Your Thyroid Isn't the Problem — Your Gut Is | Dr. Cassie Smith

But around 80% of hypothyroidism is Hashimoto's. They literally almost never address the root cause of what's going on in the thyroid.

It's estimated there could be almost 50 million people in the United States that have hypothyroidism that haven't been treated.

Why would taking birth control increase the risk or cause hypothyroidism?

So we have to remember that birth control is a synthetic hormone, is it shuts our brain's ability down to make our own. So it tricks our body.

Let's talk about PCOS. Why is it called type 3 or type 4 diabetes?

You know, we learn in school you have to be overweight, you have to be insulin resistant, and you have to be anovulatory, or you have to have irregular cycles. So it was all tied to a high insulin problem. But as of May 2026, it got reclassified as polyendocrine metabolic syndrome because we now know that there are actually 7 types of PCOS.

I just wanted to say how incredibly grateful I am for each and every one of you who makes this community so special. And as a thank you, I'm going to be giving away over $5,300 in prizes To many of you. I'm talking about a Sunlight and Sauna, a red light therapy mask, cellular blood work testing, Manukora Manuka honey, an eco hydrogen water flask, a signed copy of my New York Times bestselling book, and more. To enter, subscribe to the Dr. Josh Axe Show on YouTube. For 10 bonus entries, leave us a review on Apple Podcasts or Spotify. I'm excited for many of you to win free prizes. By the way, the only way you can be signed up in these is if you are subscribed to the podcast. The giveaway ends December 14th, and we'll announce the winners on December 22nd. Make sure to subscribe and leave a review so you can be entered to win. Today, there are millions of people struggling with hormone issues, hypothyroidism, PCOS, Perimenopausal and menopausal symptoms, low testosterone, and so much more. And today, I've brought on Dr. Cassie Smith. She's a dual board-certified endocrinologist. And today, we're going to dive in how to heal the root cause of all hormone issues. We'll talk about the top herbs and supplements. We'll talk about root causes connected to gut health. We'll talk about how most of the time when you're treating things like thyroid, you're actually treating the wrong organ to start and you need to start upstream if you truly want to heal. Yeah. and reverse whatever you're dealing with. Hey, I'm so excited to invite Dr. Cassie Smith to the show. Thanks so much for coming on.

Thanks for having me, Dr. Josh.

Well, I was watching some of your videos. You've done a great job of— what I've seen is really talking about what are the root causes of hormone issues. I know you, in fact, you wrote an entire book on how the gut is deeply connected to hormone issues. And so, what I really like to start off with here is one of the most surprising stats that people are unaware of When we talk about hypothyroidism, and I know we're going to get into a lot of other hormone issues today, but around 80% of hypothyroidism is Hashimoto's thyroiditis. There's an autoimmune component. So, why is it that people go into their doctor today and their doctors tend to run just, hey, TSH, put their patients on levothyroxine, so T4, and they literally almost never address the root cause of what's going on in the thyroid? Yeah.

I couldn't agree more. And, to your point, millions of people are hypothyroid, but it's estimated there could be almost 50 million people in the United States that have hypothyroidism that haven't been treated because doctors are running TSH and they're saying you're fine, but you have every symptom of hypothyroidism and nobody's looking deeper. Nobody's checking your free T3. Nobody's checking your reverse T3. Nobody's looking at a TPO antibody to see could you have an autoimmune issue. And I think a lot of it is tied to our lifestyle and our gut, which is what I found after I treated over 10,000 patients. And I started realizing, wow, there are all these people that have hypothyroidism. And why? That was my— always my question was why. You know, I had a thyroid issue in medical school, which is what drove me into endocrinology fellowship. I had Graves', and nobody could tell me why. And nobody, you know, they would just say take a medicine, and the medicine didn't make me feel good. And I was like, well, why do I have this? And, nobody wanted to look as to why. It was just, well, here's a medication. And, I think that's what we're taught unfortunately in traditional medicine. And, I think we really need to be pulling back the curtain and figuring out why are so many people getting sicker and sicker and sicker. I saw a post you just did talking about birth control and how birth control makes you 280 times more likely to develop hypothyroidism over your life.

Is this something you found too in practice?

100%. I wrote about it in my book. There's a whole whole chapter on medications, birth control, PPIs, statins, all of these things that we're taught to give people that actually a lot of times damage our gut. And, when our gut becomes damaged, it increases our risk of having autoimmune issues. And, the first thing that typically fails in women, especially when we're stressed and our hormones are fluctuating, our sex hormones, is our thyroid.

Talk about this for a minute in terms of why Now, you did mention gut health, so maybe that's part of that. But, why would taking birth control increase the risk or cause hypothyroidism?

It's a great question. So, we have to remember that birth control is a synthetic hormone. So, it's a synthetic estrogen progestin, but what it does is it shuts our brain's ability down to make our own. So, it tricks our body kind of. And so, it makes us stop making estrogen and progesterone so that we don't ovulate so that we don't conceive.

Yeah.

So, when we shut the pituitary down, the pituitary is our brain's or our body's command center. It's kind of like the motor of our car.

Yeah.

So, we are literally shutting our brain down saying, don't make any estrogen, don't make any progesterone. Well, the problem is that synthetic hormone that we're taking, our body doesn't accept the same as the natural hormones we make. It starts changing the microbiome in our gut. So, there are certain bacteria that live when we have estrogen and there are certain bacteria that live when we have progesterone. And, when we take that natural hormone away, those bacteria can't live. Then, we get an imbalance. So, we have bad bacteria instead of good bacteria. And then, those bad bacteria release something called lipopolysaccharide, which is something that damages our gut.

Yeah.

So, women develop leaky gut. And, when we develop leaky gut, meaning there are little holes in our gut, our immune system triggers because 70% of our immune system lives outside of our gut. And, when our immune system is chronically activated, it drives up our cortisol and our insulin, Not to mention a lot of our thyroid hormone is converted in our gut.

Yeah.

And so, there's this big nasty circle of, wow, now we have insulin resistance, our cortisol is chronically high, we're waking up in the middle of the night stressed, we don't actually have estrogen and progesterone to calm us down and to rebalance our cortisol and our insulin. And so, we just get into the cycle of we can't convert T4 to T3, we become hypothyroid. And, I think the Hashimoto's develops because of the Intense gut and immune issue that we have from leaky gut.

Well, I mean, think about how many millions, if not tens of millions of women really have Hashimoto's or hypothyroidism because they got put on birth control when they were a teenager. I mean, it is absolutely crazy. And, one of the things, and I think is another part of what you mentioned, another side effect is that when somebody would— and people could do an easy search on this on Google, on my website, draxe.com, on an AI tool, but look up what nutritional deficiencies birth control is associated with. Well, number one is good bacteria. That's the first one you mentioned. That's the biggest one. But, in addition to that, vitamin B1, B2, B9, B12, and selenium. These are all the things you also need for methylation and for thyroid function. Of course, selenium as well. And so, when people are reading the side effects on a lot of these bottles of medications, It actually isn't telling you the full side effects, right? And so, that's of course a major issue there. Another thing that I know that isn't happening in a lot of doctors' offices is a lot of the blood panels are so minimal and outdated. And, I found this to be incredibly important. I saw an interview where you talked about this and I really appreciated it getting into the most important lab markers women need if they think they have thyroid issues or hormone issues, what are the most important lab markers, maybe your top 5 in order or so, that your doctors may not be running?

Well, from a thyroid perspective, definitely you need a free T3 and you need a reverse T3 and you need a TPO. I want you to have a free T4, but free T3 is the active hormone. And so, if your free T3 is low, what that tells me is even if your TSH is happy, Your TSH is just a signal from your brain. So, the blood flowing through your body, maybe it has thyroid hormone, maybe your thyroid's actually making T4, but if the T4 doesn't convert to T3, the active hormone, it doesn't matter. And so, if there's T4— Right. In your body, your brain's gonna be happy and your TSH is gonna say, okay, great. But, your cells, your hair, your skin, your brain fog, your constipation, it's not gonna get better because it needs that active T3. And so, that conversion from T4 to T3 is inhibited in millions of Americans because of medications. So, there's an enzyme called deiodinase that converts T4 into T3. That enzyme is downregulated or doesn't work when we take metformin, when we take birth control, when we take statins, when we take PPIs, when we take antibiotics.

Basically, anything that stresses the gut or liver.

Yes. When our gut doesn't work, when our insulin's high, 93% of Americans have insulin resistance. So, all these people are walking around and although our brain may be happy and we have T4, we're not making T3. So, that would be like saying, okay, we're going to pump oil and we're going to have all this crude oil available to make gas, but we never turn it into gas and we have all these cars waiting for gas. There's no gas. Same thing in people. And so, I think that's one of the big things that women are walking around with every symptom of hypothyroidism and nobody's listening. The other thing is ferritin. And, there are new guidelines as of Friday, I think.

I just saw they just changed the number.

Your ferritin is— and the other thing, a lot of people have bad guts and their microbiome is shifted because— so ferritin is another thing that a lot of people are deficient in. You need ferritin to take T3 into the cell.

Yeah.

So, let's say, God willing, you actually have the ability to convert T4 into T3 and it goes to the cell. We go to put the gas in the car. In order to actually undo the gasket and put the gas in, We have to have ferritin. Ferritin is what takes T3 into the cell. Most women are ferritin deficient because our guts and because we have menstrual cycles and nobody checks it. They check your hemoglobin, your outdated hemoglobin lab, of course. I mean, and you're not anemic, so they say, okay, you're fine. The normal level for ferritin is 16 to 150.

What a crazy wide range.

16 to 150. And so, if you're 17, they're like, you're great. But now, the guidelines as of Friday said if you're a menstruating woman, they actually recommend at least 50. Yeah, it

was 50 or 55. Yeah, it was up there. Yeah.

And so, I say 70 for your thyroid.

Yeah, yeah, yeah. It's incredibly important. And, I mean, ferritin is so important for just oxygenation of your body to your point, your cells working properly. It's a big deal. I've seen this a lot. I talked about this recently where, and this is a little bit of a different topic, but women post-birth when they have kids, the amount of energy it takes and the amount of blood it takes to make a placenta, If a woman has a miscarriage, the amount of blood that's lost there. To make breast milk, there's a lot of those same building blocks it needs. And so, there are so many women, especially young moms that are dealing with just major— in Chinese medicine, we just call this— I mean, it's anemia or it's just borderline, but it's blood deficiency. And, this is why they're tired, their hair is thinning. Again, it's a lot of the symptoms of hypothyroidism are causing it. And so, I see this too all the time. What's the most common cause of hypothyroidism? When you look at ferritin being too low, what do you think some of the main causes of ferritin being low are?

Great question. A lot of it is your gut. So, if you don't have a good barrier in your gut, a good lining, you can't absorb nutrients. If your good bacteria are not there to help you absorb micronutrients, you're not absorbing them if the bad bacteria outweigh the good. So, I think a lot of it is gut lining integrity. Some of it's medication. There's an infection called H. pylori.

Yeah.

That I think probably millions of Americans have that don't realize it. If you're listening to this podcast right now and you've had heartburn or acid reflux for years and you've just been put on a PPI, you know, omeprazole or ranitidine, or— and you've been on it for years and nobody's looked at why, you probably have an infection. And oh, by the way, that medication long-term and turning down your stomach acid increases your risk of colon cancer astronomically. And in my opinion, it should be malpractice to just keep refilling a medication instead of figuring out why this person has acid reflux.

Yeah, absolutely agree.

So, I think a lot of people have gut issues. I think a lot of people have gut integrity issues, infections. And then, a lot of people, it's their diet. Our nutrients are so depleted in soil and we have to eat so much more food now to get the nutrients our grandparents did in the '50s that I think a lot of people just don't get, especially women, menstruating women, women who just had babies. We don't Get enough nutrients.

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Correct.

And, my entire focus has been personalize that diet because I learned really early on a patient with hypothyroidism versus a patient with IBS or cancer or a male with low testosterone. So, a lot of those diets are just completely and radically different. And, I think a lot of women think, oh, I'm eating healthy because I'm eating a lot of salads, maybe chicken, smoothies, Diet Coke. I mean, there's all kinds of things.

Green leafy things that could be making your gut worse.

Yeah, but it's like, but you're not getting any heme iron, you know, for, you know, they're so, so, you know, a therapeutic diet is what, what your body needs, you know. And so, um, you know, when I look at a lot of these ancient forms of medicine, whether it be Ayurveda or Chinese medicine or the way they would just eat in more ancient times, there was a lot more of this soups and stews and warming things. And, and it's just we're getting a lot, a lot less of that today. Okay, I wanna, I wanna ask you about the connection between different hormones and the hormone cascade? Because when I asked you about the biggest markers that we're missing, you said—

Thyroid.

Yeah, T3, reverse T3, those TPO, the different sort of antibody markers there with thyroid. Would you have 2 others on there potentially, insulin and morning cortisol, because those are so connected? And anything else you really look at?

Yeah. So, that's a great point. So, insulin and cortisol are the other 2 that I kind of hadn't gotten to, but insulin is so powerful. I think insulin resistance is the reason that we age, we get disease, and we ultimately die. Inflammation, right? Yeah. So, inflammation is the root of all evil, and insulin is the most inflammatory molecule in our body, hormone in our body in excess. We need a certain amount of insulin. Obviously, when we eat, we need insulin to take food and direct it or signal to it where to go. But, if we have too much, it is so toxic. It starts telling us to put food in the wrong places. We start developing excess adipose tissue. I think what people forget is that adipose tissue is an endocrine organ. It's the most dangerous endocrine organ that we have. When you have excess adipose tissue, it releases interleukin-6, and tissue necrosis factor alpha and all these signals that are bad, and it converts estrogen into bad estrogen. There's nothing good that happens in excess fat cells.

Right, yeah.

And insulin is the reason that people have that. And insulin also, when it's elevated, affects your gut. It affects— when you have all this, you know, elevated cytokines and all these markers that are inflammatory, you know, your immune system's like, oh my gosh, what's going on? We're being attacked. When that happens, then what happens is, okay, now we're not converting our thyroid hormone, We're not, you know, making progesterone and estrogen. So, I think insulin is definitely overlooked. I think that's why people a lot of times have issues losing weight. They have issues with their thyroid. And then, cortisol, to your point, you know, I don't know very many women in their 40s who haven't experienced, you know, waking up in the middle of the night like, oh my gosh, at 3:00 a.m., like, why, you know, why am I wide awake? It's a cortisol issue.

That's right.

And, it's because of our lifestyle. It's because our hormones are shifting. It's because of gut issues. And, these things are completely overlooked in traditional medicine. Again, cortisol, Normal range, 5 to 18. What does that mean? So you're either adrenally insufficient and dead or you're Cushingoid. Like, that's not all normal. Yeah. So

yeah, yeah. I mean, I tend to find like if I— I really feel like most of the time it's an insulin or cortisol issue. Like those are the 2 hormones because, you know, if— and one is diet and the other is stress. And by the way, I think insulin is way easier to fix, honestly, directly. Cortisol to me is the one in working with patients that's much more challenging because it is so related to somebody's childhood trauma, their daily habits, their relationships. I mean, there are so many factors. I mean, hey, I can change your diet. I can get you on some supplements to equalize and support your insulin, but cortisol then impacts insulin, right? And so, I find if I can have a really hard case and I'm like, why isn't someone breaking through? There tends to be this cortisol stress component that is the limiting factor.

Yeah. And, let me tell you about that. That's closely tied to your gut. And, this is how. So, there's a whole chapter about this in my book. I agree with you. It's so hard to fix cortisol because of people's childhood traumas. Maybe they're not eating the right diet for themselves. So, if they are eating a diet that they think is healthy but they're not giving themselves the nutrients they need, their body goes, why am I not getting those nutrients? your body is stressed, it hikes your cortisol up.

Yeah.

So, your brain, anything that enters your brain, every thought you have, what I have to do today, what did I not get done on my to-do list, I don't like how my body looks, I don't like how this person treats me, anything that enters your brain, your brain tells your stomach by way of your vagus nerve. So, anything that goes into our brain, stress can literally kill you, but it's affecting our gut by way of the vagus nerve. So, when we're stressed, our stomach is getting the signal. And then, our immune system gets the signal and it's like, oh my gosh, we're stressed. And so then, if we're eating in stressful situations, millions of Americans are eating while they're on meetings, they're driving cars, they're not chewing their food. Guess what? When you're eating like that, none of that nutrient is getting absorbed because your gut's like, oh my gosh, what's going on? Your insulin goes up. And so, all that food you're eating while you're driving, you might as well not eat because it's just being stored as fat.

Yeah.

Your body doesn't know what to do with it. And so, you're Cortisol directly affects a lot of your gut. And, this is why I also think it's so difficult to fix because people don't realize that and they don't look at the gut.

I went on a mission trip. This is almost 20 years ago. This is to Asia. And, they would take a 2-hour lunch break.

Yeah.

And so, they would go out, they would eat for an hour, and then they would— I mean, one of the cities, literally everyone in the community came in, did tai chi for 30 minutes, And then, they went back to work. I mean, these people worked incredibly hard, but they really took hours around their meals. And, that's the most important time, right? It's like, hey, you can't go and run a 5K and eat a cheeseburger because all of your blood goes to the part of your brain for alertness and your extremities versus you get that vagus nerve back on and that parasympathetic, that blood, that energy goes to those organs. You can rest and digest. Your hormones go to where they need to go for repair, regeneration. But, that doesn't happen. And, I think there's so many people, I think about my mom growing up. My mom had 3 kids and my mom worked. And, this was after my mom went through chemotherapy and radiation and all the trauma she went through when I was younger. And so, that's a lot. And, I think it's busyness, it's just excess things on the schedule. One of the biggest prescriptions I have for patients is start saying no more. Right. Let's have some time where you get to do things you love to do. Let's have family dinners. Let's just really say no more and have some margin just to relax and enjoy your life and don't be rushing all the time. But, because there's no doubt that high cortisol, to your point, is a major driver of issues. I saw this statistic recently and it kind of shocked me. I had to sit there for a minute and say, is it really that high? 88% of people are metabolically unhealthy. Wow.

I think it's 93.

Wow.

I think it's 93. I saw that from Dr. Mark Hyman because he's talking about anyone whose fasting insulin is above 5. Now, it was 93 a couple years ago. Maybe it's down to 88 because of GLP-1s, who knows? But, it's a lot, right? It is a lot. And, I see labs, we check labs on every patient, we check fasting insulin on every patient. And, I look at them all and I would say I'm lucky once a week to have someone under 5.

Lucky.

And, I'm like, oh, wow, this person's actually metabolically healthy.

Yeah. I mean, it's probably the single biggest marker. Yeah. I was looking at something recently and they were talking about, hey, if you only had these 9 markers, you could predict somebody's longevity better than anything by far. And, the number 1—

Insulin.

Was insulin.

Cortisol.

CRP.

CRP. Probably free T3.

Vitamin D might have been on there.

Vitamin D, definitely. Testosterone maybe. There's a correlation Framingham, The Framingham score, if you had low testosterone, low free testosterone, and a low vitamin D, increased your risk of overall cardiac mortality by 144%. Both.

Wow.

Each one individually was about 50-60%.

Wow.

Vitamin D is, is really important.

I have a very exciting announcement. We just found out that Heal Yourselves is officially a New York Times bestseller, and that's entirely because of you. I just want to say thank you for showing up. Thank you for sharing this work, and thank you for believing in the power of cellular health. If you haven't grabbed your copy yet, you can find it on Amazon, Barnes& Noble, or your favorite book retailer. Also, if you've already ordered but haven't claimed your bonuses yet, make sure to go to healyourselves.com and enter your email and your order number, and we'll send you hundreds of dollars in free content. Again, that's healyourselves.com. By the way, that free content includes a peptide guide, natural healing recipes, a masterclass, and loads of other free content. I'm so excited for you to read this content. I hope it's going to change your life. I want to talk about testosterone. I want to talk about PCOS. Before we do that though, I do want to talk about GLP-1s. You spent time in a research facility really looking at GLP-1s. What, what is your position on GLP-1s? How they should be used, how they're being used today, anything else that might support GLP-1s within the body? I'd love to hear your opinions.

Yeah, such a loaded question. I did research on GLP-1s in diabetic people, type 2 diabetes, very insulin-resistant. And, the doses that we use are astronomically high. They're so high. And so, it makes sense that those people lose weight and their blood sugar gets better. I don't know that we really need to push them to those levels in people, to be honest with you. I think that that's kind of an easy way to do it. I think that if we, as traditional medicine doctors or just in general medicine, talk to people about how they can lower their insulin, how they can lower their stress, it would help a lot of it. I think that in the general population, I use them, especially in people with PCOS or PMOS now.

Yeah.

Because insulin is the driving issue in these people. I mean, actually, now that PMOS has been reclassified, we talk about the gut. But, insulin's a huge issue. And so, I think in most people who are metabolically unhealthy but not diabetic, small doses, I mean very small doses, can be beneficial in addition to lifestyle modification. Yeah. But, it's not a magic crystal ball, it's not a magic wand. And so, I think that they're overprescribed in higher doses than needed, and we're going to end up with a bunch of women in 10 years with osteoporosis breaking their bones because they're losing their muscle.

I mean, you do see this in people. And, there's someone I know in particular and the face has sunken in and we see their musculature is lost. And, part of it actually has to do with because they're losing it too fast. You actually don't want to lose weight that fast. And, it's a challenge, but I agree with you. And listen, I am probably like you generally a fan of peptides because These are within our own organs. I mean, to me, they are nutrients per se or can act like that. Really, they're more these messengers in the body. And, there's a lot of, I think, a lot of things that are peptides people don't realize. Really, technically, insulin's a peptide, creatine's a peptide, glutathione's a peptide. So, I mean, I think peptides are great, but overall, and this is what I see the medical community do constantly, hey, let's find something somewhat natural. Okay. Now, let's make it synthetically. Okay. Now, let's 10 or 20x the dosage. And, rather than natural medicines, hey, let's nudge the body and support it in going where it should go. No, let's force it to do what the body's not— doesn't want to do.

Or, let's cycle it instead of just putting people on it and increasing the dose forever. Let's, like, our hormone cycle. But, I agree with you. I think that it's a very powerful tool. In people, assuming we're teaching them how to unwind the root cause of why they ended up there in the first place. Let's talk about your sleep. Let's talk about your movement. Let's talk about your diet. Let's talk about your thought processes. Let's talk about, are you seeing the sun? You know, all of these things. In addition, it's kind of like you're, you know, your cheerleader. It makes it a little bit easier, but I don't think it should be given without you being medically supervised. And I don't think it should be given with a lot of these people Oh, I got this online and somebody told me to start it and they told me to just go up by 5 units every month and that was it. And, it's like, no, that's probably not the best way to do it. And, to your point, I mean, I've put people on these GLP-1s and they've— I had a lady literally that I saw last week, she'd been on one for 3 months, very tiny dose, lost 21 pounds of fat, lost 0.5 pounds of muscle. Wow. She lost a lot of weight pretty quickly, but she was also very big, but she didn't lose any muscle because we gave her a very low dose, we gave her a very set diet, like protein regimen. And we said, you have to move your body. And then she said, I want more. And I said, too bad. Like, you don't need any more. Actually, you need less because you lost— I don't want you losing more than like a pound a week. But you can take these and not lose muscle if it's done correctly.

Yeah. And I love the way you did that because, I mean, that's the way that it should be done across the board. Part of it has to do with laziness with doctors today. Part of it has to do with not doing, you know, My philosophy has always been I'm going to treat people like my own family members and I'm going to do everything I can to help them heal naturally and not think about just them 1 year from now, but trying to get them somewhere 30 or 40 years from now. I'm really blessed. I have parents that are in their mid-70s that are water skiing. They could run if they want to. I mean, very, very good health because they've been so lifestyle and habit-oriented in doing the right things. And, I really want that for everybody to be you know, with their— playing with their grandkids and feeling great and alive. And, and if you do it the way that you're talking about, people will get there. Um, let's talk about PCOS. Why is it called oftentimes type 3 or type 4 diabetes?

Well, I think it's because in the past PCOS was, you know, we learn in school you have to be overweight, you have to be insulin resistant, and you have to be anovulatory, or you have to have irregular cycles. So it was all tied to a high insulin problem. high insulin, which then drives your body to make more testosterone, and your high testosterone and high insulin get into this circle. But, as of May 2026, it got reclassified as polyendocrine metabolic syndrome because we now know that there are actually 7 types of PCOS. There's an adrenal PCOS driven by high cortisol. There's a post-pill PCOS driven by you're on birth control.

Yeah.

There is the old-school PCOS insulin-driven type, but there are different types now. And, it's polyendocrine because we now know it's not just an ovary issue, it's not just a hormone issue, it's not just a— I feel like the old PCOS was very stigmatized. Yeah. Like, we blamed people. It is now your gut is a huge driver. There's multiple reviews last year, case reviews showing that PCOS was driven to gut issues and gut microbiome. And so, there's all this new research now showing that When our strobilome, which is the bacteria in our gut, are not metabolizing our hormones correctly, we develop hormone issues and we develop things like PCOS and our insulin goes up.

Yeah.

So, I think that it's a really good step in the right direction for PCOS or PMOS because now doctors are going to actually have to check a morning cortisol, check an insulin. Now, it's going to be, you have a form of PCOS or PMOS, let's figure out what form. And so, it's going to make people Look further.

Yeah, yeah, it's so good. Yeah, and I thought the update was fantastic. I'm so used to saying PCOS because I said it for 27 years that, uh,

PMOS.

But PMOS is definitely a more accurate way to look at it. And I do love, because it's more personalized, looking at, hey, you know, here's the, you know, 4 different types that we're looking at and the different connections. And, and it makes treatment more effective, especially when you're doing it from a more natural standpoint, uh, to, to your to your point in getting more to the root cause. And so, and of course, PCOS is also such a huge cause of infertility today.

Yeah. Huge cause.

I will say this though. So, I feel like, you know, when I think about 20 years ago when I was looking at some of the statistics around infertility rates, and I would look at things like how often is it maybe the issue with the women having the trouble conceiving and the male, the health of their sperm and their issue. It used to, be a little bit more dominant on the woman's side. Now, it's very— I mean, I saw recently it was something like 35% of the time it tends to be with a woman, 30% with the man in terms of what they're seeing statistically. And so, and this is because, I mean, male testosterone has been— I mean, it's almost mind-blowing when you look at the statistics on how far it's dropped over the last 50 years.

Yeah, I see it all the time. I see somebody almost once a week now in my clinic in their 20s, late 20s, early 30s with low testosterone, and they've gone to the doctor. And, when we say low testosterone, let's clarify this for listeners. Your testosterone can be 250 to 1,100. That's considered normal, which is crazy.

Exactly.

All comers, all age. And so, if you are a 27-year-old man and your testosterone is 250, there is a problem.

Yeah. Oh, yeah.

There's a problem and you feel it. You're tired, you're losing muscle mass, you have no ambition, you have no sex drive. And so, I think that's part of the issue as well as we have these 20- and 30-year-old people. This is part of the fertility issue. We have low testosterone. And then, when you have no desire to make babies, then we're going to have issues. But, they just don't feel well. And so, the question is why? And, a lot of times I see in these young guys, it's scary, their pituitary gland is not online. So, when your testosterone's low, your brain should be like, oh my gosh, make testosterone, make testosterone. Your FSH should be high. It's not.

Yeah.

And, the question is why. And, a lot of times, I find these guys, they have thyroid issues or they have insulin issues or they have cortisol issues or gut.

You know what's funny? In Chinese medicine, they would say that when a woman has— it's called qi and yang deficiency, that's hypothyroidism. So, the body is missing mitochondria, it's missing energy, and it's missing the ability to regenerate and heal. And so, most women with that end up being diagnosed with hypothyroidism. Men, the exact same pattern in Chinese medicine, they tend to get diagnosed with low testosterone. That's true. But, there probably are a lot of men also with— because maybe the numbers are off today and the way we look at them with these thyroid issues as well in a very similar thing. I had somebody come in recently to the clinic and his testosterone levels was— he's about 40 and were Like 91. I mean, so low. And we got it up to over 1,000 in 6 months.

That's awesome.

And we did it without TRT. We did— I mean, honestly, the single biggest thing he did was change his diet and reduce stress. Now, we did other supplements, you know, we did, you know, a couple herbals. We really focused on vitamin D and zinc because those were low clinically as well. But I mean, the body can heal very, very quickly. If you start doing all the right things.

Especially when you're young because you have a lot of mitochondria left.

Yes.

No, I completely agree. But, a lot of these guys with low testosterone too, I mean, you look at their gut, a lot of times it's like, did something happen? When people got COVID, killed their guts. When they get sick, when they get put on antibiotics, kills your gut flora. And then, when your gut flora dies, testosterone is important for your gut flora as well. You're going to get higher cortisol, you're going to get higher insulin. Then, as that starts to go up, maybe you're not sleeping as well, you're stressed, then guess what? That starts affecting your thyroid hormone production. And then, now that your gut is leaky, then you're not going to make testosterone. It's just this big circle. And then, you know, here we are. We have 20-year-olds that have testosterone in the 200s, and they go to the doctor, and the doctor says, oh, you're normal. Or they say, well, let's just put you on TRT. And it's like, no, we have to figure out why, and we have to start trying to help them fix their gut. Yeah, I

totally agree.

It's crazy. I mean, and I see it, you know, I got out of fellowship in 2017, and I used to see one of these guys maybe once a month, once every couple months. I see one at least every week now. Yeah, it is definitely a big deal. But to your point, we need to be looking— like, if that's you and you're listening to this, you need to find someone that will help you figure out why. You don't want to be like this forever.

Yeah. You know, from a nutritional deficiency standpoint, I don't know how much micronutrient testing you do, uh, or, you know, you do or don't do, but I mean, I, I tend to see a lot of micronutrient deficiencies, a lot. And I feel like one, one thing I'm always trying to do is go as far upstream as possible of like, where is this starting? And so, you know, we talked about vitamin D, we've talked a little bit about ferritin, of course, critically important. Mm-hmm. Are there any other nutrients in particular that you think that are really important when it comes to metabolic health and gut health that you see a lot of your patients missing?

Yeah, that's a great question, Dr. Josh, for sure. I mean, we look at iodine levels too. It's very controversial, but we look at iodine, we look at vitamin D, and I'll tell you why. We look at iodine, we look at vitamin D, we look at B12 and folate. So many Americans have MTHFR and low folic acid levels, and you kind of touched on it. Your ability to methylate and not have folic acid is so crucial to hormone metabolism.

Yeah.

And, a lot of people are walking around with MTHFR and they wonder, why do I have brain fog? Why am I doing all these things and I don't feel better? Well, it's so critical. So, we look at B12, we look at folate, we look at vitamin D because there's a cell— every single cell in your body has a vitamin D receptor, super important. We look at iodine, we look at ferritin. Those are minimal. Now, depending on what symptoms people have, sometimes we look at other things as well. We look at iodine because I just want to know. I want a ballpark. I think most people are iodine deficient in general because most people don't eat a lot of seaweed, raw fish, et cetera, in the US. But also, we have bad guts. And iodine, I think people forget, iodine is the backbone of thyroid hormone. So, if you go back to biochemistry—

Yeah.

Iodine is the backbone of T3 and T4. You need either 3 or 4 thyroxine molecules attached to iodine, and that's how you make T4 and T3. So, it's crazy to think, oh, you're going to fix someone's hypothyroidism if they're iodine deficient.

Yeah.

I mean, your body needs iodine. Not to mention, I think people also forget that iodine gets rid of toxic halides. So, bromide, chloride, and fluoride.

Yeah.

All on the periodic table under iodine. Iodine is able to displace those things off of cells and out of your body if you have enough.

Yeah.

And chloride, bromide, and fluoride cause our DNA to mutate and cause bad things to happen. So, you want iodine. It's very beneficial. There's studies right now going on with breast cancer. So, now they're starting to look at breast cancer and is it iodine deficient or iodine sufficient? And, I think hopefully in a few years, whenever you get a breast cancer diagnosis, it will say ER/PR positive, iodine deficient. So, you know, oh my gosh, let's get on some iodine.

Yeah. Yeah. So, I think part of the debate, and I'd love for you to share this, when it came to iodine, the way that I would look at it is if I had somebody come in and their autoimmune markers were high, I was a lot more careful with especially the dosage of iodine. If there really wasn't any sort of autoimmune reaction going on, there's TPO, antibodies were low, we would tend to sometimes go a little bit higher in the dosage and do— I would do liquid kelp and that type of thing. But, what are your thoughts on that? And, why is it controversial to talk about iodine? Is it related to sort of it increasing the risk of goiters and that type of thing?

This is a great question. So, if you actually look, and I know people have shown me the articles about why you shouldn't do iodine with high TPO antibodies.

I would say this too. I did have somebody, a family member who had Graves' disease. They took iodine.

Oh, that's not good.

they had developed a significant goiter.

Right. So, Graves' is different than Hashimoto's. So, remember, Graves' is overproduction of thyroid hormone. So, I would never give somebody who's hyperthyroid of any type iodine because your body is making too much thyroid hormone. I don't want to go give gasoline to the fire.

Of course.

You don't want to give someone iodine because then they're able to make more thyroid hormone. So, never would I give anyone hyperthyroid whether they have Graves' or they're just hyperthyroid. I would never give them iodine. Yup. Hashimoto's is the opposite though. Remember, Hashimoto's is our body's not making enough thyroid hormone or our body's being attacked. So, here's the interesting thing. If you think about how thyroid hormone is made biochemically in our body, iodine and then thyroxine attaches to the iodine molecule. And remember in biochemistry, our body is— is so made perfectly that when we have a chemical reaction that occurs, we have to neutralize it. So, when Thyroid hormone is made, the byproduct of thyroid hormone is peroxide. And, if you don't neutralize peroxide, then cells lyse open.

Yeah.

So, you know what neutralizes it? Making sure that you have enough things like methylated B vitamins, glutathione.

Glutathione is huge. Yeah.

And so, the problem is not an iodine deficiency with Hashimoto's, it's the fact that people have micronutrient deficiencies. And so, their cells are lysing. And then, when their cells lyse, that increases their TPO antibody. Then, they're also eating things like gluten and they have a leaky gut, and gluten looks very much like TPO. And so, we have multiple reasons our thyroid is being attacked. Iodine is not the reason.

Yeah.

And so, I think iodine unfortunately got this bad rap. Yes, you shouldn't take it if you're overactive, but if you're underactive, there's no reason to not take iodine. Now, do you need, again, to your point, massive amounts like some people say? No, I don't think that we need 20 times the recommended dose. But, a little bit of iodine, I think, is important because if your body's healing, you want your body to have the iodine needed to make T4 and T3.

Yeah. And, it makes total sense. Something I've been telling my patients now for quite a while is you don't need a pill, you need a protocol.

You need a protocol.

And, the reason that is, is to your point, there are a lot of different things going on in the body. And, the problem is today, and this is true in conventional medicine, it can also be true in functional medicine, is that A lot of times, it's sort of this one-size-fits-all, hey, here's levothyroxine, that's the treatment. Or even in conventional— I see this in natural medicine. A doctor had the carnivore diet help them, or a keto diet, or a vegan. And so, they recommend to all of their patients that exact same diet. Right. Or you get a doctor and they get on, everybody needs iodine, or every single person needs B12, whatever it is. But the reality is, if you're really doing a good job, getting an extensive panel, you're looking at a history, and then you're able to look at, oh, your issue is, whoa, your GGT, your glutathione is totally bottomed out. So, hey, we need iodine, but you also need glutathione. We need to change your diet. We need to do these things. And, that's how even when my mom was able to heal cancer, that was it. It was a full protocol. And, people are going to get the best results when they're working with a practitioner that is laying out a very detailed personal protocol for them. And, that's the thing I love about your approach is you're really looking at these different pathways in the body going upstream and saying, hey, let's fix the early— like for thyroid, it's like, you understand there's cortisol, there's insulin, there's iodine, there's vitamin D, there's, there's stuff going on in the gut microbiome, and we need to find out where this fire is occurring and put it out. Because, you know, there are so many people today taking supplements or eating foods or doing things where they're just wasting their money and time. 'Cause that's really not the root issue.

Right. No, I completely agree. Everyone— I love that everyone needs an individualized protocol or plan or approach because medicine is not a one-size-fits-all. That's what traditional medicine tries to teach us, and that's why so many people are so sick.

Yeah,

because everyone's body is different, to your point. And that's why I think labs are very important, but I also think lifestyle is very important. You know, you can be doing everything right. Like, I get these people sometimes who come to me, and they are— I mean, they're eating well, They're moving their body. They do everything right, except they sleep 4 hours a night and they have the biggest mental load. I had a lady recently who came in who's a big attorney and she's like, I only have time to sleep for 4 hours. That's just— I'm like, well, then I can't help you. There is literally no way I can, because guess what? The only thing wrong with you is your cortisol and insulin are high and you eat well and you exercise, but your cortisol and insulin are high because— and your growth hormone is low because you don't sleep. Yeah. And your body, that is when your body heals itself. Our body was made to fix itself, but we can't heal ourselves if we're never sleeping. And so, I think it is really important that you look. And, and I do think that we miss the gut a lot of times, you know.

Yeah, we do.

When people, especially, you know, you mentioned postpartum women twice. I— my heart goes out to them because a lot of times their hormones are shifting so much. And, when their hormones shift, it affects their gut. And, if they get a little bit of leaky gut and their hormones start shifting, guess what? Now, they're not making dopamine and serotonin or they're not able to absorb it from their gut. And then, they get postpartum depression. And then, instead of somebody using their brain and saying, oh my gosh, let's fix your leaky gut and let's get you a little bit of sleep and a little bit of help, we put them on an SSRI. And then, they go on an SSRI and that destroys their gut. And, it's just this— it's a mess.

And, that's why in these traditional cultures, pretty much for the next 90 days after you give birth, you're eating soups. It's like soups and congee and like, what is that, applesauce? It's like, what are the easiest things and best things for your gut and building blood? Though, that, that's what you're gonna eat. If you've been told your blood work is normal, but you feel anything but normal, you're not imagining it. A standard blood work panel was never built to show you what's actually going on in your cells. And your standard primary care doctor will likely never connect the dots between all of your symptoms and what's starting in your cells. And the Cellular Blood Work Analysis that I created was built just for this. It's an at-home kit that also comes with a review with a senior health advisor who will show you what is going on deep in your cells and if one of our healing protocols might be right for you. We've got hundreds of 5-star reviews on Trustpilot And most of them started right where you are. If you're ready to finally be heard, then go to mybloodwork.com to book your cellular blood work analysis today. I want to ask you about hormone replacement therapy. You know, I— so last year when Robert F. Kennedy Jr., uh, and the HHS removed this black, black box warning, I kind of had this sort of like internal struggle. It was funny because all of a sudden, all, like, all these people, even in the natural health community, were like, this is amazing, this is fantastic, it's like great for women's almost rights or freedom. And, and I thought to myself, well, you know, I mean, I want to be accurate in labeling, and maybe it shouldn't have had a black box warning, and that's, that's fine. But I still felt a little bit torn because I thought, I just don't think our entire perspective around hormone replacement therapy is Correct. My hope is, and this is across the board with everything, is if you're not coupling it with the root cause of why hormones are off in the first place with lifestyle and diet and those types of things, then I still think there's a problem with trying to do this by itself without addressing any underlying issues. But, I'd love to hear your thoughts on hormone replacement therapy and how you recommend it or if you do to patients.

Yep. So, you nailed it, Dr. Josh. I think that hormones are amazing when done correctly, but here's the caveat. A hormone is going to act in the environment you put it in.

Yeah.

So, I think that the problem here is that if you're shoving hormones in a toxic environment, those hormones are going to metabolize toxically. And then, ultimately, this is where people say hormones cause cancer. I don't think that's fair. Hormones don't cause cancer. Hormones can be metabolized in a toxic environment to toxic metabolites. that increase your risk of cancer. Yeah. And so, now, are there some synthetic hormones that have been shown to cause cancer? Yes. In the WHI, there were some, you know, progestin. But bioidentical hormone replacement, you've got to put it in a good environment. And this is my problem too with some people out there pushing hormones, is like, okay, yes, I think hormones are great. Estrogen, progesterone, testosterone are all great hormones. They do great things for us. They help with blood flow to our brain. They protect our bones. They help with mucous membrane support. They protect our heart. protect our muscle. But, if we're shoving them into a toxic environment with high insulin, no micronutrients, no B vitamins to help metabolize them, no glutathione, our estrobolome is dead and we can't actually metabolize those hormones correctly and we're making bad metabolites, are we helping people? Yeah. And so, the way we do it is we're like, okay, we check all your labs, we talk to you about lifestyle, and it's like, okay, this is where you're deficient. Here are the things we need to do from a lifestyle perspective to make sure your gut is healthy so that we can actually absorb the B vitamins that we're trying to get into our system. We can make glutathione. We can lower our cortisol. We can lower our insulin. Our estrobolome comes back on circuit, so we're actually metabolizing our insulin correctly. You have to have a bowel movement every day. Yeah. You have to because that's how we get rid of toxins. This is why a lot of people have toxic metabolites of estrogen, and this is why most women on hormones get bad hormonal symptoms because they're constipated. And, when we become constipated, our bad estrogen that we're trying to get rid of recirculates.

Can I tell you? So, my mom, she had cancer. This would have been back in, I think it was '94. This was when I was in junior high. And, she underwent chemotherapy. And afterwards, she went from having— before that, she was having a bowel movement a day. After that, it was 2 a week. And, 10 years later, my mom gets cancer again. And, I really believe that a big reason why she got cancer again was just the lack of bowel movements. I mean, honestly, when she was diagnosed the second time, we were able to help her heal naturally without chemo, without radiation. But, my single biggest focus was probably—

Her bowel movements.

Her bowel movements. It's huge.

That and sweating. That's how we get rid of toxins.

Yeah.

And so, to your point, I don't think we should be hammering hormones in someone unless we're helping them make sure that they're metabolizing correctly. and we're excreting the bad ones.

And also, you know, I've seen it too, where when I— hormone replacement therapy 20 years ago, it used to be, okay, women that are going through menopause, not perimenopause, but just menopause, we're doing— that's, that's when they're being prescribed. Or a male in their 60s or older. Now there are men in their 20s being prescribed testosterone.

Yep.

I had 3 women I've worked with over the past, just over the last 2 years they got prescribed estrogen in their early 30s and then they developed breast cancer. And, I'm not saying there's a— here's the thing. I think if it's prescribed right for the right person, the right time, the right age point in menopause, it can make sense. Yeah. I do think there's a group of people hormone replacement therapy when you're doing the right diet and lifestyle with it, I don't have a problem with it, but I do have a problem with how it's being It seems like it's being prescribed to everybody now.

Yeah. Again, I think if you have a 30-year-old that has low estrogen, the question is why. And, I don't want people to suffer. And so, if you're having really bad side effects, then maybe we need to give you a very low dose, but we need to make sure it's metabolizing correctly. We need to be monitoring those levels. So, if I ever give somebody estrogen like that, I'm following their estrone level, but I'm also making sure Are we fixing your gut? What does your astrobilin look like? Do you have enough glutathione? Do you have enough B vitamins? Are you pooping every day? Like, very easy questions. I can ask you all of that in 1 minute.

That's right.

And so, if you're not asking those questions and if you are getting hormone replacement therapy and somebody's not asking you that, it's kind of malpractice in my opinion because, I mean, we don't want to give you something that can harm you. We want to put it in the right environment.

You're one of the few medical doctors that I've ever met who's actually said that.

I know,

because— and by the way, and I really appreciate it, because I— listen,

you know,

listen, every doctor, myself included, with a DC degree, yours with an MD degree, has taken an oath of first do no harm, right? And the reality is, if you are, without ever addressing somebody's diet or lifestyle or exercise or any of those things, if you're just giving them a drug, the reality is they all have side effects. You are doing harm most of the time without

Correct.

Doing the thing that would help them the most.

To be honest with you, you know, I told you I did a lot of research. I worked for some pharmaceutical companies for a while, and then I learned better. And so I say I'm a recovering traditional medicine doctor, and I really mean it, because, you know, once you learn better, you have to do better. And I appreciate what you said, like, I treat everyone like my family too. And I can't imagine or fathom putting people on medications without explaining to them the risks and benefits, and also explaining to them like, hey, you know, we might not need this if X, Y, and Z. And I do think it's just, it's very unfortunate that in traditional medicine we give doctors prescription pads, but we don't hold them accountable to talking to people about lifestyle and other things like that.

You know what I was thinking about this is this week, I thought to myself, because I, I just spoke last week at a, uh, at a university, it was Life University in Atlanta, Georgia, and, um, there are a lot of doctors of chiropractic there. And then I also recently had spoke to a group of osteopaths and then another— and medical doctors. And, and I was thinking to myself, okay, what are they covering in school right now? And I thought about, well, MDs and DOs are pretty much getting pharmacology.

Yeah.

DCs are getting a lot of different stuff. It's more musculoskeletal. It's a little pharmacology, it's a little nutrition, and that's good. But really, for the most part, the way that doctors should be practicing today, the way that you practice, I practice, some of our amazing colleagues we have, that practice more functional medicine, we are getting almost zero training in how to practice what I would call true medicine, root cause medicine. I mean, doctors across the board, none of us are getting trained that way. We all have to learn that after school. And it's a little bit crazy because I'm like, how many, how many DCs, DOs, MDs are learning about food, you know, as medicine? How many of them are learning about herbal medicine? How many of them are learning about all the different types and benefits of what type of exercise is better, what type of people— a lot of the advanced therapies today, hyperbaric oxygen therapy, red light, ozone. I mean, so I'm gonna— a little bit of a soapbox here. Gut health.

No, I, I completely agree. And to your point, I have a degree, the highest degree in the United States, in diabetes metabolism and endocrinology, right? So, a medical degree in metabolism. Do you know how much nutrition I learned in my fellowship in the United States as a medical doctor about metabolism? Zero.

Yeah.

You know how many board questions I had about metabolism? Maybe one. I just recertified my boards. Maybe one out of 180. So, it's like, if I'm not learning it, obviously no one else is learning it. And, I agree, your gut, should— we should learn about our gut because everything starts in the gut, you know. I mean, it's, it's crazy that we don't learn this. But is it because— I don't know, is it because pharmaceutical companies have some role in that and, you know, give money to medical schools? Or is it— I don't know, but it's crazy.

Well, yeah, I mean, I do think on the DO, MD side, I do think that's part of the case. Part of it on the DC side, I think it's just being stuck in the past. But I do think, and this is why I think it's gonna be interesting to see how schools and all this stuff changes in the future, because what people need and what's going online now, and even these sort of conversations you and I are having, they're moving so much faster than the schools are, are moving. And it's becoming so outdated. 'Cause I mean, I was thinking about this week, I'm like, does there need to be a new degree and type of school out there? Probably.

Yes. A functional medicine. I've thought about it too. I

actually, 'cause there's certifications, but it really should be a full—

I agree. I've had so many people reach out to me after they read the book and they're like, oh my gosh, how can I learn? and, you know, learn more about this. I tried to write it where anyone could read it, like a patient and help themselves, but also providers. Because I'm like, doc, I didn't learn this in school either, you know. I learned it from the school of hard knocks, life, patients, like wanting to make people better. And it took years. And I agree, it's like, you know, I always want to help people. And so if I found a patient I couldn't help, I'm like, why? And then myself too, like I was really sick with Hashimoto's. And so that's how I got down a rabbit hole with gut health. And 5 years later, I was like, Okay, this has helped 10,000 people. I have to tell someone about it. And it's like, we have to make that more accessible, to your point, in school so that people understand this because it's so needed. And it's just so sad because of the amount of people we could really help just by talking to them about, do you have a bowel movement every day? What do you eat and what do you think is healthy? That conversation right there would probably do better than any prescription you could write a patient.

I totally agree. I totally agree. It's getting to the root cause. And here's the great thing is All those things you mentioned, you can fix those things. They're free. You can fix most of them free. Absolutely. Um, well, Dr. Cassie, it's been a pleasure talking to you. You're, uh, yeah, brilliant. And I want to encourage everybody to check out Dr. Cassie's book. It's called Fix Your Gut, Fix Your Hormones. Um, you can get this book in bookstores. It's on amazon.com. It's a great place to go get it, just on amazon.com. Again, Fix Your Gut, Fix Your Hormones, here with Dr. Cassie Smith. Thank you. MD. I want to encourage you guys on YouTube, let me know what is the single biggest takeaway you had from the interview with Dr. Cassie today. Is there something she said or that we talked about that you said, that's me, or I'm going to go and do this? But we'd love to hear from you the most insightful thing we talked about on today's podcast. And if you have any other questions, feel free to reference those on YouTube as well. Hey, where can people find out more about you and your amazing work?

Oh, thanks. Uh, so I'm on Instagram, YouTube, All the social handles, @modernendocrine_.

That's right. So, yeah, so it's not Dr. Cassie Smith, it's modernendocrine_.

If you look my name up, you'll— I think you'll find it.

You'll find it tied.

But there, uh, my book, like you said, it's on Amazon. It's on Audible and Spotify now too. I have a podcast, Hormones, Metabolism, and You. And we have a website, modern-endocrine.com, where we just try to help people just like you be healthier and Again, a lot of it is free. It's just education that's needed that a lot of people, even doctors, don't have, unfortunately.

Yeah. Well, we're working on getting it there. So, hey, everybody, thanks so much for tuning in here to the Dr. Axe Show. Remember, every week we're diving deep into the science and principles of how you can heal physically, mentally, spiritually, and take your health and your life to the next level. Hey, in the show notes, we'll put links here to the amazing work that Dr. Cassie's doing. Also, we will put a Hormone balancing guide in there. You can go and download that as well. And also, hey, do me a big favor. The number one thing you can do to support the show is subscribe. That way you don't miss a thing. And think about, is there one person, maybe you've got a friend and they've got some hormone issues, share this episode with them. It may change and transform their life. So thanks so much for being on mission with us. We can't wait to see you on the next episode. God bless. God bless.