Hello to the most incredible community!
I hope you're taking care of yourself this week, and if you're not quite there yet, that's okay. That's what this newsletter is for.
This week's questions come from three people who are doing what they were told and still don't feel better. One has been on thyroid medication for years with Hashimoto's and labs that keep getting worse. One has low cortisol and a doctor recommending prednisone. One has been on antidepressants for years and still has no energy.
Here's the thread tying them together. Your thyroid, your adrenals and your brain chemistry don't run on separate tracks. Your thyroid hormone has to be converted into its active form, and a lot of that happens in your liver. Your adrenals set the tone for your thyroid. And the energy you feel depends on neurotransmitters your body has to build from raw materials. Medication can be an important piece. It usually isn't the whole picture. Let's get into it.
Here's what we're covering in today's questions:
(Click to skip ahead)
Thank you for being here. Now on to the questions!
Your thyroid pill still has to be converted. A lot of that happens in your liver.
The first question below is from a reader who has been on thyroid medication for years and keeps getting worse labs. Nurse Doza's answer goes straight to the liver, because the most common thyroid medication is T4, and a lot of the work of turning it into active T3 happens there.
LIVER BOOST is the formula he reaches for. It carries the three nutrients he names below, NAC, turmeric and selenium, alongside 13 others built to support both phases of the liver's natural detox work.
October only: Buy 2, Get 1 Free. Three bottles for $222, a six-month supply.
Q: Nurse Doza, what can I take for my Hashimoto's? I've been on thyroid meds for years but I still feel terrible. Is there a supplement I should be taking? I feel like I'm not getting any better and my labs are worse than before.
A: Nurse Doza: I have three suggestions for you to try that could help support you with your Hashimoto's.
(First, keep taking your thyroid medication exactly as prescribed. Everything below goes alongside it, not instead of it. Let your prescriber know you're adding these, since your labs can shift and your dose may need adjusting. And take them at a different time of day than your thyroid pill, because minerals like calcium can get in the way of how it absorbs.)
How to support your thyroid with Hashimoto's:
Start with vitamin D3. This is a foundational supplement I think everyone should be taking, but when it comes to autoimmune disorders, vitamin D deficiency has been associated with immune system problems. Vitamin D receptors are found on immune cells throughout the body, and healthy vitamin D levels can support the immune system, even for someone who already has an autoimmune disorder. In my experience, most people do well with 5000 units of vitamin D3 daily, but for some people with Hashimoto's, I have found that 10,000 units of vitamin D3 can support its role as an anti-inflammatory hormone in the body. (That higher dose is one I only use after checking a vitamin D level, and I recheck it. Please don't jump to 10,000 on your own.) Yes, the body can and will use vitamin D for bones, activating the immune system, and converting vitamin D3 into a hormone that helps regulate inflammation in the body.
Support the liver. The second supplement I recommend is a liver detox supplement with NAC (N-acetyl-cysteine), Turmeric and even Selenium together. In my opinion, NAC is the strongest liver antioxidant you can take as a supplement and Turmeric is a close second. The liver is one of the main places where the thyroid hormone T4 is converted into thyroid hormone T3, which is the most potent thyroid hormone we want and make. With 1 in 3 people dealing with a fatty liver, a liver that is not healthy may not convert T4 to T3 the way it should. This can show up as an elevated Reverse T3, a blood test that can show the conversion being blocked. I'd want Reverse T3 ordered anytime a person is on thyroid meds, as the most common thyroid medication prescribed, levothyroxine (Synthroid), is actually thyroid T4. Most hypothyroidism patients are prescribed levothyroxine with the hopes it converts to T3 in the liver. But a fatty liver can get in the way of this. Selenium is an interesting nutrient that not only supports liver function but also supports thyroid function, another connection between the thyroid and the liver.
Support the adrenals. The last supplement I would recommend would be bovine adrenal gland. Glandular supplements have been used for years for all kinds of health issues, but I have found a direct connection between the adrenals and the thyroid in labs, and with Hashimoto's. Overactive adrenal glands due to stress and trauma have been linked to a suppression of the thyroid that presents as hypothyroidism. In my experience, treating just the thyroid and not the adrenals can lead to an overactive thyroid and underactive adrenals, and I see both in Hashimoto's.
For our Hashimoto's clients in the clinic, I recommend our vitamin D3 supplement, THE D, our liver detox supplement LIVER BOOST, and our adrenal supplement ZEN. Take these supplements for 3-6 months and recheck your Thyroid Peroxidase (TPO) lab, which is the main lab test used to diagnose Hashimoto's. I hope you see a change with this approach. If you don't, please feel free to book a thyroid lab review consult with me to figure out what else might be going on.
Extra credit: Hashimoto's rarely shows up by itself. If you want the bigger picture on how your hormones work and what throws them off, take our $10 Hormones course.
A full thyroid panel has five numbers. A lot of people only ever see one.
The answer above names two labs a lot of standard panels leave off: TPO, the antibody most associated with Hashimoto's, and Reverse T3, which can point to whether your T4 is being converted the way it should. Getting the numbers is step one. Knowing what they mean together is step two.
A Read Your Labs session is a 15-minute telehealth call where Nurse Doza has already gone through your results before you get on. Full thyroid panel, cortisol, DHEA-S, vitamin D, liver markers, whatever you have. You leave with a plain-language read and one clear next step.
$99, down from $199. Send your labs 24 hours ahead.
Q: What do you do about low Cortisol? The doctor wants to put me on Prednisone which I know is going to mess me up in the long run. Is there anything else I can do or take? I am struggling with my energy.
A: Nurse Doza: Cortisol is made in the adrenal glands, and the brain tells them when to make it. Stress activates our adrenals to produce Cortisol, and morning sunlight can also help our brains signal for healthy Cortisol to fuel our day. Too much stress and too little sunlight can lead to a lack of healthy Cortisol production. How much stress and how much morning sunlight have you had in your lifetime?
(Before anything else: if your doctor is recommending prednisone, have a real conversation with them about why. Truly low cortisol can be serious, and sometimes a steroid is the right call, at least for a while. Please don't skip it or put it off without talking it through with them. Everything below is what I'd add alongside that conversation, not instead of it.)
How to support healthy Cortisol levels:
Get morning light. If you cannot get 10-15 minutes of daily morning sunlight, consider investing in a red light panel. It's still dark in the morning for me and my family when we get the kids ready for school, so I turn on our red light panel every morning in the living room while we are getting ready for the day. This is the one we use (code nursedoza). I absolutely love our red light panel and we use it every day! Our cats even sit in front of it in the morning, seriously!
Support the adrenals. The other way I'd support healthy Cortisol levels would be to take bovine adrenal supplements. Bovine adrenal gland is a glandular that's traditionally used to support the adrenals' own function. I would try our ZEN, which has bovine adrenal gland and vitamin B5. Vitamin B5 supports healthy adrenal function and Cortisol balance. (ZEN also contains licorice root, which can interact with steroid medications like prednisone, so clear it with your doctor if you do start one.)
Recheck your labs. Recheck your Cortisol levels in blood work and don't forget to check your DHEA-s levels too, as DHEA-s can represent your overall adrenal function. You can check and recheck both using Superpower labs.
Extra credit: stress is where I started above, and it's the input most people never get real help with. Our $10 Stress Management course walks through the stress response, what to eat and take, and the labs that measure it.
It's still dark when the Doza house wakes up. This is what goes on first.
The answer above has a detail worth a second look. On school mornings it's still dark at Nurse Doza's house, so the red light panel goes on in the living room while everyone gets ready, and the cats have claimed the spot in front of it.
That panel is a Light Path LED. Pulsed light, the most LEDs per square inch they could find, veteran owned, with a two to five year warranty depending on the panel.
Use code NURSEDOZA and the discount applies at checkout.
Q: Nurse Doza, I need help with energy. I have been taking antidepressants for years and I feel like they help, but it's still not enough. Do you have any suggestions?
A: Nurse Doza: When someone says “low energy,” I often think about Serotonin and Dopamine first. Most antidepressants work with the Serotonin someone already makes, and Dopamine, which helps with focus and motivation, runs on a different pathway. Also, what if someone doesn't make a lot of Serotonin or Dopamine to begin with?
Natural energy can come from healthy Serotonin and Dopamine production. Supporting the MTHFR gene can help. The MTHFR gene is an important part of the methylation cycle that helps the body produce Serotonin and Dopamine. Some estimates put it at around 40% of the population carrying a variant of this gene, which can affect their ability to make these important neurotransmitters. Imagine living your whole life with depression, ADHD, anxiety and brain fog, and nobody ever looked at the genetic piece.
How to support Serotonin and Dopamine through the MTHFR gene:
Start with your prescriber. You're on an antidepressant, and the supplement below contains SAMe, which also affects serotonin. That combination is one to talk through with your prescriber before you start, not after. Bring this email to them, and please don't stop or change your antidepressant on your own.
Then try our BLISS. It's by far our most unique supplement, as it's a sublingual powder that helps support the MTHFR gene. A lot of people tell me they notice a shift in their mood and energy after taking BLISS. For some people with severe MTHFR issues (like me), it's been a game changer, and I've heard that from hundreds of people over the years. I am very proud of this supplement, as I know it has helped many people in their daily routine.
Extra credit: If you are wondering if you have an issue with the MTHFR gene, I would check your Homocysteine levels on blood work. A Homocysteine above 11 is where I start paying attention, since it can point to a methylation cycle that isn't keeping up, and that's the same cycle that helps make Serotonin and Dopamine. What I aim for is 6-7.2. If you want to check your Homocysteine levels, order your labs through Superpower labs.
Serotonin and Dopamine don't come from nowhere. Your body has to build them.
The answer above is about one gene that helps make the neurotransmitters behind mood, focus and motivation. It's one piece of a bigger system. Sleep, the gut, nutrients and stress all feed the same brain.
Nurse Doza's Brain Health course walks through all of it: what neurotransmitters do for mood, how sleep lets the brain recover, the gut and brain connection, and what supports memory as you age. Six self-paced lessons, and you keep them.
Ten dollars. That's the whole price.
Your body isn't broken. It's asking for better inputs.
Your thyroid isn't just a gland in your neck. It needs a liver that can convert what you take.
Your adrenals aren't weak. They've been answering stress for years without enough light or rest.
Your energy isn't missing. It's built from raw materials, and some of us need more help making it.
Start with one change. Do it daily. Repeat.
To your health,
Nurse Doza
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