Consultants in Metabolism

Consultants in Metabolism I am a board certified physician with a practice focused on optimizing thyroid, hormone management and wellness.

06/17/2026

Many people assume that if they feel anxious, shaky, sweaty, or have a racing heart after starting T3, the medication must be the problem.

But sometimes the real issue is insulin resistance.

T3 increases the rate at which your cells use energy. If insulin resistance is present, blood sugar can rise and fall more dramatically. When blood sugar drops quickly, your body responds with stress hormones like cortisol and adrenaline.

That adrenaline surge can feel a lot like "T3 intolerance":
• Shakiness
• Irritability
• Anxiety
• Sweating
• Heart palpitations
• Even panic-like symptoms

The irony is that the T3 may not be causing the problem at all. It may simply be revealing an underlying metabolic issue that was already there.

This is one reason why nutrition, sleep, stress management, exercise intensity, and sometimes insulin resistance treatment can be just as important as thyroid medication itself.

🎧 From Beyond the Thyroid – Episode 46: When T3 Doesn't Work — How to Dose Thyroid Medication Correctly (Part 2) https://youtu.be/JS0KzdkwjTs

My CORE5 lab guide explains what your TSH misses and what to order instead. Comment CORE5 and I'll send it.

06/16/2026

Many Hashimoto's patients begin their healing journey by changing their diet. That makes sense. Food is something we can control.

But what I often see is a progression from gluten-free, to dairy-free, to soy-free, to increasingly restrictive eating patterns that leave people frustrated, undernourished, and still symptomatic.

At some point, the focus shifts from nourishment to avoidance.

This can create nutrient deficiencies, inadequate protein intake, and a growing sense of anxiety around food choices.

Some food eliminations are helpful. Some are necessary. But more restriction is not always better. The goal is to improve health—not create a life dominated by food rules.

This is one of the important topics discussed in Episode 49 of Beyond the Thyroid.
https://youtu.be/1iWEqWzlFvw

06/03/2026

Most discussions about Armour Thyroid focus on whether it's "good" or "bad."

The reality is more nuanced.

One important consideration involves patients with a history of differentiated thyroid cancer. Because Armour contains thyroid tissue proteins, it may interfere with thyroglobulin monitoring, which is commonly used to detect recurrence.

There is also a theoretical concern in Hashimoto's disease since Armour contains thyroid proteins that are targeted by the immune system in autoimmune thyroiditis.

This doesn't mean Armour is inappropriate for everyone with Hashimoto's. It means treatment decisions should be individualized and made with a clear understanding of both benefits and potential risks.

That's exactly the kind of discussion we explore in Episode 48 of Beyond the Thyroid.
https://youtu.be/iBlPWbh7nxA

06/03/2026

The Armour Thyroid debate misses the point.

The real question isn't whether Armour is good or bad. It's why some patients feel dramatically better on it while others don't.

When a patient responds well to Armour, it often reveals something important about their thyroid physiology, particularly around T3 availability and conversion.

That information can help guide future treatment decisions—but it doesn't automatically mean Armour is the only answer.

Good thyroid care isn't about choosing sides. It's about understanding the patient and individualizing treatment.

That's one of the major concepts I discuss in Episode 48 of Beyond the Thyroid and in my Thyroid Clarity Checkup program.
https://youtu.be/iBlPWbh7nxA

Learn more at: danagibbsmd.com/checkup

05/21/2026

One of the biggest questions in Hashimoto’s care is this: Should everyone with Hashimoto’s avoid gluten?

The answer is more nuanced than social media often suggests.

The challenge is that food research is extremely difficult to do well. You can’t truly “blind” food studies because people know what they’re eating. Researchers can’t fully control lifestyle, stress, sleep, or every variable in someone’s diet over long periods of time.

So the absence of strong evidence doesn’t necessarily mean there’s no effect. But it also doesn’t mean we should automatically recommend permanent gluten elimination for every Hashimoto’s patient.

The one condition where we do know strict gluten removal is essential is celiac disease.

Outside of that, the real-world response is highly variable.

🎧 From Beyond the Thyroid – Episode 49: Do You Really Need to Cut Gluten & Dairy in Hashimoto’s?
🔗 Listen on YouTube, Spotify, Apple Podcasts
https://youtu.be/1iWEqWzlFvw

👉 My CORE5 lab guide explains what your TSH misses—and what to order instead. Comment CORE5 and I’ll send it.

This week’s GoodTalk is a little different.Instead of our usual short Q&A, I’ll be presenting a deeper physician-level l...
05/19/2026

This week’s GoodTalk is a little different.

Instead of our usual short Q&A, I’ll be presenting a deeper physician-level lecture:

🎙 Hashimoto’s: The Diagnosis Is Just the Beginning

We’ll cover:

- Proper diagnosis of Hashimoto’s
- Which thyroid labs actually matter
- Associated conditions doctors often miss
- Why symptoms persist despite “normal” labs
- T3 therapy and thyroid conversion

Plus:
📖 Real patient case study
❓ Live Q&A afterward

📅 Tuesday
🕧 12:30 PM CT
📍 Live on the Goodself App
https://goodself.com/chat/eWJjyESFq6jGp2jeBbQ2

If you want a deeper understanding of Hashimoto’s, this session is for you.

05/17/2026

One of the most common messages Hashimoto’s patients hear online is:

“If you remove the right foods and are strict enough, you can heal your thyroid.”

But in real clinical practice, the outcomes are mixed.

Some patients improve with food elimination. Others notice little benefit. And some become increasingly restricted and emotionally overwhelmed while still struggling with fatigue, brain fog, weight gain, and inflammation.

The emotional context matters. Many patients have already spent years being told “everything is fine” before finally getting diagnosed.

That desperation for answers can make very rigid protocols especially appealing—even when the science and clinical outcomes are far more nuanced.

This is discussed in Episode 49 of Beyond the Thyroid.
https://youtu.be/1iWEqWzlFvw

05/15/2026

One of the most harmful ideas circulating online is that Hashimoto’s must have a single “root cause” that can be eliminated if you’re strict enough.

In reality, Hashimoto’s is usually multifactorial. Genetics, stress, infections, hormone shifts, nutrient deficiencies, sleep disruption, and metabolic stress often work together over time.

And importantly, what initiated the autoimmune process may not be the same thing that continues to drive it.

This is why many patients become increasingly restrictive with food without actually improving.

Episode 49 discusses this complexity in much more detail.
https://youtu.be/1iWEqWzlFvw

05/12/2026

Food sensitivity discussions in Hashimoto’s disease are often oversimplified.

Not all reactions are immediate allergies. Some are subtle, delayed, and immune-mediated, making them much harder to recognize and study scientifically.

There is currently no conclusive evidence that every Hashimoto’s patient must remove gluten, dairy, or other foods permanently. At the same time, some individuals clearly do react to certain foods in meaningful ways.

The challenge is learning how to distinguish generalized internet advice from individualized physiology.

This is discussed in Episode 49 of Beyond the Thyroid.
https://youtu.be/1iWEqWzlFvw

05/07/2026

Do all Hashimoto’s patients really need to eliminate gluten and dairy?

In this episode of Beyond the Thyroid, Dr. Dana Gibbs discusses the growing trend of increasingly restrictive elimination diets in thyroid disease — and why the outcome is not always positive.

Many patients begin by removing one or two foods in hopes of reducing inflammation, but over time the diet can become so limited that it contributes to inadequate nutrition, elevated stress physiology, worsening fatigue, impaired thyroid conversion, and metabolic dysfunction.

Dr. Gibbs also explains an important practical issue regarding gluten:

If you are considering long-term gluten elimination, it is important to be tested for celiac disease BEFORE removing gluten from your diet for weeks or months, because standard testing can later become falsely negative.

This reel is a short excerpt from the full conversation.

Watch or listen to:
Beyond the Thyroid – Episode 49:
“Do You Really Need to Cut Gluten & Dairy in Hashimoto’s?”

Available on YouTube, Spotify, Apple Podcasts, and Buzzsprout.

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