64: We Got Weight Loss Wrong - The Real Meaning of GLP-1s and Metabolic Health with Ashley Koff

GLP-1 medications have become synonymous with weight loss—but what if their impact on women’s health goes far beyond the number on the scale? Recorded live at SXSW in Austin, this special panel brings together experts in thyroid and metabolic health, fertility, menopause, and strength training to explore what women should really understand about GLP-1 medications. Moderated by Dr. Shannon Ritchey, PT, DPT, the conversation features McCall McPherson, PA-C, Dr. Natalie Crawford, MD, and Dr. Jessica Shepherd, MD. Together, they discuss appropriate use, microdosing, insulin resistance, inflammation, thyroid disease, PCOS, fertility, perimenopause, menopause, muscle preservation, side effects, long-term use, and the importance of individualized care. 🔑 In This Episode: What GLP-1 medications actually do beyond appetite suppression Why these medications were first used for diabetes and metabolic health Microdosing vs. traditional dosing Why individualized dosing may help some women better tolerate treatment GLP-1s, thyroid dysfunction, Hashimoto’s, and inflammation Separating thyroid-cancer concerns from what the panel says current human evidence shows Why adequate calories and protein matter while using a GLP-1 The importance of preserving and building muscle GLP-1s, insulin resistance, PCOS, and fertility Why GLP-1 medications are not recommended while actively trying to conceive or during pregnancy Perimenopause, menopause, HRT, glucose regulation, and visceral fat When GLP-1 use may be short-term vs. longer-term Semaglutide, tirzepatide, and individualized prescribing DEXA scans, creatine, resistance training, and lean-mass preservation Fasting insulin, A1c, leptin, and other metabolic markers Sleep, HRV, hydration, and what wearables may reveal Food noise, body image, and why appropriate medical screening matters

What if insulin resistance is quietly driving inflammation, weight gain, and thyroid dysfunction years before blood sugar ever looks abnormal? In this episode of Modern Thyroid and Wellness, McCall McPherson sits down with endocrinologist Dr. Alessia Roehnelt for an in-depth conversation about insulin resistance and why it can be such an important marker of long-term metabolic health. Dr. Roehnelt explains how insulin functions in the body, what happens when insulin resistance develops, and why chronically elevated insulin can contribute to inflammation, weight gain, metabolic dysfunction, and disease progression. They also explore the bidirectional relationship between insulin resistance and hypothyroidism, including how thyroid dysfunction can worsen metabolic health and how insulin resistance can complicate thyroid function and treatment. 🔑 In This Episode: What insulin resistance is and how it develops Why insulin resistance may appear before prediabetes or type 2 diabetes Common physical and metabolic signs of insulin resistance Acanthosis nigricans, carb sensitivity, and rapid weight fluctuations The relationship between insulin resistance and hypothyroidism How insulin resistance may affect thyroid hormone absorption and conversion Why fasting insulin can provide useful information beyond A1c alone “Normal” vs. optimal fasting glucose, insulin, and A1c values Why population-based lab ranges do not always reflect optimal health The role of vitamin D in metabolic and hormonal health Fatty liver markers including AST and ALT

What if the brain fog, forgetfulness, emotional overwhelm, anxiety, or difficulty getting things done isn’t simply stress—or even your thyroid? In this episode of Modern Thyroid & Wellness, McCall McPherson, PA-C sits down with Dr. Jolene Brighten, women’s health expert and bestselling author, to explore the often-overlooked connection between ADHD in women, thyroid function, hormones, perimenopause, inflammation, and brain health. Dr. Brighten explains why so many women reach adulthood without an ADHD diagnosis and why hormonal transitions can suddenly make symptoms that were once manageable feel impossible to ignore. She also explains an important overlap for thyroid patients: hypothyroidism itself can create ADHD-like symptoms, including brain fog, low mental energy, working-memory problems, changes in neurotransmitter function, and difficulty with executive function. In This Episode: Why ADHD in women is often missed or misdiagnosed How female ADHD can look different from stereotypical hyperactivity Anxiety, depression, and undiagnosed ADHD How hypothyroidism can mimic ADHD symptoms Emotional dysregulation, time blindness, and executive dysfunction ADHD, Hashimoto’s, PMDD, endometriosis, POTS, histamine issues, and other co-occurring conditions Dr. Brighten’s brain-immune-hormone model Why puberty, postpartum, birth control, perimenopause, and postmenopause can change ADHD symptoms Estrogen, progesterone, testosterone, cortisol, insulin, and brain energy Why perimenopause can make ADHD much harder to manage Gut health, sleep, exercise, protein, omega-3s, fiber, and polyphenols How to work with your healthcare provider instead of trying to DIY everything

What happens when you’re doing everything “right” for your health but still don’t feel like yourself? In this episode of Modern Thyroid & Wellness, McCall McPherson sits down with Nicole Peterson Doran, co-founder of PUR-FORM, Humanaut Health franchisee, and host of The Healthspan Collective Podcast, to talk about her decades-long journey through PCOS, hypothyroidism, inflammation, fertility concerns, long COVID, mast cell activation symptoms, and ultimately finding a more personalized approach to health. Nicole’s story began at just 16 years old when she rapidly gained weight, developed facial hair, experienced irregular periods, severe fatigue, and intense brain fog. She was diagnosed with PCOS and later hypothyroidism, but traditional treatment did little to resolve how she actually felt. That experience eventually led her into integrative medicine, whole-food nutrition, mindfulness, and the concept of bio-individuality—the idea that what works for one person may not work for another. In This Episode: Nicole’s experience with PCOS and hypothyroidism beginning in her teens Why whole foods and lifestyle changes became a turning point The importance of bio-individuality in thyroid and hormone health Why there is no single “best” diet, medication, or wellness plan for everyone How Nicole prepared her body for pregnancy after years of PCOS The supplements and lifestyle changes she personally used while preparing for fertility Her long-COVID journey and mast cell activation symptoms Her personal experience with microdosed tirzepatide Thymosin alpha-1 and larazotide Why gut health became an important piece of her recovery What EBO2 is and how PUR-FORM uses regenerative therapies The evolution from struggling patient to health entrepreneur

In this episode of Modern Thyroid and Wellness, McCall McPherson, PA-C sits down with thyroid health expert and bestselling author Elle Russ to discuss why so many people with hypothyroidism and Hashimoto’s continue experiencing symptoms even while taking thyroid medication—and what may be missing from conventional thyroid treatment. They break down the limitations of relying on TSH alone, the difference between “normal” thyroid labs and actually feeling well, and why thyroid treatment may need to consider the bigger picture, including T4, T3, reverse T3, medication type, dosage, timing, symptoms, and the individual patient. If you’ve ever been told your thyroid labs are normal while you still struggle with fatigue, brain fog, stubborn weight gain, mood changes, high cholesterol, fertility concerns, or other hypothyroid symptoms, this conversation will help you better understand the questions to ask about your thyroid care. 📖 PRE-ORDER TAKE BACK YOUR THYROID McCall McPherson’s new book, Take Back Your Thyroid, is the science-based guide for people who are tired of being told everything looks “normal” when they still don’t feel well. Pre-order the hardcover and receive the Thyroid Empowered Course ($399 value) FREE with your pre-order. 👉 Pre-order here: https://book.modernthyroidclinic.com/?utm_source=youtube&utm_medium=organic&utm_campaign=take_back_your_thyroid_preorder&utm_content=episode_62_elle_russ 🔑 IN THIS EPISODE: Why you may still have hypothyroid symptoms while taking thyroid medication Why relying only on TSH can leave important information out of the picture “Normal” thyroid lab ranges vs. optimal thyroid function T4, T3, reverse T3, and thyroid hormone conversion T4-only medication vs. combination thyroid therapy Natural desiccated thyroid vs. synthetic thyroid hormones How medication dose and timing can affect thyroid treatment The connection between thyroid dysfunction, fatigue, weight, mood, cholesterol, and fertility Common misconceptions about thyroid hormone replacement Why understanding your own thyroid labs matters How to become a more informed advocate for your thyroid health