging so much more for this.” And you know the reason I'm not? Because I spent over $15,000 as a broke actor back in the day when I first struggled with this in Hollywood and I spent money I didn't have. I went to so many dumb doctors, I got put on so many, I know how much money people have already spent by the time they come looking to find me. So, I want to make it extremely reasonable and especially with the 15% off, it is like less than a functional medicine doctor appointment and it's there for you forever. Furthermore, you need to learn this like just can, if you have this problem. By the way, there's ways to correct it naturally in the course, too. I mean that's always the first order of business. I am not someone who suggests everyone should go on thyroid hormone. 

There're people that have called me then I'm like, “You don't need thyroid hormone at all.” Or have fixed it versus other methods. Just going gluten free has fixed people's Hashimoto's, literally. Sometimes just taking iron and upping your iron. Like, there are sometimes very simple fixes to this. So, I don't want anyone to think that I'm just thinking everyone with a thyroid problem needs to go right. The Paleo Thyroid Solution book, it was not about, “Hey, go on thyroid hormone if you have a problem.” It's, “Hey, here are the things you can do to solve it naturally. But if those don't work, number one, I'm going to give you the information in the course, especially to solve it specifically. And then two, at least if you've tried the sort of more natural protocol first, you've primed your body to receive thyroid hormones so that they can be metabolized properly, so they can get to where they need to go. So, it's not ever a cookie cutter. There are clients I've worked with where we go, “Yeah, try the natural thing. Maybe you need to go gluten free, you got Hashimoto's, you got antibodies, and sometimes that just has fixed it.” 

Melanie Avalon: Well, this has been absolutely amazing. So, again, for listeners, go to melanieavalon.com/ultimatethyroidcourse, the coupon code MELANIE, will get you 15% off. And, Elle, I just can't thank you enough for everything that you are doing. I was just thinking about I already said it once and I'm saying it again, this is such a huge issue affecting so many people, and there are so few people doing something about it, and you're providing answers and solutions and salvation to so many people. So, thank you. 

Elle Russ: Thank you, for all you are doing because your podcast and the work you're doing is amazing. Also, love your book. I did recently interview Melanie on my new show, The Elle Rush Show. That's a good biohacking conversation, but I love that you're getting the word out there and honestly sometimes the best comes from people who've been through it. I mean, the best-selling thyroid books, the two I mentioned as well is in line, they're thyroid patients. It's not a surprise or like someone who's been through it and you are a biohacker and presenting great information. So, I love all the work you're doing as well. Just for being a wonderful friend and awesome lady in this world. Look, hey, I'm grateful for this thyroid problem. It's not only given me an incredible life, it's helped me help other people. I've met wonderful people through podcasting in the health industry, in the paleo world like, what a wonderful thing. It was all a blessing in disguise.

Melanie Avalon: Yeah. No, I was just thinking because right at the very beginning you were talking about when we first met, I completely forgot. It was on Primal Blueprint Podcast, I think. 

Elle Russ: Yes, which I hosted for eight years. 

Melanie Avalon: I totally forgot how we met. That was so long ago, and that was when I was still really struggling with getting my thyroid together. Well, you sort of already answered it, so you could say the same answer if you like, but I always end this show with what is something that you're grateful for? 

Elle Russ: I think just on the heels of this conversation, I am so grateful that I am not suffering. If you don't have a thyroid gland, you're going to die on a stranded island. What's life going to be like when you have sub-par levels? It feels like a slow death. That's what it felt like. I list over 40 symptoms in my book. I had 30. I have none because I take the right amount of thyroid hormone to be unhypothyroid. This is what I tell everyone out there whether you have a thyroid problem or not, maybe you're struggling with something else. Let me just say that once you overcome it, I think it's actually the best thing in the world in a way because there're people out there that never have had health problems and so they don't have the contrast, and I'm not sure that they're as grateful for their health as you can be when you've overcome something. 

If someone got through breast cancer and chemo, they get on the other end usually. They're like, “Oh, my God, it taught me who my friends were, taught me what life was worth, like, what's important.” And so there are still moments. The level of gratitude I have for being normal now and not having these issues never gets old. It's like a continual gratitude thing. Also, the level of empathy you have for people that are suffering. I mean, it's a totally different level. I completely understand. I empathize because I did suffer. I just hang in there and perseverance pays is the last thing I'll say. It just pays. I write in the book, I had people being like, “Well, you're going to have to all these doctors,” 25 different doctors, people are like, “You're going to eventually have to listen to one of these doctors and da da da.” And I didn't. I did it myself. I'm glad I did. You have to persevere. I was at the point I wasn't suicidal, but I say this in my book. I got to a point of suffering so badly with hypothyroidism. I had the thought, “If this doesn't get fixed soon, I might have to think about thinking about it because I can't live this way.” I couldn't wait to go to bed every night so that I didn't have to be awake to experience what it was like to be in my body and feel the horrible symptoms. So that is just never-ending gratitude. It keeps coming up as I talk to people all over the world with problems. I'm always reminded because of their suffering. It's always just like I get off the phone call and I'm like, “Thank God I'm not there. Oh, my God, I got over.” 

Melanie Avalon: Yeah. I'm so grateful for that as well. You can't know the load that you let go of if you never had that load. It just feels so light to not have it. And then also, like you said to empathize with people because I just feel for them so much when they have these symptoms. I know you and I went on a tangent, I think, about constipation and the fears and all the things that we had with that during hypothyroidism. 

Elle Russ: Well, you can take your magnesium to help along with that everybody. If you have a thyroid problem and it's not resolved. Yeah. Also, I'm so grateful that you created the supplements you did because serrapeptase is something that, again, I take regularly because of having high fibrinogen and some other things that just were like, normal within having thick blood. I take it as a maintenance anti-inflammatory dose. And of course, I am a big fan of magnesium in general and take magnesium almost every night. And so, these are important nutrients and I'm so glad that you are providing them as well. 

Melanie Avalon: Oh, thank you. I was thinking about talking about on today's show. We didn't really get to it. We need to have another episode where we just talk about female entrepreneur biohacker, just all of that stuff because it's really, really cool, everything that you're doing, and I find it really inspiring. 

Elle Russ: Well, I think you and I are probably both examples of, like, from nothing to something. How do you create yourself as an-- How do you move forward with that? It's kind of an interesting conversation. 

Melanie Avalon: Yeah. And I really wouldn't be doing what I'm doing today if I hadn't had those health issues. So, I can genuinely say I'm grateful for them. I would not be here. 

Elle Russ: It gave you a career and it's same with me too. Essentially one that was maybe unexpected, but great [laughs] you know.

Melanie Avalon: Yeah. [laughs] Well, thank you, Elle. You are so amazing. You're one of my favorite people. I really, really mean that. So, again, listeners, melanieavalon.com/ultimatethyroidcourse, coupon code MELANIE will get you 15% off and enjoy the rest of your day. I will talk to you sooner rather than later. 

Elle Russ: You too. 

Melanie Avalon: Thanks, Elle. Bye. 

Elle Russ: Bye.

[Transcript provided by SpeechDocs Podcast Transcription]

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