Hear from Endocrinologist, Physician Assistant, and Patient Advocate about how to find and choose the right kind of thyroid doctor for you.
All right, welcome everyone. We're just going to give people a minute to come in from the waiting room. I think our speakers, you probably see my face right now, but I'll let our speakers say hi if they want. I see people filtering in, so we'll get started in just a second. My name is Katie. I am part of the team at Paloma health.
[00:00:23] And before we dive in, I do want to mention that January is thyroid awareness month and we are hosting a video campaign, inviting thyroid patients, people who suspect thyroid issues, loved ones that people who have thyroid conditions to share their thyroid story and about their experience living with a thyroid condition.
[00:00:45]You can head to, I will share this link in the chat, but you can head to third awareness.capsule.video, and there are prompts there and you can record your story. On that platform. It's a 60-second maximum. So it's pretty short. But we're hoping to raise awareness of thyroid disease symptoms, treatment options, risk factors and just what it's like for other people to understand what it's like living with a thyroid condition.
[00:01:08] So happy thyroid awareness month. This event is our monthly speaker series. This is our first of 2021 and we are talking about how to find and choose the right kind of thyroid doctor for you. Obviously there's a little logistics of Google searching a thyroid doctor, but once you've found someone, how do you know that they're the right partner for you and your thyroid health?
[00:01:28] So we have Ginny Mahar, I never said your last name out loud. You got it. You nailed it. Perfect. Thyroid Refresh here. So the co-founder of Thyroid refresh, we've gotten McCall MacPherson who heads up thyroid nation and also the modern thyroid clinic in Texas. We've got Dr. Sapna Shah who is a Paloma Health
[00:01:50] doctor. And Mary Shomon is with us as my cohost. I am gonna pass it over to you, Mary, so I can stop talking and we can get to our speakers. But Mary is a hormonal health advocate, a thyroid health advocate. She has been in the game for a long time and has a lot of wisdom and knowledge. So Mary I'll pass it over to you.
[00:02:09] You can tell us a bit about who you are and what you do, and then we can get into our speakers. Thank you, Katie. First of all, happy thyroid awareness month. And since I'm dressed a pandemic outfit here, pandemic zoom outfit I'm going to be going over right after today's speaker series to record my thyroid awareness video.
[00:02:28] And Katie said, as Katie said, she's going to share that link in the chat for us. So that's where I will be after this doing my recording. But today's topic is one that is really close to my heart, which is finding the right partner for you finding the right healthcare provider healthcare practitioner.
[00:02:45] Who's going to really be your partner, your champion, and have your back in your journey to find thyroid health and balance and awareness and to live well and feel well. But it's not always easy. We might think, Oh, like when you have a sore throat and it turns out to be strep, you go to the doctor, they test it, they give you medication all set.
[00:03:06] It's not quite as simple with hypothyroidism. We really need doctors who are going to listen and partner with us and look at our goals and work with us on our goals. So a lot of fibroid patients are bouncing around. You're going to hear from Ginny a little bit later about how many people she had to see.
[00:03:24] Before she got the right approach and the right protocol and found the right provider. So we are very excited to have our three folks here. Three experts starting with Dr. Sapna Shah who is an endocrinologist. We've got McCall MacPherson, patient advocate, and founder. And physician assistant and founder of the modern thyroid clinic and Ginny , who is the patient advocate and co-founder from thyroid refresh.
[00:03:57] So what we're going to go ahead and get started with each one of our experts is going to share a little bit of information about their approach, to what they feel you need to know about finding the right thyroid provider. And then we've got a few questions that we want to toss out to our experts.
[00:04:18] And after that, we will be opening it up to questions from the rest of the group. So if you have questions, you can start sharing them as they come up in your mind. And we will start to focus on. Covering all of your questions as best as we can during this session today towards the second half of the presentation.
[00:04:37] So I first want to start by introducing you with a little bit more information on Dr. Sapna Shah, who is an endocrinologist and a thyroid doc working with us at Paloma health. She is a board certified physician in internal medicine and endocrinology. She has said that he knew that endocrinology was really her calling after her rotation in endocrinology at med school.
[00:05:03] And she's developed a particular ashen. In helping pay students with hypothyroidism. Thank you, Dr. Shah who are trying to conceive or struggling with infertility, which is an issue that affects some women, unfortunately, and she empathizes greatly with patients who manage these conditions. And as you'll see, when you hear her speak she also has a really great success story of her own, and she has a beautiful beauty little boy who is the center of her world.
[00:05:36] So I would like to welcome Dr. Shot to share some thoughts on her approach to helping you find the right thyroid practitioner. Thanks for being with us. Thank you, Mary, for that introduction? Yes, I you couldn't have said it better. The summary. I always had an interest in women's health and endocrinology and I that's, when I did my research in, on women's minority health in particular and in pregnancy.
[00:06:03]And then you can imagine my surprise when I, myself suffered from recurrent pregnancy loss and infertility and had to undergo assisted reproductive therapies with in vitro fertilization. So this is definitely more than just an academic interest for me. It's a passion. I feel very passionate about it about helping women get through this process.
[00:06:24]But also helping women in general navigate the process of being a patient with hypothyroidism and. Trying to really find someone who understands. I think when I was trying to find a doctor and I was going through all of this, even as someone who understood everything from a medical perspective, I still just often felt like I needed someone to listen, to make eye contact with me who didn't talk down to me that I could develop a relationship with someone that I really trusted.
[00:06:55]So as Mary mentioned I am very fortunate to have to be a success story. Not everybody is I know, but I have a 17 month old son and a baby girl on the way all with my hypothyroidism being treated with great specialists that I linked up with. I'm from Ohio, I'm a big Cleveland Brown span.
[00:07:16] So if anybody's following football at all this week, I'm pretty excited. But yeah, that's me. So much for that information that is really inspiring because people need to know that you can feel well live well, he's when you're hypo thyroid, you just need to stay on it top of it. And you may need an expert like Dr.
[00:07:40] Shah on your side. Again introduction is going to come from McCall, MacPherson, and McCall is a physician assistant. And I think she'll explain a little bit more to you because I know that some people are a little confused about the role of a physician assistant and what they do. She's the founder of the fibroid clinic.
[00:08:02] And that is a thyroid centered functional medicine practice located in Austin, Texas. She's also owner and chief fibroid hope, giver love that title of thyroid nation online. She's a, in addition to her physician assistant work, she is also a recent TEDx speaker and a thyroid expert by way of being a thyroid patient herself, which is one of the themes of today's program.
[00:08:29] Everyone here has done that and has the the thyroid medication bottles to prove it. McCall's passion is really to perfect and fine tune and troubleshoot thyroid treatment based on her own experience because she went through a lot of mismanagement. So now she is really putting it into place to try to resolve these issues.
[00:08:54] For other patients. So again, she's paying it forward and her philosophy is pretty simple. There's reason you should still be suffering and symptomatic. And her focus is to change that for thyroid patients. So McCall welcome so much to our wonderful, exciting event. And we're looking forward to hearing what you have to say.
[00:09:15] Thank you, Mary. I have to tell you I'm like a big fan. So thank you for be here with you today. Yes. Like Mary said, I am a patient gone expert. My life came to a halt when I was 27 and had mismanaged hypothyroidism was on love with at Roxy and I'm sure so many of you listening are and was going to bed at three 30 in the afternoon every day.
[00:09:38] And like pretty much all of my patients. And I'm sure like everyone here repeatedly went to my doctor and really begged for help and was just honestly written off. Like I'm sure many of you are. Eventually I landed in the hands of back then probably one of the few physicians and clinicians that knew what they were doing thankfully.
[00:09:57] And he gave me my life back and then very quickly became a mentor to me. And so I now get to do what he did for me and give patients back their lives every day. Mary said, my, my outlook on thyroid and to know, ultimately if you've reached the right clinician is there's no reason to still have that rate symptoms.
[00:10:17] So if you have the right medication at the right dose at the right time, with the right support for lifestyle, you should not have that right symptoms anymore. You should live a very like healthy, vibrant, fun life. So that's your end goal steps to get there in terms of looking for someone because you guys do want me to share now my tips right now and not later, Paloma. Yes. That's what I thought. So what I want to tell you guys is don't assume that the person you're seeing is trained in thyroid hypothyroidism is way oversimplified. So it's a very complex and nuanced treatment. So you have to find someone that accepts, that believes in it and has spent the time energy and 10,000 hours perfecting it.
[00:11:01] Cause that's what it has to be. Your thyroid function has to be perfect for you to get your life back. So you have to partner with someone who knows how to do that. So you want them to specialize in thyroid disorders. This is not all endocrinologists, and this is not all functional medicine. People.
[00:11:15] It's a niche within a niche. So that's who you're looking for. You also need to find someone that listens to you, treats you like a human being. That's what my whole TEDx talk is on collaborates. Mary said, and never biggest thing is never ever partner with someone who makes you feel like the symptoms you're experiencing are in your head.
[00:11:34]That's my advice. And I'll check back in with you guys again later. Wonderful. Thank you, McCall. Those are really good points and they are in my mind more important when they're coming from someone who is working on both sides of the aisle here, both as a patient and going through the experience on herself and working to help resolve those issues for other patients.
[00:12:00]We're really fortunate to have all of our experts and McCall. We appreciate your clarification of your really innovative approach to things. We're gonna move on to our third expert. That's Ginny and Ginny is the co-founder of fibroid refresh, which you may not be familiar with it.
[00:12:21] If you are thyroid refresh is a fibroid lifestyle, health diet. LIS site that provides a variety of resources to help support your healthy wellness lifestyle. And Ginny also organizes through thyroid refresh thyroid 30, which is a periodic online game and sort of friendly competition for thyroid patients to do their best, to meet all sorts of daily guidelines, to feel well and live well, getting sleep, taking meds, break, taking breaks, drinking water.
[00:12:57]So it's a really fun way me to stay on top of all of the healthy habits that you want to develop. Ginny is a hypo thyroid and Hashimoto's pen who has been through the trenches going for several years of struggling before she found the right formula. She also happens to be a co-ordinate cord on blue trained chef.
[00:13:18] So at some point when post pandemic, we want to all get together and have Ginny. Cook for us. She's a cooking instructor, a writer, a mompreneur and she's a busy lady, I think. So Ginny, can you share with us some tips from your perspective as a patient and someone who has taken that passion and turned it into patient advocacy as well?
[00:13:44] Sure. And thank you so much, Mary, for the introduction and thank you, Katie and Paloma health for creating this space for us to have this really important conversation. And I'm so honored that you invited me and thank you on behalf of so many thyroid patients watching for include being one voice who's, more.
[00:14:04] Specifically from the w so many of us are patients here at right, but really focusing on the patient experience here. I was diagnosed as a while ago, as you mentioned, Mary I'm coming up on my 10 year hypothyroidism anniversary. I went four years without knowing that I also had Hashimoto's because so many of you out there, my doctor didn't test me for that.
[00:14:28] And my health just steadily declined until I hit rock bottom and eventually started realizing I need to make some changes. I can't work the same. I, my whole life had been impacted every single facet. And I asked my doctor to run a complete thyroid panel. And I remember going into the lab that day and Waiting to have my blood drawn.
[00:14:53] And there was a series of nature photographs on the wall, and I'm looking at them. And at the end of the series, there's a letter from the photographer saying I have an auto-immune disease. Most days I can't get out of bed. I can't live a normal life or hold a normal job. But when I feel well enough, this is what I love to do.
[00:15:12] Nature photography and the autoimmune condition I have is Hashimoto's. And I was there being tested for that. Now my doctor said, I didn't test you for this because it doesn't change my treatment protocol. And. So it, it doesn't really make a difference from where I sit, but from the patient, see, it really does make a difference.
[00:15:32] That was really empowering to find out that yes, I did have Hashimoto's and I think that I wanted to share that story quickly because I think it highlights like a disconnect and a frustration between doctors and patients with the conventional current standard of care. And that being an issue for people.
[00:15:53]We come across people at thyroid refresh every day who have been suffering for decades and have never had anything more than their TSH tested. I haven't been able to even have a conversation about alternative kinds of medication or other brands of medication. So I'm really awesome to have this conversation.
[00:16:15] Now my tips just off the bat, I love that Mary used the word partner to find your partner, not just a doctor, but a partner, because I think that is like the highest ideal here is that we find someone we can really collaborate with. And I knew that I was starting to find the right, not just person, but people to work with when it felt like that collaboration, when I felt heard and not dismissed for my symptoms and for my complaints and for my concerns.
[00:16:47] So I think, try and hold that intention and hope and goal to find. A partner, a healthcare partner. And also I would add to that a team, I think sometimes we hope to find that one person who's going to address all facets, but we know that this is, it's not just medication, it's not just diet.
[00:17:09] It's not just lifestyle. It's not just root. Cause it's all the things. And one of the things I love about Paloma is that you guys offer, nutritionists. And I think, adding people like that to your team can be incredibly empowering. Mary is a health coach that there's just so many great options out there.
[00:17:28] So excited to dig into that in this conversation today. Thank you, Ginny. And what you were talking about brings up an issue that I saw there was a meme going around that basically said, it's yeah, doctor, don't try to replace my 10 years of medical school and training with Dr.
[00:17:48] Google that, what you searched on the internet. And then patient says don't try to replace your med school classes with my 15 to 20 years of living with a condition. And I it's the kind of doctors and patients sometimes are talking past each other. And what we're really trying to focus on here is getting them to talk with each other and gather and be in communication.
[00:18:12] And in partnership in that collection that we're talking about. So I think you're highlighting that of that issue. So thank you. And again, a little plug for Ginny, if you haven't visited thyroid refresh, check it out because there's a lot of great information and it's a wonderful compliment in many ways to what we learn at Paloma and working with Paloma and other sort of cutting edge, innovative thyroid savvy physicians.
[00:18:39] So it can be a really great part of staying informed and being empowered patients. And that's what thyroid awareness month is about too. Okay. We're going to move on. Thank you to all three of you for your excellent sort of summary of your tips. Now we're going to get into a little bit more depth information on some questions for you.
[00:18:59] And we're going to go back to Dr. Shah. With an inquest and an important question that a lot of thyroid patients have because there are some endocrinologists Dr. Dr. Shah is a good example that are open-minded to finding safe, effective treatments for hypothyroidism from among all of the. But as we know, and many patients have experienced, there are some controversies in the endocrinology world and you will occasionally run into endocrinologists and also a general practice doctors, family care, family practice, doctors that are dead set against some of the options that patients want to exercise, like getting their T3 tested, or adding T3 to their Livo thyroxin or Synthroid treatment, or even in some cases taking a natural desiccated fibroid drug.
[00:19:52] So this brings up a question, how can patients know if they have found the right endocrinologist? And I think from Palomas perspective, that would be an endocrinologist who is willing to consider the full range of treatments and apply whatever treatment will best work safely for their patients.
[00:20:14] Yeah, I think it's a really good question. I think everyone's needs are different. So I certainly don't mean to speak for everyone. You, other people may have priorities that are higher on the list. Some people look at things like where did people train or how many years of experience do they have?
[00:20:30] I think those things are really important when you're doing your initial search for how to find where you go, but at the same time those things might not necessarily lead you to a person. Like I said before, who listens. So someone who's not just going to go by the numbers but really look into your history.
[00:20:48]Thyroid disease can take some detective work to diagnose and manage thyroid disease can mask other Conditions like adrenal disease and other hormone issues, anemia, other underlying medical conditions. And we don't want to just be, so laser-focused on one thing that we miss something else or vice versa.
[00:21:09] If you have a known medical condition that we miss. Thyroid disease as a cause of your symptom. So I think, the second thing outside of someone who listens to someone who's really thoughtful someone who's gonna listen to. What has been asked, what has been done before what are your medical conditions?
[00:21:27] What are your other medications? And how do we try to look at all aspects of your health to find the best treatment option. One may be safer when maybe more effective one might be one you should never try and your whole life, and we should keep you away from that. So I think going through all the pros and cons of treatments with you are really important because unfortunately there's no perfect treatment for thyroid disease.
[00:21:54] I would say if someone tells you that, then maybe that's you might not have gone in the right place because everybody is so different. If we're not individualizing our treatment plan, then we're making a mistake. Yeah, sorry, go ahead. I was going to say that's a great tip. If they tell you that one size fits all it may be a sign that it's time to to run and look for a new dog.
[00:22:19] Yes. I think they may say what is best. And I think that's always important to listen. Because as I said, not everything is safe. So we always have to listen to medical advice to a degree, but I think the the important thing is to know that there are multiple options and how do we pick the right one for you?
[00:22:37]And then I think a third thing would be access. And I think that's one of the great things that Paloma addresses is. Many people would have to drive far or wait months to be able to get an appointment with an endocrinologist. And that stinks when you're feeling terrible to have to wait months to get in for treatment.
[00:22:55]Or when. Like me, you were, putting off having a kid just to try to get your health in order. So I think that's one of the great things that I love about Palomas that we really prioritize, trying to get patients in to see the right doctor as soon as possible. That's great. Now I have one just follow-up question to that because a lot of patients we have a lot of patients that have access to Paloma and may already have practitioners that they like, but if someone was looking for an endocrinologist and couldn't necessarily access the type of care that we're offering through Paloma but they're looking for an endocrinologist.
[00:23:34] Do you think it's reasonable for a patient to call up the doctor's office and maybe speak with the staff person and say, I'm hypo thyroid. And I really would like to work with a doctor who at least is open-minded or willing to consider a T3 treatment natural desiccated thyroid, or leave a thyroxin based on whatever safely and best is going to work for me.
[00:23:55] Is that something the doctor is open-minded to do you think that's a reasonable approach for a patient to take. Yeah, I think that's fair. I think when expectations are in line between a patient and a doctor, then everybody's happier. Nobody likes being able to tell someone, I can't give you what you want and no one likes being able to hear.
[00:24:14] I can't have what I think I need. I think w as much as you can align expectations before an appointment, it's always helpful. I think, some people would just, I think if someone called, for example, my office and asked that question, I would just want to make sure that I include the caveats that you said, Mary, that.
[00:24:31] Willing to consider all the options, but always keeping in mind what's safest for the patient. So it's certainly not a promise of treatment, but yeah. Great. Because I, I have had some patients where I've counseled them to do that. And they have called certain doctor's offices and been told.
[00:24:43] Absolutely not. Dr. Smith, Dr. Jones does not do T3 treatment, does not use natural desiccated, thyroid, et cetera. And at least the patient knows what they're going into. If they choose to work with the doctor, they know what the parameters or limitations are. If they don't want a doctor that only limits their approach to certain kinds of treatments, then they need it's.
[00:25:07] That's a sign that it's time to keep going. But I think as you said, having as much information and being aligned up front with what the options that are going to be carefully considered are, is probably the recipe for greater success. Great. Thank you. Okay. We have a question for McCall and this is one that I hit on a little bit earlier McCall.
[00:25:31]There are a lot of people in the patient community who aren't exactly clear on what a physician assistant is. And sometimes they're even confusing it with a very different title and very different job medical assistant. And so I'm wondering if you can briefly explain what physician assistants do, their roles, responsibilities and how a PA, which is what a lot of people call them.
[00:25:58] PA for physicians could benefit a hypothyroid patient as far as the being their primary healthcare provider for their hypothyroidism care. Yes. Great question. Yes, like Mary said, I am a PA I'm a physician assistant. What that means and what that looks like is I'm trained in the same model of medicine as a physician.
[00:26:22] I'm not a physician. I did never go to a residency. I'm actually board certified and trained in all specialties of medicine, which allows PA's uniquely one to keep a really like global mindset when they're looking at a patient. But two, it allows us to move around in medicine. When I first graduated, I thought my dream job was neurosurgery.
[00:26:42] Was I ever wrong? And then, because I'm a PA, it allowed me to move around. And now, I work with RA patients, obviously PAs and NAS physician assistant and medical assistant are very different. PAs have a medical license. They're able to prescribe medication. They're able to order lab work, interpret lab work, diagnose conditions.
[00:27:03] They always work in collaboration with a partner, a doctor partner that they can, if they have questions, they can go to that kind of a thing. So it's a very fluid and flexible profession. We're extremely well-trained I think, gosh, extraordinarily well-trained and well prepared for the practice of medicine and the cool thing about PAs in terms of thyroiditis, we're trained in formal endocrinology, but because we hold a license in all specialties in medicine, it does allow us to think about this aspect of the patient and this other component of medicine for the aspect of the patient.
[00:27:37]I very much advocate for. PA's in the thyroid sphere in general, PAs tend to be open-minded to learning new things. Our ego factor tends to be pretty low. So it, we make great partners. We make great listeners. So if you have an opportunity to see a PA that's trained in the nuances of hypothyroidism rocket, I couldn't have said it better.
[00:28:02] And I think one of the things that people need to understand, I was just doing a little bit of research on this the other day. Typical PA has the equivalent of master's degree level knowledge in the practice that they're working in. And I think it's something like 2000 plus hours of additional education on top of a bachelor's degree.
[00:28:26] I'm a call. Yes for sure. You graduate with at least a bachelor's degree, sometimes a master's in an additional bachelor's degree. So no, we're very well-educated. We rotate through our rotations, our clinical setting in school. Medical students. So we're side-by-side with them. So we're yeah, extremely knowledgeable to say the least.
[00:28:48]Some people are probably more familiar with nurse practitioners and their capabilities to practice and prescribe in various ways. Yeah. But I want people to understand that nurse, a nurse practitioners, MDs, osteopathic doctors, and physician assistants are all capable of being frontline primary care overseers of your thyroid ism.
[00:29:14]You may need to consult with an endocrinologist here or there, or check in with other practitioners for various things. But when it comes down to it for overseeing your labs, working with you on your symptoms and titrating and managing your medication, a PA could be a good choice for you. So I just wanted to make sure Stan that thank you, McCall.
[00:29:35] That's a very really helpful overview for us to understand how things work. Ginny, we have a question for you as a patient advocate and someone who hears from a lot of patients you and I both know what it's like. We hear a lot of people talking and sharing their experiences. What have you heard that sort of stands out in your mind that patients have said about the challenges or experiences that they have in trying to find doctors or healthcare providers to treat their hypothyroidism?
[00:30:07]Yeah. Another great question. So there's a few different. Main things that, that we hear. Number one is that people can't find doctors in their area who are willing to offer this higher standard of care for thyroid patients. And they're not willing or not able to pay out of pocket expense to work with someone outside what their health insurance offers.
[00:30:30] So yay for Paloma. This is such a prayer answered for thyroid patients. And I know Katie, you guys, I think last I heard it was 12 States you're in, but no, you guys are shooting for more and more coverage in various States and your doctors are covered by insurance. So this is it's the unicorn where you guys are really, cherry picking practitioners, doctors who are.
[00:30:56]A lot of them have personal experience like Dr. Shah they've had that spark that inspired them to say, I really want to look into this more deeply, so I can really address my patients' concerns at a higher level. So exciting to have, this platform But what do we do? In the meantime a lot of us end up having to pay out of pocket.
[00:31:18] That was what I ended up having to do when I had this big awakening and went, Whoa, I, I really am not doing well. And I don't feel like my current general physician is the person to help me do the detective work. I ended up my best option here in Missoula. Montana was a natural path. Now I had to pay out of pocket for that.
[00:31:39] But when people hear that, it's just like to change a Ching, it makes people feel paralyzed. And the another word to say that it makes people feel stuck. And there's a lot of patients who are stuck. We did a survey and we got 1600 responses. And the number one issue people had is I'm too tired, sick, and stuck to do anything about it.
[00:32:03] And that's heartbreaking for me. So that's another big. Stumbling block is the out of pocket costs. And the third and final thing is just, the frustration with that incongruousness of that standard of care where, you go to your doctor's appointment and it's marketed to us like, Oh, this is no big deal.
[00:32:24] You just take your legal thyroxine, we test your TSH, and it's really invalidating and demoralizing to hear that when your life is falling apart and we had a conversation, our team had a conversation about this yesterday and Devani, our editor was like, yeah, I'm just, I'm hearing that it's, it's not your, the, your concerns aren't related, or it must be your mental health.
[00:32:48] And it's Hey, I'm just busy going bald over here. Like we need to address, we need to feel heard as thyroid patients. It's the thyroid cancer patients who hear this is the good kind of cancer. Hypothyroidism is a big deal. We, we hear from people every day who are living out what a big deal it is, especially when they're not getting the care that they need.
[00:33:14]If we can heal that disconnect between the practitioner understanding of thyroid treatment. Cause I know like the doctors want to help. It's just, this is what they're trained to do, but if we could heal that disconnect, I think it would be really life-changing for millions of people.
[00:33:32] So that's the big picture issue. Wonderful. That's very well said. And as Ginny, I agree a hundred percent with everything you said, because so many patients are out there. And as you said, doctors do want to do their very best, but thyroid is not always front of mind for doctors.
[00:33:51] And I think one of our goals is to eat is to help make it more front of mind. But in many cases, why not just head straight for the doctors for whom it is. Front of mind where, you're good. If you say I'm tired, I'm losing my hair. I'm gaining weight. I'm feeling bummed out and stressed out and you're not going to be told you're stressed, depressed PMs menopausal, of course, you're tired.
[00:34:15] You're old, it's a pandemic. You're, you've got kids, you're working too much. Get off the couch, exercise more, eat less. Those are all understandable, but that's not what we need. We need, wait a minute, let me, we hear what you're talking about and let me see if I can get to the bottom of it.
[00:34:30] And so I think that's what all of us, really, every one of us on this group and all of the doctors at Paloma and all the folks at Paloma, that's what we're really trying to do is to find people who don't have to spend a lot of time going up. The learning curve to get to the doctors and practitioners and support that's going to help them feel and live well more quickly.
[00:34:54]I'm gonna circle back around to all three of our experts with one question, the same question, and it's an opportunity for them to give us one last emphasis inf emphatic point about what they really want us to know about how to find and partner with the right practitioners. And my question really is there one piece of advice that you have for our viewers today about how to find a top-notch thyroid savvy practitioner for their hypothyroidism care?
[00:35:24] And so we'll start with Dr. Shah Dr. Shah what of Jim or nugget of wisdom do you have for us as far as how to find that. That thyroid savvy practitioner that's going to help us get on track. Okay. I think what you had said earlier about having expectations in line is a really big thing.
[00:35:44]Being honest with your doctor about what you're looking for and asking them to be honest with you about what. Resources do they have at their disposal to try to help you? Because I think, again, everybody benefits from that honesty. And by the same token, I look for a doctor who knows the science knows the evidence.
[00:36:03]I don't want them to use me as a Guinea pig, but I also want them to try to think about my overall health picture, what needs to be addressed by medication. But what also can we do from a lifestyle perspective? I think that's one of the great things about Paloma is that we do have dieticians who are focused specifically on patients with hypothyroidism or thyroid disease.
[00:36:25] And how do we help them to address the concerns from a big picture approach? Not just Checking labs on our, certain frequency and then just hoping that everything falls into place. And then I think w to everybody else's points, sorry, not trying to repeat what everybody said.
[00:36:43] Oftentimes there are symptoms which remain fatigue, weight gain low energy, low libido, memory issues, all these kinds of things. What are we doing to address those both from a medication perspective and looking at what else could be going on in my health picture that is going unaddressed right now that we could just be blowing by, because we're so focused on making sure that the thyroid is is in check that we're missing the bigger picture of someone's overall health.
[00:37:11]I guess in summary, I'm looking for someone who's not just a yes, man. Someone who's a doctor, who's gonna push me and say, okay, This is what looks good. This is what we're doing, right? This is what we're doing wrong. How do we find a balance between your health and your symptoms? And I think that is what the doctors at polo are really focused on.
[00:37:31] Fabulous. Thank you. McCall, what what's your takeaway message for patients about finding a thyroid savvy practitioner? Yeah, so I love what everyone said so far. Absolutely. I agree. Thyroid is probably not your only thing going on that you need to repair to get your life back, but it's a huge cornerstone, right?
[00:37:52]In the same token too. I love that Paloma is now seeing people with insurance. Somehow I miss that guys. That's huge. In to piggyback off of that, I would say, do not see someone, that can help you because you don't want to pay cash for them to help you the investment that you make.
[00:38:07] And I'm sure Mary can attest to this every darn dollar you will recoup and productivity and quality of life within the first six months. Like it's just not worth waiting to fix yourself. And it's, I know that's easy to say, but you can save up money. I've had a patient who literally lived in a school bus with six children and saved between her appointments to come see me.
[00:38:26] So it's worthwhile. If you can find a way to do it, but even if I had to draw a line in the sand and say, this is the one thing I want you to take home today, if you're on this webinar and you're still having thyroid symptoms, I would take it to Vegas. That you need some form of T3 added to your medication or adjusted.
[00:38:46] You're stuck in an inactive thyroid state, and you're having difficulty activating your love with that rock scene or your own T4. Find someone who will prescribe desiccated, thyroid T3. Let that be your question. When you call and you ask if they can help you. Great. That's a great advice. Because that is a very common issue and we're discovering it's much more common than many people realize is that we do need that active hormone at the cellular level to function.
[00:39:16]Ginny from the patient advocate get perspective what's your takeaway message for patients about finding that super practitioner, the top-notch really, up to speed on thyroid issues for hypothyroidism care. I'm just over here, applauding what everyone else has said already.
[00:39:35] And this is so great for all of us to hear cause this is a huge roadblock for patients and I just want to quickly touch on what Dr shot said about expectations. I think first you gotta let go of this expectation that someone outside yourself is going to be the CEO of your health.
[00:39:53] You really are the captain of the ship and you have to, own that responsibility and have like realistic expectations, the best practitioner, the very best. The number one is not going to do the work for you. You still have to do that. But to, get down to the nuts and bolts of how do we find these top-notch thyroid savvy practitioners?
[00:40:15]I think here's three essential questions to interview your doctor with. Are you willing to run a complete thyroid panel? The answer needs to be. Yes. Are you willing to discuss all treatment options? Not just leave out Iraq scene, the answer needs to be, yes. Do you have three? Do you have experience treating patients for whom TSH testing and levothyroxine maybe wasn't enough or do you have personal experience?
[00:40:41] I think sometimes it's the doctors and PAs, like McCall's has been through it themselves and who have had that personal awakening. So yeah, and ask around, they can be a little bit needle in a haystack, finding those people. So ask around for referrals, use the power of social media, ask people in your area, Hey, I'm looking for for this I and Kalamazoo or whatever.
[00:41:05] And Put that to work for you. And I also want to echo what McCall said. I think the reality is that whole health care and health optimization and root cause testing may require out of pocket expense. And it's like that old saying, you're either going to pay for it now, or you pay for it later.
[00:41:25] It's like eating organic, you make these investments in your health. And I will say I had that mental hurdle to get over with paying out of pocket that. Had me tired all day, every day for four years. And I had to get over that, to pay, to find work with this natural path who changed my life and gave me my life back within a few months.
[00:41:48] So it really was worth every penny you're worth it, your health and your life and your dreams are worth it. So don't give up, if Paloma doesn't have doctors in your state yet check the Institute for functional medicine site, there's a find a doctor database on thyroid change.org. There's some other, online databases to help you in your particular area.
[00:42:12] But yeah, really think outside the box, find that health care team think about people like nutritionists, health coaches, even acupuncturist, people who can collaborate with you as part of this comprehensive team. And. Try to stay open to the possibility of making that investment to, to augment the care that you're currently getting.
[00:42:35] That's that is covered by insurance. Fantastic. Ginny, you actually answered one of our viewer questions already, cause we're going to move into the viewer question, but that question was, I, how can I find a doctor near me? What sites or databases can I check? And, you mentioned the Institute for functional medicine and asking around, talking to people obviously checking to see if there's Paloma options in your state.
[00:43:02]You're you are very precious because you hit one of the key questions that our viewers already have shared with us. I want to go take one of our viewer questions to Dr. Shah because one of our viewers wants to know. What do we do when we need to have a hard conversation with our doctors?
[00:43:22]Or we're not being heard. Maybe we're asking the doctor, Hey, I'd like to test my we're in an existing relationship already. Please test my T3. Or as Ginny mentioned, do I have mushy motos? Do I have an immune disease? And the doctor says, it doesn't matter. Cause it won't affect how I treat you.
[00:43:42] So there's no reason to test you. How do we have that conversation with a doctor when we feel like we're not being heard or a doctor's really adamantly disagreeing with something that we're requesting. I think it's difficult. Again, it's about expectations. You don't want a doctor to order a test and you, if they don't know how to interpret it and they don't know what it means.
[00:44:05]I think you always have to be you're your own advocate and you always have to ask for what you want, but again, if your doctor is saying, no, I don't do that. Do you really want them to test something that they don't understand? I'm not sure. So maybe at that point, it is time to find someone who, is able to interpret that information is able to order that information with comfort and actually interpret it and give you an answer that might help you.
[00:44:35] Great. Thank you. We have another question and actually, no, actually I think that's a good question. I want to take it to all three of our experts today because I think everybody has different approaches to this McCall. What's your take on, obviously there's been situations where you may have had a patient who disagreed with you or maybe felt like they weren't being heard.
[00:44:59] And I know as a patient you were in that chair yourself, what do you think patients need to keep in mind about those hard conversations? Gosh, I think sometimes I think in idealistic terms, in my first visit with people, one of the very first sentences I say is, look, I want you to know that this is collaborative.
[00:45:22] Like you feel free to speak up, you be candid with me. Don't ever feel pressure for me to do anything. And in the same token, yeah, by the time people get to me, they've been told it's in their head for so long, they almost believe it. I would use that as a red flag that none of this is in your head.
[00:45:39] This is very biochemically explainable. And when you go to have a hard conversation with your doctor, I so agree with Dr. Shah and that it's like the likelihood of you convincing someone who wants to practice medicine a particular way and is trained to practice medicine in that particular way to change that to something completely different is going to be a really hard sell, so you can say, Hey look like, here's my experience. Here's what I've read about this. Would you be open to running? My T3 would be open to considering a T3 based medication if it's just, really yeah. Shut down and shut down in a very closed. Perspective person. It might be a good indicator.
[00:46:28] Unfortunately, after that conversation to just pivot, don't wait 20 years of having these symptoms, trying to convince someone who's unconvinced bubble to hear you great. Someone that will hear you. Cause there are, Paloma there's plenty of people that will hear you. And I'm actually going to pivot to a related question that one of our viewers had specifically FEMA call, which is one of our viewers said love that Paloma has an at home test kit that can measure TSH free, T4 free T3, and thyroid antibodies.
[00:47:05] But for people who are not in a Paloma state are not working with Paloma yet. How do I get my doctor to order a comprehensive panel too? And not just stick me with a TSH only management and evaluation testing process. Great question. I think the easiest thing is Paloma, unless I'm mistaken, we'll ship you a nice, neat little test kit, no matter where you are.
[00:47:30]You can do that test, get your labs from them. And I recommend people do this whenever I'm on podcasts and things. And then you can take that and you can go to my website and you can see my lab ranges, sister, like a posted up there. This is where I want your TSH. This is where I want your free T4. So you can take that data and say, I wonder.
[00:47:50] How my thyroid looks. And if you can't tell and on your doctor to order that lab work, there are so many ways you can do it yourself nowadays. And something called direct to consumer labs where you pay for those labs yourself without a doctor's order, just like Paloma, you get those lab results back yourself in pretty much every state, but in New York.
[00:48:08] And in New York, you can drive up to Connecticut. And I would add to that, when you're in, some of us are in States that don't allow the direct to consumer labs like New York I'm in Maryland where they don't allow it. And one of the things that I've told patients too is to really just sit down with the doctor and say, look it's my medical insurance.
[00:48:30]It's my situation here. I th I really do want these tests, whether or not you're willing to do anything with the results. Don't worry about it. Let's but I do really want this information and, sometimes the doctor will be reasonable. But if you have to play hardball, let's say you're stuck in a situation where you just can't jump out to any other options.
[00:48:50] Sometimes it's helpful to put it in writing and say, I'm a formerly requesting these following tests. And if you are refusing them, please sign and date this and put it in my medical record. And I got to tell you very few doctors or practitioners will formally sign or date. The fact that they're refusing to give you a couple of tests that are not a particularly expensive panel.
[00:49:12]But I don't re I don't recommend going to that. That's going nuclear. Rather, start out with with a an assertive, but cooperative conversation with your doctor. Let's see Dr. Shah, we have a question. Why would some doctors only test TSH? Because this is a question that a number of patients have had and they run into this occasionally, what w what's going to cause them to say I'm only going to really test TSH to diagnose or manage your thyroid.
[00:49:43]So when we think about long-term health outcomes, and again, this is, I think, where sometimes the disconnect comes there's health and symptoms, and sometimes those are the same things, and sometimes those are different. But when we talk about long-term overall health outcomes, those are mostly linked to your TSH.
[00:50:01] So it is the one test that provides doctors with the most information about how do we make sure that. If you're trying to conceive within the next year that we have you in a safe place, if we're concerned that you may have a heart condition down the road, how do I keep you in a safe place? And as a result, I think many doctors only look at that test, and we're only trained to look at that test because another thing that we're trained to look at is cost effectiveness.
[00:50:30] And so if we have to pick one test, that would be the one to pick. So I think that's probably where that stems from. And I think it's not always thought from the perspective of as Ginny mentioned, a patient empowerment, number one. And then number two how are we able to explain the disease better to patients and how are we able to target our treatments better for patient when it comes to symptoms?
[00:50:56] And so I think that's where that disconnect kinda comes up. Makes sense. Yeah. I think that a lot of us have run into these kinds of situations along the way. I think we're going to be wrapping up in just a couple minutes. So I'm gonna go, I want to jump over to Ginny with a question and.
[00:51:15] Just, what would you tell? Our viewer who it said she's on Dr. Number five in six years. Three doctors have left the area. One doctor told her she needed a psychiatric consult. The others are leaving her health plan. They only allow 10 minutes, 20 minutes a patient. She's ready to throw her hands up and head for the Mayo clinic, which I've heard before from people.
[00:51:38] I've just forget about it. I'm just going to Mayo. And she's checked for doctors within a hundred miles. They're either not rated well, not taking new patients. And she's just completely frustrated with the system. What's your pep talk, Ginny? Oh my that's my specialty. So here's the secret to success on the healing journey.
[00:52:01] Maybe even for life in general, two words, keep going. I know. And we hear this don't we, Mary Ann McCall. It just the frustration of finding the right person and maybe they're the right person for a little while, and then you got to find somebody else and that finding the right doctor hurdle is so huge.
[00:52:22]You want to find that person and be good to go forever. And unfortunately that doesn't, that isn't always the case. So trust yourself, keep asking the questions, keep searching for your ideal doctor and don't settle like any relationship, and you might have to kiss a few frogs, but but better care is out there.
[00:52:41] So don't give up on finding it. And it sounds like you probably this person asking the question has already done a lot of this, but One thing I think is really important is for patients to educate themselves and that doesn't have to cost hardly any money at all. If you have a library card, go to the library, read there several incredible books.
[00:53:02]Read Ron one of Mary's 12 books on, on thyroid health, like living well with hypothyroidism, the more we know the more empowered we can be and the more we can do to optimize our health. And I don't want to say depend less on the doctors, but it's maybe help minimize some of our symptoms so that we're not leaning so heavily on the just medical advice, prescriptions, it's helps us embrace the big picture approach to caring for ourselves with a chronic thyroid condition.
[00:53:38] Fantastic. Thank you. And before we wrap up we've got we've got a number of patients that have been, or viewers who've been asking they want to know how can I become a patient of Dr. Shah? How can I become one of McCall's patients? They've got a growing fan club already among our viewers.
[00:53:57] And so I'm going to let them at first, we'll go back to McCall. Tell us how a patient can be, how a patient become your patient. How do they get in touch with you and get a consult with you? Yes. Couple things. One is just look at my clinic, modern thyroid clinic. We are easy to find.
[00:54:17]If you give my office a call, what happened pre COVID is people had to fly in to see me for their initial appointment in certain States right now. And it's waning because of the way that the legislature is working for telemedicine, but in certain States, even now, We can establish care online and not have to have you fly in for your first appointment or next appointment or the one after that.
[00:54:40]Now more than ever, if you want to become my patient and you live out of state of Texas or Austin call my office because the clock is ticking literally and state by state my availability to see you by way of computer is waning, but I'd love to see ya. Great. And our friends at Paloma have said too that if we there, and there's a link in your chat, and I think Katie there'll be, we'll be putting links in a follow up email for people who are interested in scheduling with a Paloma doctor or Paloma practitioner like McCall and Dr.
[00:55:16] Shah that you can also contact Paloma health.com, thyroid dash consultations, and Dr. Shah can you just share with us the different ways that people may be able to contact you and do a telemedicine and hopefully eventually in person treatment with you as well? Sure.
[00:55:37] So in my capacity through Paloma, it's all telemedicine and that is through the link that I think is in the chat, the Paloma health.com/uh, Thyroid Daesh consultations, I think is what it is. And there'll be able to link you through who is covered to see you in your state, because it is according to as physicians, we are licensed by state.
[00:55:59] So it's according to who is licensed to be able to see you in your wherever you are living. So there'll be able to hook you up let you know about insurance coverage versus self pay. Other details about ordering the kit, getting hooked in with a dietician. There's also the Paloma app that you can get.
[00:56:20]So there's all kinds of ways to get LinkedIn to Paloma. And I want to just add we got a breaking news update while we're doing this webinar. Apparently Maryland has changed their regulations and are now permitting direct to consumer lab testing, which I didn't know. And so as a Maryland resident, Bravo, I'm very excited.
[00:56:41] I can now get access to all the cool tests that I'm always recommending to everyone else. So that's good news for those of us in the DMV as we call it. DC has had that already. Maryland has had it already, but Virginia has had it, but Maryland has been excluded, excited to say that we are included in this.
[00:56:59] So I am going to say thank you to all of our incredible experts. Dr. Shah McCall MacPherson Ginny, our patient advocate, extraordinary. We are really fortunate to have had an opportunity to hear from you, pick your brains ask these questions, get this info, information out to the patient community.
[00:57:22] And so thank you very much. I really thank you on behalf of all of our patients and viewers and the people that will watch this afterwards in the replay. Thank you very much. And I am going to turn it back over to. Katie to wrap it up and give us any other additional information we need before we finish things up for today.
[00:57:41] So thank you everyone for your questions for your attention and thanks to our experts for all your great contributions and thanks to Paloma for providing this opportunity for us to share. Thanks, Mary. We you're welcome in short, we, I, and we are excited about this monthly opportunity to have a real conversation.
[00:58:04] I know we can't see your faces attendees, that the chat option is so awesome to be able to get the ear of experts in the women's health field. You're welcome. And thank you for being here. Thank you to our speakers. Thank you to you, Mary for co-hosting and thank you to everyone who's attended.
[00:58:17]On a Wednesday, we will send out a replay of this event in the next couple of days. And we will make sure to include links to all of our speakers, where you can find them, or you can participate and follow them and all of this kind of stuff. Like we've said, Paloma is available in 13 States right now and expanding quickly.
[00:58:34] Our kit is available in all States except for New York, New Jersey and Rhode Island. And again, we will include that information. I know a big takeaway for me today was around setting expectations with your doctor. I have an appointment upcoming with a specialist and I am going to call their office ahead of time now to learn what to expect and what I can do ahead of time to come prepare it to that appointment.
[00:58:53]Thank you for this information. Have a great Wednesday and we will see you guys soon.