Can Ozempic and Mounjaro Fix Thyroid Issues? The Anti-Inflammatory Power of GLP-1 Agonists! | McCall McPherson

McCall McPhereson: [00:00:00] These medications originally were meant to treat diabetes two decades ago. Just over time, they noticed, wow, we are really seeing these people lose a lot of weight. 20 years later, they are now being marketed specifically for weight loss. Ozempic, 

Dr. Brighten: Wigovi, Monjoro, what they are and what they do in the body.

Narrator: McCall McPherson. isn't just a thyroid expert. She's a force of change in thyroid health. Founder of the Modern Thyroid Clinic and the powerhouse behind the advocacy platform Thyroid Nation. McCall turned her own battle with hypothyroidism into a mission to transform the way thyroid conditions are treated.

As a TEDx speaker and Anchor 5000 honoree, she's dedicated to one thing. Helping the millions still struggling with symptoms finally get their lives back. 

Dr. Brighten: What have you found in the research and in your clinical experience that These medications are doing outside of just the weight loss conversation.

McCall McPhereson: This is the most fascinating thing that I've encountered in medicine, maybe ever, but. 

Dr. Brighten: Welcome [00:01:00] back to the Dr. Brighton show. I'm your host, Dr. Jolene Brighton. I'm board certified in naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist. As always, I'm bringing you the latest, most up to date information to help you take charge of your health and take back your hormones.

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Don't forget to subscribe, leave a comment, or share this with a friend because it helps this podcast get out to everyone who needs it. All right, let's dive in. McCall McPherson. 

McCall McPhereson: Welcome to the Dr. Brayton show. Thank you so much for having me. I can't even tell you how excited I am to be here. Thanks for the invite.

Dr. Brighten: Yeah, I'm really excited. It's actually been a while since you and I have talked in person. We know each other in real life and this is, I'm just delighted. We're going to have an opportunity to talk about thyroid health, about weight loss, and about these new drugs that everybody is chatting about. GLP 

McCall McPhereson: ones.

I'm so excited to. Dig in and kind of change the narrative and shift the perspective, or at least offer an alternative perspective to what most people just hear in general media and everyday articles. Yeah, the 

Dr. Brighten: media has been doing a lot of scare tactics versus like, this is our savior. It's been so [00:03:00] interesting to see how one media outlet will be like, this is the best thing to ever happen to humans ever.

And then the next week they're publishing something of like, Oh, you're all being, you know, crazy on this, like Ozempic craze and you're killing yourself. And so I really want to help sort through that today. But as we're getting into it, Ozempic. We hear a lot about them in the media, and I think we should just start by breaking down what they are and what they do in the body.

McCall McPhereson: Yeah, so, you know, we inherently endogenously actually have GLP, GLP receptors. It's something that is normal for our physiology. Um, And a lot of times what I think people don't understand is people become resistant to these peptides in their own physiology and it's what drives a lot of metabolic disease.

So these medications originally were meant to treat diabetes many, two decades ago. [00:04:00] Almost. And side note, just over time, they noticed, wow, we are really seeing these people lose a lot of weight. What's going on? And 20 years later, they are now being marketed specifically for weight loss and diabetics, but also just overweight, obese people.

They activate our own endogenous GLP receptors, which, you know, shift quite a few things in our physiology. They reduce our hunger. They slow down our digestive tract a little bit. They make us feel a little bit more full, longer. They curb cravings. They allow our insulin to kind of slowly become resensitized.

And those are like the normal everyday things that people know about, about these medications. We're just missing so much more of the conversation. These meds are about so much more than like, well, we're just eating less. That is not the mechanism of action of these meds, and it's important to open up that dialogue for people.

Absolutely. 

Dr. Brighten: And as you said, these are not [00:05:00] new drugs. They're being marketed in a different way. They're not new. People often will criticize online and say, well, you know, these drugs, we don't have enough research. They haven't been around long enough. And that's actually not true. If you dig into the research, we've got decades worth.

And that doesn't mean Also lends itself to our understanding around safety, and we're going to get into all of that. But the primary reason people are using these medications that we see talked about so often is weight loss. And I want to talk about what should be evaluated or recommended first if somebody comes to your clinic and they say, I want to lose weight.

Put me on, you know, ozempic. Let's go. What would you recommend that they first take a look at and really unpack before jumping to this medication? 

McCall McPhereson: Yeah. You know, my patient population is a little bit unique, so I'd probably have to extrapolate their experience more in the broad general sense because [00:06:00] I really feel like these medications are best suited for people who have already gotten their habits in order.

They already eat well, balanced. We should not be having to eat perfectly to maintain our weight or to try and lose weight. That's a sign of metabolic dysfunction, but people that eat a balanced, healthy diet, high protein, low inflammatory people that already exercise. So my best use case for these meds are people that actually cannot lose weight with effort or appropriate amounts of effort.

So that is sort of where I see them functioning Best. Um, I think a lot of the people that potentially don't use them correctly over are over medicated. Are trying to diminish their appetite to the point of they're not even eating enough nutrients, calories, macronutrients, micronutrients. They're losing massive muscle.

Those are the people that are set up for failure. If they stop these drugs, they're going to gain weight back. If they want to preserve their muscle mass, they're not [00:07:00] going to. So it has to be a both and situation. It's a lifestyle as well as these meds. And these meds should be used. to make your lifestyle efforts worthwhile and actually pay off.

Dr. Brighten: And are there things that are being missed? So there's a lot of med spas out there that are being criticized because they hand out these medications just for weight loss. And I know as a doctor, it always gives me pause of like what conditions could we potentially be missing? So what would you raise?

Like if somebody is like, Uh, like, you know, they're criticizing this. What are some of the boxes that we should check off that we're not missing certain medical conditions? 

McCall McPhereson: Yeah, I mean, I think there's some that are black and white, like with a history of medullary thyroid carcinoma, which I know we'll get into more in depth later about the truth.

I read cancer risk, but someone with a history of that, a family history of that multiple endocrine [00:08:00] neoplasia. family history or personal history. I feel like those people need to be excluded outright. I also think people with a history of pancreatitis should be excluded, like non negotiable. Um, medicine doesn't have it set up that way.

I think it's, you know, within the last six months, I believe if it's over six months, they can have it. But to me that feels risky. If it were myself, I wouldn't do it. Um, and then people who, um, You know, have active, pretty, intense, disordered eating. And I do, that's a delicate topic. I do want to talk about that and unpack it a little bit.

Because I honestly think these meds very well might be the future of treating disordered eating in a lot of specific cases. Um, but those are the big ones. Like really, these meds, There's a lot of data on them. There's not a lot of contraindications to them. There's not a lot, I mean, despite media, you know, screaming at the top of their lungs, there's so many side effects.

Really, when we compare the list to most every other medication, like [00:09:00] Tylenol included, these meds are really well tolerated with very little long term downsides and a lot of long term benefits. 

Dr. Brighten: Yeah. Okay. So I want to talk about that. You brought up the eating disorder aspect. What should we know about people with eating disorders and using GLP 1 agonists?

McCall McPhereson: Yeah. So this is very much evolving in real time. And this is not what I expected when I started our program two years ago, but my patients at Modern Thyroid Clinic is who I created this program for initially are women who Put a lot of effort into their lifestyle. They exercise. They cannot lose weight.

So what ends up happening is we begin to restrict more and more and more. And we create these negative food patterns in our brain that are constantly, you know, reactivated and become stronger and stronger. Food is bad. I'm a failure. Food makes me gain weight. It doesn't matter what I do. I can't lose weight unless I don't eat, you know, and that evolves over years, decades, especially in the thyroid [00:10:00] community because there is a loss of control.

These women can no longer influence this part of their health. And we begin to look at food as bad. Well, what I've noticed as one of the most profound You know, outcomes of my analysis of my patients is these people, these people's disordered eating is healing. So instead of reaffirming that negative cycle about food, what they're doing is they're eating a balanced diet.

They're putting effort into their health, their metabolism, their weight, and now it's paying off. They're eating and they're not immediately getting bombed with inflammation. And so slowly that cycle of looking at food as bad and feeling like a failure because you're eating what you should be, they begin to get healed from that disorder and pattern.

And it really has been one of the most sacred things I've ever seen in medicine because it is in a huge percentage of these women and [00:11:00] it's fascinating. 

Dr. Brighten: I think it would be really wise for us to say what we're talking about is disordered eating. If you're looking at somebody with an eating disorder like anorexia, that's a different conversation.

And that's not necessarily, I mean, certainly if somebody is already under fueling their body, we don't want to put them on a medication that may make them restrict further. A hundred percent agree. Now. You know, we hear so much about how like GLP ones help reduce food noise. They help with weight loss, but there's also this fear that you'll also lose muscle.

How do people prevent that? 

McCall McPhereson: Yeah, I mean, Honestly, I don't want to oversimplify it, but kind of the same way that you prevent it in regular life too, right? If you are eating 800 calories a day and you are not working out, guess what happens? [00:12:00] You're losing muscle. It doesn't matter if you're on a GLP 1. Or you're not like you are losing muscle.

So if you want to build muscle, what is the solution? It is eating protein. It is lifting weights. It is fueling your body in order to be able to do that. And it's honestly as simple as that. There is no magic. component in this medication that all of a sudden, if you are weight training and eating protein, your muscle dissolves.

No, like we have patients build muscle all day, every day in our program. And it is incredible to watch, but you have to work for it in the same way you have to in regular life without a GLP 1. 

Dr. Brighten: Mm hmm. 

McCall McPhereson: There 

Dr. Brighten: is a fear. That glp ones are for life and that you can never come off of it without gaining weight What is the reality for the average person in terms of the weight they regain when they stop?

McCall McPhereson: Yeah, so I will tell you in our program and our program is based in a model For short term [00:13:00] use with the exception of people who have a pretty life changing experience from an inflammatory standpoint. But, And what does short term mean? Short term means, so I define that as not forever. Our goal in our program, not forever, is our goal in our program is to reverse metabolic dysfunction.

So we want their insulin sensitive. We want their leptin sensitive. We want their hemoglobin A1C balanced. We want their CRP balanced. We want all these signs to show, Hey, The metabolic dysfunction and the loss of metabolic potency that led you to the point of not being able to influence your weight appropriately, we want proof and data that shows that that's reversed.

And that's when we pull people off of medications. Ideally, also, they've hit their goal weight, right? And sometimes we have to leave people on beyond their goal weight on a micro dose and allow them to get to the point of metabolic sensitivity. So that when they come off of these meds, they can [00:14:00] appropriately eat well, balanced diet, 80 20, I think people should not have to do more than an 80 20, we should not have to live in a 100 percent restrictive, you know, dogmatic lifestyle, and um, can exercise and be able to maintain their weight with appropriate effort.

That is our goal, we, we have a lot of success with that, but we are not med spas. Giving out GLPs to people and being like, we'll figure it out. Good luck. Maybe we'll see on the flip side, you know, no, we are intricately involved with these people's, you know, progress and taking a lot of data, checking in constantly, and that goes a long way.

That's important if you want long term success and outcomes. 

Dr. Brighten: Okay, so we're going to have to talk about how do you achieve that success because we know from the data that roughly about, you know, two thirds of the weight that you've lost, the average person, two thirds of the weight they've lost is going to come back when they stop that GLP 1.

So how are you achieving that [00:15:00] success with your patients? 

McCall McPhereson: Yeah, I mean, I think one. Obviously, our patients have their thyroid perfected, which is the core cause to a lot of these people's weight gain, right? So, if someone has a pervasive thyroid issue and they haven't addressed it appropriately and they lose weight because of a GLP 1, they go off of a GLP 1, they still have the same darn thyroid issue.

They're probably going to gain it back, you know, so that is one thing that uniquely we have um In our, you know repertoire of services We are expanding our program nationwide under modern weight loss as a new brand that launches next month Those people will not have perfect thyroid function, you know, and so i'm curious to see how the data pans out with them But we really use this time to get habits in order to develop good lifestyle, you know, systems, put that in place, really show metabolic sensitivity.

And when you combine those [00:16:00] things with appropriate hormone thyroid care, we absolutely do not show that people gain their weight back after they discontinue. 

Dr. Brighten: Yeah. I would imagine people gain some weight back and that there is like the holidays and things like that. Uh, but what I'm really hearing from you is that it isn't enough to just start a GLP one and go on your way.

If you want to maintain your muscle mass, get your, your metabolic health in order with your body composition, it's going to take habits. It's going to take nutrition and lifestyle. And that is part of the key of how you prevent the weight gain. the weight gain in the future. 

McCall McPhereson: Absolutely. And honestly, it's not uncommon.

It's fascinating for me, but when we have all of those cogwheels in place, it's, I mean, literally I was talking to a patient last week. She went on three week vacation to Europe where obviously she ate more and pasta and delicious things and had wine with lunch. She came back two pounds lighter than she was when she left.[00:17:00] 

And she has long discontinued a GLP one, because again, the goal is, um, Our bodies should be a little resilient to shifts and changes in our lifestyle. I totally agree where some people are always going to gain water weight, especially just from the inflammatory component. So we always tell people, look, expect to gain back a little bit of this weight.

So you're going to swing even in a matter of a week from water because that inflammatory response is so curtailed with GLP ones. 

Dr. Brighten: Mm hmm. And you know, I just want to be fair to the people that are listening to this They're probably gonna be in the comments and be like everybody loses weight when they go to Europe It's true.

A lot of people do lose weight as they walk more they're eating different foods but there are people uh, and we all probably know somebody who take a trip to italy and There they don't necessarily have that same experience. So, uh, there is something to be said about this inflammatory component. I want to get into the inflammation, more of the benefits, but you mentioned [00:18:00] microdosing.

Yeah. What is that? And is there any evidence to support this? 

McCall McPhereson: So I'll tell you, this is definitely a fringe thing. Right. I don't think it will be a fringe thing for long. So, I think it will absolutely become standard in GLP 1s. I think very, very quickly big pharma companies are going to realize, Oh, maybe the dose that diabetics need is not the same dose that people need.

Without diabetes need to lose weight. We sort of ended up in our microdosing adventure organically. Um, we have a very tailored approach to people. And so when people had side effects in the beginning, we'd reduce their dose. We'd split their dose. We'd get all these creative methodologies. And then we started tailoring doses per person, depending on their response and their unique physiology.

And what we found after probably eight months of doing it is. Guys, people do not need this high [00:19:00] dose of medication. People do not need to increase their dose every month. In fact, why are we doing that in general at all? If people are still very responsive to lower doses of medication. Um, and we sort of, you know, I'm a data person.

I'm just constantly evolving based on data that I find. It's how I built Modern Thyroid Clinic. It's how we developed Modern Weight Loss. Um, and we just found in our data that most people need less. Most people need less dose increases and that anti inflammatory treatments. Impacts especially show up at microscopic doses of these meds.

So I think the data will come out. Um, Eli Lilly this week announced that they are, they are going to release vials of medication and not just preloaded injectable pens. And I think that is the beginning of the evolution of microdosing as standard of care. And we'll have to have another conversation about this in a year or so because I think it'll all be different.

Dr. Brighten: Yes, I, [00:20:00] I don't think everybody knows about the dosing and I think when we say micro dosing and then these high doses, I think that might be confusing. Um, I know what you're, you're talking about that standard 2. 5, you know, getting to that goal, but like, why are we going to that goal? I think from, because, you know, Ozempic.

Is the most common. We should start from that place. Let's talk about what is the standard protocol and then what do you do different and then and then what is how is it micro dosing is different from that? 

McCall McPhereson: Yeah, so let's say standard is, you know, we use compounded, so we use 25 units. We divide that in fourths to start.

So we start with one quarter of a dose. We consider increasing after a couple weeks, if people need it, to half of the lowest dose. Um, And we increase in quarter doses only as people need along the way. [00:21:00] So we just do not pencil it in every four weeks. You're supposed to essentially double your dose in the early phases of treatment.

Instead, no, we just step wise up in very, very quarter doses compared to what everyone else would dose as a full dose. And 

Dr. Brighten: I imagine you're not seeing the same side effects that other providers are seeing when you go from, you know, ha, you know, the 0. 5 to one to 1. 5, just following an arbitrary four week schedule without considering the individual.

Are you seeing the same side effects? And what are the side effects that I'm alluding to? 

McCall McPhereson: Yeah, no. I mean it, I prescribed my first anti nausea Zofran prescription and That I've sent preventatively in a year because we don't have people with nausea anymore. Like it just doesn't happen. We don't have people in GI distress.

Um, You know, if you're worried about [00:22:00] ozempic face and ozempic butt and losing muscle again, the surefire way to do that is take so much medication that you can't eat food, right? I mean, if you're worried about losing your hair, well, if you don't eat food, you're going to lose your hair. Um, if you don't want gastroparesis, do not slow your digestive system to a screeching, screeching halt.

Ignore all the signs and keep. Keep on dosing. Um, when you reduce doses, side effects almost completely vanish. We've never had a single serious side effect at all in our program, but at this point, truly we hardly have people with nausea, GI upset. I think the one, two remaining symptoms that I do see is a little fatigue in about like 20 to 30 percent of people.

They just feel a little more tired. And I also see period changes that isn't, I have not found that in the literature. [00:23:00] Um, definitely I see how it influences fertility and there's great studies on that, but it just shifts timing of people's periods as well. 

Dr. Brighten: Absolutely. Let's talk about that fertility component because that was another media scare.

Ozempic babies are upon us. And then, you know, in the current political climate where women are very afraid of getting pregnant, they're like, Oh God, Ozempic is making everybody get pregnant. And it's not that Ozempic will make you get pregnant, but it's that Ozempic does what? 

McCall McPhereson: Well, it improves your fertility.

It gives you better egg quality. more eggs that you can potentially fertilize. And yeah, it reduces severity incidence of PCOS. So I can see that scare. Um, and then on the flip side of that is, Hey, there's a lot of women who've probably struggled with fertility that even though we don't allow them to use these meds for, you know, a few months leading up to pre pregnancy [00:24:00] planning, that it could potentially help them as well.

Dr. Brighten: I think it's important for people to understand that, um, you know, as much as like, it is not a comfortable topic to be like, oh, you're overweight and that could be impacting your fertility. We do know from the research that high, Adiposity, lots of body fat can impact ovulation in cases of PCOS. We do see egg quality and these are all linked to insulin and inflammation.

Things that you talked about before and this is why when you go to a fertility clinic, they might tell you, you have to get your BMI down, which I'm like, that's not the best way to talk about someone's body composition. But when people do lose weight, they find that like they do, maybe they fall pregnant more easily.

They have less incidents of miscarriage. And that can be due to the shift of the hormones and the metabolic factors, which is, I think what's important to [00:25:00] understand is that while we focus through the lens of like weight loss and how much, you know, fat, how a bigger fat stores that what we're really focusing on what really is happening when you lose weight to the point we can be underweight and that can have a negative impact is that shift in the metabolic factors and in the hormones.

And as we know, with P. C. U. S. There's been lots of P. C. U. S. Women who have reported like I couldn't get pregnant. I used ozempic. I was like, I'm getting really, really nauseous. What's happening? And then they find out that they are pregnant because once they had that insulin sensitivity, ovulation was restored.

Ovulation comes before menstruation. So maybe you didn't notice your period came back, but ovulation sure did come back. And as you were saying, I just want to echo. We shouldn't be, it's not the ideal to be on a GLP 1 and get pregnant. The manufacturers in animal studies have said that there could be adverse outcomes.

Therefore [00:26:00] they recommend a two month period off, at least two months of discontinuation before you try to conceive. And I, you know, we're going to have studies that come out that show us because things are happening, right. But we can't ethically. put somebody on this, have them get pregnant, stay on it through pregnancy because there's an entire other human being who cannot consent to being in that kind of trial.

And we don't want to have adverse effects. Is there anything you would add 

McCall McPhereson: to that? You know, the one thing I would add that most people don't know, I think, is for men, they are instructed to discontinue it. Three months before actively trying to have a baby. And for women, it's 60 days for men, it's 90, which seems counterintuitive.

I get it from sperm production, et cetera, but I thought that was really interesting to add and couldn't agree more. There is no way I would let my patients stay on or be on a GLP 1 if they're actively pregnancy planning, nor would I do [00:27:00] that personally. Um, so can't echo that enough. 

Dr. Brighten: Yeah. Yeah. It's an important aspect that I feel like always gets left out of new drug conversations.

Again, these aren't new, but the conversation around it is so new being in the general public is often women's periods, reproductive health. It gets like, just like left out because, you know, we're going to sensationalize everything else. And that's why I appreciate you coming on so that we could really talk through the details around these with that in mind.

It's more than just weight loss. We, you've said this, you've, you've, uh, mentioned the inflammatory component, other benefits to it. What have you found in the research and in your clinical experience that these medications are doing outside of just the weight loss conversation? 

McCall McPhereson: Yeah, this is the most fascinating thing that I've encountered in medicine maybe ever, but.

definitely in the last several years. It just it excites me so much. So I again, I'm a [00:28:00] data collector. So the moment we started our beta program years ago, I started collecting and mining data on my patients to have an understanding of patterns and what's happening very quickly. I started seeing significant shifts in people's H.

S. C. R. P. which is an inflammatory marker um that shows general inflammation. It also can uh more specifically look at cardiac inflammation or risk for future cardiovascular events like heart attack, stroke, which are the number one killers of men and women in our country for sure. 

Dr. Brighten: Mm hmm. 

McCall McPhereson: I started noticing that people CRP was dropping within weeks and that was kind of my earliest touch point Research at that time was looking at CRP after one or two years Now a study came out several months ago where they started looking at CRP every in starting in six weeks six weeks Yeah, weeks so on and so forth.

They too Mentioned very early on reductions in [00:29:00] CRP, and what I want to emphasize here is what people again, what they say is, well, people are less inflamed because they've lost weight, right? That is not the pattern I'm seeing. I'm seeing this number drop long before people are losing weight. And the average 

Dr. Brighten: person starting these isn't going to see significant waste, weight loss at six weeks.

So that wouldn't 

McCall McPhereson: track with this data. No, exactly. Um, research shows it's two to three months in that people lose, start to lose more of their weight for us. Sometimes it's even a little slower because we use microdosing. Um, but I would see people CRP patients that I've had for seven years go from 35 To nine in a matter of three or four weeks, but I had a fascinating case a few weeks ago of a woman who started our program the week before she got her medication.

She had her labs drawn, CRP checked. It was almost 10 did her first injection, rechecked her CRP and it was four. [00:30:00] Wow. After one injection of a microdose of a quarter of the lowest dose 

Dr. Brighten: of 

McCall McPhereson: semaglutide. I mean, it was fascinating because again, I've seen this data, data, data. And the number one thing that my patients say in terms of feedback is I cannot believe how much less inflammation I have.

Um, and that is the resounding number one sort of benefit to these people. Um, I see it drop antibodies for Hashimoto's. Could have told you that a couple of years ago, long before we started looking at autoimmunity. Definitely is shutting down that inflammatory response that's driving autoimmunity. Now it's being studied for MS, and psoriatic arthritis, and other autoimmune diseases.

But potent, potent anti inflammatory effects that are unrelated to autoimmunity. Weight in the research, it has multiple pathways that it influences inflammation, not a singular pathway, but GLP [00:31:00] receptors themselves have an anti inflammatory component. 

Dr. Brighten: Mm hmm. And I've seen patients with endometriosis have their endo belly symptoms resolve.

They've been doing everything right. They've been getting a handle on things. I've seen patients who their period pain has reduced. And I am not making anyone any promises that this is a treatment or a cure, but with endometriosis having that potential autoimmune connection, It makes sense that these could potentially have benefits there as well.

And so, I think women's medicine is going to probably be the last thing that really gets explored in all of this, right? As we talk about MS, as we talk about autoimmune diseases, they do predominantly affect women. But autoimmune diseases get more attention than endometriosis, than PCOS, and a lot of these things that primarily affect women.

But I think I think this is why conversations like this are so [00:32:00] important because if we start voicing now that we want to see that research, perhaps we can get it sooner. And you and I both know, like, we decided to focus today on GLP 1s. We, this is not sponsored. This podcast is not sponsored by anybody who makes those GLP 1s.

We do not take money from anybody who manufactures these. No pharmaceutical sponsorship whatsoever. You and I both know that the tried and true is nutrition and lifestyle as a foundation. But also there is a point where the body arrives. That we may need higher level interventions to really turn that around so that those diet and lifestyle efforts can have a greater impact, which is what you said at the top of this, but I want to remind people of that because I think when we have these conversations about these medications, there's, it falls into two camps, like the people who are like, give it to everyone, it saves that, like all of these things, all these wonderful things.

And then we've got people who are like, it's a [00:33:00] medication. It is, it is bad. It cannot ever be good. And I think we just have to have that more nuanced take of they have benefits. They're not for everyone. They work well for some people and unlike the narrative that really is getting pushed right now that they are lifelong, they do not have to be.

Is there anything you would add to that? 

McCall McPhereson: Yeah, you know, I would speaking because we are such representatives for women, right? I mean, that is our career calling and it makes me so frustrated, angry and sad when women who decide that they do need to go on these medications are accused of being lazy and not doing the basics.

And, you know, and I, I am surrounded by women that do more than they should ever have to. And I, Am so frustrated by medicine's answer for women who eat well exercise pour into their health and can't make an influence I am so tired of the answer being eat less and exercise more There is a point like you said [00:34:00] of no return and these women especially women Of course, there are men too.

They have to be accounted for they have to be Looked at as, yes, these people are putting in the work and no, this is not a calories in calories out methodology that will work for them and they need help. And it's not that they're taking the lazy way out. It's they need something to intervene with their metabolic sensitivity.

What made you decide to start using GLP 1s in your practice? Such a good question. It was those women. Okay, so there is a timeline of symptoms that improve with thyroid when you perfect someone's thyroid function. Within first treatment cycle, their brain fog's gone. They feel better energetically, you know, their dry skin, hair loss, all these things start to improve.

You know what doesn't improve when you perfect someone's thyroid function after a decade of dysfunction? their metabolism. There has been so much metabolic breakdown that has to be reversed before they [00:35:00] can lose weight with effort. And I have been in the trenches with these women, many of them for a decade, and they cannot out lifestyle this poor metabolic function.

It is not uncommon for me to have patients be like, you know, I've been on Whole30 since 2017. I'm like, yeah, that's not. Appropriate. Fun. It's not fun. Yes. That's not realistic. You know? And people, women especially, deserve to be able to put in reasonable amounts of effort into their lifestyle, but then also see the outcome of that work.

Dr. Brighten: Yes. There's a lot of people who are under the impression that if you are not diabetic and you're using these Medications that you you're selfishly taking a drug away from a diabetic and I would love to hear your take on that 

McCall McPhereson: Yeah, you know, I think the majority of people who are on these medications for weight [00:36:00] loss, either from, you know, a BMI too high, prediabetes, you know, obesity or overweight, but with a complication of that, you know, of being overweight.

A lot of them are on compound medications. They are not on any form of the drug that's taking away the direct supply to diabetics. Um, also I think a secondary part of that conversation is this is the responsibility of drug manufacturers to make enough medication for people. You know, they, this is, Eli Lilly is going to be worth more than any pharmaceutical company in the world.

Um, if it's not already, but it's, it's up there with the biggest tech companies and they can certainly afford to invest in the people that need their medication. Um, that that's kind of my, I have a lot of thoughts on that, but those are the highlights. Like we use exclusively compounds, um, high grade compounded medications.[00:37:00] 

It gives us a lot more dosing flexibility, and again, that's not taking away the supply for anyone with diabetes that needs these medications. It's completely independent. And I 

Dr. Brighten: also think that it's It's a misunderstanding that these are only used for diabetes and that weight loss is a vanity metric that people are after.

As you said, it has the component of anti inflammatory support, it's being studied for autoimmune disease. I just started to think about, you know, it's not for the average individual who knows nothing about, about another person's health to really judge them in the steps that they're taking. I am curious though, in the, in the same vein as you brought up MS, what are we seeing in terms of neurological health and the benefits there?

McCall McPhereson: Yeah, huge. So lots of more and more studies are looking at and coming out with, um, you know, It's correlation with improved cognitive function as we age in the realm of Alzheimer's, dementia, it's neuroprotective [00:38:00] benefits from an inflammatory perspective, from a blood sugar, insulin perspective and again, You know, Alzheimer's dementia is a big, big medical burden in our country and is heavily tied in to blood sugar.

Um, and if we could, again, intervene early before these people are on, on the decline, but it definitely shows in studies to slow the progression of Alzheimer's, which is pretty fascinating. It 

Dr. Brighten: really is. Talk to us about the thyroid cancer risk with GLP 1s. 

McCall McPhereson: Yeah, you know, this is it's funny the media like picks a topic and then they blow it up and then they move on to another fear based topic and so my whole thing is thyroid right like my practice.

The reason I started our weight loss program was in a thyroid clinic. So obviously I dug in deep to this literature. Um, one, I think there's a misunderstanding that this is a [00:39:00] scientifically founded in humans risk because there has never been an incidence of thyroid cancer caused by a GLP one. Um, the, the fear around this came about when we looked at studies involving rats where there was an increase of specifically medullary thyroid carcinoma.

Rats have in a much, much higher quantity and amount of GLP receptors in their thyroid glands than humans do. So we're not really comparing apples to apples. Albeit the FDA included the black box warning, but multiple studies, independent and meta analysis have come out that show zero increased risk for thyroid cancer of any kind associated with GLP1s.

I think it's also really important to clarify, having a history of thyroid cancer is not an [00:40:00] exclusion criteria of these medications, unless again, it's a medullary thyroid carcinoma. 

Dr. Brighten: A lot of 

McCall McPhereson: people post thyroidectomy desperately need metabolic support. These people's metabolism have been completely shut off for their, much of their lives, you know, and obviously you have to weigh risk versus benefit with your clinician, your, you know, your practitioner, and I encourage everyone to do that.

But I also want to get clear on the actual reality of this risk, and I certainly treat a Many of my patients and we decide this on an individual basis together, but with a history of thyroid cancer And then the other thing I'll add is you know In our program, we've, we've weaned off of it some now, but we were collecting ultrasounds on people every three months to be sure.

So I was going to ask if you were screening and monitoring people. Yeah. Yeah. I was crazy about it for the first probably year, year and a half. There was never changes. Like it just, nothing was happening. And so now we still give them an [00:41:00] ultrasound order every three months, but we don't make it mandatory.

for them to continue in the program. It's their choice. Um, but again, that's my way of collecting data to see independently. What am I seeing in my practice related to thyroid? 

Dr. Brighten: Why do you think that these are so effective for your thyroid patients? 

McCall McPhereson: I think a couple things. One, I think, you know, my people are metabolically disadvantaged.

Dr. Brighten: You know, um, 

McCall McPhereson: they, what does that mean? 

Dr. Brighten: If you say metabolically disadvantaged, I want to make sure everybody is with us in the conversation. 

McCall McPhereson: Yeah, I would say the odds are stacked against them that they can ever get to a weight, a place that they feel comfortable like themselves. Because again, they, they can't restrict enough to lose weight because their metabolism is so incredibly low.

I kind of describe it as being in hibernation, right? Like, yeah, [00:42:00] it's, it's really, really difficult to repair that. Um, I also think it works really well because my patients generally are inflamed. A lot of them have autoimmune disease and that inflammation too makes you feel bad. It makes you puffy. It makes you not feel like yourself.

And in days these medications so grossly reduce that inflammation that people are like, wow, I just feel better, clearer, more like myself. Um, Yeah. And then I think it also goes back to, I have a sacred relationship with my patients. Like they trust me. I trust them. We problem solve. We dig in deep, you know, and I think that that's a big factor in this.

I do not think people should be left alone navigating this complex landscape of these medications without a lot of contact with their clinician and provider. 

Dr. Brighten: So would you say everybody with thyroid disease should consider these medications or is everybody a candidate? [00:43:00] 

McCall McPhereson: I would say no. I would say, I mean, in my opinion, these medications are for people that can no longer lifestyle their way out of being overweight or obese, that the effort that they put in no longer yields the outcome.

If they can lifestyle, I mean, in a balanced way, right? I do not think people should be eating 800 to 1000 calories a day and exercising 7 days a week. Right. But within reason. If you can lifestyle your way out of this and reverse, you know, Insulin resistance, leptin resistance, pre diabetes. Do it. Like absolutely do it.

If you can't, those are the people that I think really deserve a chance. 

Dr. Brighten: We're missing a lot of people who have thyroid disease. Specifically the most common is hypothyroidism in the United States. Roughly how many people are walking around with hypothyroidism and how many 

McCall McPhereson: don't even know it? Call me biased, but in my opinion, if you're a woman and you're a woman with [00:44:00] Children, eventually, you're going to have a thyroid disorder, in my opinion, if you are properly screened, I think.

I mean, it's a rough estimate, right? From my own clinical experience, which could be skewed because I only serve people that don't get well in the traditional sector, but I would say 85 percent of people are walking around either with a diagnosed thyroid condition and being inappropriately managed or walking around being told they do not have a thyroid condition when they actually do.

Oh my gosh. Okay. We have to unpack 

Dr. Brighten: that. So firstly, how does someone know if they have thyroid disease? What are some of the signs? And then we're going to get into like. We're going to get into the nuance around all of that. 

McCall McPhereson: Yeah. So, you know, I, I tell people, look, if it looks like a duck, it walks like a duck, it quacks like a duck.

It's probably a duck. So if you have quite a few thyroid symptoms, fatigue, brain fog, dry skin, brittle nails, brittle hair, low sex drive, depression, constipation, um, brain fog, if I didn't say that poor metabolism, um, insulin [00:45:00] resistance, high cholesterol, high blood sugar. There's a good chance you have a thyroid problem.

And medicine's answer to this is those are just really general, general symptoms. They don't mean anything. Well, they do. When you have a constellation of them, it means you probably have a thyroid issue, but medicine's diagnostic measures for this are grossly getting worse over the years, as opposed to better and more sensitive.

Dr. Brighten: Mm hmm. So you made a statement. If you're a mom, you're probably gonna have a thyroid disorder. Why? Why mom specifically? 

McCall McPhereson: Yeah, so postpartum is our highest risk for transient, even autoimmune thyroiditis, like Hashimoto's, for example, where your body attacks your thyroid gland and it erodes away part of that hormone secreting tissue and it leaves tissue that just doesn't function.

doesn't work as well. It's, it's kind of inflammatory, scary. And that, even if [00:46:00] your Hashimoto's goes away, you know, you're done breastfeeding, you're done with your baby season, you still have that loss of function. Women in general are already much more at risk, like we mentioned earlier for autoimmune disease, but postpartum we are at our highest risk.

Dr. Brighten: Yeah. That's how I developed Hashimoto's and roughly one in 12 worldwide will. And I had doctors who told me, you are tired because you're a mom. Of course you're gaining weight. I'm like, I, Can't fit into clothes I wore in my third trimester. And they're like, that's because you're not exercising enough because you're a mom and everything was, you're a mom.

And it was once I fell asleep at the kitchen table after so many hours of sleep at night. And my husband was like, you're not motivated. You're crying all the time. You're depressed. Like you complain your joints hurt. Your skin is so dry. And he's like, just, he's really worried about me. And is he? And I was like, I have hypothyroidism and it's so hard sometimes to see in [00:47:00] yourself.

You need somebody, I always say, understanding your own health is like reading a book that's too close to your face. And what you need is a provider who can stand back. You have all the data, you know. When you get that diagnosis, sometimes you're like, of course, duh, Oh my God, how did I not know this?

Because it was too close to you and you needed that objectivity. But it's more than just that. We need to be doing lab testing. And that's immediately what I went to. I was like, I'm labs today, immediate. I need to know what's going on. What lab testing should people be getting done? And what is the problem?

With the way too many people are interpreting these and telling people your labs are normal. You have all these symptoms, but your labs are normal. All right, you got one foot in the grave, your lab is normal. 

McCall McPhereson: Right, totally, totally. So let's talk labs first. So, you know, the standard is checking TSH, thyroid stimulating hormone.

That is not an adequate screener for hypothyroidism, and it is a wildly inappropriate way to manage people [00:48:00] once they are on medication, most especially if they were on the standard of care. T4 based medication like levothyroxine or Synthroid in that class of medication. TSH is essentially completely invalid at that point.

So you do need TSH. It is in fact important, but you also need free T4. You also need your active hormone, free T3. You need your inhibitory hormone. Reverse T3. And then you also need to be worked up for both antibodies for Hashimoto's, which is TPO, thyroid peroxidase antibody, or thyroglobulin antibody.

Nothing less. If you have Graves, potentially you want to check Graves antibodies, which is TRAB and TSI, thyroid stimulating immunoglobulins, and The problem is, yes, you get all this lab data and I can share with your audience, Jolene, my free thyroid lab guide that tells them about ranges, et cetera. So they have it all in black and white, but we can put that link.

So it's easy to find. [00:49:00] Love it. The problem in medicine is there actually is no standardized range for what's okay. Versus not. Okay. Um, it varies depending on whatever the lab says is normal. The lab that you go to, which even between, um, The same lab, different locations. Those ranges shift because they're just based on their own collection of data.

That is, again, based on people who are sick and going to the lab and trying to figure out what's wrong with them. So now we're basing optimal lab ranges on people who are ill, which is never okay. And then the biggest, I think, issue is damning piece of research that came out and the interpretation of it was a few years ago, a study came out that said, you know what?

People on Levothyroxine or Synthroid, they're actually not getting well if their TSH is under 10, they're not feeling any better. So we need to just stop treating, we need to stop treating these people if their TSH is under 10. When in fact, if we looked at that, that study a little differently, hey, maybe the medication we're using isn't working [00:50:00] and that's why people aren't getting well.

Instead, now we're going to limit access to a huge percentage of people with hypothyroidism until their TSH is above 10, which you and I know basically means they're not getting out of bed for like, you know, seven or eight years. They are non functioning members of society and their family and their kids.

It's, it's very hard to wake up every day and just put on pants if your TSH is 10. 

Dr. Brighten: Mm hmm. And when your TSH being 10, your TSH is a pituitary hormone. I think it's very easy if there, if someone's listening to this and they're in perimenopause or menopause, they may very well understand, or primary ovarian insufficiency.

There's lots of conditions where your follicle stimulating hormone is very high. And that is your brain is screaming at your ovaries to do their job. TSH, another pituitary hormone, if it's above 10, it's screaming at your thyroid to do its job. But we've got to go back to something because. It's a bit controversial and I know that some people are gonna be like, say what?

You said when you're being given Synthroid that [00:51:00] TSH isn't very valuable anymore. Why is that? 

McCall McPhereson: Yeah, so Synthroid or Levothyroxine is what's called a T4 based medication. I want you to think about T4 like crude oil. So we don't put crude oil in our car to make it go. We need it to produce gasoline to put in our car and make it go.

Okay, so what we are giving people is Basically, ubiquitously is T4 based mets. Okay, what happens if you can't make that gasoline from your crude oil hormone of levothyroxine? If someone gives you a bunch of crude oil and you can't really make gasoline from it, what do you have? You have a lot of crude oil.

So you are kind of just stockpiling crude oil in your garage. And guess what happens? It sends a message back to your brain and it says, Oh my gosh, we have so much thyroid hormone, lower her TSH. And so your TSH is, you know, 0. 3, looks fantastic. That's all your doctor checks. Oh my [00:52:00] gosh, all your symptoms are not related to your thyroid.

Your TSH looks great. Or perhaps they check your TSH and your T4, your inactive hormone. Both look great because all of that unused hormone is sitting there. Suppressing your TSH. Meanwhile, your active hormone, the thing that you need to feel good, to work metabolically, to think, to have energy, is low.

Because you can't convert crude oil to gasoline. So, in essence, The worse you are at using a T4 based medication, the better your labs will look for your regular doctor if they are only checking TSH or TSH and T4, which is standard. Is this 

Dr. Brighten: why you, 

McCall McPhereson: is 

Dr. Brighten: this why you would say that Synthroid and Levothyroxine, most people who are taking them, don't feel better on them?

McCall McPhereson: Right. We have a massive issue activating our thyroid hormones in this country. I can't speak to worldwide because I don't have that data personally, 

Dr. Brighten: but 

McCall McPhereson: we are not activating our [00:53:00] thyroid hormones and we are giving people only inactive thyroid hormones. And so we have a lot of people walking around that will forever be symptomatic because it doesn't matter how much crude oil you give someone.

If they cannot convert that crude oil to gasoline, they are not going anywhere in their car. 

Dr. Brighten: Okay. 

McCall McPhereson: Absolutely. 

Dr. Brighten: And I have seen cases where people's TSH, it looks, it's very low and their T4 is very high and their doctor is saying to them, you need to lower your medication. And when we pull the labs and look at free T3, which should be above three.

That's looking more like 1. 8 and I'm like, well, we've got a conversion issue. That's where we need to focus when it, when it comes to conversion issues, what can inhibit that our ability to get from T4 to T3 and what can we do to help support conversion? 

McCall McPhereson: Yeah. So I want you to think about this as like a purposeful mechanism of our body.

It's not just like [00:54:00] creating pain and suffering in our lives. It's trying to preserve resources. Okay, so when our body wants us to lay down, rest and recover, it halts the activation of your T4 to T3. So if you think about that, it's in times of sickness. Stress, micronutrient depletion, caloric restriction, over exercise, inflammation, pregnancy, breastfeeding, um, not sleeping well.

So these are the things that our body says, no, these things are happening. We need to make you tired so that you can recover. So let's not activate your thyroid hormones. So if you can reverse engineer that, that can be a huge help. I think. And honestly, in my opinion, I almost believe there is a degree. Of poor conversion that's associated with standard American lifestyle.

Our food is depleted in nutrients. It's highly inflammatory. We're all kind of stressed. Our lifestyle in America promotes quite a bit of stress, right? [00:55:00] Car culture. You're not walking. You're not moving. No, and you're sitting in rush hour traffic for an hour and a half on both ways to work. Um, and so all of those things impact the activation of our hormones.

So as much as I'd love to say, Hey, when we try to adjust all these things, some nutrients to, you know, can help activation, but, um, When we try to account for all these things, some people still are not activating enough T3 to have a quality of life, um, that they deserve. So in those cases, I always think it's worth supplementing that T3 to give people the empowerment to feel well, but also work on their lifestyle, right?

So they're not having to pull up their bootstraps when they're just exhausted. Well, and when you say supplementing, this isn't a supplement. What do you mean by that? Yeah, so I, I mean, adding in T3 based medication to either their T4 or even if they're not on T4, just to their normal endogenous T4, supplying their body with some of that fuel, [00:56:00] some of that gasoline is absolutely life changing.

Dr. Brighten: Mm hmm. And it's so important. I think that is clinicians. We recognize when you ask somebody, I need you to eat better, eat more meals at home, cook your food, exercise, make sure that you've, you know, you're doing these stress reduction practices like this is all energy and nutrition. It's so important that we give people the necessary treatment so that they do have the energy to do those things.

So, as we were talking at the top of this, we talked about GLP 1s and like you're doing everything right but you're not moving the needle. And these may give you a leg up and be a temporary solution to kind of reset the system. I've heard a lot of patients talking about how they used GLP 1s for about three months.

And they came off and they're like, it's like something clicked into place. And now my body remembers what it's supposed to do. Fantastic. Same thing when we're talking about thyroid medication, [00:57:00] we want to be supporting you with, I mean, of course you cannot activate your thyroid hormone without those nutrients, without the appropriate nutrition and lifestyle.

But sometimes. We have to bring in these interventions so that people can actually have the energy, the drive, the ability to do what they need to to take care of themselves. And this also doesn't mean you always need this medication forever. In what instances do people need these medications lifelong?

McCall McPhereson: Yeah, so when people have lost true endogenous thyroid function, when their thyroid gland is no longer functioning, adequately secreting hormones. They need permanent supplementation with thyroid medication, meaning they're complementing the endogenous production they have that is insufficient. There are people who are what I call pure conversion disorder people that literally just have a hard time activating their own T4.

Those people can temporarily be on T3, you know, and, um, [00:58:00] go on it, try and work on these lifestyle pieces exactly like you said, and I'm. So thankful that you realize when people come to us and they're exhausted and they can't function in their families and relationships and work. The last thing we need to do is dump a lot of expectations on their plate before we give them answers and solutions to their lack of energy.

So I so appreciate that. And you can solve that problem with adding a little bit of T3 or balancing those hormones and then later removing it and seeing if they can get by on their own. 

Dr. Brighten: Mm hmm. And I think that's a hope that's not often offered to people. They're usually told once you're on a medication, you're on a medication for life.

Certainly if you've had a thyroidectomy, you don't have a thyroid anymore. If your autoimmune disease, Hashimoto's the one we're speaking to here has ravaged your thyroid and we no longer have functional tissue, we're not going to be going back. You might be able to step down, but we're not going to be able to go back to having full thyroid function like we did when we [00:59:00] were born.

Like we're just. You're just not going to be able to achieve that, which is why I would say to everyone listening to this, if you suspect you have a thyroid condition, your best, best efforts now to get with a provider, get it diagnosed and start reversing that because Hashimoto's can be reversed, not cured, but the autoimmune attack can be reversed.

That is going to be your best chance at maintaining your thyroid function for the rest of your life. 

McCall McPhereson: Absolutely. And the prevention of, so many people are like, well, I don't want to go on thyroid medication. Like, listen, if you need this, you're going to protect yourself from becoming diabetic. You're not going to have to go on diabetes meds.

You will protect yourself from, you know, Lipitor and, and other cholesterol meds that are literally just an issue manifesting from a thyroid condition. So I couldn't agree more. It's such a foundational piece to [01:00:00] health and vitality. Thank you. 

Dr. Brighten: Absolutely. And as you brought up diabetes, nobody ever debates if your pancreas stops working due to an autoimmune condition, should you or should you not take insulin?

It's never something where someone says, Oh, I don't want, you know, I wouldn't want to be on insulin or they shouldn't be on insulin. You know, there's a shame that happens when you take a medication and I see it play out in the thyroid community and I'm like, you can't live without thyroid hormone. It's nonnegotiable.

You don't die as quickly as you do if you don't have insulin. But you will die sooner. You will lose organ function and vitality sooner. And I don't say that to be like, dun, dun, dun. But we have to drop this judgment and shame. These are non negotiable. You cannot live without insulin. You cannot live without thyroid hormone.

And if you need them. Praise everything good. We have access to these because once upon a time, these medications didn't exist. And when you consider that most conditions like [01:01:00] hypothyroidism that primarily affect women do not get the research, the funding or even the medication development and interventions and access to care in the same way that I mean, erectile dysfunction does, then we can be grateful that we do have access to these and we can be judicious because To use it the right time in the right place at the lowest dose to get us the benefits we need and potentially with a plan, it's not always a promise, but potentially a plan to not have to need them lifelong.

McCall McPhereson: I love that. It's so true. And I do. I want to change the stigma. And I think, you know, it goes back to so much in medicine is like Thyroid issues aren't a big deal. Hashimoto's isn't a big deal. These women are fine. It's all in their head. They don't really have these symptoms. All you do is put them on levo and they're totally fine.

No, like this is a big giant debilitating disease that needs to be taken seriously and we don't need to be minimizing people suffering from it and making them feel like they shouldn't take medication because of it. 

Dr. Brighten: [01:02:00] Yeah, I agree. I, so I take a thyroid medication because my, by the time everything was caught, it was a little bit too far.

I have to just share this story though that I was in Paris. My son got very sick. I, now I don't travel with less than three to six months of medication because I'm like that less, I had a lesson there. Let me just tell you all that's a, it's an expensive insurance plan, but not as expensive as not having thyroid hormone.

But so I found myself there. I ran out of medication. I went to the pharmacy. And I was able to refill my medication there and I was like, okay, I'm going to, they're probably just going to have T4. That's all I'm going to be looking at. And they had a combination of T4, T3. And I was hoping like to have it separate so I could kind of like try to get, like match my dose a little bit better.

And when I was like, Oh, you don't have just T4. And they were like, why, why on earth would we have just T4? And I was like, well, you are kidding me. No, I was like in the States that's most commonly prescribed. And the pharmacist is like, [01:03:00] That is the most awful thing I've heard like and they only had a t4 t3 combination Let me say that makes it hard to get things dialed in exactly right because it's just very standard But it's so interesting to me.

There is no consensus worldwide On thyroid and there is no consensus about medications because it was something I think it was Belgium that people were like, if you drop, if you jump a train to Belgium, you can get natural desiccated thyroid hormone. And if you go to the UK, then you can get these separate medications.

And I was like, this is so interesting. Never as a doctor in the United States did I ever have to think about this, but like how different these things are varying worldwide. Um, and that's just all to say. Stay tuned because as the research develops, we'll be bringing you a lot more 

McCall McPhereson: insights on this topic.

Amen to that. And we are working so hard to develop a study ourselves, just really looking at more progressive, because so much of the studies that involve, you know, combo [01:04:00] use or active thyroid hormone use are executed so poorly and done so, so poorly that they don't show a significant difference in how people feel.

And the reality is, is that's wildly not true. If it's done well and it's done appropriately, people's lives are absolutely changed and there is so much hope. So, yeah. 

Dr. Brighten: I love that. I have loved this conversation. It has been so fantastic chatting with you. We're going to put all your links in the show notes, including your link to the thyroid lab guide, so people can get that.

You are launching a new clinic that is, is that in Austin 

McCall McPhereson: that you're launching? Yeah. No, so we are launching a nationwide telemedicine practice, modern weight loss, open in all 50 states. Simultaneously. We took our modern thyroid clinic from Austin and we are launching it nationwide. Slower rollout for that.

We're in about 14 or 15 states now. New ones are added every couple of weeks. So, so exciting. Like I just, and the GLP one thing is just a [01:05:00] whole passion that landed in my lap that I wasn't expecting. And I'm so grateful. to be a part of it because it really is. It's a fascinating and sacred journey with these women that I've been able to serve.

Dr. Brighten: Fantastic. And congratulations on all of that. This is one of the reasons why I wanted to bring you on because there are so many brilliant people talking in this space, but not everybody has capacity to accept new patients. And you, my friend have actually expanded your clinics and set it up so that you do have compassion capacity so that anybody listening to this, we'll put it in the show notes.

You can contact McCall's clinic and they can get you started on the path of healing. 

McCall McPhereson: I love it. Thank you so much for having me today and thank you for all the work that you're doing advocating for women, educating them. It, it really changes lives. 

Dr. Brighten: Oh, thank you so much. And we will talk soon. Thank you all for listening.

 

And certainly we would love to hear from you. You can leave us a comment below and share this with somebody that you feel could really benefit from this information. [01:06:00] So thank you all for being here. It is always an honor to spend time with you. I hope you enjoyed this episode. If this is the kind of content you're into, then I highly recommend checking out this.