Low Cortisol

Thyroid health, blood sugar, stress, and metabolism with Amie Hornaman


In this interview, Laurie and Amie Hornaman discuss Thyroid health, blood sugar, stress, and metabolism and which tests you should consider, if you think that you have a thyroid issue. As well as what thyroid issues might look like.

Dr. Amie Hornaman DCN, MsN, CFMP, a.k.a The Thyroid-Fixer, a woman on a mission to optimize thyroid patients around the world and give them their lives back using her transformational program: The COMPLETE Thyroid Fix Method (CTFM).
After her own experience of insufferable symptoms, misdiagnoses and improper treatment, Amie set out to help others who she KNEW were going through the same set of frustrations and who were on the same medical roller coaster.

This is a transcription of an Instagram live conversation. You can find the full video on Laurie’s IGTV tab on Instagram and on soon on YouTube.


Today I’m with Dr. Amie Hornaman. We’re going to be talking about thyroid health, stress, metabolism and blood sugar, how it’s all related and how it’s all connected.

Amie has specialized in thyroid health. She’s a woman on a mission to optimize thyroid patients around the world and give them their lives back using her transformational program called The Complete Thyroid Fix Method. 

Amie has been helping thyroid patients for many years and I’m a thyroid patient myself. 


We’re working together and you’re seeing those little glimmers of light already, which is amazing. 

When we start optimizing a thyroid patient, someone that’s been struggling, maybe they’re not on the right meds, they or their practitioner isn’t addressing underlying issues and not putting that whole picture together, then that person continues to suffer. 


Absolutely. Before I figured out that something was going on with my thyroid, I was suffering for at least two or three years, where I felt like things were on a slow decline and symptom after symptom was accumulating. 

I was an athlete. So I was training pretty hard. I was paying attention to my diet, but maybe a little too much and it was having an effect on me.

When I finally figured out that there was a connection with the thyroid, it just turned everything around.

I had always wanted to get off of my thyroid medication. I’d always had this feeling that maybe I didn’t really need it. Recently I tried to stop. Then I came back on and I’ve been a mess ever since. That’s when I contacted Amy to get me back on track.

So I’d love to dig into this relationship. I work in the hormone health world, but I primarily love to help women with the foundational pieces, blood sugar being one of them. 

I’d love to talk about this relationship between thyroid health and blood sugar and what comes first or does it go both ways? 


I see blood sugar issues across the board with all of my patients. So if you have a thyroid problem, whether it’s just regular primary hypothyroidism or Hashimoto’s the auto-immune form, you have to remember the thyroid is the master gland. 

It starts dysregulating all the hormones below and they’re going to be affected by things like insulin regulation and blood sugar regulation. 

So I see insulin resistance in about 99% of the patients that I work with, thyroid problems and insulin resistance go hand in hand. And then beyond that, we start to see hormone dysregulation. Any kind of hormonal function in the body starts to go haywire, when the thyroid is off, since the thyroid controls the show. It controls everything going on in your body. There’s a receptor site on every cell for thyroid hormone.

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So once you get your hormones optimized in terms of the thyroid hormones, does that have the same effect on optimizing blood sugar?


It does. The two go back and forth.

I always say you have to do both. We start to optimize your thyroid, but at the same time, you can’t be eating McDonald’s, dairy, sugar and carbs and think that because you are optimizing your thyroid, everything will be better. You have to do both. 

You have to address that insulin resistance or blood sugar dysregulation. You have to change your diet. You have to change your lifestyle. You may have to take some supplements that assist in utilizing blood sugar better and in lowering insulin levels. 

When you work with both, that’s when you get the best results. Your thyroid can work and it can heal. If you’re optimizing your thyroid and you’re eating like garbage, your insulin will be high, which creates inflammation and that’s going to dysregulate thyroid function.


It’s a stressor on the body when our blood sugar is not regulated. 


It’s a huge stressor on the body and stress creates inflammation.


So that makes it more difficult for your hormones to function, because it’s not getting into the cells.


Inflammation is occurring from keeping your insulin and your blood sugar high by eating garbage and from being on that blood sugar rollercoaster. That up and down rollercoaster of highs and lows with blood sugar is going to create a stress on the body, which creates inflammation. 

A lot of times people think of inflammation as, I bumped my elbow and it’s all red and swollen. That’s one form of inflammation, but there’s another form that occurs in the body that starts to throw off all of your body’s functioning. 

So if you have systemic inflammation from high insulin levels, that’s going to shut down thyroid function. If I came and beat you up daily and made you all bruised and inflamed, you wouldn’t be doing your job very well. You would be a little bit slower in your day to day activities with your job. 

Same thing, if there’s all this inflammation going on, there’s inflammation around the cell. The thyroid is going to be overwhelmed and not know what to do. It doesn’t know how to function properly. 

So your little cell that’s waiting for the thyroid hormone has all this inflammation around it. Your cell is thinking, “I don’t even know where I am. I’m in just this fire. I can’t even find the hormone that’s supposed to attach to this little receptor that I have. So I can’t do my job either.” 

It’s just a huge cascade of events that people don’t realize is going on. All people realize is: I’m gaining weight. I’m tired all the time. My hair is falling out. I can’t lose weight no matter what I do. I’m cold. I’m constipated.


When you mentioned that if you came over here and beat me up, I was thinking how many times do we do this to ourselves. When I had to fill out your form, I had mentioned that I had run 12 marathons in a year. I was training at a very high level, several times a week.

In a way I was beating myself up. I was creating inflammation in my body everyday with my heavy training.


Very true. That can do it. I have a specific podcast, which I think is titled running sucks, because it creates so much inflammation. It’s a stressor. 

We can get into running, but it can increase cortisol, which increases inflammation, which increases your insulin and your blood sugar.


That’s probably how I ended up going down that path, but women can get there for a variety of reasons. You touched on how suboptimal thyroid function affects our metabolism, mood, energy, body composition and weight. Can you clarify what suboptimal means?


When you go to your doctor with a list of symptoms like the weight loss issue, you’ll get a bunch of tests. Actually you get two main tests, TSH and free T4. Doctors look at those. If they’re in that standard lab value normal range you’ll be called normal. 

When we look at it from a functional perspective and preferably we look at all the tests needed, some of those numbers can be in a normal lab value range, but they’re not normal for functional medicine. 

We look at it and we say, that is suboptimal. That’s subpar. That is not an optimal level for you to feel your best. In functional medicine we just have a different range to know when people are going to thrive, be able to lose weight and feel their best.

When the thyroid is off, keeping in mind that it’s the master gland, which is going to affect your metabolism and your body’s ability to actually burn fat for energy. It can’t burn the food you’re taking in. It can’t burn the fat that’s on your body. It just is low and slow. 

So when your thyroid is hypo, everything slows down, hypo is low and slow. Your slowing down your metabolism, your energy, your ability to go to the bathroom on a regular basis, your ability to feel good, everything slows down.


Is it possible for women to be in this suboptimal range, just temporarily and then switch back over, when they’re in a high stress state in their life. 

Is it possible for stress to down-regulate the thyroid? And when you help heal your body it upregulates again.


So whether we’re talking about primary hypothyroidism, that’s caused from excessive dieting, extreme exercise, extreme stress, and pregnancy. We often see hypothyroidism kind of pop up after pregnancy. 

Anytime those situations have occurred where the thyroid itself has slowed down, we can absolutely do lifestyle changes, nutritional changes, supplemental help to just boost up. Maybe some of those nutrients that are low, like iodine, are imperative for the thyroid. Selenium and magnesium are imperative for the thyroid. Low vitamin D levels are a stressor on the body. 

So all of those little factors we can address and improve on to bring someone into better thyroid function. Now, if it’s Hashimoto’s, which is the auto-immune form of hypothyroidism, then we just take a different route. We still look at all of those lifestyle factors, behavior, nutrition, supplement, nutrient status, hormone status, blood sugar status.

We look at all of that, but we also look at how we can support the immune system so that the body is no longer attacking the thyroid. Hashimoto’s, that’s the autoimmune form of hypothyroidism is where your body is literally attacking the thyroid. 

If the immune system is beating up the thyroid and is destroying it, we want to support it, so that it gets less confused. So it knows that the thyroid is a nice gland and to not go out and attack it. 

We just have to calm down that auto-immune response and support the entire body to support the immune system through a variety of different ways. 

So the base question is, is it possible to reverse thyroid disease naturally? 

Yes, it is. Depending on how far along you have progressed, it all depends on where you are in that spectrum. How far has your hypothyroidism gone? How deeply into Hashimoto’s are you? What stage are you in? 

That determines whether or not we can completely avoid medication or whether medication may be warranted just to help support the body and give the body hormones, thyroid hormones, when it’s no longer properly producing on its own.

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So how would somebody go about finding out if they’re in the optimal or suboptimal range?


First you have to do the testing. I mentioned that if you go to your doctor and tell them your symptoms, you will get a TSH and a free T4 test. That starts the process. But that does not tell us how healthy your thyroid is.

TSH is a pituitary hormone. It senses if there is enough thyroid hormone in the body. If there is not then that TSH, thyroid stimulating hormone will go up. TSH is not a thyroid hormone. It’s a pituitary hormone. So if that’s screaming, then absolutely you have a thyroid problem, because it’s your pituitary saying, “Hey, thyroid. Wake up. You’re not doing your job. Come on. Let’s go. Let’s go. Let’s go.” 

It’s like yelling at your kids. The first time, you might whisper. The second time, you might talk in a normal voice. By the third time, you’re yelling. High TSH is your pituitary yelling at your thyroid to do its job. 

Then we have free T4. Now that’s the inactive thyroid hormone. So if your doctor’s testing that and it’s low, it gives us a little picture, but let’s go deeper. 

Let’s check free T3, the active thyroid hormone. That’s vital. That tells us how much of that thyroid hormone wants to get into the cell, when it’s not inflamed from high blood sugar. So how much of the hormone wants to get into the cell to do its job, to give you a metabolism, to grow your hair, to strengthen your nails, to give you energy. We need to know about free T3, because that’s the active thyroid hormone. 

Then there’s reverse T3, which is the anti thyroid hormone. I love giving analogies. So reverse T3 is the bouncer outside of the cell. It’s standing outside of your cell door telling T3 that it can’t get in. 

You could have someone with an optimal, even functional optimal range of free T3, but if reverse T3 is elevated, that doesn’t matter, because that T3 can’t get into the cell. It just can’t. That’s why we have to test it. 

Then we check for antibodies, TPO and TGA. Once you have all of the testing, then you can lay it out and go by the functional medicine optimal lab values. 

I have a download on my website, the lab and symptom checklist that actually gives you the optimal lab values. 


Once you know that, where do you begin?´What are the next steps?


So from there it becomes a puzzle. So you might have a great free T3, but you have a high reverse T3. Why? We go back and ask what causes high reverse T3? 

That would be low iodine, low magnesium, low selenium and underlying infection like Epstein-Barr virus or Lyme disease. It could be walking around with high insulin. It could be estrogen dominance. It could be you’re anemic and you have low ferritin levels. 

There are so many factors that come into play that can cause high reverse T3, and get in the way of T4 to T3 conversion. 


If you have some or many symptoms of hypothyroidism, then you should maybe consider working together with a health practitioner. 

Symptoms start with low energy, low metabolism, difficulties with weight loss and you might notice hair loss. You might notice things like losing the outer third of your eyebrow. Maybe slow digestion. 

Basically everything is going to slow down in your body and you’re going to be experiencing constipation. 

If you are thinking that this might be you, I would encourage you to explore it further. Ideally with a functional medicine approach. Conventional medicine typically lets it get really bad, until you aren’t feeling good at all, before they help you. 

Keep in mind that this is also a journey and you’re going to try and get your thyroid optimized again. It’s a journey for the rest of your life. You’re gonna keep going in and tying to tweak things so that you really stay in an optimal range.


If you think that you are misdiagnosed or you are diagnosed with a thyroid problem with Hashimoto’s and you’re still not feeling right. Then there’s more that can be done. The message is don’t stop and accept feeling like garbage, don’t accept your doctor telling you that your labs look good and there’s nothing more that they can do. 

That’s not right. We want you to feel your best. We want you to have the best life possible. Our bodies were not built to walk around feeling like garbage day in and day out, suffering with symptoms with no answer. There’s always an answer. There’s always something we can do. 

We can go down the medication path if we have to and we can go down the natural path and heal your body naturally. But there’s always something that we can do, something that we can find and address that root cause problem to get you your life back.

You know something is off with how you feel, when you are not yourself, when your body is not responding the way it should be responding. If you know that you’re eating right, and you’re not overworking, you’re exercising and taking care of yourself and you’re getting sleep and you’re doing all of those things and you still feel like garbage. That’s your body telling you that there’s something wrong. Something’s not right. So listen to your body. 


Thank you so much

Find out more:

Connect with Amie Hornaman on Instagram @dramiehornaman or check out her website, where you will also find her podcast.

This information is for educational purposes only and is not intended to diagnose, manage, or treat disease or serious conditions. Always check with your doctor before making any changes. It’s important to consult a well-informed health practitioner for personal advice about your situation before relying on general information we’re all wonderfully unique.

Laurie Villarreal, FNLP, CHWC, FNS, LMC, CPT, RYT

Hi, I'm Laurie, a functional nutritionist and board certified health coach, athlete, dog-mom, and biohacking adventure-lover. After having struggled for years to find lasting solutions for my own debilitating hormone-related symptoms, I created my online practice to begin helping other active, driven women get the support they need. I now help  women around the world elevate their health, energy, business and life by optimizing their hormones with personalized nutrition and lifestyle tweaks. Together, we discover new tools and strategies that keep you showing up at your best so you can play even bigger in your life and work.

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