Your TSH is "normal" but you still feel exhausted, cold, and foggy — sound familiar? In this episode I sit down with Dr. Saadia Mian, a board-certified endocrinologist and functional medicine practitioner, to unpack why standard thyroid labs miss so many patients. Chapters & Time-stamps 00:39 Meet the Endocrinologist 01:43 Thyroid Symptoms Explained 03:20 Core Thyroid Lab Panel 04:34 Reverse T3 and Illness 07:33 Thyroid Metabolism Links 08:54 Insulin Testing and Targets 10:38 Treating Insulin Resistance 14:03 Thyroid and Sex Hormones 16:33 Why Free T3 Matters 19:19 Optimal Thyroid Ranges 20:47 Reverse T3 Ratio Use 21:58 Hashimoto’s With Normal Labs 24:51 Key Nutrients and Iodine 28:10 Hypothyroid Medication Options 31:33 Choosing the Right Meds 32:52 Graves’ Treatment Reality 35:31 Adjuncts and Nervous System 37:06 Supplements for Inflammation 38:31 Final Advice and Where to Find Her Key Takeaways: Why free T3 matters more than TSH alone — and the optimal ranges Dr. Mian looks for (free T3 ≥3.0, free T4 ≥1.0)The free T3-to-reverse T3 ratio functional practitioners use to catch what standard labs missHow untreated hypothyroidism quietly drives high cholesterol and insulin resistanceFasting insulin targets (≤5) and why postprandial insulin testing matters tooBerberine, inositol, and cinnamon for blood sugar supportThe gut-autoimmunity-thyroid triad: genetics, leaky gut, and triggersSynthetic vs. desiccated thyroid hormone — how Dr. Mian decides which to useLow-dose naltrexone and ashwagandha as adjuncts for Hashimoto's and Graves'Why iodine supplementation needs to be individualized, not routine Guest Details Dr. Saadia Mian, MD, FACE, IFMCP is a board-certified endocrinologist and Institute for Functional Medicine Certified Practitioner, as well as a certified life coach. A Fellow of the American College of Endocrinology, she blends conventional endocrinology with root-cause, systems-based medicine. She's the founder of Precision Endocrine and The Functional Endocrinologist, focusing on thyroid health, metabolic optimization, weight management, and bioidentical hormone therapy. She's the author of Hormones in Sync: An Endocrinologist's Guide to Reclaiming Your Energy, Joy, and Health (releasing September 2026), a Detroit Hour Top Doc, and a sought-after speaker and educator. Connect with Dr. Mian: 🌐 Website: www.saadiamianmd.com📸 Instagram: @dr.saadiamianmd📘 Facebook: Saadia Mian MD💼 LinkedIn: Saadia Mian MD📍 Clinic: Woodhaven, Michigan About Your HostsMicah Yu, MD, MHA, MS, ABOIM, DipABLM, IFMCP Dr. Micah Yu is a triple board-certified integrative rheumatologist who blends conventional medicine with holistic, nutrition-based healing to treat autoimmune and chronic inflammatory conditions. A patient himself, Dr. Yu brings a deeply personal perspective to his work, having reversed his own autoimmune arthritis through lifestyle and integrative medicine. He is certified in internal medicine, rheumatology, integrative medicine, lifestyle medicine, and functional medicine. As the founder of MyAutoimmuneMD and co-founder of Dr. Lifestyle Clinic, Dr. Yu empowers patients to address the root causes of illness and reclaim their health from the inside out. Melissa Mondala, MD, MHA, MS, DipABLM Dr. Melissa Mondala is a dual board-certified physician in Family and Lifestyle Medicine, with advanced training in Integrative Psychiatry and Integrative Medicine. As President of Dr. Lifestyle Clinic in Newport Beach—recognized by UC Irvine as a Public Health Site of Excellence—she pioneers a holistic, patient-centered approach to chronic disease. Dr. Mondala is a nationally recognized Lifestyle Medicine Intensivist, core faculty at Loma Linda University's Preventive Medicine Department, and a passionate advocate for plant-based nutrition, mental health, and women's wellness. A sought-after speaker and educator, she combines cutting-edge science with deep compassion to empower lasting healing, especially for those silently suffering from autoimmune, mental health, and long COVID conditions. She shares practical inspiration for healthy living and cooking at @drmelissaskitchen. About AutoImmune Alchemy Podcast Mission: Blending science with soul to transform autoimmune struggles into healing alchemy AutoImmune Alchemy is a podcast dedicated to the autoimmune community, offering hope, validation, and evidence-based solutions for those struggling with complex autoimmune conditions. Hosted by the dynamic duo Dr. Melissa Mondala and Dr. Micah Yu, the show features expert interviews exploring root causes like hormonal imbalances, leaky gut, and inflammation that traditional medicine often overlooks. Each episode empowers listeners to take proactive control of their health through lifestyle medicine, nutrition, and integrative approaches. Connect with AutoImmune Alchemy Website:MyAutoimmuneMD.comDr. Lifestyle Clinic:www.drlifestyle.orgInstagram: @myautoimmunemdFacebook: @MYAutoimmuneMDYouTube: @myautoimmunemdEmail: contact@myautoimmunemd.com Subscribe & Review: Available on Apple Podcasts, Spotify, and all major podcast platforms. If this episode helped you understand environmental toxins and autoimmune disease, please leave a 5-star review!
