425: Thyroid, Perimenopause & Weight Loss: What Women Need to Know with Dr. Rachel Vong

In this empowering episode, I sit down with Dr. Rachel Vong, a naturopathic doctor who specializes in women’s thyroid health, especially hypothyroidism and Hashimoto’s.

We dive into the connection between thyroid function, perimenopause, and weight loss—exploring why so many women struggle with fatigue, weight gain, and hormonal shifts even when they’re “doing everything right.”

Dr. Vong breaks down the importance of optimal lab testing, the dangers of chronic dieting, the role of inflammation, and how sustainable lifestyle changes can restore health and resilience. You’ll leave with practical takeaways, a fresh perspective on weight gain, and the encouragement to advocate for yourself on your health journey.

Dr. Rachel Vong is a licensed Naturopathic Doctor in Toronto, Canada with a passion and clinical focus on thyroid disorders, specifically hypothyroidism and Hashimoto's Thyroiditis. She runs a successful 4 month comprehensive thyroid program called the Thyroid Reset System that has helped hundreds of women with hypothyroidism and Hashimoto’s reclaim their energy, lose weight effortlessly and get back to feeling like themselves again.

Having struggled with debilitating anxiety, burnout, and a myriad of gut issues herself for several years, it has become her mission in life to help guide and empower other women to take charge of their own health so that they can live a life that they love.

If you want to connect with her, you can find her at the links below! 

drvongnd@gmail.com
https://www.drvongnd.com/thyroidresetsystem
https://www.instagram.com/drvongnd
https://www.facebook.com/groups/244653034411113

 00:22 Meet Dr. Rachel Vong
 01:03 Thyroid 101: Role in Health & Energy
 01:44 Signs of Hypothyroidism
 02:28 Perimenopause vs. Thyroid Symptoms
 05:17 Why Testing & Family History Matter
 07:54 Beyond Thyroid: Other Key Markers
 09:30 Normal vs. Optimal Lab Ranges
 12:01 Thyroid, Metabolism & Weight Gain
 17:39 Reframing Weight Gain as Protection
 20:23 Case Study: Reducing Inflammation
 24:23 Nutrition, Inflammation & Resiliency
 27:14 The Risks of Chronic Rest

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Transcript

Angie: 0:00

What's up runners? Welcome back to the Real Life Runners podcast. Today we're diving into a topic that so many women in midlife struggle with, but often don't get clear answers about, and that's the thyroid. If you've ever felt like you're doing all the right things, like you're running, you're exercising, you're eating well, and yet you're still gaining weight, exhausted, cold all the time, or dealing with hair. And brain fog, your thyroid could be playing a big role. Today I am joined by Dr. Rochelle Vong, a naturopathic doctor from Toronto who specializes in helping women with hypothyroidism and Hashimoto's reclaim their energy, lose weight without endless restriction, and start feeling like themselves again. This podcast is so full of information. We talk about how the thyroid is the body's ma metabolism regulator. Why so many symptoms? Overlap with perimenopause and menopause and how to tell, like how to start untangling what's actually going on in your body because thyroid dysfunction and perimenopause symptoms often look the same. We dig into the difference between optimal ranges and normal ranges in our blood work and how blood sugar and inflammation play into weight struggles, and most importantly, you have. Way more control than you've been told in the past. So I can't wait for you guys to hear all of the information that Rochelle brings to today's podcast. So if you have any questions or if you wanna connect with Rochelle, all of her information is in the show notes. So let's dig in. Welcome to the podcast today, y'all. I'm so excited to have Dr. Rachel Vong here with me. What's up, Rochelle? How are you?

Rachel: 1:55

Hello. So good. I'm so happy to be here.

Angie: 1:57

I'm so glad you're here. I am so excited to dive into our conversation today. So I'm gonna let Rachel introduce herself. So tell us a little bit about who you are and what you do.

Rachel: 2:08

Yeah, so I'm Rachel. I'm a naturopathic doctor. I'm based out of Toronto, Canada, and, I focus on a very specific niche and demographic. So I help women with thyroid disease, specifically hypothyroidism and Hashimoto's. I help these women reclaim their energy, lose weight effortlessly, and just get back to feeling like themselves again.

Angie: 2:29

Lose weight effortlessly. Yeah. I love that. I know that's, there's a lot of people that are listening to this that are probably like, that made their ears perk up a little bit. Like effortlessly Wait, say more. so let's start, the thyroid is such an important organ in the body, and I think it's one that is not well understood by a lot of us. So can you start us off with just a little thyroid 1 0 1? explain Yeah. the thyroid's role in the body, like what does it do and, why is it so important?

Rachel: 2:58

Yeah, and as you said, like I think a lot of people underestimate the importance of the thyroid, and it's a very small organ, so it's, it actually sits at the base of our neck. It looks like a little butterfly, but it literally impacts everything. So our thyroid hormones. Regulate our metabolism. It regulates our weight management. It regulates our appetite. our temperature production, like literally every cell in our body is impacted by our thyroid hormones. So you can imagine that if you don't have enough or you have too much. It can really throw everything off tilt. And a very common, again, because I work with women with hypothyroidism, meaning you don't have enough thyroid hormones, often we do see that the main signs and symptoms would be things like weight gain, especially when you don't change anything. Like a lot of these women have not changed their exercise, have not changed their diet. Literally nothing has changed, but all of a sudden they're gaining a lot of weight. That is, tends to be a really key sign of hypothyroidism. Also, feeling cold all the time. Like you're the coldest person in the room, you're wearing a sweater and everyone's like hot in a t-shirt. That tends to be a sign. hair loss, fatigue, like debilitating fatigue, constipation, like you can see how, again, it literally impacts the entire body.

Angie: 4:14

Yeah. And so I think that's really important because, we are gonna get into perimenopause and menopause, in our conversation today because a lot of what you're explaining can also be a side effect or a symptom of perimenopause. So it becomes this thing of, how can we figure out what exactly is going on? And I think that's why it's so important to have this conversation so that we can really. Continue to educate ourselves in what exactly is going on in our body so that we can start checking boxes. because. What people a lot of people don't understand is that there's no one good test for perimenopause. So you can't just go and take a blood test and decide whether or not you're in perimenopause, but we can take a blood test and figure out what's going on with our hormones, and I think that it's really important that we understand that because while there are some things that we can attribute to perimenopause. We wanna make sure that we're ruling other things out first. And I think that the thyroid is a big one because there's a lot of overlap there of like the symptoms of a thyroid issue and symptoms in perimenopause.

Rachel: 5:16

Yeah. I find, a big proportion of my clientele actually are women going through perimenopause and menopause and they're always, one of the questions they ask me is like, how do I know, how do I know if it's menopause? How do I know it's my thyroid and Yeah, it's really tough.'cause again, like all those symptoms that I mentioned, even like insomnia and mood swings and all that stuff can be either one. Yeah. But the thing that's important to note, and what you were talking about is that. There's so many things happening in tandem during that period of per perimenopause and menopause. So it can be very hard to entangle what belongs to what thing. But it's important to understand the process behind, like what is actually happening in your body during this time. Like it's a very important transition in a woman's life. Like it's inevitable. We're all gonna go through it at some point. But it doesn't have to suck. a lot of people think, oh gosh, I'm going through it now. It's gonna suck. Or even younger women who are thinking forward to be like, oh my gosh, I saw my mom go through it. I don't want the same thing as her. So it doesn't have to be that way. And I think that's why it's so important to have this conversation now. So that. Again, you educate yourself and you take the right steps to learn more about what is happening and you can be proactive. Because the more proactive you can be, the less that transition's gonna suck.

Angie: 6:29

Absolutely. Let's get into if you have a client that's coming to you and telling you, some of the symptoms that you're talking about with, especially specifically with the weight gain. And specifically, someone that's working out and they just find like they're gaining weight and nothing that they do can help. I've changed nothing and nothing's helping. So where do we start?

Rachel: 6:49

Yeah. So that happens like 99% of the time with the clients that I work with. Yeah. and some of the women I work with know they have a thyroid issue, so that's one thing, but if you don't, then that's where I think comprehensive blood work can be so helpful. Yeah. Again, just to understand like, where's this coming from? And the thing that really don't mind my language, but pisses me off is when they go to their conventional doctors and they're just given that oh, it's just a part of aging. you're fine. Everything looks fine. When in reality like, this is not normal. You shouldn't be just gaining weight out of nowhere. Yes, you might be aging, but that doesn't always have to come with that kind of symptom. So it's important at that point to, again, just dig deeper, know that there is a reason, there is absolutely a reason for it. You just have to find what it is. And so for, the work that I do is. That deep dive investigation. Okay. What kind of testing do we do? So obviously looking at the thyroid, that's a huge one because in the majority of cases I do find that the thyroid is off, and because the thyroid does regulate metabolism, when we hit perimenopause and menopause, I always say, In a woman's life, we go through different hormonal transitions. So puberty is a obvious big one. Pregnancy and childbirth is another, and then perimenopause and menopause. So three kind of major hormonal shifts in a woman's life. At every. Transition. There is an opportunity to see like a glitch in our system because at the end of the day, these hormonal shifts can be like stressors in the body. So depending on the woman, sometimes these transitions can be glitches. So for a woman who has say like a predisposition for a thyroid issue, so if your mom has thyroid disease, if your grandma has thyroid disease, if there's some sort of. Genetic, like family history, you are definitely more at risk for yourself developing a thyroid issue. And all you need is a trigger or a glitch to happen. So it could be again, postpartum is very, a very common time, but perimenopause and menopause is another very common time, which is why a huge, like so many of my clients are in that stage of their lives. if you're in that. Time, if you are noticing that you are experiencing some perimenopausal symptoms or you're at that age and you're noticing that weight gain coming outta nowhere, then I would say definitely start looking at the thyroid because it could. It could be that it glitched. It's a weird word to say, there can be a change in your thyroid hormones, and also the immune system as well. And all of that can affect your metabolism. And all of a sudden now your metabolism set point is lower and that can cause the immediate weight gain that you see. Okay. So definitely deep dive into blood work.

Angie: 9:32

Yeah, I agree. And so what other, besides just looking at our thyroid hormones, what other markers in our blood should we be looking at?

Rachel: 9:41

Yeah, so I. Aside from the thyroid, which again includes all your thyroid hormones and even your thyroid antibodies, that's really important. I like to look at a few different things. So nutrient levels is important. So looking at your vitamin D, looking at your B12, looking at your iron, like these nutrients are so important for metabolism, for overall optimal health. For energy. I wanna make sure that all of these things are optimized. As well as looking at inflammation markers. Also really important, and I can get a little bit into that later if you want, but inflammation tends to be another big culprit for stubborn weight loss and tends to happen and come about around that time of, again, perimenopause and menopause. because of some blood sugar. Regulation issues, but generally we see like an increase in inflammation. And inflammation can be like a warning signal to the body. The body doesn't like inflammation, so when it sees that there's a heightened level, it will actually down regulate your metabolism because it's trying to conserve energy. So that's where we see, again, that metabolic set point. Come down and then the weight go up. So I like to see, can we see it in the blood work? So we'll do, inflammation markers? also look at hormones, especially again, if you're going into perimenopause and menopause, it can be valuable to see where is your estrogen at? Where's your progesterone at, where's your testosterone at? So getting that really holistic, high level look at your health Can give us so many different clues as to where the barriers. Might be coming from. and it could be a combination of a lot of different things, but it's important to look at your health from a bird's eye view.

Angie: 11:16

Yeah. And I also would love for you to talk a little bit too about the difference between being within a normal range and being optimal. Yes. Because I think that's a big thing that a lot of people don't understand and they go to their doctors and they get some of these blood panels done and. And the doctor says, oh, all of your blood is normal. Blood work looks fine, everything you're normal. But then when you actually look at it and you see where you are on that quote unquote normal spectrum, there's a huge range for some of these things. Yeah. And so just because you might fall into the normal range, that doesn't mean that you're in the optimal range for feeling good and having good health.

Rachel: 11:53

Exactly. And I'm gonna just talk about the thyroid specifically here. Yeah. Because, I see this a lot where again, you're gaining weight for No reason and you're tired and your hair is falling out. So you'll go to the doctor and the doctors will often run usually one test, and it's TSH, so thyroid stimulating hormone. That is a routine test done usually. And like even part of your annual and all that. However, that hormone, so that comes from the brain actually, that's a brain signal that goes to your thyroid to tell your thyroid how much thyroid hormone to produce. So we're only looking at one marker. First of all. it's not indicative of the overall function of your thyroid, but it's just one marker that comes from the brain. So that's a problem in and of itself. But with that marker alone, as you've said, the range of normal is quite wide. I think it's like 0.32 to 4.5 or something like that. Yeah. Now somebody who's sitting at a 0.32 is gonna look very different and feel very different than someone who's at a 4.5. So we cannot say that people at both ends of these ranges are normal. Exactly. So what we're trying to aim for is really this optimal range. So when most people are in this optimal range, they feel great. Their health is optimal. So really with every marker, not just thyroid, but every single lab marker, we really gotta get rid of this idea that as long as we're in the normal range, we're fine. That is not true. We really wanna strive for optimal, because if your TSH is at a four. And you're gaining weight, guess what? Your thyroid is likely involved in this. Your thyroid is not okay.

Angie: 13:30

Yeah, and I think that people don't really get that. And one way that I like to look at it is we obviously are a running podcast, and so as a runner you can go out and you can run a 5K and say you run that 5K in 36 minutes and you're like, okay, you ran a 5K, that's in the normal range, like you were able to complete the 5K, right? But as a runner. We often want to get a little faster, right? Do a little better. Like we want to improve ourselves and see how fast can I get here? So 36 might be in the quote unquote normal range, but what if we, but you know what, I kind of wanna get under 30, I wanna get under that 30 minute mark, and that's because you wanna. Optimize your running. Yes. And that's the same thing here, right? Just because you're in the normal range, just because you were able to complete a 5K doesn't mean that you were happy about your time and your performance here. And it's the same with our hormones and our blood markers is just because we're in that normal range does not mean that is our optimal levels for us to be at.

Rachel: 14:30

Yeah,

Angie: 14:31

I love that comparison, by the way. That's really good. I just came up with it on the spot, so there you go.

Rachel: 14:36

So good. Alright, but no, you're right. Like optimal is best Yeah. for everything and sometimes too, like it allows you to be proactive because if you see that things are still normal but not optimal, that is literally the best time to take action. Yeah. To make changes because you're not at a point where maybe things aren't necessarily significant or severe. But again, it, things are changing. Like you have gotta trust that there, it's your body's telling you something. Yeah. That something is off. Yeah.

Angie: 15:02

We don't need to wait until we're pathological, until we run actually in a disease process to make changes. And I think that's really the big thing. I think the difference between the way that you practice medicine and the way that a lot of western doctors practice medicine, is that, we in the western medicine world are very good at. Treating diseases and managing disease, but we are not good at promoting health and really optimizing health. And I think that it's a huge mindset shift and a shift in perspective of which one do you really wanna pay attention to? Are you, do you wanna just be in the normal range so that you can avoid disease? Or do you wanna be in an optimal range so that you can really feel your best and promote? Good health and be able to do whatever you wanna do both now and in the future. And I dunno about everybody listening, but that's definitely what I'm shooting for. when we talk about the optimal range, is that optimal range the same for each person or would you say that it varies from individual to individual.

Rachel: 16:01

It definitely ranges. It depends on what tests you're looking at. Okay. like for example, hormones, The optimal range for hormones is going to depend on age. A lot of the times. So like an estrogen level for a young female is gonna be very different than from someone who's in, perimenopause. For example, so it does depend on the in individual. And that's where, again, with health, you've gotta look at the individual in front of you. So like knowing that you are a different person than even your sister and your mother, And so it's important to take that deep dive to see where can we optimize here. Beautiful.

Angie: 16:35

Yeah. So what role does the thyroid play when it comes to metabolism and weight loss? Why is weight gain such, a key symptom when it comes to thyroid issues?

Rachel: 16:48

Yeah, so again, like the thyroid hormones regulate what your me metabolic set point is. you know how much food you're eating and how much exercise you're kind, like the whole calories and calories out. Calculation. your thyroid kind of sets what that number is. So as long as you are eating, a certain amount and you're exercising a certain amount, and it like. Cancels each other out, you're not gonna gain any weight, right? If you eat less than your kind of, set point, then you're gonna lose weight. So all of that kind of, it's just for someone without, say, a metabolic issue or a thyroid issue, it's pretty mathematical in that sense, right? But for women who have thyroid issues, that equation unfortunately goes out the window. It's not gonna apply because if someone's metabolic setpoint has been lowered, which happens with hypothyroidism, they could be eating in a supposed calorie deficit and not see any weight loss because their metabolic setpoint has been lowered so much. So that's the problem that we see is that these women. Are working their butts off. like they're in the gym five days a week. They're running, they're doing CrossFit, they're literally killing themselves, working out and even eating in a calorie deficit. And nothing is budging. And you can imagine that's frustrating.

Audio Only - All Participants: 18:08

Yeah. And

Rachel: 18:09

if anyone's listening, I'm sure so many of you're in the same boat, I don't know why this is not working like this is, this used to work for me 20 years ago? Why is it not working for me now? And it's because of the fact that your metabolism has gone down and we call that like metabolic inflexibility, so it can't account for the changes in calorie intake and expenditure and all that stuff. So that's the problem here with women who have thyroid disease. and remembering that at the end of the day, like your body is First of all, your T three hormones, if you don't have enough. That's why, again, it's not being able to push up that metabolic setpoint. But generally speaking too, with hypothyroidism, there's so many other different things happening in your body. As I've said before, inflammation tends to be rampant in your body. Blood sugar dysregulation. adrenal dysfunction issue, so cortisol imbalance. So you, you'll start seeing other things happening in the body and often these are all again, warning danger signs to the body. So you know, your body will go into kind of more defensive mode protection mode. Yeah. Because of all these things and that will push your mepo me metabolism even lower.'cause your body's trying to protect you. I often say we sometimes have to reframe how we see and view, weight and weight gain. Often women think it's a result of what they are doing and a lot of, there's a lot of like guilt and anger put on themselves. And shame. And shame.

Angie: 19:33

Yeah.

Rachel: 19:34

But instead I want you to think, your body is protecting you. Weight gain, Adipose tissue is actually protective. it will give you energy. It will keep you warm. Like your body's literally adding on more adipose tissue because it feels that there's a threat. Yeah. It feels unsafe. And that's why we're gaining weight. So your body is doing everything that it can to protect you. And if we can just acknowledge that it's not trying to, Does it punish you for anything like

Angie: 20:02

or sabotage you or sa a lot of people use that word, the sabotage word, but it's really protection and

Rachel: 20:08

survival. Yeah, but it's protection. It's survival. And what we need to do is first of all, acknowledge that, And thank our bodies for doing the amazing things that it does for us. And then listen to our bodies to say, okay, I hear you. There's something going on. Now it's my job to look into it. Let's see. Where, why do, why does my body feel unsafe?

Angie: 20:30

Yes.

Rachel: 20:31

let's find that. things like, again, inflammation and, Chronic infections, gut infections, like there's so many things that could be going on, but if we can identify these things, which we can,'cause we've got lots of cool functional testing and all the things, and actually address'em and we remove the threat, and this is why I say effortless weight loss, I don't just throw that word around. If you can remove the threat and the body feels safe again The body will let go of that weight and it will feel and look effortless.

Angie: 21:03

Yeah,

Rachel: 21:04

it's not that you have to change anything. you're not being asked to work out more or eat less. You just have to remove what the barrier or the blockage is for your body right now. It's not that your body can't do it, it's just there's so many barriers right now for you. So we just gotta uncover that and remove that, and you will see that weight shed.

Angie: 21:25

Yeah. I love that reframe so much, and I think that it's so important for women to really understand that because like you said, there is a lot of guilt and shame and pointing fingers at yourself like, there must be something wrong with me when your body's just doing exactly what it's supposed to do. Exactly, and it's. Such a beautiful thing when you can understand that you can give your body a little hug and say thanks, thank you body for protecting me. Thank you for doing this for me. Like you're doing exactly what you're supposed to be doing. Okay. Now let's get to the bottom of this. Exactly. So where do we start? when we start to realize, Okay. I hear you, Rochelle. Things are things, my body's under threat, but where do I start here? Where do I start to uncover why my body feels threatened?

Rachel: 22:09

Yeah. I would love to use an example because I actually had a client, come into the program and she had very typical hypothyroid symptoms, so she was extremely exhausted. She had, I think it was three kids under. Four. And so you can imagine

Angie: 22:26

that's

Rachel: 22:26

gonna very, that's

Angie: 22:27

gonna put

Rachel: 22:27

anybody's

Angie: 22:28

fight

Rachel: 22:28

or flight on, on guard there. Yeah. she's tired, right? She is, she's a busy mom of young kids. but she also had a thyroid issue, which is, it just makes it, compounds that right. Her hair was falling out. She was so bloated. and that's another thing like the thyroid is very intimately tied to your gut health. So a lot of people with thyroid issues will experience tons of bloating, like often looking six months pregnant by the end of the day, every day. constipated, nauseous, like a lot of issues. And so she was even throwing up from the discomfort of the bloating. Just not a good, not in great shape. and there was some stress too. She was taking care of her father at the time, so there was just a lot going on in her life. But she loves to run. She's actually a runner herself and she's, she loves being active, but of course, just with everything going on, and especially with the energy She just couldn't get back into it. Like she would do little runs here and there, but like she really wanted to run a half marathon, but she just could not. Go through the training, she just couldn't get herself there physically. Yeah. And even she even said even if she did go for a run, she'd feel so depleted after. it would take her days to recover, whereas before it was like nothing, Yeah. So she definitely felt like something is not allowing my body to do this anymore. And so she found my program and she, we started working together and one of the first things that I do with all of my clients is. Try to reduce inflammation as quickly as possible because again, most of these women are dealing with a lot of inflammation.

Angie: 24:01

Yeah.

Rachel: 24:01

So nutrition is probably one of the best ways to address inflammation. and We had her do an anti-inflammatory diet. So just really ensuring that she was eating foods at work, bringing down inflammation, and getting her macros in the right, proportions, her protein, carbs, fats, and all the things that alone helped so much to get her energy back up. But that's the thing, like with inflammation, it's not just one thing, one improvement that you will see. Inflammation really does affect. All areas of your health, including your recovery time, joint pain, muscle pain, weakness, strength, like all these things can be affected by inflammation. So already, just by addressing the inflammatory piece and bringing inflammation down, she felt stronger. She felt more resilient. And often that's what it takes to be able to, Run for longer and more, for more often and, hit those prs and all that stuff. Like you, you need that resiliency. You need to build that resiliency. So

Angie: 25:01

absolutely

Rachel: 25:02

she did that plus some other things. We worked on her gut health a little bit, worked on her adrenals, but we really didn't do all that much. I think for her inflammation was probably the biggest block for her. And within a couple months she ran her first 10 k, or sorry, not, no, sorry, not 10 k. Half marathon in 10 years. It's been 10 years since she ran one and she finally ran one and she was blown away by her own results because she ran faster than she thought she would. And she felt great. Yeah. Like great. So just to show you that, it's not that you can't do it, but there just sometimes you just have to remove that block.

Angie: 25:38

Yeah.

Rachel: 25:38

Whatever that is. So for her it was inflammation, but as I've said for other people, I, I do a lot of gut work, Some people have a lot of what we call dysbiosis imbalance in bacteria. some, for some others it's a lot to do with their blood sugar. So we have to adjust the insulin resistance. it's hard to say generally what these things are because it can look very different for every single person.

Angie: 25:59

But what I'm hearing you say is that it's so much connected to our nutrition as well. Because that's obviously where you started with this client, and I'm guessing with a lot of other people too. Every client, yeah. Is getting her to actually, yeah. Eat foods that are going to nourish her body and decrease inflammation, versus just focusing on weight loss and restriction, which is what so many people do in this phase of life, right? They try to eat lower calorie, they try to eat low carb, they try to eat low fat, and it throws your body completely off, especially if you're a runner or any sort of. Active woman that is exercising regularly, you have to feed your body. And if you are not nourishing your body with the proper foods, then you are going to have increases in inflammation, increases in gut issues, and so many other things because you're not giving your body the fuel that it needs. And I think that's such an important shift again, right? that way that we're looking at our food intake and the way that we're looking at nutrition. Not just looking at calories and calories out and making sure that I'm hitting the right number of calories every day, but am I giving my body enough protein? Am I giving my body enough carbohydrates and the good carbohydrates so that I can have more energy? Because carbohydrates are our energy source, and protein helps us build stronger muscles and healthy fats help with our nerves and our gut and like all these other things, right? Looking at this, like you said, very holistically from that bird's eye view and saying, what does my body need right now? Yeah. And what can I eat to give it to myself?

Rachel: 27:32

Yes. And I love that you said that because I think the narrative right now, at least for women in weight loss is that you just have to exercise more and you just have to eat less. And that's it. I hear this all the time. I do too.

Angie: 27:45

And it's complete baloney, especially if you're already aware of what you're doing. And if you're exercising, the answer is definitely not. Eat more and or eat less and move more.

Rachel: 27:56

Yeah, that's not the answer. And with women who have, metabolic issues like hypothyroidism,

Angie: 28:02

yeah.

Rachel: 28:02

It's even more important to not do that because, I find that your resiliency is already so low. And when I say resiliency I mean like your ability to handle stress, your ability to handle inflammation. Like we are all born with a pretty good. level of resiliency. And that's why we're able to, occasionally eat junk food and do this and do that and not have it completely wreck your system. But with hypothyroidism, that resiliency has become much, much lower. And when you're eating less, and this is very, factual information, research shows us this. Yes. When you're eating in a chronic calorie deficit, that can actually add more stress to a woman's. Body and with, again, your resiliency being so low, it means that stress impacts you that much more. And stress, we all know about cortisol. I think you, I'm sure you've talked about cortisol before. Yeah. But cortisol is a fat storing hormone. So if we, if our bodies are now more stress and we have more cortisol raging through our system, this is literally going to signal to our bodies to store more fat. So all that calorie deficit, Strategy and exercising more, which can also be a stressor. Yes. All of that is adding to the signal of, Hey, I think we're stressed out here. My bot our, we can't handle this right now, so we're gonna just store more fat.'cause you're telling us that we're actually more in danger mode here.

Angie: 29:26

Yep. Yep. a hundred percent. And I'm so glad you said that because I, that's one of the things I try to tell people all the time, and they, it's so hard for people to make that shift because of diet, culture and the things that we've been told for decades and decades, Of the eat less and move more. that's just how it is. It's just that equation. That's the only thing we have to think about, which is such an oversimplification like yes. Calories matter, but not when you're like your, like you said, not when your body's not operating optimally. Yeah. And that. Chronic stress and overstress and adaptability, like you, you call it resiliency. I like to call it adaptability. It's both, right? But it's essentially like our bodies are amazing and they can take on so much. We just have to learn how to support them a little better and yeah. that's where I think things get really confusing for women. Especially in this phase of life, because now, like you just mentioned, say you have a thyroid issue and now your metabolic set point is lower, which means that your body is less resilient, your body's less adaptable. Now you throw on perimenopause and the loss of estrogen on top of all. Yes. That And so now estrogens doesn't even have your back anymore. And so there's all of these multiple factors that are affecting you. And that's what I think makes it so confusing and frustrating for so many women. Yeah.

Rachel: 30:45

I know totally. and that's where again, we have to take more of that comprehensive approach In looking at what's going on because it's so complex, because it's so multifactorial, Absolutely. but yeah, I think that Just for anyone who's thinking, does that mean I can't be working out? And what should I be doing here? I always say that sometimes you're, you just need to take a break before you can ramp back up.

Audio Only - All Participants: 31:09

Yeah. And

Rachel: 31:10

recognizing, and I've seen this. A lot where some women who again, used to go to the gym five days a week Already just shifting to let's just say low intensity workouts or maybe taking more breaks. So having maybe two days a week instead of the five. Just that shift alone can cause weight loss. Yes. Which is Crazy, if you think about it. Totally counterintuitive to everything we've been told. Completely. So I have seen that to happen. Now I'm not saying it's gonna happen for every single woman But just goes to show you again the impact that, exercising and that physical kind of demand on our body, like what that actually does to our hormones. And especially with, the changes like the hormonal shifts that we do experience in terms of perimenopause And menopause, where now we're having drops in our hormones. It's interesting because during that period of life, we go from, having our ovaries and our reproductive organs doing most of the hormone production to now our adrenal glands. And I think that's where this becomes even more important when we're talking about stress and, physical adaptability if you will. So when we go through perimenopause and menopause, our adrenals take over. Some of that hormone or most of that hormone production from the ovaries. So if you already are somebody who has gone through a lot of stress in their life, maybe already acknowledges that they have a bit of adrenal dysfunction going in, this is where I see that a lot of women will have some more significant kind of like menopausal symptoms because their adrenals are having a very hard time coping with that shift. And again, because the adrenals are taking over. It becomes more important to manage stress because the adrenals are already overworked trying to manage that hormone production load. Now it's okay, if we're gonna push our bodies, we're exercising too much or we're eating too little. We're just telling our adrenals, Hey, We're just gonna work you till you can't work anymore. And the adrenals will like poop out too. And then now you've got that whole thing with cortisol and everything that comes with that. this is where again, we just have to be very mindful of kind of the stage of life that we're in and what our physiology is doing, what's happening in our bodies, and realize that there is a better approach. and like you said, it starts with kind of just understanding and that shift in mindset. Definitely. that we don't need to push our bodies so much and that we don't need to restrict,'cause restriction often is not the answer and is not helping you at all. We need to nourish, we got to fuel. Bodies, and hormones require a lot of resources, like I said, good fats, proteins, right? We need to have enough of these things so that your body has enough building blocks to actually make the hormones.

Angie: 33:56

Absolutely. And I, there's also I think, a lot of fear around that. when I talk to women about this idea of maybe you're overdoing it and maybe you're restricting too much, I think you actually need to eat more. And like the number of times that I've said that to someone. And the response that I've gotten has been fearful of, yeah, I can't, but what if I Start eating more and then I just keep gaining more weight. Because again, that's the narrative we've been told, Is that if you eat more, you're just gonna gain weight. And I think there's so much fear around that too, of if I let my foot off the gas and don't exercise five days a week, or if I start to eat more and don't keep myself in this calorie deficit, then. God forbid what is gonna happen. So can you address that fear that a lot of people have around this idea?

Rachel: 34:46

Yeah, I hear it a lot as well. Yeah. and I get it. I totally get it. Especially when like the evidence that you have is stacking. with that thought. Yeah. So I do understand that, but I think that's where, again, just like that education piece is really important to like really truly understand like the impact of what is, your activities and how that's actually impacting your hormones, but also. Doing that comprehensive kind of deep dive.'cause I often, if I have clients like that, then usually in the, when we do our comprehensive blood work, we see what's going on with their thyroid. We see what's going on with their adrenals a lot of the time. It's that like light bulb aha moment for them to be like, oh, maybe there is more to my weight loss struggle than just the calories and calories out issue. Maybe this thyroid thing is actually a bigger deal than I thought, or oh, maybe this The fact that my cortisol is tanked, like that has something to do with it. So I think just like even just opening your eyes to the awareness of there could be more going on in your body and that starts with, again, just being more comprehensive with your investigation. So I find that tends to help my clients feel more. I don't know, just less, a little bit less fearful in understanding that there could be more going on than meets the eye. and all too, if we're gonna make changes to their exercise regimen or their diet, like it's never drastic anyway. We do it very slowly. Even if it's just like adding one little more like snack midday to start, or, we're gonna cut down by one day or cut this one day by half the time, we're just gonna make small changes, small transitions, so they still feel con in control

Audio Only - All Participants: 36:20

Of

Rachel: 36:20

the situation without, and being able to experiment, if you will, with that as well. So that's at least what my clients have found worked for them.

Angie: 36:29

I agree. I think that starting with small steps that are very doable and sustainable is the key here, and I love that's what you teach with your clients as well. Because when I. Talk to people or hear people going on these very drastic metabolic reset type of diets. It's always this red flag that goes up for me because, maybe you can get some results. And I have friends that have done these very significant severe, I, I like severe extreme type of diets, called that are claiming to reset your metabolism and. It works at the beginning, right? And then it doesn't anymore because it's very hard to sustain that type of restriction in your regular life. I wanna shift a little bit because you talked about, looking at holistically. all the things that are going on in the body. Can you speak a little bit about blood sugar and insulin resistance? Because you, you mentioned that a little bit before. but like the role of blood sugar regulation and insulin resistance and how your thyroid, connects all of those things and how those things also affect our me metabolism and our weight.

Rachel: 37:36

Yeah. This is probably one of my favorite topics to talk about because I do just find it, it's so important and can be. Like really, pivotal in someone's kind of transformation because when we can actually address insulin resistance, everything can change. for a woman going through perimenopause and menopause, we obviously know that there is gonna be hormonal shifts. Like estrogen and progesterone. Now these hormones are not just sex hormones that, affect reproduction and sexual development and all that, but they actually do play into a lot of other hormones in the body, which is like super cool. So estrogen, in particular. We see that it actually can impact immune function And can impact, like other hormone signaling. So for example, insulin. So insulin is that hormone that's released from the pancreas in response to an increase in blood sugar. So when we eat something, it's broken down into glucose and it enters our blood bloodstream. Our pancreas will then release insulin to help that sugar go into our muscles to be used for energy and for fuel. That's normal. Now again, estrogen can actually like talk to insulin to tell it how you know how well to do its job essentially. And the thyroid, same thing. T three hormones can actually impact insulin signaling and insulin function as well. So you can see how like insulin's doing its job, but it has a lot of different supervisors and managers around to ensure that it's doing its job, right? Yes. But unfortunately, if one of those managers goes array and it just goes crazy, then it does impact how insulin does its job. So for estrogen, the fact that, with perimenopause. And menopause. We do see lots of different fluctuations, but especially through menopause. When we hit like a low with estrogen, we lose a little bit of that signaling power from insulin. And so we, that's where we see, and that's why we see so many issues with blood sugar after perimenopause. And with insulin's such an important and crucial hormone because like cortisol, it also is a fat storing hormone, When we have increases in insulin in our bloodstream, that's where again, we see that signal saying, Hey, we need to store more adipose tissue. And then we start seeing a lot of that weight gain come about. So a lot of the women I work with, when we're trying to investigate stubborn weight loss, insulin resistance, or blood sugar dysregulation tends to be the culprit for like at least 70 to 80% of them. It's huge. And especially in that population of women who are going through perimenopause and menopause because of how estrogen and insulin go hand in hand, Okay. And you, on top of that, you have the glitch in the thyroid, right? So you also have that component that also impacts insulin signaling. With insulin resistance, essentially, it's your insulin is no longer working the way it should. You know your cells are not responding to insulin as well. So when that happens, insulin starts to build in the bloodstream as well as glucose. And those two things are not great because now you've got a buildup of insulin, which I said is signals the body to store fat, which is gonna make it very hard for you to lose weight. And then you've also got a buildup of glucose, which can, increase your risk factor for things like diabetes. And then we start seeing like a lot more of these kind of blood sugar rollercoasters. We see really high highs of glucose because insulin's not doing its job, but then we see also low lows because now the brain's actually gonna tell the pancreas to dump insulin into the blood. It's like you're not doing your job. Why is there so much glucose in the blood? So insulin comes in and it just does its job, but too well, where then your blood sugar crashes. Now these ups and downs can cause a. The whole array of symptoms. Okay? So if you're somebody who, tends to like crash after lunch, you feel like between two to 4:00 PM you always need to take a nap. That can be a sign of blood sugar regulation issues. If you have intense sugar cravings, especially at nighttime That can also be a sign of blood sugar dysregulation or insulin resistance. And it's all because of this up and down and up and down of your blood sugar. personally, this is something that I experienced as well in my, a decade ago when I was going, going through my own health. issues. I had no idea. Actually, I was very clueless at the time before I went to naturopathic medical school, so clueless about blood sugar and the impact that it really had on my health, but it really impacted my cognition. I had a lot of brain fog. I had have anxiety as well. Every time I hit a low in my blood sugar, I would be so anxious and I have no idea why. And just like all the things. So I just feel I think everyone needs to be aware of. The impact of their blood sugar and how it can really impact it just quality of life. and the potential symptoms that they have and how that is all related, but especially when it comes to weight, knowing that insulin resistance can be a very common reason why someone can't lose weight. And it's just especially common in women who are going through perimenopause and menopause.

Angie: 42:52

Yeah. And is that something that would show up on a blood test? How would someone know that they have higher levels of insulin or blood glucose?

Rachel: 43:00

Yeah, so there's a couple ways to test. At the minimum, you can run a fasting glucose and a fasting insulin on blood work. And then when you get those values, I will plug it into a calculator called Homa ir, so HOMA dash ir. You can literally just Google. It's Tons of free calculators out there, and you just plug those numbers in and it'll give you a ratio, and the ratio will tell you basically how. Insulin resistant or not. You are. Okay. and then I usually like to do that every four months, four to six months to track somebody's progress in terms of their protocol. Now, that's one way of doing it. I wouldn't say it's the most accurate way, but it's probably the easiest. Way to track. Yeah. Another way to do it would be doing an, we call like a two hour insulin, glucose challenge. If you've ever been pregnant, When you drink that nasty sugar drink. Yeah. And then they have to do the blood tests on you like every 30 minutes. That's essentially what it is. So it's just seeing how your insulin and your glucose responds to a glucose load. So that's actually a much more accurate test. It's just that not everyone has two hours or three hours to spend at a lab to get pricked. and then another way is actually wearing a CGM. Okay, so you know, a continuous glucose monitor, and I love those actually because the blood work will show you a point in time like you know, in the morning or that two hour window. But the CGM can tell you so much about your day to day activities and what things that you're either doing or eating that is contributing to that blood sugar rollercoaster. Because people often think, when they hear blood sugar, they think diet. And a lot of people are like, I don't eat sugar. I don't eat poorly. Like I'm sure a lot of your, list listeners and audience are clean eaters as are like my clients. they're not eating junk, a lot of them. and so they're just puzzled as to why they wouldn't have insulin resistance.

Audio Only - All Participants: 44:54

And

Rachel: 44:54

what else they can do to even correct it if they're already eating clean. But you'll find that when you do, when you actually wear a CGM, you'll notice that it's so much more than just. Nutrition and food that can spike your blood sugar. Yes. And again, that's it's so cool when you think about the connections between all the different hormones, but often the biggest culprit is stress.

Angie: 45:16

Yep.

Rachel: 45:17

And it's not even mental emotional stress. It could also be physical stress. So for you runners out there, if you can access a seat gm, wear it while you're running and see what happens. Because sometimes, if the body perceives what you're doing as too stressful, you are going to see a spike in your blood sugar because it literally is telling your body that you're stressed. And cortisol will go up and cortisol will. Spike your blood sugar. So it's all really interesting. But, just having, so wouldn't

Angie: 45:46

you say that's that's a normal response though, for like in the body?

Rachel: 45:51

It can be, but it depends on how long you're doing it for, how often you're doing it for, and again, your baseline kind of resiliency. So it can be okay for some people, and again, normal, I'm not saying that your blood sugar shouldn't be spiking at all like we Because that's that.

Angie: 46:05

We want to have spikes in our blood sugar because that's what's getting the energy to our working muscles a hundred percent. So there is gonna be that.

Rachel: 46:13

The problem though, is when we see irregular rhythms, or patterns to that, right? If we're seeing too many spikes. Or too many of these ups and downs, like too many of the rollercoasters and stuff like that. Okay. and also we're looking at symptoms as well, so we do have to still look at the big picture right. Of things, but it's just like really interesting and can be really insightful to just see like what else Might be adding to this because when we're trying to address insulin resistance, we are actually trying to blunt a little bit of those ups and downs. Sure.

Angie: 46:44

That makes sense because, yeah, that makes sense. And it's funny because my sister actually just did a self experiment and she was wearing a CGM just to see what, what was going on. And that was, those to me were some of the most interesting findings that she had was not just. Which foods were spiking her That she had, was definitely not expecting to spike her, but then also what other events and stress was a big one. Like when she was in a place, maybe where she was disagreeing with her husband. I don't wanna say a fight, right? But like, when she had like a disagreement and she was like all, Holding onto some resentment or whatnot. Yeah. She's my blood sugar was just spiking, like it completely unrelated to anything I was eating. And it was just so interesting of how the stress and the different things were affecting that. Or if she had, one too many espresso martinis right then, like she's my blood sugar spiked for three days straight. Wow. And there was nothing that I could do about it. Like I was eating. Super clean, but it was, my body was still recovering from what I did over the weekend, Yeah. I'm gonna have her on the podcast because I would love to talk to her about, just some of the things that she observed. But I love that's, you mentioned that because it's not just the things that we're eating, right? Yeah. Like it is all of these things that we've been talking about, This whole episode.

Rachel: 47:57

Yeah. So I think it's really cool. Just again, just about learning more about your body.

Angie: 48:01

Yeah.

Rachel: 48:01

Essentially. Absolutely. And you'll find everyone's so different and as long as you figure out what is working or not working for your body, like that's what's key.

Angie: 48:09

Absolutely. So we've talked a lot about hypothyroidism and I want to respect your time here, but I just wanted to touch, a little bit on Hashimoto's,'cause I know that's one. Other area of expertise that, that you have. How does Hashimoto's differ from what we've been talking about today, both in the symptoms and some of the things that we need to take a look at? Because I know there's a lot of runners out there that have Hashimoto's or other forms of hyperthyroidism, can you speak to that?

Rachel: 48:38

Yeah, so Hashimoto's, I would say, adds a little layer of complexity to the picture because now we're involving the immune system. Okay? So Hashimoto's thyroiditis is an autoimmune disease. That causes hypothyroidism. So I would say 90% of women who have hypothyroidism have Hashimoto's. And it's crazy because hypo

Angie: 49:01

or hypo?

Rachel: 49:01

Hypo.

Angie: 49:02

Hypo, okay.

Rachel: 49:03

Hypo, yeah. Low thyroid. So 90. Exactly. Low thyroid. So 90% of women who have hypothyroidism or low functioning thyroid have Hashimoto's. Okay. So it's a huge percentage of women. And like I said, it just adds another level of complexity.'cause now we have to look at the immune system. The reason why you have a low functioning thyroid is because your immune system has literally created antibodies, thyroid antibodies that will then attack the tissue of your thyroid, causing inflammation, causing damage. Then eventually can result in the. Compromisation of the actual thyroid function. So then, in saying that, you can see how that does take time. So a lot of women actually have Hashimoto's for many years before they actually develop hypothyroidism. And this is why I'm such a huge proponent of being proactive because Hashimoto's is a progressive disease. It may take a long time, but it is, ever, progressing right. So the sooner you can catch it. The sooner you can implement. Action items and do things that can actually help to potentially stall or reverse the process. Okay. the immune system is a whole other area that we have to look at and that goes into a lot of other things, but there's a lot of different things that can actually affect the immune system and why it's potentially. Dysfunctional. We're looking at gut health, we're looking at stress, we're looking at liver health. We're looking at environment and toxins and like all these kinds of things. So still taking a very comprehensive look, but just a little bit different. A little bit of a different perspective, different lens that we have to put on when we're looking at Hashimoto's. But that said, like if you are somebody who you know, you have Hashimoto's, you have. Thyroid antibodies, but you don't have hypothyroidism. However, you still experience all the symptoms like fatigue or even just again, weakness in your muscles or, poor recovery time, like all these things, all of that can be a result of the Hashimoto's process itself. You don't have to have hypothyroidism to experience those symptoms because that immune system dysfunction that's happening. Those antibodies. It is creating, like I said, a lot of inflammation. There is a lot of inflammation that comes as a result of that. And we talked about inflammation already. Yeah. and so that autoimmune process is inflammatory. There's a lot of things happening. So there's still so many, areas that you can explore and you can work on to help with reducing inflammation and to calm that immune system so that you can feel better,

Angie: 51:36

Yeah. Basically what I'm hearing you say in all of this is really understanding that you have control over how you feel, and a lot of it is tied to stress and the lifestyle choices that we're making in our lives, like both with our exercise and our nutrition.

Rachel: 51:57

Huge like, and we're told the complete opposite. I cannot tell you how many doctors, endocrinologists, all specialists, whatever, who tell my clients, it doesn't matter what you eat, it doesn't matter how you exercise, it doesn't matter what you do. You can't change your thyroid disease. You can't. Do anything about it that is just completely false. Like you have so much control over this. You have so much power in the trajectory of your health. Yeah. And we need to take our, we have to claim our power back.

Angie: 52:28

Heck yeah. Heck yeah. I'm on board. Let's get more people on board with that. Yeah.'cause I think that's, you are right, like it's such a toxic message that is out there of yeah, there's nothing you can do about it. And none of that stuff. Stuff matters. I remember my husband was diagnosed with ulcerative colitis when he was in his twenties, and the gastroenterologist told him, yeah, your food doesn't matter. And I was like, whatcha talking? Like it's an intestinal disease? What? In what world would his food intake not play some sort of role? I don't know how much of a role, but no, none whatsoever. Yeah. And so I just, I didn't believe that and we changed the way that we ate and he has not had to take. Meds for over, like for decades. Amazing. And he's had no flareups whatsoever. So amazing. He's actually healed himself. And I'm not saying that is something that's available to everyone at, so please don't say that. I'm not saying if you have uc, don't take your meds. But I'm just saying like there is always a connection.

Rachel: 53:27

Yeah.

Angie: 53:28

And it's just a matter of really understanding our bodies, listening to our bodies, taking those steps. To reduce stress, to nourish and support all of the different systems in our bodies, our immune system, our thyroid, all of the different body systems that work together to make us a healthy individual. And I just absolutely love, your approach to all of that. So thank you so much for everything that you've shared with us today. Is there anything else that you want to add before we wrap up today? so many things, but so many things. I know.

Rachel: 54:03

I'm like, we could just have another hour of conversation here too. Yeah. But I'm like, like I am just such a huge, like I wanna empower women. like I said, I just, I really want. You to just claim your power back in this whole journey? I think we give too much of our power away to, our, like healthcare providers. Not to say you can't, you shouldn't listen to them or you shouldn't trust them. But I just think that there's just such a gap in the knowledge, that some of our practitioners have and in just like the overall approach to just overall wellness, And so Do your research, listen to podcasts, like really immerse yourself in this kind of more, I guess I call it functional world because there is just so much out there and you'll realize like how many more things that you. You can do for yourself. That can really move the needle. Despite what the conventional narrative says, So I just want you to know, if you feel a certain way, you don't feel well, there is absolutely a reason for it, and you can find out what that is and do something about it.

Angie: 55:13

Absolutely. I 100% agree and I want to, I'm on that, in that same mission with you of empowering more women to really be their own advocates And really do what is right for them because we know, like when we tap into ourselves. We know when something's off. We know that something's not right here. Yeah. And I really want people to start trusting them more. Yeah. And to then seek help and not just take a surface level answer from someone that says, oh, it, my doctor said my blood work was normal. So I guess it's just in my head. And that is such a lie, that we need to continue to break and. Really help women understand that there's nothing wrong with you. But yeah, there's a lot and there's also a lot that you can do. yeah, trust yourself. Alright, Rochelle, where can our listeners connect with you If they wanna, follow you or work with you, where can they connect with you?

Rachel: 56:07

Yeah, so I am on Instagram. My handle is at Dr. Vong nd so you can definitely gimme a follow over there. DM me anytime. I'm super easy to chat with. So just send me a message if you liked this episode, if you have any questions about it. And my team offers free 45 minute discovery calls as well. If you are somebody who's you know what, I've had this thyroid issue for a while, or I suspect I have a thyroid issue. And I just wanna get to the bottom of it. I wanna figure out what to do. Like we just, we offer free consults, so you can definitely book one there and it's all through my Instagram, so

Angie: 56:40

love it. And we will link to all of that in the show notes below so that you guys can just access that very easily. Thank you so much, Rochelle, for being welcome on the podcast today, and, we'll talk to you guys soon. Thank you.