Podcasts about T4

TSH: The Most Misunderstood Thyroid Lab — 25 Questions, Answered If you've been told your TSH is "normal" but you still feel exhausted, foggy, inflamed, or hypothyroid — this episode is for you. In this deep-dive Q&A episode, Dr. Eric Balcavage answers 25 of the most common and misunderstood questions about TSH, the lab marker most often used — and misused — in thyroid care. You'll learn: What TSH actually measures (and what it doesn't) Why TSH can go up in some stress states and down in others How inflammation, stress, sleep, dieting, and medication timing distort TSH Why "normal" TSH doesn't guarantee healthy thyroid function How to tell true hypothyroidism from adaptive physiology Why chasing TSH often keeps people stuck How thyroid medications affect TSH differently (T4 vs T3) Why tissue hypothyroidism can exist even when labs look "fine" This episode is designed for: Patients frustrated by "normal labs" Clinicians who want better thyroid interpretation Anyone trying to understand thyroid physiology beyond numbers

Welcome back to another episode of the unSeminary podcast. Today we're talking with Tim MacLeod, a former nurse who escaped the financial treadmill by flipping couches—and now teaches others how to do the same. Are you a church leader feeling the financial squeeze? Looking for a side hustle that doesn't require debt, special skills, or hours you don't have? Tim's story offers a practical roadmap—and encouragement—for anyone needing to close that income gap. Burnout and financial pressure. // Tim became a nurse at 21, newly married, supporting his wife through teacher's college, and quickly thrown into adult responsibilities. The only way to stay financially afloat was by working overtime once or twice a week. When their second child was on the way, he realized the path he was on was unsustainable. Finding financial freedom. // Options like upgrading his nursing degree, relocating, or working in dangerous psychiatric facilities were unappealing. Tim needed something flexible, part-time, and profitable enough to replace overtime. He discovered flipping phones and iPads first, but competition was fierce. Then, after borrowing a trailer and responding to a free couch listing, everything changed. He cleaned it up, sold it the next day for $280, and instantly covered more than an entire nursing shift. Why flipping couches works. // The opportunity exists because of a gap in the marketplace. Most people don't own trucks, can't move heavy furniture, and face tight deadlines when moving. Sellers value reliable pickup over price; buyers value affordable furniture delivered to their door. Tim steps into this gap. With polite communication and kindness, he creates a “win-win-win”: sellers get rid of furniture quickly, buyers get affordable delivered couches, and Tim earns a consistent profit. He estimates most beginners can make $1,000/month by flipping just five couches—buying each for around $50 and selling for $250 with delivery included. A side hustle with time freedom. // One of the most surprising parts of Tim's business is the flexibility. He built the early stages of his flipping business in the evenings with his wife and baby riding along—road dinners, cheap pizza, and trips to pick up inventory. Now he schedules pickups during school hours, stacks deliveries based on availability, and can pause or accelerate the business as needed. It's ideal for ministry families with unpredictable schedules. Why you can succeed at this. // Many of Tim's students are pastors or church employees, and he says ministry workers have unique advantages: access to storage at the church, a heart for helping people, strong communication skills, and the ability to bring calm to awkward interactions. Many pastors live outside their ministry communities—creating the perfect “import/export” opportunity where they can buy in one market and sell in another. And unlike many side hustles, flipping couches doesn't conflict with ministry—it simply provides supplemental income with minimal stress. A free resource to get started. // Tim created a free Google Doc of scripts—his exact messages for starting conversations, vetting couches, and negotiating with integrity. To get it, simply comment scripts on any of his Instagram videos and he’ll email it your way. He also offers an affordable course walking through his full system, including storage setup, videos, delivery strategies, and scaling beyond $1,000/month. To learn more or access Tim's free scripts, visit him on Instagram @thefulltimeflipper or explore his full course at tim-macleod.com. Thank You for Tuning In! There are a lot of podcasts you could be tuning into today, but you chose unSeminary, and I'm grateful for that. If you enjoyed today's show, please share it by using the social media buttons you see at the left hand side of this page. Also, kindly consider taking the 60-seconds it takes to leave an honest review and rating for the podcast on iTunes, they're extremely helpful when it comes to the ranking of the show and you can bet that I read every single one of them personally! Episode Transcript Rich Birch — Hey, friends, welcome to the unSeminary podcast. So glad that you have decided to tune in. We’re definitely having a very un-unSeminary episode today. You know recently I heard some statistics that I was like, man, we gotta do something about this. According to the Bureau of Labor and Statistics—you’re like, it’s a little early in the year for the Bureau of Labor and Statistics—but there’s a 13% gap between what religious workers—people who are clergy actually, is the title—and the average income in the country makes – a 13% gap. In fact, it even gets worse when you look at people, there’s a category called “religious workers, other”, which these would be like not the senior pastor types. This is like everybody else that works in a church. There’s a 40% gap between those people and the the average salary in the country. Rich Birch — And so why am I bringing this up? Because I know that there are people that are listening in today that are feeling that gap. Here we are in January and they’re feeling the pressure of that. And I want to help you with that. And so I’ve got a friend, like a friend from real life, friends. This is like we’re in the same small group. We know each other, incredible leader, and I want to expose you to him. But more importantly, I think he can help you with that gap.Rich Birch — It’s my friend, Tim MacLeod. Tim was a nurse with the dreams of fatherhood and home ownership, but after a few years was faced with reality and no time, no amount of overtime was really going to fill the gap that he needed to make things work. And after being stuck on that kind of financial treadmill, he found a way out. He found the niche of, wait for it, friends, flipping couches. What? Flipping couches and was able to quit his nursing job and now does this full time. And I’ve asked him to come on. Uh, because I think what he did at the beginning, even part-time, I think could help some of us today that are, that are listening in. Tim, welcome to the show. So glad you’re here.Tim MacLeod — Thanks so much for having me, man. I’m excited.Rich Birch — This is going to be a good conversation. Kind of fill in the story. Tell us a little bit, uh, tell us about your background, and how did you get in? How did you go from nursing to flipping couches?Tim MacLeod — So I wanted to be obedient and I got married maybe a little bit too young at 21. My wife was still in teacher’s college. And so very, very quickly I was thrown into adulthood of two cars, rents and all the things that come with that.Tim MacLeod — And nursing was good. I was a registered practical nurse, so not a university educated RN making bank, but doing okay with a college diploma. And I got the comfy gig at a long-term care home because I preferred eight-hour shifts and not the, I didn’t want nights.Rich Birch — Midnight and all that.Tim MacLeod — I just wanted, yeah, exactly.Rich Birch — Yeah, yeah, yeah.Tim MacLeod — I wanted the free parking and the the reliable six to two shifts. That was just the lifestyle that I liked. And the only way that I could stay afloat financially was with doubles. I had to do my six to two and then at least once a week, usually twice, if I wanted to have any money to play with, um I would work the two to ten.Rich Birch — Wow.Tim MacLeod — And that was cool while my wife was in college or while she was finishing up teacher’s college, that was fine. And then, we had a newborn baby and that was fine. Because anytime that I would have to do those doubles, she’d go to sleep, go for a sleepover at her parents’ place. And, uh, and I would just drudge up the shifts.Tim MacLeod — And, but then when we were pregnant with number two, I knew that there was difficulties coming. And the road ahead did not look very good. And so I needed something different and all my options for replacing the income suck. Like I could go back to school and upgrade to RN, but I scraped through the first time. So that was nuts.Rich Birch — Right.Tim MacLeod — I didn’t have much hope in myself in that avenue. And I could go, I could relocate, I could move or I could commute about an hour and 20 away to the mental health hospital and make like danger pay in like an asylum, basically with my current qualifications.Rich Birch — Right.Tim MacLeod — And everything just looked terrible. I hated all of that. And all I needed was something better than overtime. I just needed to replace that portion of the income. And I needed something better in my evenings that hopefully I could do with my wife or from home. And so I was looking at side hustles.Tim MacLeod — And I had a little bit of success flipping phones and iPads because that’s all that I really understood…Rich Birch — Okay. Yeah, yeah.Tim MacLeod — …all I understood at the time. And I live about an hour north of where my in-laws live, which is a pretty dense population. I’m in the sticks and the supply was really light there. So I could reliably go for a free meal at my in-laws place, pick up an iPhone or three and for like 300 bucks and then bring them home and sell them for 450 bucks. And so that took that took the pressure off and that was like grocery money.Rich Birch — Right.Tim MacLeod — And it was really consistent, really reliable. And and it was fun too. I really liked it. I liked the negotiations. I liked, I liked not trading time. Rich Birch — Right.Tim MacLeod — Like I liked making making a profit instead of a wage. And that I was hooked on that, but there was competition. Like I wasn’t that clever doing that.Tim MacLeod — There was there was kids that were closer to the inventory ripping around in little Hyundai Elantras and uh i remember meeting this this Indian kid named Lucky, at least his Canadian name was Lucky, and he was beating me to all the goods. And and I met him one time to buy a phone for myself and I actually got to meet him and ask him some questions and he was making four grand a month flipping phones.Rich Birch — Wow.Tim MacLeod — And I thought that is so sick, and it’s just a pure cash hustle. And he was making more doing that than whatever his office or IT job was at the time. And I was super inspired by that, but I didn’t want to compete with him. So that kind of that kind of festered with me a little bit.Tim MacLeod — And um I just got an awesome idea. Well, was gifted to me by the Holy Spirit, I think, based on how fast and how fierce it came, that I need to get skills and tools to sell in a different category, something with a higher barrier to entry. And I wanted something where I didn’t have to compete with the Honda Civics and the Hyundai Elantra’s that were closer to the action.Rich Birch — With Lucky. Yes.Tim MacLeod — Yeah, exactly. He was smoking me. And and it also, it was a little bit of that and then also a little bit of me coveting. I wanted to get like, um I wanted an excuse to buy a Ford Ranger. I wanted a truck at the time.Rich Birch — Love it.Tim MacLeod — And so this combination, this combination of like wants and needs at the time, had me pitching an idea to my brother, Ross. I’m just like, Hey, what do you think about instead of phones and iPads? What if I got a truck and I started doing like washers and dryers or appliances or something like that? And he said, that’s a cool idea.Tim MacLeod — You’re good at the phones and iPads thing. And I definitely like, you’re good at the negotiations, all that. But don’t start eight grand in debt. That’s so stupid. Why don’t you just borrow my trailer and just try it? And I said, well, I don’t have a, I don’t have a hitch on my car. He said, get a hitch on your car, buddy. Okay. So, put that on the Visa, did not have the money for it. Rich Birch — Wow. Tim MacLeod — Put that on the Visa, put a two inch two inch hitch and four prong wiring on Mazda 5 like the little four cylinder, little mini minivan.Rich Birch — Oh, I wish I would have saw this at that. I wish I would have s seen this at this phase. Cause that, that, that would have been amazing to see him getting pulled around.Tim MacLeod — It was it was pretty cute and it was a big trailer too 12 by 6 aluminum being pulled by this little aaaaahhh. And it was stick shift and and…Rich Birch — Nice.Tim MacLeod — …and the first day I got the trailer, the only thing I could find, because I was just itching to use it, was a free couch. And it was one of those beige microfiber, like gets dirty if you look at it wrong.Rich Birch — All right. Yes.Tim MacLeod — Like they hold on to every water stain.Rich Birch — Yes. Yes.Tim MacLeod — And it was that and it was free and it needed a little bit of TLC. And I went and I got it for free. Brought it home and with a damp cloth, scrubbed out all the little marks and had it looking good. Took a picture of it, listed it with an offer of delivery and it sold the next day for 280 bucks.Rich Birch — Wow. That’s amazing.Tim MacLeod — It was awesome. Because a nursing shift net was like 180.Rich Birch — Wow, OK.Tim MacLeod — I think I was, I think I was 28 bucks an hour for an eight hour shift after taxes. Yeah. Probably like 180 hit the account.Rich Birch — Wow.Tim MacLeod — And so 280 for that. And it was one of those trips of free meal at, at the in-laws and then a free couch and then bring it home and then solve somebody’s problem of, I just got an apartment. I don’t have a car or my car’s too small and I need a couch.Rich Birch — Yes, yes.Tim MacLeod — And their option was, rent a U-Haul or go to Leon’s and finance something that comes delivered. Both are not very good options for most people. And then lo and behold was this guy who said, I got a couch, I can bring it by. And it was just the easiest yes for them. It was a win for everybody. Rich Birch — Right.Tim MacLeod — The person who needed the couch picked up, didn’t care about the money. They needed reliable pickup more than they needed cost recovery of the item because they had a deadline. I needed a way to make some cash and the person on the receiving end needed a couch that was affordable that came delivered. So it was just a win-win-win for everybody. I was like, okay, forget about appliances. Couches – I love this. And it was easy, it was it was easy enough to lift by myself. Rich Birch — Did you ever do appliances? Did you ever do appliances in there? Tim MacLeod — Yeah. I did a washer and dryer and ate a loss on that because it needed repair and I didn’t… Rich Birch — Love it. Tim MacLeod — …I paid for someone to assess and they were like, yeah, this thing’s broken. Was like, sweet. Okay. So a hundred bucks to you for, for, to tell me that it’s hopeless, and then pay for junk removal too.Rich Birch — Yes.Tim MacLeod — Like it was just such a loss. But couches, I could reliably sit on it and be like, well, that’s not broken. And I can handle that little stain or I can, my wife could stitch that up.Rich Birch — Right. Right.Tim MacLeod — And, uh, it was just so safe. And I loved it. If, if I were handier, I’m sure I could, flip snowblowers or lawnmowers or cars or something like that, but I’m not handy. I’m just, I have the ability to relocate stuff. Rich Birch — Right.Tim MacLeod — And so couches were just so perfect where I could just accurately be like, that’s 300 bucks to me. Rich Birch — Right.Tim MacLeod — And they only want 60 for it. Perfect. Let’s do that.Rich Birch — So and let’s double click on that. A part of what, so friends, like with the reason why, I think you’ve seen why I’ve got Tim on the the line today. I want to inspire you to think like, hey, you you could in part-time make a little extra a month. And I’m going to get to that with Tim. I’m going We’re going hammer down on, okay, what exactly would be some of the first steps that you take? But let’s unpack a little bit more. You’ve talked about once this insight, which I think is just a stellar insight that’s obviously at the core of your business. It’s this whole timing thing. Like people, you know they think a couch is worth certain certain amount, but they’re moving on X date, and the value of that couch goes down. But then it’s literally the reverse. Someone on the other side, they have an empty living room and they’re like, I need something here.Rich Birch — Unpack that a little more, kind of double click on… that value exchange and how you’re in the middle of that. What’s it talk us through what that looks like.Tim MacLeod — Yeah, there’s there’s a gap. There’s a gap in the marketplace. On the one end, we’ve got people who need it picked up and their options are hope that someone will pay the price that they want. And then if they hit a deadline, then their option is junk removal or put it to the curb. And so there’s a gap to fill there. Tim MacLeod — And then on the other side, there’s a gap of people who need a couch dropped off but can’t do it themselves. Like how many, what’s the population of people that own a truck that can actually do it is probably less than 10%. Most people have cars and hatchbacks and SUVs and stuff like that.Rich Birch — Right. Tim MacLeod — And then there’s also the how many people can lift a couch. I would say easily less than half the population. And so there’s just this huge gap that can be filled. And so by just committing to being the dude, you can help a lot of people solve a lot of problems. And there’s a little slice in it for you too.Rich Birch — So one of the things I’ve heard you say is that you have found this process of buying couches and then, you know, sitting on them for a while, maybe cleaning them a little bit and then turning around selling them is really flexible. Talk us through that. You know, it feels like you’re, you know, you’re, you have some time control. Talk us through what that looks like for you in your current world.Tim MacLeod — Yeah, the time freedom is crazy. And that was the appeal in the beginning was [inaudible] I didn’t want to be strapped to a location, a building to to make money. I had to be away from my wife and kids. But when it, couches just took off so fast that the first time I flipped a couch, I immediately called the scheduling office and reneged on all of my overtime. I said cancel all my two shifts.Rich Birch — Oh, wow.Tim MacLeod — I’m done. I’m I’m I’m just doing my 10 shifts. And, and then it didn’t take too long before i wanted to quit so fast, man. I wanted to be out of there. My, my my passion for the, like, I was so replaceable. Like as soon as if if I’m gone, someone’s going to fill the shift.Rich Birch — Right. Right.Tim MacLeod — Like, ah but there was a, there was a huge, there was a need that, and it was fun for me too. It was a game. I forget the question.Rich Birch — Yeah, I was just talking about the time flexibility, like how you feel like it’s, you know, you have a fair amount of time freedom. Part of what I’m trying to get to is pastors are busy people. Church workers are busy people. Is this even the kind of thing that they could fit into, you know, an existing as like a side hustle kind of thing?Tim MacLeod — Yes. Yeah. The time freedom is crazy. And so on the buying side, I’m just letting people know when I’m available. And sometimes I’ll tie it up with ah with a $50 deposit so that they can market it sold with confidence and they know that I’m not going to ghost on them. And that I have the peace of mind of nice, that’s mine for when I need it. And I’ll squeeze them for a deadline so that I make sure that I’m providing the service of reliable pickup in a manner that works for them. Tim MacLeod — But yeah, I’m just stacking pickups when it’s convenient for me. And in this current season, it’s during school hours. Rich Birch — Right.Tim MacLeod — So I’ll drop the kids off at school and then rip south and grab some stuff. But in that season, it was I’m available in the evening. And so I would come home from school, I’m sorry, work from my nursing job. And my wife would pack up, we pack up a little cooler bag of like a road picnic of dinner.Rich Birch — Right.Tim MacLeod — We had a one-year-old baby at the time and, uh, oh, that summer there was a lot of 50% off pizzas. Pizza Hut had a, the, the apps, we had all, all the apps, lots of road dinners. Rich Birch — Yes. Yes. Tim MacLeod — And Costco was clutch too.Rich Birch — Yeah.Tim MacLeod — But, um, yeah, just when I had an availability, I would acquire inventory and then they’d sell when they sell. And and again, full flexibility of, okay, I’m available at this time. I can squeeze in a delivery or someone could come pick it up. But yeah, the the time freedom is crazy and it’s sweet to to to just dabble in profits instead of relying on a wage. Rich Birch — Right.Tim MacLeod — Yeah, time freedom is awesome.Rich Birch — Well, you talked about the fact that your you know your brother was telling you you’re good at negotiations. I know there are people that are listening in today that are feeling like, oh, there’s no way that I would be good at negotiations. Obviously, you’ve got to buy the thing for considerably lower than what you’re selling it for. Talk us through even just a couple, help us get over that hurdle in our brains. Man, I just don’t know that I could do that.Tim MacLeod — Yeah. So the first thing is I’m scrolling a lot. And not not frequently. I’m not glued to my phone. But when I do it, I lock in. Like today was the shopping session and it was headphones in with some instrumental music, just kind of vibing. And I’m probably scrolling, looking at probably 400, 500 couches. Rich Birch — Okay.Tim MacLeod — And I’ll message probably 20 to 30 of them. Because a lot of them are crap. A lot of them are actually new. There’s no opportunity with new coaches. like There’s lots of warehouse stuff that’s still on first Facebook Marketplace and stuff like that. But what I’m looking for is very specific. I’m looking for private sales from real people. You got to be able to spot the scammers and weed them out. Tim MacLeod — And I’m looking for couches that I would want in my lockers. I’m not worried about the price whatsoever. Because the price is super subjective and it’s just kind of like what they’re hoping for. It’s not actually what they’re necessarily going to get. So the price is irrelevant. I’m just looking at pictures and I’m compiling lists of couches that I would want. And I’m starting conversations so that it’s kind of like I’m, I’m, it’s it’s like I’m offering my service. I’m starting the conversation to see why they’re selling it, if there’s a deadline, and if they would be someone who would be receptive to my service. And it’s kind of like they’re paying me for my reliable pickup service with a smoking and deal on a couch.Tim MacLeod — And so I have to get them there. And it’s not just, I can’t just go around lowballing everybody because you burn the bridge and you hurt feelings. Rich Birch — Right. Tim MacLeod — So I’m starting conversations and I’m filling in the gaps on the item. So I’ll read the description and see what’s missing. Like, did they specify that there’s pets in the house? I want to know, is there pets? Are there smokers in the house? Does it need any repairs? Does it need any stain removal or restoration if it’s leather? And I’m filling in all the gaps. So I have a complete picture of what it is that I’m actually buying. And that’s all kind of like a trauma response from my many, many drives of shame of I didn’t ask the right questions.Tim MacLeod — And so it’s it’s definitely preventing the drive of shame. And I’m just running through these scripts that I have. And it would sound like it’s a lot of typing, but I’ve actually made keyboard shortcuts for all of it. So my opening question is, I’ll never say, hi, is this still available? Because everybody hates being asked, hi, is this still available? On Facebook Marketplace, right? Because they’ve made it ah they’ve made it a button… Rich Birch — Yes. That’s why it’s up. Tim MacLeod — …where it’s just like, hi, is this still available? But that upsets people, which is fair, because it’s annoying. But at the same time, most people don’t have empathy for the fact that, how else are they going to start the conversation? Why would you ask questions if you’ve got someone lined up for it? So I’ll ask the exact same question, but in a way that annoys nobody. And I’ll say, is anyone scheduled to pick this up? It’s the same question, but upsets nobody.Rich Birch — Same question, just in a different way.Tim MacLeod — So that’s, that’s my first shortcut is, good morning, good good afternoon, good evening, whatever. And then any, and so on my keyboard, any with two wise expands into anyone’s schedule to pick this up. And then the next one is, does it need any repairs or stain removal? That’s if it’s fabric. And that’s does D or D O E S S and then D O E s S S S or with three S’s is, does it need any repairs or restoration? That’s if it’s leather. And so it’s just these quick little, my thumbs are just, and just… Rich Birch — So cool. Tim MacLeod — …I’m, I’m drafting up this quick little paragraph that fills in all the gaps, firing that over. And then, And then they’ll reply and fill in the gaps. And then I park it. I pause the conversation by saying, okay, awesome. Thanks so much. Just starting to have a peek at options, might get back to you.Tim MacLeod — And that one line separates me from everybody on Facebook. Because most people ask a question and then they just leave it on read. They got that little picture, that little tiny profile picture of yourself that says that, hey, he read it, but he’s gone and it’s crickets.Rich Birch — Yes.Tim MacLeod — And it’s a very, very infuriating experience. And that’s kind of like part of my service is that I am very, very different on Facebook Marketplace. Like an experience selling to me is better than anybody…Rich Birch — Right.Tim MacLeod — …because of how I talk. Like I’ll receive offers every day from people that don’t use words. They just send a number. Rich Birch — Just money. Tim MacLeod — Like I’ve got a couch listed for 1150 and someone just sends 700 – no dollar sign, no question mark, no good morning, nothing like that. And, and that’s a fair offer. Like he’s… Rich Birch — Yeah. Tim MacLeod — …I paid, I paid a fifth of that, like 700 is a fair offer, but I automatically hate this guy. I don’t, I don’t hate, I don’t hate him. Rich Birch — Yes. No, I get what you mean.Tim MacLeod — But, but it’s immediately just like, dude! Rich Birch — Yes. Tim MacLeod — You like say, say hi, say please. Rich Birch — Yes. Yes. Tim MacLeod — Even a, even a question mark would be, you know, so that’s the kind of people that I’m dealing with. And I’ve got thick skin and I always operate on the mindset of, I do want to sell this guy and I, and I do want to see him later today. So I’m not going to match his energy. Rich Birch — Right.Tim MacLeod — I’m never, I’m never a thermometer. I’m always a thermostat. I always set, set the temperature in the room, you know?Rich Birch — Right. Love it. Yep.Tim MacLeod — And so that’s ah that’s a big factor. But yeah, running through those scripts and and just getting people to their best price. And so after pausing it of, thanks so much, just starting to have a peek at options, I’ll reconnect with them.Tim MacLeod — Now, this is this is if their price is optimistic and it’s not a price that I’m willing to pay. I’ll slow play it a little bit by pausing the conversation. And then I’ll come back and then I’ll hit them with my my secret weapon is my polite lowball offer. And the number they might hate the number, but it comes gift wrapped in this like apologetic, like, Hey, I’m…Rich Birch — Oh, you got to tell me more that you’re, you’re setting that up. Well, you’re like, what is the polite low ball offer?Tim MacLeod — For me, I’m shopping in Toronto, which is like 90 minutes, two hours away.Tim MacLeod — And so my apologetic offer is: It’s so far, is there any chance you’d consider this much, any chance you’d consider for an out of towner? And then I just plug in the number. And, and it’s always received well. And even if it’s even if it’s even if they’re firm, that’s fine. Now I know. Rich Birch — Right. It’s data. Tim MacLeod — But and ah honestly, if somebody accepts my offer, then I didn’t offer low enough. Like I’m i’m really pushing the limit.Rich Birch — Oh, interesting.Tim MacLeod — I’m flirting with the line between an optimistic offer and a rude offer, but because I’m so nice about it. And it’s, it’s kind of like, it’s my secret weapon to get them to their best price. Because the the worst way to get someone to their best price is what’s your best price?Rich Birch — Right.Tim MacLeod — Like whenever someone asks me that, it’s again, it’s just like, that’s annoying. I don’t like you.Rich Birch — Yes. Yes. Right, right, right, right, right.Tim MacLeod — But to politely lowball and then their counter is their best price. So I just want to squeeze them for their counter offer. And now I know what their best price is.Rich Birch — Right. Okay. That’s cool. There’s a lot there. And I know you’re want to stay tuned because Tim’s got an offer of some free help that he wants to give you that we’re going to, we’re going to get to here in a minute. So I know some of you were like, go back and ask questions on that. But I know that the free offer to help is going to help with some, some of those things. Rich Birch — What about negotiation on the other side? So I get a sense of what you’re talking about to try to get them, you know, there’s a time thing there and we’re going to wait and all that. But now on the other end, you’re trying to obviously maximize or get the biggest money for that couch you just bought, bought. What are some things we should be thinking about on that? How are you offering the couches in a way that, you know, captures people’s imagination and says like, oh, okay, that’s this, I want to do business with this guy.Tim MacLeod — So a big thing is where I’m selling it. It’s almost like I have an import business. It’s that I’m I’m ripping down the city and I’m shopping in the Tesla BMW neighborhoods where nobody has trucks and they sell really slowly. Rich Birch — Yeah.Tim MacLeod — And I’m loading a trailer and then bringing it home to the sticks where there’s not as much supply. And I’m selling to people who do have pickup trucks. Like where I live, there’s lots of people with trucks and trailers, but they weren’t doing that drive to the city like I did.Rich Birch — Right. Right.Tim MacLeod — So I’m destroying a Toyota Highlander in kilometers, which is really hard to do. It’s at 400,040 and she ain’t quitting anytime soon. It’s been a great car.Rich Birch — Love it.Tim MacLeod — So that is definitely like the fact that it feels like an import business feels like cheating.Rich Birch — Well, and can I just, I just want to interrupt you for a second here. This, because that dynamic, this is a part of why I wanted to have you on the show. Because one of the things that I’ve seen is like, it’s super common, like super common for church leaders to not live in the community that they serve. Because frankly, they can’t afford to live there because of that gap that I just told you about.Rich Birch — There is a wage gap between what people make and the communities they serve in. And so they typically live you know, 45 minutes, an hour away. I actually think that that, the fact that they’re just driving into the office could be, and then going back to wherever they live, could actually set them up for running this kind of business just because they’re in and out of where they’re at.Tim MacLeod — Oh, yeah. Yeah, that’d be cheating. If you could, if you could grab a couch on your way home from on your way home from work to bring it back to the sticks, that’d be awesome.Rich Birch — Yeah. Yeah. I see that all the time.Tim MacLeod — For sure. And at a lot of…Rich Birch — So the distance is one way. So there’s like an import out, out, port anything else that you get, it’s kind of an interesting part of how you negotiate on to try to increase the, the, the price.Tim MacLeod — Knowing what it’s worth and how quickly it would sell is definitely a factor. And just patience wins on both sides.Rich Birch — Right.Tim MacLeod — Being the dude who um can pick it up and someone is now, they had their optimistic kick at the can and now it needs to go and their patience has run out. Patience wins there. And then on the selling side to where I don’t, it’s not in my foyer. It’s not in my living room. The new couch hasn’t arrived. It’s in a storage locker ready to be picked up anytime. And my lockers are fairly affordable being in a rural spot.Tim MacLeod — And so it’s kind of like if if we were playing poker, I’m holding aces. I can deliver it. I can sell to anybody. I’m not relying on people on the small demographic who can pick it up. I can sell to the Honda Civic crowd. I can sell to seniors who can’t lift a couch themselves. I can finesse it into a patio door by myself. And so there’s the there’s the skill gap there as well. And all of the all of the hindrances that make selling a couch difficult are not a factor for me. I can lift them by myself. I can I have the best trailer. I have storage lockers. They can take as long as they need to sell. And I live in a market where there’s not as much supply. So it’s just, it feels like cheating. Like I’m just really, really set up for it. And it’s super easy to be patient.Rich Birch — Now, I don’t know if I’m going to force you to give away one of your secret weapons here, but talk about the videos that you shoot ah of the, you know, of the products. Because i to me, I think this is one of the things you do that I think is super unique. What is what’s unique about the videos that you might shoot? Say got this nice leather couch. It’s like, you know, it sells for $5,000 somewhere else. You’re selling it for whatever, $1,500, $2,000. What’s actually in that video that might set your your listings apart?Tim MacLeod — Yeah, so that was something that I feel like I pioneered. And since then, Facebook has now added a feature where you can add a video to a listing. But it’s so nice to have. So I’m I’m posting flattering photos. So it’s it’s a scroll stopper when they’re on Marketplace.Tim MacLeod — And they’ll inquire. And then my video is super, super honest. And the goal is for it to be so detailed that they could confidently say, okay, he just showed me all the reasons not to buy the couch because all my stuff is used. I’m not selling anything new. It’s all pre-owned. They all have some blemishes or some quirks or worn spots or something like that. But to include ah a video that shows all of the reason not to buy it really, really greases the wheels because no one’s coming to see a couch and then being disappointed when they get there. Everything was already shown.Rich Birch — Right. Right.Tim MacLeod — So they’re coming to just give, basically just come sit and sniff and make sure that it’s something that they would want in their house, or something they’d want to sit on for two hours a day. And, um, and so those videos really, really saved me so much time and gasoline. And since then they’ve added that where you can add a feature. So, or where you can add a video into the listing. And so as long as the video is less than a minute, so I’m aiming for 59 seconds, I’ll fill the whole thing and I’m showing every inch of it and I’m packing it with dialogue on the neighborhood that it came from, the people, the house. And a lot of times that’s a selling feature of this this couch came from North York. The house was ridiculous. Rich Birch — Right.Tim MacLeod — It’s one of those houses with three living rooms. And this is the one that had the Christmas tree for a month a year. Like this was barely used. And I’m just packing it with dialogue and really, really selling it.Rich Birch — Yeah.Tim MacLeod — And my goal is that I could deliver it with them like sight unseen that they could firm up. And that when that couch arrives, there are absolutely no surprises. It’s everything they ask for [inaudible]…Rich Birch — Which from from your point of view, like this isn’t the only couch you’re hoping to sell this week. And and a part of the way that you have to protect your time and protect your business, frankly, is not having a bunch of people come and check out couches and then decide against it. Whether they’re coming to your locker or you’re driving it to their place. That’s like the worst case scenario is they show up and they’re like, oh, I don’t want this. So you might as well be fully upfront and be like, hey, here’s some stuff that’s not great about it.Rich Birch — And you do it in a really clever way. I love those videos. You helped me sell a car, which was fantastic. And I love the video you did for, you know, for that, because it was the same thing. It was this kind of like fun, um you know, here’s five reasons why you shouldn’t buy this, which which is just endearing. People, you know, lean in and want to hear more about that.Rich Birch — Well, what about the lifting piece? So, you know, if you’re not seeing one of these clips, Tim is a man of a certain size. He’s got some girth to him. He can pick stuff up. But what if I can’t? What if I’m not that guy? What if it more like me? You know, you’re like, hey, I’m not sure that guy can pick up 20 pounds. Like, is that like, I know that’s a part of what your you offer. Obviously, it’s a part of your advantage. But, you know, not everybody can do that. Talk us through that hesitation.Tim MacLeod — Yeah, I don’t think that it’s a deal breaker for having success. I think that if you can carry in a stubborn load of groceries in from the house that you could make a lot of money flipping couches.Rich Birch — That’s good.Tim MacLeod — And it it feels like a very unique form of laziness. Like I’m the kind of guy that if I need to go start start the barbecue or go run and grab my wallet from the car, I’m going to walk across the whole house and look for my flip flops instead of bending over and lacing up my boots that are right there. Like it’s a very unique form of laziness where I could jackknife park the trailer up to the storage locker. I have the dolly, but I’d way rather just, hey-yep-hey-yep-pep-pep just, just he-man lift it myself. And I’ve got a lot of really good mechanics lifting it. Tim MacLeod — Lifting a couch solo actually is not very heroic. And, and I’ve taught a lot of people how to do it. And there is, there are some heroic angles where, where the couch is on the ground and all four feet are on the ground to like clean and jerk it up overhead is that would definitely take some mass and some explosive power, but you can always also lift the couch up from the side until it’s vertical and then kind of like let it teeter and, fall on you in ah in a safe manner. And the lift itself, like once it’s up, it’s it’s as easy as like portaging a canoe. It’s not it’s not as heroic as it seems.Tim MacLeod — And I’m still reliant on other people. I am a one man show and it’s not, the money’s not good enough to pay an employee to sit in the car with me for four hours for 30 seconds of actual work. And so that’s one of my, one of my questions that I’m asking people, lift with two T’s on my phone expands into is anyone available to help me lift it? I’ll be alone. So I do need muscle.Tim MacLeod — And, um, if it’s in the garage, I can do it solo, like dragging a couch onto my trailer is easy enough. They slide very well. And I do have the dolly if there’s anything overly technical, like the pullouts, it’s nice to have a dolly. But yeah, a lot of the times there’s people, there’s someone there to help me lift it. And very, very rarely is it, sorry, I had back surgery or sorry, I’m a single senior lady or something like that. There’s usually, and even even when they say that, sometimes I’ll press a little further. Like, do you have a helpful neighbor? Rich Birch — Right. Meet us.Tim MacLeod — Do you have a son-in-law who can who could that I could coordinate with? Yep. And a lot of times I’m just handing it, or I’m squeezing them for a cell phone number of whoever the the muscle is. And now I’m on their schedule.Rich Birch — Yeah, that’s cool.Tim MacLeod — So solo lifts are not required, but they are, they are helpful sometimes, especially at the locker when I’m by myself.Rich Birch — So this is how many years you’ve been doing this full time? Like you, so you left nursing, you know, I know this goes way back to the beginning the story. You left nursing and then how many times, how many years you’ve been doing this?Tim MacLeod — July, 2019, I borrowed the trailer from my brother. And I did full-time nursing plus evening couches for about a year, pulled back from full-time to part-time, part-time to casual. And I think it was May, 2021. Like I did a year of COVID nursing and hated every second of it. Like as soon as COVID was announced, I wanted to be out of there, but I had mortgage approval on the brain and T4 income, or W2 income for the Americans, is much more preferred for lenders than self-employed income. So I held on for that reason. And eventually left just because I hated nursing. I was getting like ulcers on my ears from wearing masks all day. Just the the charades of COVID were really, really ruining it for me.Rich Birch — So we’re going I want to get to that, that help that you’re, you know, you’re offering, which is fantastic. But I want to think about like a person that, you know, they, we want people to stay in their jobs. We don’t want them necessarily to leave. And so ah somebody that wants to make maybe like an extra thousand bucks a month, maybe that’s like, which is, you know, to lots of people, that is like a, that’s a game changer. Like that’s like, that makes all the difference in the world.Rich Birch — Give me a sense of what you think that would take to actually get to that point where, okay, yes, I could, you know, how much time do you think they would need to invest? You know, what would, what is that going to look like? How many couches do you think I’d have to move? You know, I know that’s hard to say. It’s like all North America wide, but give us a sense of kind of the framework of for an extra thousand bucks a month, what would that look like for somebody? Maybe it’s like a youth pastor that’s that’s listening in or an executive pastor. Or and they’re like, Hey, if I just had an extra 1000 bucks that’d make a huge difference in my life. What what would that look like?Tim MacLeod — Sounds like five couches to me.Rich Birch — Five couches. Okay.Tim MacLeod — Buy them for 50, sell them for 250. Delivered. Yep. And that’s that’s a great way to start is just three-seaters. Just rinse and repeat. Three-seater, three-seater, three-seater. But the money is sets and sectionals. That’s where my focus is now.Rich Birch — Okay, okay.Tim MacLeod — Now that does require trailer privilege. But with a with a minivan, you can pick up a three seater. Most three seaters will fit inside a Dodge Caravan or an Odyssey or a Toyota Sienna. And that’s a really good way to start lean and mean with a U-Haul, enclosed trailer, you just need a V6 all wheel drive. So obviously preferred, especially if you have the kind of weather we do, but, um, yeah, for 45 bucks for a U-Haul enclosed, that’s, that’s insured so that you could get in an accident and you’re not paying for it. Always take the insurance. Always. It’s only like five bucks. Tim MacLeod — But um yeah, 45 bucks for 12 by 6. And then you can pick up couch, love seat twice. But yeah, just fill in those trailers. But yeah, starting lean with what you have available and scaling up when it’s smart. And once you’ve proven that it’s possible in your market as well. But everyone’s using couches, so I think it’s good alright.Rich Birch — Yeah, so five, so five couches. How many conversations do you think I’d have to get into take to buy five couches, maybe on that side first?Tim MacLeod — I think, yeah, with the numbers, I think that if you were to start 30 conversations a month, that there would be, there would be five people that hit deadlines and they’d be like, sure. 50 bucks. If you can actually show up, it’s yours.Rich Birch — Right. Right. That’s that feels very doable. That doesn’t feel like crazy out of reach. Like there’s no way that feels like a good, you know, a great starting point for sure.Tim MacLeod — And nobody wants to do it. The barrier for entry is, is ah high enough that it’s it’s basically a private little fishing pond. A lot of people to help.Rich Birch — Right. So let’s talk about, I want to, you’re going to help people, which is amazing. And so you’ve put together some resources to help them kind of get the the ball rolling on this front. And how do, first of all, tell us what it is and then talk to us about how we can get that contact information. We’ll put links and all that in the show notes, but talk us through this.Tim MacLeod — Yeah. So those scripts that I was talking about, um, I’ve made a Google doc that is available. All you got to do is comment scripts on any of my videos and, uh, my little robot Tim will fire over, um, just squeeze you for an email and then I’ll fire that over. And, uh, it’s a good little list and you can plug those in just copy and paste and plug them into keyboard shortcuts in your phone. And then you can use those. Tim MacLeod — And it doesn’t have to be for couches. Like a lot of them are pretty couch specific, but just using those as inspiration for starting conversations and getting people to their best price and making sure that you have all the information so you’re making an informed purchase and there’s not any surprises. And and you’ll see with the with the flow of the conversation, I really am just gifting the blueprint on getting people to their best price. Tim MacLeod — And yeah, and then in my in my bio on instagram I’ve also got the couch course and I’ve run that before as a high ticket offer um and I had help from an agency to, to get leads and all that stuff. And I didn’t like it cause I didn’t like how much people were having to pay in order for me to afford that team. And I just want it to be an impulse buy price range. Tim MacLeod — So for a one hundred bucks, you can come along on a three month ride along with me while I’m pulling like $15,000 months. And, uh, the summer that I recorded that, was 2023 and I did 180k in sales with a gross profit so just sales minus cost of goods was north of a 100k, I think, after tax. I think it was like an 80k a year income. Rich Birch — That’s amazing. Tim MacLeod — And I had a three-year-old with me the entire time. My wife had gone back to work and was using her teaching license and I had a little three-year-old tow. And I also got 75 rounds golf in that year. So it’s, it’s…Rich Birch — That just got some people’s attention. Yeah, that’s amazing.Tim MacLeod — Yeah. The time freedom is stupid. The money is incredible. And, uh, it was, yeah, that was a really, really fun year.Rich Birch — Love it. So what we want to do is send people to your Instagram. Would that be the best? So @thefulltimeflipper, @thefulltimeflipper. And again, you can just comment on any one of his videos.Rich Birch — Well, first of all, Tim’s a great follow on social media. I’ve said this to lots of folks. It’s just such a fun follow. You know, it makes something like flipping just like I was like, man, I think I could do that. And, but just comment scripts on any of those and we’ll get access to those scripts.Rich Birch — And then if you’ll find the link to tim-macleod.com on there as well, which takes you to the course, it’s only a hundred dollars friends. That’s worth your investment. It’ll, it’ll really literally outline. There’s a bunch we could have talked about today and there’s a bunch of details to get into. It will drive into all of those. Literally just take his approach and just do it. Like just, take his scripts, take the what he’s done and apply it. And you’ll for sure be able to find that extra thousand dollars a month or more, you know, down the road. So, yeah, I would love that. and Anywhere else we want to send them. So Instagram, @thefulltimeflipper, anything else about that?Tim MacLeod — Oh, that’s lots. That’s good. And I was feeling pretty pretty silly that I never asked to come on your podcast earlier because a lot of my students are in church ministry in the States. And I think it’s such a sweet side hustle.Tim MacLeod — For me, it was an escape from a job that I didn’t like. But the fact of that most people need supplementary income is pretty across the board and especially in ministry. And a lot of my students have um have had that background and are still in it. And a lot of the time, the people that are in church ministry have an advantage of storage where the church, like they’re like, oh, I got free storage at my church. Pastor said the back room is available. And he said, as long as I just keep a rotation of couches for the student ministry…Rich Birch — Oh, that’s a good call.Tim MacLeod — Yeah, there was a lot of advantage there for church leaders. But yeah, it’s awesome, reliable, supplementary income. And it’s nice to not rely on your ministry for income. Like people aren’t in ministry for the big bucks. They’re there because they that is their purpose. That’s their calling. But the pressure of having to rely on that for income isn’t always the best.Rich Birch — Well, and I do think, um you know, I think folks who are in church ministry, a part of what I why why I think this is great that we’re talking about this is you might underestimate that even like a part of your core, it’s like literally core to your business is like, be kind to people and like be helpful. Tim MacLeod — Yeah.Rich Birch — And, you know, you don’t need to be sleazy. You don’t need to be, ah you know, some sort of like, oh, you’re like a used car salesman of couches. No, that’s not what it is at all. You’re just being kind and helpful and you want to try to close this gap in the market. And and I think there’s a lot of people in ministry who are like, my I could totally do that. I can make that happen for sure. So, Tim, I really appreciate this.Tim MacLeod — It really does feel like stewarding my gifts, you know?Rich Birch — Yeah, that’s great. So again, that is, if you just go to Instagram, @thefulltimeflipper, you should follow them there and then comment scripts for any of those. Appreciate you being on the show today, sir. Thanks so much.Tim MacLeod — Thanks, man.

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In this Part 2 of our 2-part podcast series on thyroid emergencies Anton, Dr. George Willis and Dr. Alyssa Louis answer questions such as: When a patient presents with “sepsis without a source,” what bedside features should trigger you to prioritize thyrotoxicosis? How can PoCUS help you decide whether tachycardia is dangerous — or lifesaving — before starting β-blockade? Why can TSH and free T4 be falsely reassuring in a crashing patient, and what labs actually matter early? In which patients does propranolol increase the risk of cardiovascular collapse — and why is esmolol the safer first line medication? Why does the order β-blocker → thionamide → steroid → iodine matter, and what happens if you get it wrong? When is not giving a β-blocker the safest decision in thyroid storm, even in a profoundly tachycardic patient? In an agitated, hyperthermic patient with thyrotoxicosis, why might intubation be more dangerous than helpful in the first hour? How does amiodarone-induced thyrotoxicosis fundamentally change your management — and why can iodine make it worse? and many more...

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Is Your Brain Keeping You Stuck in Thyroid Purgatory? | Thyroid Shorts #22 Most people assume persistent hypothyroid symptoms mean their thyroid is failing or their medication is wrong. But what if your thyroid isn't broken at all, and your brain's perception of safety or threat is controlling everything? In this episode, Dr. Eric Balcavage reveals why many people get trapped in Thyroid Purgatory. In this state, thyroid physiology is perfectly adapted to protection, not performance, which is why more T4 or adding T3 often makes symptoms worse, not better. You'll learn how two key cortisol receptors (MR and GR) determine whether your body operates in:

In this rare and powerful interview, I sit down with Dr. Denis Wilson, the creator of Wilson's Temperature Syndrome, for his first podcast appearance in years. Can you say AMAZING?! We dive into the origin of Wilson's Temperature Syndrome, what it actually is, and how it differs from classic hypothyroidism. Dr. Wilson explains why body temperature is one of the most accurate reflections of your metabolism! And why metabolism is the true core function of the thyroid. You'll learn why you can't measure metabolism on a blood test, why normal thyroid labs don't always mean you're well, and how doctors may completely overlook conversion issues, low T3 function, and cellular-level hormone activity. We also explore: Why low body temperature is a red flag for metabolic slowdown How to increase temperature with T3 and how weaning off can still leave symptoms resolved How the deiodinase enzymes work to control T4-to-T3 conversion Why so many people remain symptomatic even on thyroid medication The cellular reasons behind fatigue, weight gain, brain fog, and low mood How stress is one of the biggest drivers of thyroid dysfunction The shocking impact that just one night of poor sleep can have on metabolism And lots more! This episode is essential for anyone who has low thyroid symptoms but “normal” labs, struggles with chronic fatigue or low temperatures, or wants a deeper understanding of metabolism from the physician who pioneered this field. Denis Wilson, MD, described Wilson ‘s Temperature Syndrome in 1988 after observing people with symptoms of low thyroid and low body temperature, yet who had normal blood tests. He found that by normalizing their temperatures with T3 (without T4) their symptoms often remained improved even after the treatment was discontinued. As a result of his findings, Dr. Wilson developed the WT3 protocol for Wilson's Temperature Syndrome (now standard of care) and originated sustained release T3. He was the first doctor to use sustained-release T3. Find out more about Dr Wilson here; Youtube - ‪@RestorativeMedicine‬ Website - https://wilsonssyndrome.com/

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Winter can silently worsen thyroid problems like hypothyroidism, fatigue, weight gain, hair fall, brain fog, and cold intolerance. Many thyroid patients notice their symptoms flare up during cold months — but most don't know why or how to fix it naturally.In this video, Dr. Anshul Gupta explains a complete Winter Thyroid Survival Guide, covering:- Why winter affects thyroid hormones- The role of sunlight, diet, and circadian rhythm- A 1-cup winter drink that supports thyroid activation- Foods you should eat and avoid in cold weather- Why golden milk at night can be helpful for thyroid patientsThis video is ideal for people suffering from:✔ Hypothyroidism✔ Hashimoto's Thyroiditis✔ Winter fatigue & low metabolism✔ Weight gain despite thyroid medicines

「「ドクターイエロー」が完全ワイヤレスイヤホンに。現役駅員による録り下ろし音声や警笛音など収録」　JR東海と瑞起は、2025年1月に引退した点検用新幹線「ドクターイエロー（T4編成）」をモチーフとしたワイヤレスイヤホン「923形ドクターイエローT4型ワイヤレスイヤホン」を製作するクラウドファンディングプロジェクトを受付中だ。JR東海公式オンラインマーケット内のクラファンページにて実施され、受付は2026年2月28日（土）まで。

In the ED, we regularly care for sick patients presenting acutely with abnormal vital signs, altered mental status, and end organ dysfunction. Oftentimes, the culprit ends up being sepsis, or overdose, or organ failure. But it is important that we consider rarer endocrine presentations like decompensated hypothyroidism. In this Part 1 of this two-part podcast with Dr George Willis and Dr Alyssa Louis, we answer questions like: Why is the term myxedema coma a misnomer and should be abandoned? How can we differentiate between sepsis or environmental hypothermia or toxidrome from decompensated hypothyroidism at the bedside? When is it appropriate to order a TSH, a T4 and T3? What are the most important life-threatening triggers that need to be addressed in patients with decompensated hypothyroidism? Why is it important to test for cortisol levels and consider stress-dose steroids in all patients with decompensated hypothyroidism? Why is endotracheal intubation particularly dangerous in decompensated hypothyroidsm? What is the best way to manage hypothermia? Why is the order of medications for treatment of decompensated hypothyroidism so important? and many more... Please consider a donation to EM Cases to ensure continuing Free Open Access Medical Education: https://emergencymedicinecases.com/donation/

V září 2025 se Ondřej Matěj Hrubeš vydal na svou další cestu na Ukrajinu, tentokrát v roli radního pro dopravu Prahy 6. Společně s moderátorem Milošem Kellerem v novém díle Dopravního podcastu probírají nejen stav tamní MHD, ale i syrovou realitu země, která už dvanáctým rokem čelí válce.Cesta vlakem do válkou zmítané země není jen o romantice na kolejích. Ondřej v podcastu popisuje zdlouhavé čekání na hranicích, osazenstvo v ukrajinských vlacích, i smutný pohled na odstavené a poničené vagony a lokomotivy, které lemují tratě.Ondřej detailně mapuje proměnu vozového parku ve Lvově, kde staré české "tatrovky" KT4 doplňují moderní nízkopodlažní vozy Elektron a nově i darované tramvaje ze švýcarského Bernu a Basileje. Dozvíte se také o historické tramvaji T4, vytíženosti jednotlivých linek a také o tom, jak Ondřeje zadržela ukrajinská vojenská hlídka při fotografování tramvají. Druhá část cesty vedla do partnerského města Chmelnický. Tady se podcast zaměřuje na hmatatelnou pomoc z České republiky. Město totiž brázdí pět autobusů SOR NB 12, které darovala Praha a slouží v městské dopravě. Zároveň ve městě probíhá velká obnova trolejbusového parku.Rozhovor se nevyhýbá ani vážným tématům. Ondřej popisuje jednu z nejtěžších nocí, kdy Rusko podniklo masivní dronový a raketový útok. Jak vypadá noc v krytu? Jak fungují nemocnice a školy?V podcastu se dozvíte také postřehy z návštěvy hasičské stanice, nemocnice, školy, školy, nebo z centra, kde se vyrábí a opravují drony.

On this episode of Vitality Radio, Jared welcomes functional medicine dietitian and gut-health expert Lisa Smith for a deep dive into one of the most overlooked systems influencing hormone balance: the estrobolome. If you've never heard that word before, you're not alone — but by the end of this conversation you'll understand why the estrobolome may be the missing link in stubborn hormone symptoms, estrogen dominance, thyroid sluggishness, mood changes, and even men's testosterone challenges. Jared and Lisa break down how gut bacteria influence estrogen detoxification, what beta-glucuronidase is actually doing behind the scenes, why bile flow matters (especially if you don't have a gallbladder), and how fiber, cruciferous vegetables, and targeted nutrients can support healthy hormone metabolism. This is a practical, empowering discussion designed to help you understand root causes rather than chase symptoms. Whether you're navigating perimenopause, PCOS, thyroid issues, mood swings, stubborn weight, or low energy, this episode brings science down to earth with simple, realistic starting points for rebuilding gut balance and restoring hormonal resiliency — naturally and safely.Products:Precision ProbioticLiverVitality EndoCleanseAdditional Information:Pretty Well PodcastInstagramLisa Smith WellnessVisit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

Hypothyroidism And The New FDA Ruling The thyroid gland plays a vital role in regulating key body functions, but when it's dysregulated, the typical treatment involves synthetic T4 and T3. A small number of patients still use desiccated thyroid extract derived from animals, but the FDA plans to phase it out due to safety and dosing concerns. Our experts explain why patients are still using DTE and why they're being transitioned to other options. Saving A Life: How To Reverse An Overdose Many people know what to do in emergencies like fires or animal encounters, but far fewer understand how to respond to an opioid overdose. A nonprofit is teaching the public to recognize key signs of an overdose and use tools like naloxone and fentanyl test strips to save lives. As education and access expand, the goal is to make harm reduction strategies as familiar as any other life-saving precaution. Medical Notes: Why You Should Spend More Time On Your Phone, The Dangers Of Kids Playing Tackle Football, And How Light Therapy Can Mend Your Heart Are sound waves the next big thing in cancer treatment? Tackle football isn't as kid-friendly as you think. Why you may want to spend more time on your phone. Light therapy could mend your heart. Learn more about your ad choices. Visit megaphone.fm/adchoices

The thyroid gland plays a vital role in regulating key body functions, but when it's dysregulated, the typical treatment involves synthetic T4 and T3. A small number of patients still use desiccated thyroid extract derived from animals, but the FDA plans to phase it out due to safety and dosing concerns. Our experts explain why patients are still using DTE and why they're being transitioned to other options. Learn more about your ad choices. Visit megaphone.fm/adchoices

En el Día Mundial del Sida, 1 de diciembre, conversaremos con Alvaro Ortiz de Zarate y Marco Imbert de la Asociación T4. En su décima edición nos hablan del reconocimiento Trayectorias Positivas de la asociación que tras la junta de gobierno ha decidido por unanimidad otorgar este año el reconocimiento al Área de Salud y Consumo del Ayuntamiento de Bilbao, poniendo en valor más de tres décadas de camino compartido. Osakidetza ha llamado a "acabar con el estigma que rodea aún a las personas que viven con el virus". En este sentido, ha recordado que cada año en Euskadi se detectan cerca de 125 nuevos casos de VIH. La mayor parte de los nuevos diagnósticos se da en hombres, y la edad media del total de personas diagnosticadas es de 37 años. Por territorios, en 2024 el 63,2% de los casos se detectaron en Bizkaia

In this episode, I sit down with Dr. Jeffrey Dach to unpack the most misunderstood aspects of thyroid health - from TSH and Synthroid to T3 conversion, desiccated thyroid, iodine, selenium, cardiovascular risk, and more. If you've ever been told your TSH is “normal” but you still have symptoms (even if you taking Synthroid)… this conversation is going to change how you think about your thyroid therapy. We discuss: • Why TSH is an unreliable marker and why it often reflects inflammation more than thyroid output • How T3 works primarily at the pituitary and T4 at the periphery • Why T4-only therapy (Synthroid/Levothyroxine) can leave patients still feeling rubbish and with symptoms of hypothyroid • The benefits of combination thyroid therapy and why natural desiccated thyroid (NDT) helps so many people • Selenium's role in T4→T3 conversion and thyroid antibody reduction • The importance of around iodine • How low thyroid function increases cardiovascular disease and cancer risk • The best supplements for thyroid support, including berberine and myo-inositol. And lots more! This episode is a deep dive into thyroid physiology, hormones, optimal treatment, and the gaps in conventional endocrinology that leave so many patients ignored. This is a conversation, even if you don't think you have thyroid issues, you don't want to miss! Jeffrey Dach, MD is a board-certified physician and integrative medicine advocate with over four decades of experience in healthcare. In 2005, after retiring from radiology, Dr. Dach founded the clinic TrueMedMD — where he serves as Medical Director. Under his leadership, TrueMedMD has specialized in bioidentical hormone therapy (BHRT), natural thyroid care, and integrative medicine. Dr. Dach is also a prolific author and educator. His works include Bioidentical Hormones 101 and Natural Medicine 101, aimed at making complex medical and hormonal science accessible and practical for both clinicians and patients. Find out more about Dr Dach here; Website - https://jeffreydachmd.com/ Natural Thyroid Toolkit Book - https://a.co/d/2gyUYzn BioIdentical Hormones 101 Book - https://a.co/d/3d5HBSn

Will Best's journey from T4 to Big Brother hasn't been straightforward. It might surprise you to know that in between he's run a tech company, launched an alcohol brand, and ask a lot of questions to Simon Cowell. His start has never been brighter than it is right now - hosting Hits Radio breakfast with James Barr and Fleur East and standing alongside AJ outside the Big Brother house. It's a fascinating story which has seen Will pick himself up after several false-dawns. He's always adding to his knowledge, and learning from every challenge - something we can all learn from. Enjoy the episode! Cheers. Hosted on Acast. See acast.com/privacy for more information.

Drive with Dr. Peter Attia: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Antonio Bianco is a world-renowned physician-scientist and expert in thyroid physiology and metabolism. In this episode, Antonio explores the complex biology of thyroid hormone production, conversion, and regulation—highlighting how deiodinase enzymes modulate hormone activity at the tissue level and why that matters for interpreting lab results. He discusses the shortcomings of relying solely on TSH as a marker of thyroid function, the ongoing debate around combination therapy with T3 and T4 versus standard T4 treatment, and how genetics, tissue sensitivity, and individual variability influence thyroid hormone metabolism. The conversation also examines how hypothyroidism affects energy, mood, cognition, and longevity; why some patients remain symptomatic despite "normal" labs; and how future research could reshape treatment paradigms. We discuss: How the thyroid produces, stores, and activates hormones like T4 and T3 to finely regulate thyroid activity [2:45]; How fasting alters thyroid hormones to conserve energy [12:45]; Action of the deiodinases: how D1, D2, and D3 enzymes control the activation and inactivation of thyroid hormones [19:15]; The normal function of thyroid hormone and the roles of the hypothalamus, pituitary gland, and deiodinases in maintaining hormonal balance [23:30]; Why understanding thyroid physiology is essential for proper diagnosis and treatment of hypothyroidism [33:45]; Testing for thyroid hormones: understanding free vs. total levels, the limitations of current T3 assays, best practices, and more [36:00]; Genetic and sex-based variability in thyroid hormone regulation and their limited clinical significance [43:45]; Hyperthyroidism: causes, symptoms, diagnosis, and treatment options [46:00]; Hypothyroidism: diagnosis and autoimmune causes of hypothyroidism [56:30]; More on hypothyroidism: diagnostic biomarkers, antibody patterns, and non-autoimmune presentations [1:05:00]; Thyroid hormone replacement therapy [1:15:15]; More on thyroid replacement strategies: exploring the evidence gaps, mortality signals, effects on lipids, and more [1:28:00]; Hypothyroidism basics: causes, antibody implications (including pregnancy), and how to make the diagnosis before choosing therapy [1:35:15]; Thyroid medication: compounded controlled-release T3, brand name versus generic, and what Antonio prescribes to newly diagnosed hypothyroid patients [1:42:45]; Redefining treatment success: why normalizing TSH isn't always enough for patients with hypothyroidism [1:54:45]; Case studies: analysis of two unusual cases of thyroid disease [1:57:00]; Dangers of supplementing with high levels of iodine, and female-specific risk of thyroid disease [2:05:45]; Case study of a patient who presents with elevated TSH but no symptoms [2:09:30]; How future research could reshape treatment, and Antonio's new book called "Rethinking Hypothyroidism" [2:13:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Did American eugenics really fuel the murderous euthanasia programs of the Nazis? Yes, according to Susanne Paola Antonetta, author of The Devil's Castle, a history of Nazi eugenics and euthanasia. According to Antonetta, pioneering American eugenicists not only influenced Nazi thinking—Hitler himself corresponded with them and praised U.S. sterilization laws in Mein Kampf—but the New York City-based Carnegie Institute proposed gas chambers in 1918 as one solution for dealing with what eugenicists called the ‘hereditarily tainted' population. While Germany's response was uniquely brutal, Antonetta argues that American psychiatric thinking provided the conceptual framework for deciding whose lives had value and whose didn't. Moreover, the notorious Nazi Aktion T4 euthanasia program killed 300,000 people with neuropsychiatric disorders, yet it was never properly prosecuted by the Americans at Nuremberg and remains largely unknown today.1. American Eugenics Provided the Blueprint The U.S. passed sterilization laws in 1907—decades before Germany's 1933 laws. Hitler praised American eugenics in Mein Kampf, American eugenicists taught in Germany, and the Carnegie Institute proposed gas chambers in 1918 for the “hereditarily tainted.” The conceptual architecture was Made in America.2. Action T4 Killed 300,000 and Was Never Prosecuted The Nazi euthanasia program murdered roughly 300,000 people with neuropsychiatric disorders in gas chambers built into asylums. Because Nuremberg only tried international crimes—not crimes against a nation's own citizens—this program escaped proper legal reckoning and remains largely unknown.3. Doctors Could Say No—But Didn't Some asylum doctors, like Carl Kleist, simply refused to participate in T4 and faced no punishment. This makes the complicity of other doctors—many of them idealistic, not monsters—more damning. The system allowed for refusal; most chose collaboration.4. Psychiatry Still Assigns Value to Lives Antonetta argues that psychiatry's troubled legacy persists: rigid diagnostic categories inherited from German psychiatrist Emil Kraepelin, neurotransmitter theories that haven't improved outcomes, and a system that still decides whose consciousness has value. The DSM itself was created by self-described “neo-Kraepelinians.”5. Neurodiversity Is the New Civil Rights Frontier From autism to schizophrenia, our public discourse about neurodiversity remains “relentlessly negative.” As CRISPR and gene editing become reality, Antonetta warns we're facing the same eugenic questions—but now with the tools to act on them. We need more honest and nuanced conversations about different forms of consciousness before we start editing them out.Keen On America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit keenon.substack.com/subscribe

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Antonio Bianco is a world-renowned physician-scientist and expert in thyroid physiology and metabolism. In this episode, Antonio explores the complex biology of thyroid hormone production, conversion, and regulation—highlighting how deiodinase enzymes modulate hormone activity at the tissue level and why that matters for interpreting lab results. He discusses the shortcomings of relying solely on TSH as a marker of thyroid function, the ongoing debate around combination therapy with T3 and T4 versus standard T4 treatment, and how genetics, tissue sensitivity, and individual variability influence thyroid hormone metabolism. The conversation also examines how hypothyroidism affects energy, mood, cognition, and longevity; why some patients remain symptomatic despite "normal" labs; and how future research could reshape treatment paradigms. We discuss: How the thyroid produces, stores, and activates hormones like T4 and T3 to finely regulate thyroid activity [2:45]; How fasting alters thyroid hormones to conserve energy [12:45]; Action of the deiodinases: how D1, D2, and D3 enzymes control the activation and inactivation of thyroid hormones [19:15]; The normal function of thyroid hormone and the roles of the hypothalamus, pituitary gland, and deiodinases in maintaining hormonal balance [23:30]; Why understanding thyroid physiology is essential for proper diagnosis and treatment of hypothyroidism [33:45]; Testing for thyroid hormones: understanding free vs. total levels, the limitations of current T3 assays, best practices, and more [36:00]; Genetic and sex-based variability in thyroid hormone regulation and their limited clinical significance [43:45]; Hyperthyroidism: causes, symptoms, diagnosis, and treatment options [46:00]; Hypothyroidism: diagnosis and autoimmune causes of hypothyroidism [56:30]; More on hypothyroidism: diagnostic biomarkers, antibody patterns, and non-autoimmune presentations [1:05:00]; Thyroid hormone replacement therapy [1:15:15]; More on thyroid replacement strategies: exploring the evidence gaps, mortality signals, effects on lipids, and more [1:28:00]; Hypothyroidism basics: causes, antibody implications (including pregnancy), and how to make the diagnosis before choosing therapy [1:35:15]; Thyroid medication: compounded controlled-release T3, brand name versus generic, and what Antonio prescribes to newly diagnosed hypothyroid patients [1:42:45]; Redefining treatment success: why normalizing TSH isn't always enough for patients with hypothyroidism [1:54:45]; Case studies: analysis of two unusual cases of thyroid disease [1:57:00]; Dangers of supplementing with high levels of iodine, and female-specific risk of thyroid disease [2:05:45]; Case study of a patient who presents with elevated TSH but no symptoms [2:09:30]; How future research could reshape treatment, and Antonio's new book called "Rethinking Hypothyroidism" [2:13:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

In this episode, Dr. Andrea Rosen, a first-year endocrinology fellow at UVMMC, opens with a rapid-fire endocrine round, from her favorite organ and go-to hormone excuse to T3 vs. T4, metformin's true identity, and endocrinology in five words. She then shares what inspired her to pursue medicine, the biggest learning curves of her first fellowship year, and the moments that reaffirmed her choice of endocrinology. Dr. Rosen also offers advice for trainees considering the field and reflects on where she hopes to take her career next.   Co-Hosts: Caity Decara: caitlin.decara@med.uvm.edu Haley Bayne: haley.bayne@med.uvm.edu

Alle Informationen zur Carnivoren Ernährung unter www.carnitarier.de. ______________________________________________ Herzlichen Dank an unsere WERBEPARTNER: www.carnivoro.eu: Supplemente rund um die Carnivore Ernährung Mit dem Gutscheincode CARNITARIER erhältst du 10 % Rabatt auf deinen ersten Einkauf! Affiliate Link: www.carnivoro.eu/carnitarierinwww.kaufnekuh.de: Fleisch aus artgerechter Haltung mit fairen Preisen für Landwirte Mit dem Gutscheincode CARNITARIER erhältst du 10 € Ermäßigung auf deinen Einkauf ab 50 €. www.mindful-meat.com: Hochwertiges Hirschfleisch aus den Wäldern Deutschlands. Mit dem Gutscheincode CARNITARIER erhältst du 10 € Ermäßigung auf deinen Einkauf. www.pemmican-shop.de: Europas einzige originale Survival Beef Bar – Made in Germany. Mit dem Gutscheincode CARNITARIER erhältst du 10 % Ermäßigung auf deinen ersten Einkauf.www.theminerals.de: Beste Elektrolyte für die Umstellung auf Keto und für Carnivoren, die viel Sport treiben. Mit dem Gutscheincode CARNITARIER erhältst du 10 % Ermäßigung auf deinen Einkauf. _________________________________________________________________________Folge 207: Epidemie der Schilddrüsenunterfunktion vom Typ 2 – Dr. Dirk LemkeAuf dem Symposium der EMG (Gesellschaft für evolutionäre Medizin und Gesundheit) in Baden-Baden hielt Dr. Dirk Lemke, funktioneller Mediziner, einen Vortrag über die Epidemie der Schilddrüsenunterfunktion vom Typ 2. Es handelt sich dabei um eine Schilddrüsenhormonansprechstörung, die nicht durch ein einfaches Blutbild diagnostiziert werden kann. Auch wenn die Schilddrüsenwerte bei vielen Menschen normal sind, leiden sie unter vielen Symptomen einer Schilddrüsenunterfunktion. Dr. Lemke erklärt, dass ähnlich zu einer Insulinresistenz das Problem auf Zellebene besteht, da die Zellen nicht mehr auf die Schilddrüsenhormone ansprechen. Neben vielen Symptomen gibt eine Temperaturmessung häufig Klarheit über diese Stoffwechselstörung. Er empfiehlt zur Behandlung unter anderem die Einnahme von natürlichen Schilddrüsenextrakten, da diese nicht nur die beiden bekanntesten Schilddrüsenhormone T3 und T4 enthalten, sondern das gesamte Spektrum von bis zu 27 Schilddrüsenhormonen.Ihr könnt Dr. Dirk Lemke erreichen über seine Homepage www.doclemke.de.________________________________________________________________________________Fleischzeit ist der erste deutschsprachige Podcast rund um die carnivore Ernährung. Hier erfahrt ihr Tipps zur Umsetzung des carnivoren Lifestyles, wissenschaftliche Hintergründe zur Heilsamkeit sowie ökologische und ethische Informationen zum Fleischkonsum. Eine Übersicht über alle Folgen findet ihr hier: www.carnitarier.de/fleischzeitpodcastAndrea Siemoneit berichtet nach über sechs Jahren carnivorer Ernährung über ihre Erfahrungen und Erkenntnisse. Außerdem interviewt sie andere Carnivoren und Wissenschaftler.Ihr findet sie auf Instagram unter @carnitarier.deHandbuch der Carnivoren Ernährung: www.carnitarier.eu Haftungsausschluss:Alle Inhalte im Podcast werden von uns mit größter Sorgfalt recherchiert und publiziert. Dennoch übernehmen wir keine Haftung für die Richtigkeit, Vollständigkeit oder Aktualität der Informationen. Sie stellen unsere persönliche subjektive Meinung dar und ersetzen auch keine medizinische Diagnose oder ärztliche Beratung. Dasselbe gilt für unsere Gäste. Konsultieren Sie bei Fragen oder Beschwerden immer Ihren behandelnden Arzt.

Are you struggling with hypothyroid symptoms like fatigue, weight gain, hair loss, or brain fog?  Have you been told the reason is that you have "low T3"? Many patients are told the solution is simple: add T3 thyroid hormone replacement. But is that the truth? Is that the correct strategy? In this Thyroid Answers Shorts episode, Dr. Eric Balcavage, functional medicine thyroid expert and host of the Thyroid Answers Podcast, explains: ✅ Why low T3 doesn't always mean you need medication ✅ How stress, inflammation, and the Cell Danger Response affect T4-to-T3 conversion ✅ Why simply adding T3 or desiccated thyroid may not fix your symptoms ✅ A new way to understand your thyroid labs through the Adaptive Thyroid Model™

Following a fruitful European Society of Medical Oncology (ESMO) Congress 2025 for gastrointestinal malignancies, CancerNetwork® organized an X Spaces discussion hosted by 3 experts. They were Nicholas J. Hornstein, MD, an assistant professor at the Donald and Barbara Zucker School of Medicine of Hofstra University and Northwell Health; Timothy Brown, MD, an assistant professor in the Department of Internal Medicine and the associate program director of the Hematology & Oncology Fellowship at UT Southwestern Medical Center; and Udhayvir S. Grewal, MD, an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Each doctor focused on a specific disease type, highlighting the most important abstracts in colorectal cancer, pancreatic neuroendocrine tumors (NETs), and upper gastrointestinal cancers. The Phase 3 MATTERHORN Trial (NCT04592913) Results from MATTERHORN demonstrated that adding durvalumab (Imfinzi) to 5-fluorouracil, leucovorin (folinic acid), oxaliplatin, and docetaxel (FLOT) improved overall survival (OS) compared with FLOT plus placebo in patients with resectable gastric/gastroesophageal junction (GEJ) adenocarcinoma, regardless of pathological status.1 In the intention-to-treat population, the median OS was not reached in either arm, and the hazard ratio (HR) was 0.78 (95% CI, 0.63-0.96; P = .021). Notably, the improvement was observed regardless of PD-L1 status; in patients with PD-L1–positive disease, the HR was 0.79 (95% CI, 0.63-0.99), and in patients with PD-L1–negative disease, the HR was 0.79 (95% CI, 0.41-1.50). “This, I believe, will seal durvalumab plus FLOT as the standard of care for resectable [gastric/GEJ] cancers,” said Brown. The Observational ASPEN Study (NCT03084770) The ASPEN study showed that active surveillance was a safe approach for patients with low-grade, asymptomatic, nonfunctioning pancreatic neuroendocrine tumors (NETs) fewer than 2 centimeters in size.2 Of the 1000 patients enrolled in the trial, 20 patients died, of whom 18 underwent active surveillance and 2 underwent surgery. Nineteen of the deaths were unrelated to pancreatic NETs; 1 death in the surgery arm was related to a pancreatic NET. After surgery, 5 patients had disease relapse or progression. With a median follow-up of 42 months (IQR, 25-60), the OS analysis showed a P value of 0.530.  “This really settles the debate on whether or not to surgically operate on patients with a [pancreatic NET] size of [fewer] than 2 centimeters and shows that active surveillance is a safe option for these patients with pancreatic NETs [fewer] than 2 centimeters in size and non-functional NETs,” said Grewal.  Data From the Phase 2/3 FOxTROT (NCT00647530) and Phase 2 NICHE-2 (NCT03026140) Trials Neoadjuvant nivolumab (Opdivo) plus ipilimumab (Yervoy) achieved a clinically meaningful and statistically significant improvement in long-term outcomes, including responses and survival, compared with chemotherapy strategies in patients with mismatch repair deficient (dMMR) or microsatellite instability–high (MSI-H) locally advanced colon cancer.3 In NICHE-2, neoadjuvant nivolumab plus ipilimumab achieved a 3-year disease-free survival (DFS) rate of 100% compared with 80% (95% CI, 73%-85%) with all chemotherapy strategies in FOxTROT (P

Canada's tax problem isn't just slow phones at the CRA—it's a century of bolt-on rules that made filing confusing, subjective, and expensive to administer. A new review found CRA contact centres gave accurate answers only 17% of the time during the 2025 tax season window, echoing long-standing issues flagged by earlier audits (including millions of dropped and blocked calls). This complicated tax system creates unnecessary bureaucracy, wasted money, unpaid taxes, and a subjective audit process that means you can pay more (or less) taxes depending on how well your auditor slept the night before.Hiring more agents won't fix a tax law that's impossible to interpret. Simpler rules will. In this episode, I sketch a path to simpler, fairer, faster taxes. First, a quick history lesson on why we have income taxes, and how they became a Frankenstein's monster of laws that no one can understand. This will show us that the problem is getting worse, and will keep getting worse until we have a major system overhaul. Then I'll get into solutions.I explore proven options from abroad:Pre-populated / return-free filing (pioneered by Denmark; now used in most OECD countries) to slash time, phone calls, and errors—already being piloted in Quebec for simple returns. Flatter, broader bases with minimal carve-outs (think Estonia's ultra-simple system) and NZ's broad-base/low-rate GST—models that raise revenue with less friction. Withholding-as-final for straightforward T4 earners, so most people don't file at all unless their situation is complex—borrowing design cues from the Nordics. Look, nobody wants to talk about tax until they have to. But when they do - and they have to every year - they hate everything about our tax system. It creates unnecessary frustration and anger. Nobody wants to deal with the CRA, and nobody wants to work for the CRA either. Why would they?Many people who don't pay taxes do it out of frustration - they just give up. They're not evil; they're just overwhelmed. Tax filings have become a game.I'm not anti-tax; I'm anti-waste. My companies happily pay millions of dollars in corporate taxes annually. Its employees add another 1M in income taxes to our society, and you can add HST on top of all of it. What I want is less money burned collecting taxes and more money spent on services. If Canadians want better healthcare, safer streets, and a clearer deal with citizens, we should push for tax simplification, not just bigger call centres.Sources:CRA call centres: 17% accuracy (Feb–May 2025); prior audits on access/accuracy. Investment Executive+1Canada's income tax history (1917 “temporary” tax). The Canadian EncyclopediaProvincial/territorial corporate tax—CRA administers most; exceptions Quebec & Alberta. Canada.caPre-populated returns (Denmark origin; 28 OECD countries). Tax Policy CenterQuebec simplified / pre-filled return pilot (2025 filing for 2024 year).

New study suggests taking thyroid medication WITH food may be just as good as taking it on an empty stomach; Natural support for Parkinson's Disease; Reviving the lost art of handwriting may be key to kid's learning; Dr. Jeffrey Bland does a deep dive on why not all fish oils are alike.

With a calcium score of zero, is there any fat in your diet?  Are there any recommended supplements for IBS?What is the safest and most appropriate dose of vitamin D3 for most seniors?

INFINITY Study on the timing of thyroid medication ingestionI have a growth near my eye that is changing in color and becoming crusty. What should I do?I've been suffering from hip pain for the last three years. Any suggestions on what to do?Could toxic exposures like mold cause conditions like low thyroid or autoimmunity?

In this episode, we explore the connections between Autism and Parkinson's, focusing particularly on the basal ganglia and its substructures, notably the substantia nigra within the midbrain. We discuss how the substantia nigra, known for its high concentration of neuromelanin, plays a critical role in these disorders. The episode examines how neuromelanin, a dark pigment, not only absorbs all frequencies of light but also has antioxidant properties, binds metals, and acts as a neuroprotector. This discussion leads into the broader implications of environmental signals, particularly light, on human biology, touching on how modern changes in light exposure might affect these conditions.We examine the role of tyrosine in the synthesis of neuromelanin and its derivatives like dopamine, which are crucial for neural function. We look at how deficiencies or imbalances in these pathways could lead to the symptoms observed in Autism and Parkinson's, including motor function issues. The conversation also covers the direct and indirect pathways in the basal ganglia, explaining how these pathways facilitate or inhibit movement, respectively, and how their dysfunction can manifest in the characteristic motor symptoms of both disorders. We also touch on the significance of thyroid function, particularly the roles of T3 and T4 hormones, in brain development and neuron health, tying these elements back to the overarching theme of energy loss and transduction in both Autism and Parkinson's.Autism and Parkinson's are a lack of, or a loss of, energy.Biological Energy: Quantum Mechanisms, Water, DHA, and NF-kB: https://youtu.be/2-IA_gunXbwDaylight Computer Company, use "autism" for $50 off athttps://buy.daylightcomputer.com/autismChroma Light Devices, use "autism" for 10% discount athttps://getchroma.co/?ref=autismCognity AI for Autistic Social Skills, use "autism" for 10% discount athttps://thecognity.com0:00 Autism and Parkinson's; Basal Ganglia; Substantia Nigra; Neuromelanin; Internal Calculators2:15 Tyrosine; Chromophores; Aromatic Amino Acids3:50 Biological Energy; Mitochondria; Environmental Signals; Cytochrome C Oxidase; Autism Research Miss6:20 Deep Brain Stimulation6:48 Neuromelanin9:02 Reverse Engineer ATPase10:48 Tree Examples11:45 Hypoxia and loss of energy & dopamine12:26 Eyes, hair, & skin; RPE; efficiency & power; What is Light?13:58 Light; Information & Energy; electromagnetic; wave-particle duality; sunlight versus artificial light17:08 Thyroid; T3 & T4; Iodine18:31 Roles of T323:00 Loss of energy in the womb & Autism research25:00 Melanin + Water = Electrons26:40 Basal Ganglia; "Motivations" & Movements; Direct Pathway30:55 Indirect Pathway32:52 Go, No-Go; Action selection, learning & habits; fine motor skills34:18 Parkinson's and loss of timing & energy; modulating the two pathways & dopamine37:07 Reviews/Ratings & contact infoX: https://x.com/rps47586YT: https://www.youtube.com/channel/UCGxEzLKXkjppo3nqmpXpzuAemail: info.fromthespectrum@gmail.com

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog You will learn: What holds up new treatments for diseases and conditions How long the FDA sits on a known safe medical medication before it is released to the public. Why safe and effective drugs are NOT approved by the FDA Why doctors are forced to use medications off label How you can help During my 44 years of medical practice, I have encountered conditions for which there is no approved medication or surgical treatment available as recognized by the American College of OBGYN or the FDA. This situation can present challenges both for physicians managing these patients and for individuals seeking relief from their symptoms. This issue is not often addressed on Dr Oz, in the news, or at medical conferences. For many conditions, physicians wait for the development of approved medications or treatments, and in the meantime may inform patients that there is currently no treatment or cure available. Some doctors may attribute a patient's concerns to aging, stating that it is a universal experience. While this may be accurate, such explanations may not provide comfort to patients seeking solutions to their symptoms. This lack of helpful guidance can discourage individuals from seeking medical care when they feel their concerns are not acknowledged. This seems to result from insurance companies prioritizing cost savings by minimizing patient care.  Every year insurance companies decrease what they pay doctors for their services, while their expenses go up, and the Government requires more and more work behind the scenes like HIPPA, OSHA, and Clia requirements that costs more to deliver the same service.  If you have a problem with the time your doctor spends with you then blame the insurance companies whose profits rise every year…Soon doctors will do what I do and only take cash.  The practice of medicine is not working in a free market. While insurance limits the prescriptions of medication to those meds that are FDA Approved, the FDA and medical specialty colleges often delay approval of new, low-risk treatments for up to 20 years after their effectiveness is demonstrated. This lengthy process should be reconsidered to treat people who are ill and suffering, now. There is plenty of research in the medical journals that explain the safety of new and effective treatments that can save peoples' lives that are not FDA approved yet. The FDA is not interested in expediting the release of medication/ devices quickly to those people who need help now. They drag out the testing of a medicine that has been effective for years and may or may not approve it. On the flip side they have approved many drugs that later are found to have severe side effects, and they just change the warnings on the medication inserts. They don't take them off the market except in severe cases. Drugs that have worked treating patients successfully are being used but are not FDA approved. These “grandfathered drugs” don't need to go through the testing that new drugs go through because they work with few well-known risks. I use many if these medications because they are inexpensive for my patients and are often more effective than new meds for the same problem. One of the drugs that the FDA has not had to approve is Armour Thyroid, a natural thyroid replacement. My experience with treatments not approved by the FDA Armour Thyroid: Armour Thyroid (AT) has been prescribed by doctors to replace thyroid hormones for about 100 years. It is natural, made from Pig thyroid. It only comes from “medical Pigs” that are raised for medical purposes.  We use medical pigs for skin grafts, and other parts of the pig to treat human diseases like heart valve replacements.  Armour Thyroid is composed of the four thyroid hormones that humans make: T4, T3, T2, T1. The synthetic thyroid replacement, Synthroid/levothyroxine is only T4.  The active form of thyroid is T3, and it requires an enzyme to convert T4 into T3. If a person can't convert T4 into active T3 then nothing improves except the blood levels of T4, and TSH. The majority of women cannot convert T4 into T3. Therefore, if they take Synthroid or levothyroxine and their doctor only checks their TSH level and not the level of free T3 and free T4 to see if the Thyroid is working, then women are told that they are healed, yet they know they are not because none of their low thyroid symptoms are resolved. When this happens, doctors tell female patients that it is all in their heads and dismiss us when we tell them we are not cured with this synthetic T4 medication. Yet Synthroid is a chemical, and AT is natural from medical pigs, so the FDA is trying to Bann the only drug that has successfully treated millions of women. PS. Synthroid was not tested on women like many other drugs that were passed through the FDA before 2014! If you think this is a small problem, think again. Thyroid hormones are vital to human life, and the thyroid gland requires Iodine in the diet. The Midwest US has no Iodine in the soil or water. Therefore, this area is overburdened with hypothyroidism. I have been on AT for 50 years without complication and I have prescribed it thousands of times ever since I went into private practice.  AT works to relieve the symptoms of hypothyroidism for women and men, and it works better for women that the “new” drug Synthroid/levothyroxine, which is FDA approved. You ask how could the FDA approve a drug that doesn't successfully treat women? It is because Synthroid was not tested on women!  Until 2014 the FDA did not test women in the required drug trials.  AT works for us (women), Levothyroxine does not. Now the FDA wants to ban AT. It is not approved because it was around for decades before they started testing medications like they do now, and the history of successful treatment should stand on its own merit! Example 2: Bio-Identical Hormones BIH:  BIHs had not been approved by the FDA until recently and there was no announcement that they are now approved for women who have hormone deficiency symptoms or postmenopausal symptoms. Most doctors and women who have been afraid of the only hormones that can help them, bioidentical hormones, haven't yet been told that NOW, FINALLY the medical colleges and the FDA finally have quietly approved BI hormones.  There are no pure estradiol and pure testosterone pellets that are made by a drug company for women. My patients get their estradiol and testosterone pellets from a compounding pharmacy.  I have been prescribing BIH since 1985 without FDA approval because the oral estrogen formulations that were available at pharmacies caused weight gain and put women at high risk for blood clots. Non-oral BI hormones have fewer risks than FDA approved estrogens.  I waited more than 45 years for the FDA to approve BI hormones for treatment of women.  All those women in the last 45 years who were taking FDA approved estradiol and those who couldn't tolerate them have been harmed by FDA goals of never approving compounded or bio-identical hormones.  The delay has harmed 50% of American women. Example #3 Devices for Weight Loss I was involved in the discovery and testing of a unique device that stimulated acupuncture points with a TENS-unit-type patch connected to your cell phone for easy adjustment of your hunger or “fullness”. The FDA requires testing to approve any new device so the group of investors I was part of had to invest thousands of dollars for a device we already knew worked. The FDA told the investigators of all new devices who they should test, who they can't have in the study, and how long the testing should take. I found their parameters for the study of this device to be unrealistic. The women in our test group could not be taking hormones of any kind (birth control, ERT, HRT), and could not be on antidepressants, could not have diabetes or insulin resistance or be on any drug that assisted in weight loss. These women subjects had to be a certain BMI (level of obesity) and had to be tested repeatedly with weight and body composition measurements None of my patients who needed weight loss could participate.  Most GYN patients are on some medication or supplement, so the FDA made this study of our device so narrow that REAL WOMEN weren't tested! Sadly, we lost many women in the control group from the study because they were NOT losing weight while the ones on the device were obviously dropping pounds, so we had trouble maintaining test subjects. The testing phase of this simple device took 7 years! Our device works and no one will ever know about it or be able to use this non-medicinal weight loss device because when the FDA rejects your device you will be breaking the law if you produce and sell it directly to the public. It has no side effects or dangers..it just controls the amount you eat with stimulation of an acupuncture point. There are many ways to change this situation, and it takes years and billions of dollars to change the whole system of bringing treatments to patients quickly.  I'm afraid I won't see a revolution of the way we bring medicines and devices to market during my lifetime. Currently there is a 17-year delay between proving a drug or device works for a particular illness or condition and when it becomes available to doctors and patients. So what do we do in the meantime?  I seek treatments for patients who are unresponsive to traditional medicine by reading journals like Life Extension, that inform doctors and patients alike about new effective solutions for common medical complaints and diseases that the FDA has ignored or stymied with endless drug trials.  Life Extension Magazine highlights studies on new medications for diseases without an FDA approved solution and publicizes diagnostic tests often overlooked by mainstream publications because they are not yet FDA approved. The medical journals I read (New England Journal of Medicine, JAMA, Menopause, Metabolism and Endocrinology, Journal of Age management, to name a few) offer treatments for orphan diseases or even common problems that haven't been blessed by the FDA. It takes an average of 17 years from the culmination of research on a new drug, test or device until it is approved for use by the public! At the end of this Blog, I will give you a link to make your voice heard by signing a petition to shorten the approval of new treatments and medications from the average of 17 years to 3 years! My patients don't have time to wait for relief, and that may be the case for you as well. If you want to do something to help, please click this link and let the FDA know how you feel. Please sign a Petition to enact an amendment to the FOOD, DRUG and COSMETIC ACT, by going to: https://age-reversal.net/fda/

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you ever doubted your doctor because she wrote a script that you later “Googled” and found was not FDA approved, I hope you trusted your doctor enough to realize that she wouldn't recommend any medication that would hurt you…. What is an unapproved use of a drug, also called “off-label”? Unapproved use of an approved drug is often called “off-label” use. This term can mean that the drug is: Used for a disease or medical condition that it is not approved to treat, such as when a chemotherapy is approved to treat one type of cancer, but healthcare providers use it to treat a different type of cancer. The drugs that are not approved by the FDA, yet are commonly used, have been used for decades before the 1964 law that required new drugs to go through extensive and very expensive testing before their release to the public. The operative word is NEW DRUGS AFTER 1964. Today I will talk about the safety of non-FDA approved drugs because they are: Older cheaper drugs used for many diseases and conditions before 1964 and are still used Drugs that are approved for one use, or one condition, but not for other conditions that it is effective and safe for. Drugs made by compounding pharmacies for diseases that the FDA has not approved a drug for, but there is research backing the drug and years of safe use. First, before we discuss the non-FDA approved drugs, I will discuss the safety/risks of FDA approved drugs, and why FDA approval doesn't mean a drug will do no harm or even that it is effective for the use it is approved for. A little background will help you understand the problem and the reason an FDA approval does not necessarily mean a drug is safe.  Since 1964, a law was passed that established testing prior to a drug being approved by the FDA became mandatory.   Since that time several drugs that survive FDA approval and are released but are later removed or banned after their FDA release when the public finds side effects that the FDA didn't discover in their trials. One such drug is Fen-Phen, Fenfluramine/Phentermine. This drug was released during my time practicing medicine and was withdrawn after one study claimed it caused heart valve disease…In the end the “one post approval study” that claimed that heart valves were affected by this drug that caused its bann was found to be false. The withdrawal of the drug followed one study by a single cardiologist from Kansas City had reviewed all of the cardiac valve echo tests and falsified the results to make Fen-Phen appear dangerous to heart valves, when in reality it wasn't.  She lost her license, but the FDA never put Fen-Phen back on the market!  The FDA hates to be wrong twice, so they never allowed this drug back on the market after its removal. Other mistakes made by the FDA include not allowing women in the studies to approve a drug before 2014 which ignores or misses all of the side effects or lack of effectiveness for a drug when taken by women.  Despite all the expensive testing before the release of a drug by the FDA, many drugs not tested on women were later often found to have severe side effects only on women. A few examples follow: You might have heard of the FDA approved drug Ambien that causes many women to experience “night eating”, sleepwalking, and night terrors, while their male counterparts were not affected, so because they only tested men the drug was approved. In retrospect it should have been tested on women as well, and then either not passed through the FDA or should have had a black box warning for women. It takes years get action from the FDA, notifying doctors of these side effects. Women were not included in testing for any drugs except female hormones until 11 years ago, but no other drugs.   Before 2014 all (non-hormonal) drugs that passed the FDA were not tested on women so the effect on women was unknown until it was tested on the public. The FDA left women out of drug-trials because it viewed women as “mini men”, or they didn't consider us important enough to test new drugs on…OR worse, they believed we were too complicated to easily test us because of pregnancy, menopause and other hormonal swings that normal healthy women have.  In any case, we are now suffering their decisions, when a medication works one way for men and another way for women! Finally, we are tested when drugs are being evaluated for approval by the FDA. Professional women have achieved a level of authority in medicine and pharmacology (2025) and are weighing in on the inequity. Women in the medical profession and the public are pulling back the curtain on the side effects of FDA approved drugs that are experienced by women only! Slowly, study by study investigators are now publishing the side effects and problems for women with FDA approved drugs….yet these findings are not included in the warnings on most of these drugs, even now over 15 year after they became obvious to the doctors who treat women! Drugs that either don't work for women, or that have severe side effects include that were approved before 2014. All statin drugs for high cholesterol (Crestor, rosuvastatin, atorvastatin, etc.) cause women to have muscle breakdown and muscle pain. Synthroid (levothyroxine), doesn't cure the symptoms of hypothyroidism in 80% of women, but just makes the TSH lower, so it appears as if it is working! This leads doctors to tell women that their symptoms are all in their heads!! Wrong.  It is the wrong medicine. Women have enzymes that differ from men that make it difficult for them to convert the inactive form (T4) into the active form (T3), so we can't convert Synthroid (all T4) into the active form. Synthroid, the FDA approved drug for hypothyroidism, shouldn't be given to most women. Women should be given the non-FDA approved drug Armour Thyroid or NP thyroid that have both T3 and T4 in them! Ambien Prednisone and other oral steroids We have reviewed the lack of testing on women before 2014, now we will discuss safe drugs that have been used for decades even before 1964 when the FDA required testing for FDA approval? Older, yet effective and inexpensive drugs have been tested by the public, some for almost 100 years that have saved thousands of lives, yet they are not given the FDA stamp of approval!  In fact, the FDA tries to put these drugs out of circulation, replacing them with very expensive drugs that are new! Or they just shut them down, because they are not FDA approved.  Young doctors are told not to use them by their medical schoolteachers who rarely have experienced these medications in private practice…. These doctors in training don't know the history of older safer, cheaper drugs, or even why the FDA tells them avoid them. They comply not knowing why, so you are left with no drug that works for you, or you pay 3-10 times the amount for a newer FDA version of the older drug which may even have more side effects. Some of these older very effective and cheap drugs are Penicillin, Nitroglycerine for chest pain, Morphine (pain), Phenobarbital (seizures), Codeine, Armour Thyroid, hormone injections including estradiol injections and testosterone, Thorazine for psychiatric use, (Pitocin) oxytocin for labor, lactation support and Autism Colchicine:Used to treat and prevent gout. Progesterone in oil (IM) Estradiol in oil (IM) B12 for injection Testosterone Cypionate for injection Compounded Estradiol in any form Compounded Testosterone for women These drugs have been used for so long that any safety risks or side effects have been found through the use of these drugs in the population. Yet the FDA won't grandfather them in and approve them based on their history! What do doctors do when the drug the FDA has approved a drug that doesn't work for a group of their patients (gender, race, blood type, etc.)?  What happens when a doctor can't find a drug that is FDA approved needed to treat a condition she is faced with? Why do we as citizens, allow the government to have power over doctors who are already controlled by their state licensing boards as to what medications they?  Lastly Why do taxpayers allow a government agency that they fund with tax dollars control their health by banning, or not approving drugs, or banning one drug so an outrageously expensive drug is put in its place? Compounded Medications/ Compounding Pharmacies: These drugs are made by mixing ingredients to meet individual patient needs and are not subject to premarket review for safety, effectiveness, or quality. However, they ARE subject to the success or failure for which they were prescribed. If a doctor prescribes a compounded drug that doesn't work, she is apt to be confronted by her patient who is not getting the expected results.  Compounding pharmacies usually don't get paid by insurance, so patients are more invested in getting a drug that works and that is one of the big reasons that Compounded medicines are at least as good or better than big pharma or generic drugs. I absolutely could not successfully treat the thousands of women and men that I have without compounding pharmacies.  They compound hormones/drugs that are safe and effective, mostly hormones that can't be patented because they occur in nature and won't ever be made by big pharma. More than that, big producers of drugs can't produce in mass quantities many doses of a certain hormone like compounding pharmacies do.  Compounding pharmacies provide what people need and they continue to do so because patients prefer their dosing and quality.  FDA approved Generic Drugs can be legally 25 % lower dose than what they say they are.  That would be a big problem if my compounded pellets had that kind of variability. People might need pellets every 2months or every 5 months instead of every 4 months..it would be like guessing what you need ahead of time…..I believe dedicated compounding pharmacists are more accurate than any generic on the market. Compounding pharmacies: Unsung Heros Compounding pharmacies serve the public when big pharma fails and hasn't developed a safety net for production if they have a problem and the FDA shuts them down. That situation leaves patients who take their medications, without an alternative. Compounding pharmacies step into the breech when big pharma has a problem with a particular drug and stop making a drug (e.g. Lidocaine, B12 injectable, IV Fluids, to name a few shortages and no production that have occurred in the recent past). What if patients couldn't get the meds they need, and if there were no compounding pharmacies—Chaos and suffering and dying patients would closely follow! The FDA is Fickle and is not on your side! For years the FDA did not approve of Bioidentical estrogen and testosterone in any form, and just a few months ago all of a sudden, long after they scared women from taking the hormones they needed to improve their length of life and quality of life, they decided bioidentical hormones are better than the FDA approved hormones!!!  That is a little too late.  Some of us will never forget the stress lack of approval of compounded hormones caused for doctors and patients alike.  Other doctors criticized us and now most of them aren't even in practice anymore.  Maybe the FDA read my blog!!! Compounded hormones have been approved by the masses of women who have taken them under my signature! Compounded BI hormones are medications with a long track record and should not have to be tested with the bloated expense required of testing for the FDA. For Gynecological Disorders that don't have an FDA approved hormone drug because testosterone and estradiol have been used for so long that they don't need testing. If there was a significant problem with them their history of use of over 5-7 decades has proven the efficacy and safety of the female hormones for treatment and hormone replacement. For Psychiatric Disorders: Some patients need compounded ketamine products for conditions like severe depression, despite lacking FDA approval for these uses and potential risks, yet it has been used for this purpose for decades and was used for childbirth for almost a century, until epidurals and saddle blocks took their place. Testosterone for women still is not recognized as a female hormone even though women produce over twice as much Testosterone as Estradiol when they are in their fertile years.   Replacement of T with bioidentical T pellets offers a treatment for dozens of symptoms women face after age 40, and it prevents the diseases of aging: osteoporosis, heart disease, sarcopenia, frailty, diabetes and more that have not been addressed by mainstream medicine and the FDA. Over a decade ago, the FDA turned down the approval of testosterone patch after over 3 years of positive research studies, the FDA said they didn't approve T for women is because the side effect of T for women, facial hair, was dangerous for women.…I cry B—–S—-!  That is really men not wanting to share testosterone replacement with women. I say leave us alone and let women and their doctors determine what they need.  It is proven that only 5% of all professionals in any profession are not trustworthy, so give doctors their due and trust that we are looking for answers to our patients' problems that you don't even know about! The FDA is paid for by us…everyone in this country. I say hands off! Speed up the approval process or forget it for older drugs and BI hormones! ~

This podcast is sponsored by YARAL Pharma.  In this episode, we are focusing on the management of hypothyroidism -- a treatable, but not curable condition – and will explore unique challenges for patients with hypothyroidism in long-term care – from tolerability and formulation considerations to consistent dosing and patient needs. Dr. Tamara Ruggles is not affiliated with YARAL Pharma. All views and opinions regarding hypothyroidism are solely her own and are not attributable to YARAL or the Pharmacy Podcast Network. IMPORTANT SAFETY INFORMATION for levothyroxine sodium capsules INDICATION AND USAGE Levothyroxine sodium capsules are L-thyroxine (T4) indicated for adults and pediatric patients 6 years and older with: Hypothyroidism - As replacement therapy in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism Pituitary Thyrotropin (Thyroid-Stimulating Hormone, TSH) Suppression - As an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well differentiated thyroid cancer Limitations of Use: Levothyroxine sodium capsules are not indicated for suppression of benign thyroid nodules and nontoxic diffuse goiter in iodine-sufficient patients as there are no clinical benefits and overtreatment with Levothyroxine sodium capsules may induce hyperthyroidism. Levothyroxine sodium capsules are not indicated for treatment of transient hypothyroidism during the recovery phase of subacute thyroiditis WARNING: NOT FOR THE TREATMENT OF OBESITY OR FOR WEIGHT LOSS Thyroid hormones, including levothyroxine sodium capsules, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Contraindications Uncorrected adrenal insufficiency Warnings and Precautions Cardiac adverse reactions in the elderly and in patients with underlying cardiovascular disease: Initiate Levothyroxine sodium capsules at less than the full replacement dose because of the increased risk of cardiac adverse reactions, including atrial fibrillation Myxedema coma: Do not use oral thyroid hormone drug products to treat myxedema coma Acute adrenal crisis in patients with concomitant adrenal insufficiency: Treat with replacement glucocorticoids prior to initiation of levothyroxine sodium capsules treatment Prevention of hyperthyroidism or incomplete treatment of hypothyroidism: Proper dose titration and careful monitoring is critical to prevent the persistence of hypothyroidism or the development of hyperthyroidism Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing, or discontinuing thyroid hormone therapy Decreased bone mineral density associated with thyroid hormone over-replacement: Over-replacement can increase bone reabsorption and decrease bone mineral density. Give the lowest effective dose Adverse Reactions Common adverse reactions with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage. They include the following: General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating Central Nervous System: headache, hyperactivity, nervousness, anxiety, irritability, emotional ability, insomnia Musculoskeletal: tremors, muscle weakness Cardiovascular: palpitations, tachycardia, arrythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest Respiratory: dyspnea Gastrointestinal (GI): diarrhea, vomiting, abdominal cramps, elevations in liver function tests Dermatologic: hair loss, flushing Endocrine: decreased bone mineral density Reproductive: menstrual irregularities, impaired fertility Adverse Reactions in Children Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height. Seizures have been reported rarely with the institution of levothyroxine therapy. Hypersensitivity Reactions Hypersensitivity reactions to inactive ingredients (in this product or other levothyroxine products) have occurred in patients treated with thyroid hormone products. These include urticaria, pruritis, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur. Drug Interactions: Many drugs and some foods can exert effects on thyroid hormone pharmacokinetics (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to Levothyroxine sodium capsules. Administer at least 4 hours before or after drugs that are known to interfere with absorption. See full prescribing information for drugs that affect thyroid hormone pharmacokinetics and metabolism. To report SUSPECTED ADVERSE REACTIONS, contact Yaral Pharma Inc. at 1-866-218-9009, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. For Full Prescribing Information, including Boxed Warning, go to www.yaralpharma.com/levothyroxine-pi.

Feeling drained or stuck with stubborn weight that just won't budge? Or maybe you're endlessly exhausted, breaking out in rashes, or other seemingly unexplainable symptoms? A sluggish liver or thyroid can leave you feeling tired, bloated, or in a fog. Don't worry, this episode is all about how your liver and thyroid team up to help your body ditch toxins, and what you can do to support them, boosting overall wellness. This week, Jenn Trepeck is joined by Sara Banta, renowned Certified Dietary Supplement Professional and a member of the National Association of Nutritional Professionals. Sara Banta shares her personal journey and practical tips on detox support, thyroid and liver health, estrogen balance, and using nutrition and lifestyle to support your health whether your goal is more energy, weight loss, and simple detoxification. Get ready for actionable advice, real talk, and holistic strategies to help you feel lighter, brighter, and more energized. What You Will Learn in This Episode:✅ How liver health impacts detoxification and weight loss ✅ The role of thyroid function in energy, metabolism, and overall wellness ✅ Practical strategies to reduce toxins and support estrogen balance ✅ Supplements that help optimize liver and thyroid function The Salad With a Side of Fries podcast, hosted by Jenn Trepeck, explores real-life wellness and weight loss, debunking myths, misinformation, and flawed science surrounding our understanding of nutrition and the food industry. Let's dive into wellness and weight loss for real life, including drinking, eating out, and skipping the grocery store.TIMESTAMPS: 00:00 Detox support links toxins to stalled weight loss and why liver health is vital for detoxification05:32 Sara Banta's journey with thyroid function and toxins, and her son's leukemia scare, tied to poor detox support12:20 Sara's son struggles with his heart stopping, and the value of natural supplements19:22 Signs of sluggish thyroid function can include unexplained weight gain, loss of hair, eyebrows, thinning, dry skin, bloating and more23:49 The liver controls the detoxification, hormones, thyroid, estrogen, and cortisol, removing environmental chemicals and more27:50 Fatty liver epidemic linked to toxins, not just alcohol31:16 Detox support starts with lifestyle, not just supplements36:23 Iodine deficiency can block thyroid function and detox support38:22 Supplements for liver health without toxins or fillers42:09 Discussion of iodine supplements and how to choose quality supplements for adequate detox support 44:16 Hope for holistic health through detox support strategiesKEY TAKEAWAYS:

In this episode, Dr. Jockers sits down with guest Dr. Justin Marchegiani to dive into how thyroid hormones control your metabolism, energy, and overall health. Discover why symptoms like fatigue, hair thinning, or cold hands could signal underlying thyroid issues. We break down TSH, T4, and T3, and explain why conventional testing often misses the full story.   In this episode, learn the key drivers of thyroid dysfunction, including insulin resistance, chronic stress, and inflammation. Explore how your gut and liver influence hormone activation and why common nutrient deficiencies can silently impair thyroid function.   In this episode, get actionable strategies to support your thyroid naturally. From optimizing nutrient intake and stabilizing blood sugar to reducing environmental toxins, sleep and stress management are highlighted as essential components for better thyroid health. In This Episode: 00:00 Introduction to Thyroid Hormone Activation 00:13 Impact of Stress and Inflammation on Thyroid Function 02:38 Interview with Dr. Justin Marchegiani 03:16 Understanding Thyroid Hormones and Metabolism 04:22 Common Symptoms of Thyroid Issues 07:18 Conventional vs. Functional Medicine Approaches 12:20 Role of Nutrients in Thyroid Function 16:16 Gut Health and Thyroid Function 17:12 Holistic Approach to Thyroid Health 18:42 Understanding the Role of Gut Health in Diet and Exercise 19:48 Main Root Causes of Hypothyroidism 21:15 Impact of Toxins and Nutrient Deficiencies on Thyroid Health 21:50 Interpreting Thyroid Lab Results 25:58 Foundational Steps for Thyroid Health Without a Practitioner 30:36 The Thyroid Reboot Book and Final Thoughts If you want a nutrient-packed boost, check out Paleo Valley's Grass-Fed Organ Complex—a supercharged multivitamin containing liver, heart, and kidney from healthy pasture-raised cows. It delivers a full spectrum of B vitamins, minerals, amino acids, and peptides without the strong taste of organ meat. For a 15% discount, visit paleovalley.com/jockers and stock up on this powerful supplement to support energy, mental clarity, and overall health. Think heartburn comes from too much stomach acid? Think again. Most digestive issues actually stem from too little stomach acid. That's why I recommend Just Thrive Digestive Bitters—they naturally stimulate stomach acid, bile, and enzymes to improve digestion, reduce bloating, and boost nutrient absorption. Save 20% off your order with code JOCKERS at justthrivehealth.com.   "Chronic stress and inflammation can disrupt thyroid hormone activation and impact your metabolism."   Subscribe to the podcast on: Apple Podcast Stitcher Spotify PodBean  TuneIn Radio   Resources: Get 15% off Paleovalley: paleovalley.com/jockers – Use code JOCKERS Save 20% on Just Thrive: justthrivehealth.com – Use code JOCKERS   Connect with Dr. Justin Marchegianni Book:  https://amzn.to/41FtiJX Website:  justinhealth.com Connect with Dr. Jockers: Instagram – https://www.instagram.com/drjockers/ Facebook – https:/www.facebook.com/DrDavidJockers YouTube – https://www.youtube.com/user/djockers Website – https://drjockers.com/ If you are interested in being a guest on the show, we would love to hear from you! Please contact us here! - https://drjockers.com/join-us-dr-jockers-functional-nutrition-podcast/

What's the best thyroid medication to be on — NDT, T4, T3, or a combination? And how do you actually know what's right for your body? In this episode, I'm breaking down the nuanced art of thyroid optimization — from natural desiccated thyroid (like Armour or NP) to biosynthetic options such as Synthroid, Tirosint, and Cytomel. I explain why there's no one-size-fits-all treatment, what to consider if you have Hashimoto's, and how fillers, conversion issues, and reverse T3 can all impact how you feel. You'll learn how to spot when your thyroid meds need tweaking, why “natural” doesn't always mean better, and how to use your labs and symptoms together to guide your treatment. If you've ever felt confused about which thyroid medication is best or frustrated that your current dose isn't working, this episode will give you the clarity, confidence, and questions to bring to your next appointment — so you can finally get the right combination, in the right dose, for you. Shop ALL of Dr. Amie's Fixxr® Supplements: ⁠⁠betterlifedoctor.com⁠⁠ LET'S GET YOUR LIFE BACK...Connect with Dr. Amie Hornaman Book a free application call:⁠ ⁠https://dramiehornaman.com/pages/book-a-call⁠⁠ FREE DOWNLOADS… ⁠⁠What Are the Optimal Lab Ranges? What Steps Can I Take?⁠⁠ Don't know where to start...don't know which labs are useful? And what to do when you get your results? ⁠⁠“How To” Guide For Supplements⁠⁠ Here's your Fixxr® supplement timeline and guide. ⁠⁠Fix Your Thyroid and Adrenals To Fix Your Life⁠⁠ Check your symptoms of hypothyroidism and know OPTIMAL thyroid lab values. Learn why you are being told you're “NORMAL” by your doctor. ⁠⁠Can Supplements Help with Hypothyroidism?⁠⁠ Grab this thorough guide to help you select the most advantageous supplements that will best suit your health circumstances. RATE, REVIEW AND FOLLOW ON APPLE PODCASTS Show your love for Amie and The Thyroid Fixer Podcast! If you're enjoying our journey together, I'd be thrilled if you could take a moment to rate and review the show on Apple Podcasts. Your support helps me reach and help more people just like you, guiding them towards their optimal selves! Just click⁠ ⁠HERE⁠⁠, scroll all the way down, give us those 5 stars, and share what you enjoy about my episodes in a review. Haven't subscribed yet? Make sure to follow The Thyroid Fixer Podcast to catch all the new episodes that come out every week. Follow⁠ ⁠HERE⁠⁠ and never miss out on a moment of the journey! CONNECT WITH ME ON SOCIAL MEDIA: Join my exclusive Facebook Group, Dr. Amie…The Thyroid Fixer®...Love Your Mirror, for a Community of HOPE and Support in your thyroid journey. ⁠⁠https://www.facebook.com/groups/dramie/⁠⁠ Like me on Facebook:⁠ ⁠Amie Hornaman Nutrition and Functional Medicine⁠⁠ Subscribe on Youtube:⁠ ⁠Dr. Amie Hornaman⁠⁠ Follow me on Instagram:⁠ ⁠@dramiehornaman

Episode 15 – Myth: Low fT3 Means You Just Need More T3 Many people struggling with chronic hypothyroid symptoms are told the answer is simple: “Your free T3 is low, so you just need more T3 medication.” But is that really the solution? In this episode of Thyroid Shorts, Dr. Eric Balcavage explains why low T3 is often an adaptive response to stress, not a sign that your body is broken. He explores how gut health, diet, inflammation, and immune activity drive thyroid conversion, and why simply adding T3 may provide temporary relief but can worsen long-term issues. Key insights include: Why the majority of T3 is produced outside the thyroid gland How dysbiosis, leaky gut, and inflammation reduce conversion The risks of overmedicating with T3 (immune suppression, anxiety, palpitations, and more thyroiditis) Practical strategies to restore healthy T4-to-T3 conversion through gut and lifestyle support If you've been chasing “optimal labs” with more medication but still feel unwell, this episode will give you a new perspective, and tools you can start using right away.

Ready to take a deep dive and learn how to generate personal tax-free cash flow from your corporation? Enroll in our FREE masterclass here and book a call hereShould you really set up a holding company for tax savings—or could it actually cost you more in the long run?Many Canadians hear that incorporating is the golden ticket to tax efficiency and wealth building. But the truth is more nuanced. If you're a T4 employee or just starting your real estate journey, rushing into a corporate structure might create unnecessary fees, added complexity, and even higher taxes. The real challenge is knowing when incorporation makes sense and when it's better to stay personal with your investments. This episode unpacks the myths and realities so you don't fall into an expensive trap.By tuning in, you'll discover:Why transferring personal investments into a holding company can backfire tax-wise.The clear line between when to keep assets personal versus when a corporation truly adds value.How to build a strategy that creates a tax problem worth solving—rather than a structure that solves nothing.Press play now to learn how to spot the right time—and the wrong time—to incorporate on your path to financial freedom.Discover which phase of wealth creation you are in. Take our quick assessment and you'll receive a custom wealth-building pathway that matches your phase and learn our CRA compliant tax optimized strategies. Take that assessment here.Canadian Wealth Secrets Show Notes Page:Consider reaching out to Kyle…taking a salary with a goal of stuffing RRSPs;…investing inside your corporation without a passive income tax minimization strategy;…letting a large sum of liquid assets sit in low interest earning savings accounts;…investing corporate dollars into GICs, dividend stocks/funds, or other investments attracting corporate passive income taxes at greater than 50%; or,…wondering whether your current corporate wealth management strategy is optimal for your specific situation.Building long-term wealth in Canada requires more than just saving—it's about investment optimization, tax-efficient investing, and making the right choices between personal vs corporate tax planning. Whether you're exploring holding companies, corporate structures, or real estate investing in Canada, a smart Canadian wealth plan aligns your financial vision setting with proven wealth building strategies. From RRSP optimization and navigating salary vs dividends in Canada to using retirement planning tools for an early retirement strategy, the key is balancing financial buckets for growth, proReady to connect? Text us your comment including your phone number for a response!Canadian Wealth Secrets is an informative podcast that digs into the intricacies of building a robust portfolio, maximizing dividend returns, the nuances of real estate investment, and the complexities of business finance, while offering expert advice on wealth management, navigating capital gains tax, and understanding the role of financial institutions in personal finance.

In this Thyroid Answers Shorts episode, Dr. Eric Balcavage explores the critical role your mitochondria—the true powerhouses of your cells—play in thyroid health and recovery. Too often, thyroid care focuses solely on optimizing lab values like TSH, Free T4, or Free T3. But true recovery isn't about chasing numbers. It's about understanding what happens inside your cells. Dr. Balcavage explains how cellular stress impacts mitochondrial function, how this stress disrupts thyroid hormone conversion, and why patients can still feel hypothyroid even when their labs look “normal.” In this episode, you'll learn: Why mitochondria are the missing link in thyroid recovery. How cellular stress shifts thyroid physiology away from homeostasis. Why simply adding more T4 or T3 may provide temporary relief but rarely leads to lasting recovery. Practical ways to support mitochondrial health and improve thyroid function. Whether you're on thyroid medication, exploring functional medicine, or still searching for answers, this episode will help you understand why addressing mitochondrial health is essential for lasting thyroid recovery.

What happens when too much T4 builds up in the body—and could it actually raise your risk of cancer? I'm digging into the latest studies that suggest a connection between high free T4 levels and cancer progression, and breaking down what this really means for anyone on thyroid medication. You'll hear why the issue isn't the pill itself, but the dosing, the conversion to T3, and how reverse T3 plays a hidden role in slowing down your entire system. I'll explain how T4 can mimic estrogen in certain cancers, why reverse T3 puts your body into “hibernation mode,” and the essential nutrients that can protect your thyroid and keep conversion running smoothly. If you've ever wondered whether your thyroid meds could be hurting you instead of helping—or if you want clarity on how to lower risk and finally feel better—this conversation will give you the answers you've been searching for. Shop ALL of Dr. Amie's Fixxr® Supplements: ⁠⁠betterlifedoctor.com⁠⁠ LET'S GET YOUR LIFE BACK...Connect with Dr. Amie Hornaman Book a free application call:⁠ ⁠https://dramiehornaman.com/pages/book-a-call⁠⁠ FREE DOWNLOADS… ⁠⁠What Are the Optimal Lab Ranges? What Steps Can I Take?⁠⁠ Don't know where to start...don't know which labs are useful? And what to do when you get your results? ⁠⁠“How To” Guide For Supplements⁠⁠ Here's your Fixxr® supplement timeline and guide. ⁠⁠Fix Your Thyroid and Adrenals To Fix Your Life⁠⁠ Check your symptoms of hypothyroidism and know OPTIMAL thyroid lab values. Learn why you are being told you're “NORMAL” by your doctor. ⁠⁠Can Supplements Help with Hypothyroidism?⁠⁠ Grab this thorough guide to help you select the most advantageous supplements that will best suit your health circumstances. RATE, REVIEW AND FOLLOW ON APPLE PODCASTS Show your love for Amie and The Thyroid Fixer Podcast! If you're enjoying our journey together, I'd be thrilled if you could take a moment to rate and review the show on Apple Podcasts. Your support helps me reach and help more people just like you, guiding them towards their optimal selves! Just click⁠ ⁠HERE⁠⁠, scroll all the way down, give us those 5 stars, and share what you enjoy about my episodes in a review. Haven't subscribed yet? Make sure to follow The Thyroid Fixer Podcast to catch all the new episodes that come out every week. Follow⁠ ⁠HERE⁠⁠ and never miss out on a moment of the journey! CONNECT WITH ME ON SOCIAL MEDIA: Join my exclusive Facebook Group, Dr. Amie…The Thyroid Fixer®...Love Your Mirror, for a Community of HOPE and Support in your thyroid journey. ⁠⁠https://www.facebook.com/groups/dramie/⁠⁠ Like me on Facebook:⁠ ⁠Amie Hornaman Nutrition and Functional Medicine⁠⁠ Subscribe on Youtube:⁠ ⁠Dr. Amie Hornaman⁠⁠ Follow me on Instagram:⁠ ⁠@dramiehornaman

Cortisol Episode: https://youtu.be/3b1hmZQsSEkInflammation Episode: https://youtu.be/WHQVnXcqHiEDetox Episode: https://youtu.be/b7Vt3Anj_WkLiver Episode: https://youtu.be/TX55v-lOZyYUndereating Episode (Reverse Dieting): https://youtu.be/PCOhgg-PXSU‣ Book Your COMPLEMENTARY CONSULATION and CALORIE CALCULATION call:- how much & what to eat, exercise & lifestyle recommendations, and specific resources to support you on your journey

Today, we have the first episode of a series of AMAs with McCall McPherson. McCall McPherson is the visionary behind Modern Thyroid Clinic, a thyroid-centered functional medicine practice in Austin, Texas. McCall is a physician assistant and thyroid expert. She is a recent TEDx speaker, a frequent guest on podcasts and summits, and the owner, host, and Chief Thyroid Hope Giver of the Thyroid Nations podcast.  Today, McCall joins me to dive into a range of listener questions, covering whether intermittent fasting damages the thyroid, the role of GLP-1s, constipation, split-dosing medication, adrenal health, ADHD, phentermine versus Glucophage versus GLP-1s, and how HRT affects thyroid medication. We also explore the impact of lipids on thyroid health and the role of nutrition, and we share our opinions on the Dutch test.  This invaluable AMA was made even more special by the flood of questions submitted by listeners. IN THIS EPISODE, YOU WILL LEARN: The benefits of adopting a nuanced approach to intermittent fasting  How Graves' disease and Hashimoto's differ in terms of fasting Why fasting is not advisable when taking GLP-1s Do thyroid medications cause constipation? Strategies for overcoming constipation and improving gut health McCall shares her rationale for splitting thyroid medication doses Will progesterone increase free T4 levels? The importance of rechecking thyroid labs after starting or adjusting HRT Foods to avoid and include in your diet for thyroid health Is the Dutch test worth using? Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Connect with McCall McPherson Modern Thyroid Clinic  Modern Weight Loss On Instagram and TikTok Modern Thyroid and Wellness Podcast

Dr. Kathleen Horst, Dr. Rachel Jimenez, and Dr. Yara Abdou discuss the updated guideline from ASTRO, ASCO, and SSO on postmastectomy radiation therapy. They share new and updated recommendations on topics including PMRT after upfront surgery, PMRT after neoadjuvant systemic therapy, dose and fractionation schedules, and delivery techniques. They comment on the importance of a multidisciplinary approach and providing personalized care based on individual patient characteristics. Finally, they review ongoing research that may impact these evidence-based guidelines in the future. Read the full guideline, “Postmastectomy Radiation Therapy: An ASTRO-ASCO-SSO Clinical Practice Guideline” at www.asco.org/breast-cancer-guidelines" TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/breast-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-25-01747  Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I am interviewing Dr. Kathleen Horst, expert panel chair from Stanford University; Dr. Rachel Jimenez, expert panel vice chair from Massachusetts General Hospital; and Dr. Yara Abdou, ASCO representative from the University of North Carolina, authors on "Postmastectomy Radiation Therapy: An American Society for Radiation Oncology, American Society of Clinical Oncology, and Society of Surgical Oncology Clinical Practice Guideline." Thank you for being here today, Dr. Horst, Dr. Jimenez, and Dr. Abdou. Dr. Kathleen Horst: Thank you for having us. Brittany Harvey: And then just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Horst, Dr. Jimenez, and Dr. Abdou who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. Then to dive into the content that we are here today to talk about, Dr. Horst, could you start us off by describing what prompted the update for this joint guideline between ASTRO, ASCO, and SSO, and what is the scope of this 2025 guideline on postmastectomy radiation therapy? Dr. Kathleen Horst: Thank you. This joint guideline was last updated in 2016. Over the past decade, the treatment of breast cancer has evolved substantially. Newer systemic therapy regimens have increasingly personalized treatment based on tumor biology, and local therapy management has explored both the de-escalation of axillary surgery and more abbreviated courses of radiation therapy. Given these advances, it was important to revisit the role of postmastectomy radiotherapy in this modern era of breast cancer therapy. This updated guideline addresses four key questions, including postmastectomy radiation therapy after upfront surgery as well as after neoadjuvant systemic therapy. It also reviews the evolving role of various dose and fractionation schedules and optimal treatment techniques and dose constraints. Brittany Harvey: Excellent. I appreciate that background, Dr. Horst. So then, next, Dr. Jimenez, I would like to review the recommendations of this guideline across those four key questions that Dr. Horst just mentioned. So first, what does the panel recommend for PMRT for patients who received initial treatment with mastectomy? Dr. Rachel Jimenez: The panel provided pretty strong consensus that patients with positive lymph nodes or patients with large tumors involving the skin or the chest wall should receive postmastectomy radiation. However, the panel also recognized that the omission of postmastectomy radiation may be appropriate for select patients who have positive lymph nodes and have an axillary lymph node dissection if they have a low nodal burden and other favorable clinical or pathologic features. For patients without lymph node involvement at the time of surgery and no involvement of the skin or chest wall, postmastectomy radiation was not advised by the panel. Brittany Harvey: Understood. It is helpful to understand those recommendations for that patient population. Following that, Dr. Abdou, what are the key recommendations for PMRT for patients who received neoadjuvant systemic therapy before mastectomy? Dr. Yara Abdou: When we think about PMRT after neoadjuvant treatment, the key point is that the initial stage of presentation still matters a lot. So for example, if a patient comes in with more advanced disease, say a large primary tumor, like a clinical T4, or more extensive nodal disease, like an N2 or N3 disease, those patients should get PMRT, no matter how well they respond to neoadjuvant therapy, because we know it reduces the risk of recurrence and that has been shown pretty consistently. On the other hand, if there are still positive lymph nodes after neoadjuvant treatment, basically residual nodal disease, PMRT is also strongly recommended because the risk of local-regional recurrence is much higher in that setting. The gray area is the group of patients who start with a lower burden of nodal disease, such as N1 disease, but then become node negative at surgery. For those patients, we tend to individualize the decision. So if the patient is young or has triple-negative disease, or if there is a lot of residual disease in the breast even though the nodes are cleared, then radiation is probably helpful. But if everything has melted away with pCR in both the breast and the nodes, then it may be safe to omit PMRT in those patients. For patients with smaller tumors and no nodal involvement to begin with, like a clinical T1-T2 N0, if they are still node negative after neoadjuvant treatment, then PMRT is generally not recommended because their baseline recurrence risk is low. And finally, if the margins are positive and cannot be re-excised, then PMRT is recommended after neoadjuvant therapy. Brittany Harvey: Yes, those distinctions are important for appropriate patient selection. So then, Dr. Horst, we have just reviewed the indications for PMRT, but for those patients who receive PMRT, what are the appropriate treatment volumes and dose fractionation regimens? Dr. Kathleen Horst: The guideline addresses coverage of the chest wall and regional nodes with a specific discussion of the data regarding internal mammary nodal irradiation, which has been an area of controversy over many years. The guideline also reviews the data exploring moderate hypofractionation, or shorter courses of radiation therapy. The task force recommends utilizing moderate hypofractionation for the majority of women requiring postmastectomy radiation, which is likely to have a large impact on clinical practice. This recommendation is based on the evolving data demonstrating that a 3-week course of radiotherapy after mastectomy provides similar oncologic outcomes and minimal toxicity for most patients compared to the standard 5-week treatment course. Brittany Harvey: Thank you for reviewing that set of recommendations as well. So then, Dr. Jimenez, to wrap us up on the key questions here, what delivery techniques are recommended for treating patients who receive PMRT? Dr. Rachel Jimenez: So this portion of the guideline is likely to be most helpful for radiation oncologists because it represents the most technical part of the guideline, but we do believe that it offers some important guidance that has, to this point, been lacking in the postmastectomy radiation setting. So first, the panel recommends that all patients should undergo 3-dimensional radiation planning using CAT scan based imaging, and this includes contouring. So contouring refers to the explicit identification, using a drawing interface on the CAT scan imaging, by the radiation oncologist to identify the areas that are targeted to receive radiation, as well as all of the nearby normal tissues that could receive unintended radiation exposure. And we also provide radiation oncologists in the guideline with suggestions about how much dose each target tissue should receive and what the dose limits should be for normal tissues. Additionally, we make some recommendations regarding the manner in which radiation is delivered. So for example, we advise that when conventional radiation methods are not sufficient for covering the areas of the body that are still at risk for cancer, or where too high of a dose of radiation would be anticipated to a normal part of the body, that providers employ a technique called intensity modulated radiation therapy, or IMRT. And if IMRT is going to be used, we also advise regular 3-dimensional imaging assessments of the patient's body relative to the treatment machine to ensure treatment fidelity. When the treatments are delivered, we further advise using a deep inspiration breath-hold technique, which lowers the exposure to the heart and to the lungs when there is concern for cardiopulmonary radiation exposure, and again, that image guidance be used along with real-time monitoring of the patient's anatomy when those techniques are employed. And then finally, we advise that patients receiving postmastectomy radiation utilize a bolus, or a synthetic substance placed on the patient's skin to enhance radiation dose to the superficial tissue, only when there is involvement of the skin with cancer or other high-risk features of the cancer, but not for every patient who receives postmastectomy radiation. Brittany Harvey: Understood. And then, yes, you just mentioned that section of the guideline is probably most helpful for radiation oncologists, but I think you can all comment on this next question. What should all clinicians, including radiation oncologists, surgical oncologists, medical oncologists, and other oncologic professionals, know as they implement all of these updated recommendations? Dr. Rachel Jimenez: So I think one of the things that is most important when we consider postmastectomy radiation and making recommendations is that this is a multidisciplinary panel and that we would expect and encourage our colleagues, as they interpret the guidelines, to employ a multidisciplinary approach when they are discussing each individual patient with their surgical and medical oncology colleagues, that there is no one size fits all. So these guidelines are intended to provide some general guidance around the most appropriate techniques and approaches and recommendations for the utilization of postmastectomy radiation, but that we recognize that all of these recommendations should be individualized for patients and also represent somewhat of a moving target as additional studies, both in the surgical and radiation oncology realm as well as in the systemic therapy realm, enter our milieu, we have to adjust those recommendations accordingly. Dr. Kathleen Horst: Yeah, I would agree, and I wanted to comment as a radiation oncologist, we recognize that local-regional considerations are intertwined with systemic therapy considerations. So as the data evolve, it is critical to have these ongoing updates in a cross-disciplinary manner to ensure optimal care for our patients. And as Dr. Jimenez mentioned, these multidisciplinary discussions are critical for all of us to continue to learn and understand the evolving recommendations across disciplines but also to individualize them according to individual patients. Dr. Yara Abdou: I could not agree more. I think from a medical oncology perspective, systemic therapy has gotten much better with adjuvant CDK4/6 inhibitors, T-DM1, capecitabine, and immune therapy. So these are all newer adjuvant therapies, so the baseline recurrence risks are lower than what they were in the trials that established PMRT. So the absolute benefit of radiation varies more now, so smaller for favorable biology but still relevant in aggressive subtypes or with residual disease. So it is definitely not a one-size-fits-all. Brittany Harvey: Yes, I think it is important that you have all highlighted that multidisciplinary approach and having individualized, patient-centric care. So then, expanding on that just a little bit, Dr. Abdou, how will these guideline recommendations affect patients with breast cancer? Dr. Yara Abdou: So basically, reiterating what we just talked about, these guidelines really move us towards personalized care. So for patients at higher risk, so those with larger tumors, multiple positive nodes, or residual nodal disease after neoadjuvant therapy, PMRT remains essential, consistently lowering local-regional recurrence and improving survival. But for patients at intermediate or lower risk, the recommendations support a more selective approach. So instead of a blanket rule, we now integrate tumor biology, response to systemic therapy, and individual patient factors to decide when PMRT adds meaningful benefit. So the impact for patients is really important because those at high risk continue to get the survival advantage of radiation while others can be spared the unnecessary treatment and side effects. So in short, we are aligning PMRT with modern systemic therapy and biology, making sure each patient receives the right treatment for their situation. Brittany Harvey: Absolutely. Individualizing treatment to every patient will make sure that everyone can achieve the best outcomes as possible. So then, Dr. Jimenez, to wrap us up, I believe Dr. Horst mentioned earlier that data continues to evolve in this field. So in your opinion, what are the outstanding questions regarding the use of PMRT and what are you looking to for the future of research in this space? Dr. Rachel Jimenez: So there are a number of randomized phase III clinical trials that are either in active accrual or that have reported but not yet published that are exploring further de-escalation of postmastectomy radiation and of axillary surgery. And so we do not yet have sufficient data to understand how those two pieces of information integrate with each other. So for example, if you have a patient who has a positive lymph node at the time of diagnosis and forgoes axillary surgery aside from a sentinel lymph node biopsy, we do not yet know that we can also safely forgo radiation entirely in that setting. So we expect that future studies are going to address these questions and understand when it is appropriate to simultaneously de-escalate surgery and radiation. Additionally, there is a number of trials that are looking at ways in which radiation could be omitted or shortened. So there is the RT CHARM trial, which has reported but not yet published, looking at a shorter course of radiation. And so we do make recommendations around that shorter course of radiation in this guideline, but we anticipate that the additional data from the RT CHARM study will provide further evidence in support of that. Additionally, there is a study called the TAILOR RT trial, which looks at forgoing postmastectomy radiation in patients who, to Dr. Abdou's point, have a favorable tumor biology and a low 21-gene recurrence score. And so we are going to anticipate the results from that study to help guide who can selectively forgo postmastectomy radiation when they fall into that favorable risk category. So there are a number of questions that I think will help flesh out this guideline. And as they publish, we will likely publish a focused update on that information to help provide context for our colleagues in the field and clarify some of these recommendations to suit the latest data. Brittany Harvey: Absolutely. We will look forward to those de-escalation trials and ongoing research in the field to build on the evidence and look for future updates to this guideline. So I want to thank you for your work to update these guidelines, and thank you for your time today, Dr. Horst, Dr. Jimenez, and Dr. Abdou. Dr. Rachel Jimenez: Thank you. Dr. Yara Abdou: Thank you. Dr. Kathleen Horst: Thank you. Brittany Harvey: And then finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/breast-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Un debate bilateral entre China y Estados Unidos tiene lugar en Madrid, con la asistencia de dos ministros del Gobierno español. Se acuerda que TikTok, con 1.800 millones de usuarios, pase a ser propiedad de una empresa estadounidense, con una llamada telefónica entre Trump y el líder chino prevista para el viernes. Se comenta que EE.UU. no quiere que China use España como "patio trasero". Pedro Sánchez anuncia nuevas ayudas de alquiler con opción a compra para jóvenes, un seguro de impago de rentas y subvenciones para la compra de vivienda en el medio rural. Sin embargo, los expertos señalan que las condiciones solo son aplicables a menos del 4% de los alquileres actuales. Se critica que el problema de la vivienda es de oferta y ninguna de las 158.000 viviendas públicas anunciadas se ha construido. Se revoca 8.000 pisos turísticos en Málaga, señalándolos como "enemigo". Se vive una jornada de caos en el aeropuerto de Barajas con colas en la T4 debido a una huelga indefinida del ...

Pilar Cisneros actualiza la situación que se vive en Barajas en este tercer día de huelga de vigilantes en los controles de seguridad. "Se roza casi la normalidad. No hay prácticamente cola ante estos controles que dan acceso a la zona de seguridad donde me encuentro", relata en 'Herrera en COPE'.Así, da más detalles, explicando que hay "bastante gente, pero va muy ligera esta cola. Ahora, aproximadamente, en 20 minutos se pasa el control de seguridad. Los viajeros no se fían". Es el caso de Lucía y Rosa. Dos jóvenes que han acudido con tres horas de antelación. Van a Dublín y no quieren perder el vuelo, "sino sí que empieza la aventura de verdad", cuenta una de ellas a Pilar Cisneros.Según los datos facilitados desde Aena, las colas están fluyendo mejor hoy que en días anteriores y el punto con más tiempo de espera es el control de la T4, con "alrededor de 20 minutos". La situación está mejor en el resto de las terminales, añaden.Los tiempos de espera llegaron ...

El debate en torno a la cancelación de la última etapa de la Vuelta a España en Madrid domina la mañana, tras las protestas propalestinas que dejaron 22 policías heridos y 2 detenidos. Javier Guillén, director de la Vuelta, lamenta los incidentes atribuidos a manifestantes radicales, que impidieron al ganador disfrutar del podio. Se destaca la injusticia de las protestas, dado que el equipo israelí participa por invitación obligatoria de la UCI, y la organización de la Vuelta no pudo desinvitarlo. La imagen de España se ve afectada internacionalmente, con condenas en medios internacionales y perplejidad en la prensa francesa. La dirección de la Vuelta subraya que solo buscaban competir. Mientras, Pedro Sánchez se reúne con la dirección de su grupo parlamentario tras animar a los manifestantes, generando críticas. En el aeropuerto de Barajas, una huelga indefinida del personal de seguridad provoca largas colas y retrasos, aunque la situación se normaliza en la T4 con esperas mínimas. ...

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Anonymous: Hi Dr. Cabral, My OATs test came back with normal markers for bacteria and fungus. I was on an extremely low carb diet when I took the test and was wondering if that could cause a false negative. I have taken herbal Antimicrobials and garlic in the past which sometimes eliminates the bloating and brain fog and does so within a few days but only at double doses and only working temporarily. I have a few mild chronic fungal infections, IBS, cognitive symptoms, and MCAS. Do you think the issue is more likely related to an overgrowth or intestinal permeability caused by MCAS? How should I begin treatment since I am sensitive to many supplements? My food sensitivity test unfortunately showed a false negative to all foods.                                                                                                                                                                Zonia: Hello Dr. Cabral, Thank you for all your insightful information! My husband has lipoma's all over his body ranging from dime size to 1/2 tennis ball. His mom has them too, but very few. He started getting them removed by the dozen and I understand they can regrow. How can we help prevent the regrowth? Also, we have twins (B/G)and are there any labs that can determine if either have the genes or how to minimize the chances they will have any? Thank you in advance!      Chris: Hi Dr Cabral, regarding magnesium intake and supplemental H2: The tablets we have include 80 mg of magnesium for 8ppm H2. If you were going to rely on H2 tablets for your exclusive molecular hydrogen source, how many tablets would you take per day to maximize H2 benefits while maintaining advisable magnesium levels and not too much? Assuming 2 scoops of DNS at breakfast (50mg magnesium) + 2 Full Spectrum Magnesium caps at dinner (250mg). I've been varying from 1-3 H2 tablets/daily throughout the week. I stopped taking a scoop of your very delicious & effective Calming Magnesium before bed (300mg) in order to prioritize the benefits of Molecular Hydrogen, however, would love to add this back in if its not too much Magnesium with everything else. Thank you always.           Anonymous: Hi! I have a couple questions. Might have to submit two for the length. First is about thyroid. My thyroid labs are showing normal TSH .56, low free T4 1.33, low total T3 114, high reverse T3 17.20 & TPO high at 25. Does this indicate Hashimoto hypothyroidism? Is this fixable or will I be on supplements or meds for ever? Is TPO specific to the thyroid or is this indicative of autoimmune issues in general? Im curious what even causes these issues to begin with Thank you so much!                                                                                                                                                                    Anonymous: Hi again, 2nd question. I have a hard time gaining muscle & showing tone. I'm a petite person, and have never really shown muscle tone even in high school despite being in sports.After my third baby I lost muscle. I can tell by my body composition changes.I weigh less but look and feel like it's no muscle & more fat. A PT once was shocked at my glute weakness comparing it to the elder. If I ever take a break in exercising, for about two weeks or more I feel much weaker than before I even started, seems like my strength is decreasing rapidly if I get sedentary for even 2 weeks. Could this have an underlying cause or is this just how some of us are? Should I accept the fact that maybe I won't ever build or show much muscle tone? For reference, 33 y/o female, possible hashimotos and lipedema.       Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3488 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

The FDA's Ban on NDT Medications: What You Need to Know Now The FDA has announced a ban will go in effect in one year on Natural Desiccated Thyroid (NDT) medications, including Armour, NP, and compounded thyroid meds. This isn't just about NDT, it could be the first move toward restricting all bioidentical hormone options. In this episode, I break down the FDA letter line-by-line, follow the money trail, and explain why NDT has been the gold standard for decades. I share what's at stake if this ban goes through, why T4-only medications fail most patients, and the critical differences between bioidentical and synthetic options. You'll hear clinical insights from my practice, where thousands have thrived on the right thyroid med combination, and you'll get clear steps for taking action, emailing the FDA, signing petitions, and protecting your right to choose the treatments that work for you. This is your health freedom alert. The decisions made now will affect your weight, energy, hormones, and quality of life for years to come. Sign this Petition: https://chng.it/RwB8mF72tY Subscribe to my Newsletter: https://health.dramie.com/newsletter Contact the FDA: Email: druginfo@fda.hhs.gov - The Division of Drug Information in the Center for Drug Evaluation and Research, specifically for questions about drugs.

What if the architects of Nazi atrocities weren't just politicians or soldiers, but psychiatrists who twisted science into a deadly ideology? In this insightful episode of The Jeremy Ryan Slate Show, we take a critical examination of how leading psychiatrists shaped the eugenics movement, enabling the horrors of the Holocaust and forever staining the field of medicine. With research grounded in the book *Psychiatrists: The Men Behind Hitler* by Thomas Röder, Volker Kubillus, and Anthony Burwell, we explore the troubling ties between psychiatry, Nazi policies, and the lingering influence on modern society.From Germany's rise as a scientific powerhouse to the brutal T4 program and its leaders, this deep dive uncovers how respected professionals became the architects of genocide. Was this driven by ideology, opportunism, or something more sinister? And how do these historical events resonate with modern ethical debates in science and medicine? Through this unique perspective, we unravel chilling details, from the origins of eugenics to postwar cover-ups and the shocking reintegration of Nazi-affiliated psychiatrists into society.Join the conversation—comment with your thoughts on whether these atrocities were a result of unchecked authority or an intentional agenda. Don't forget to like, subscribe, and hit the notification bell for more must-watch deep dives into hidden history. Follow me, Jeremy Ryan Slate, CEO and co-founder of Command Your Brand, on X @JeremyRyanSlate for updates and discussions. Together, let's keep questioning, keep digging, and stay vigilant. See you in the next episode!#physicianliability #history #medicine #ethicalinquiry #passiveeuthanasia___________________________________________________________________________⇩ SUPPORT OUR SPONSORS ⇩BRAVE TV HEALTH: Parasites are one of the main reasons that so many of our health problems happen! Guess what? They're more active around the full moon. That's why friend of the Show, Dr. Jason Dean, developed the Full Moon Parasite Protocol. Get 15% off now by using our link: https://bravetv.store/JRSCOMMAND YOUR BRAND: Legacy Media is dying, we fight for the free speech of our clients by placing them on top-rated podcasts as guests. We also have the go-to podcast production team. We are your premier podcast agency. Book a call with our team https://www.commandyourbrand.com/book-a-call MY PILLOW: By FAR one of my favorite products I own for the best night's sleep in the world, unless my four year old jumps on my, the My Pillow. Get up to 66% off select products, including the My Pillow Classic or the new My Pillow 2.0, go to https://www.mypillow.com/cyol or use PROMO CODE: CYOL________________________________________________________________⇩ GET MY BEST SELLING BOOK ⇩Unremarkable to Extraordinary: Ignite Your Passion to Go From Passive Observer to Creator of Your Own Lifehttps://getextraordinarybook.com/________________________________________________________________DOWNLOAD AUDIO PODCAST & GIVE A 5 STAR RATING!:APPLE: https://podcasts.apple.com/us/podcast/the-create-your-own-life-show/id1059619918SPOTIFY: https://open.spotify.com/show/5UFFtmJqBUJHTU6iFch3QU(also available Google Podcasts & wherever else podcasts are streamed_________________________________________________________________⇩ SOCIAL MEDIA ⇩➤ X: https://twitter.com/jeremyryanslate➤ INSTAGRAM https://www.instagram.com/jeremyryanslate➤ FACEBOOK: https://www.facebook.com/jeremyryanslate_________________________________________________________________➤ CONTACT: JEREMY@COMMANDYOURBRAND.COM