Why Thyroid Health Matters for an Active Life (Performance & Longevity Series)

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Transcript: Why Thyroid Health Matters for an Active Life (Performance & Longevity Series)

Season 12, Episode 13  | February 26, 2026

Jamie Martin

Welcome to Life Time Talks and our series on performance and longevity with MIORA. I’m Jamie Martin. I’m back again with my colleague and friend, Jim LaValle. How are you, Jim?

 

Jim LaValle

Doing great.

 

Jamie Martin

OK, we’re talking about a big topic today. I want to make sure people, before we get into it, know who you are, what you do for Life Time. Jim is a clinical pharmacist, the co-chair of the American Academy of Anti-Aging Medicine, the chair of the International Peptide Society, and for Life Time specifically, the chief science officer. It’s a mouthful.

 

Jim LaValle

Yes it is.

 

Jamie Martin

You’ve got a lot.

We are talking about one of those health issues today that we hear a lot about and maybe not be quite clear on what it is. We’re talking thyroid health and why it’s so important for living a healthy, active lifestyle. We’re gonna take a different approach today. We’re gonna do kind more of a rapid fire question and answer. Before we get to that though, we just gotta set the foundation as we do with all of our episodes. What is the thyroid and like, can you just help us understand from a general level what its function is in our body and why it matters?

 

Jim LaValle

Yeah, so thyroid hormone gets made by your thyroid gland. basically, you have multiple thyroid hormones. You have two primary thyroid hormones. T4 and T3. And you need nutrients to make thyroid hormone. So things like iodine, selenium are important, tyrosine. So there are nutrients your body needs in order to make thyroid hormone.

 

And thyroid hormone is basically involved in all aspects of how your body functions. Everything from how you produce energy, which is kind of like the big thing people look at. But it’s also involved in how your hormone receptors open up, how your neurotransmitter receptors function. It’s involved in virtually everything. So your body makes T4 and then supposed to convert it to T3. T3 is the active thyroid hormone. So when you’re looking at thyroid hormones, say in a blood test, you’ll see reported total T4, free T4, total T3, free T3, TSH, thyroid stimulating hormone.

 

And then you can look for things like antibodies. So your immune system attacking your thyroid. And a lot of people have heard the term Hashimoto’s thyroiditis. So, thyroid located right here, right? Butterfly shaped organ. It’s responsible for creating one of the primary hormones that drive your metabolism. So what I want you to think about metabolism is more than just you’re burning calories. It’s driving other aspects of how your body performs.

 

Jamie Martin

So that’s very high level. And each of the following questions is gonna get more in depth on this, will build on it. Okay, I know you’re ready. You can answer any of these. Okay, so what are some common signs or symptoms of thyroid dysfunction, both for hypo and hyperthyroidism? Let’s start with hypo.

 

Jim LaValle

Let’s start with hypo. So dry skin, brittle hair, brittle nails. Losing the outer third of your eyebrow is actually a sign. Sinusitis is a sign. The obvious one of weight gain and fatigue, those are a sign. Cold limbs, especially cold hands, cold body temperature, your body temperature goes down. Mood, so you can get depressed from low thyroid function.

 

Those are some of the biggest ones that are there, that are common. People would go, okay, I identify with that. There’s some other things that show up, but those are probably the biggest that people would go, okay, yeah, that’s me. I’ve got dry hair, I’ve got brittle hair, my skin is dry, why am I losing that outer third of my eyebrow? Why is my body temperature cold? How come I feel so sluggish? Low energy, yeah, just, you, fatigued from morning to night. And then if you are high weight gain, typically, if you’re hyperthyroid, your heart rate could be elevated. You could get goosebumps easily. You can notice yourself feeling anxious. In real severe cases, you get something called exophthalmos, meaning that youe eyeballs start to bulge literally. And so exophthalmia is a sign of high thyroid. And of course your lab numbers get all wonky on either one of these, But those are the key ones where you could be running hot as well. So those are the key signs that you see.

 

Jamie Martin

Is one more common than the other? I feel like I hear more about hypo, but is that fair to say?

 

Jim LaValle

Very, very much so. Hypothyroid’s way more common than hyperthyroid, but sometimes now, so let me tell you how this is shifting a little bit. Everybody’s hearing, you gotta take iodine. Take iodine. If you take too much iodine, you can push yourself into hyperthyroid. And that’s why it’s important to get lab tests to understand where are my organs functioning at, and the other one is.

 

And thyroid’s complex, it really is. Just because you have a certain amount of thyroid in your blood test, it doesn’t mean your thyroid hormone receptors are working well. And so the common thing you see is people will say, gosh, my doctor told me I was hypothyroidic, I got put on thyroid medication, kinda helped I think. I’m still heavy, I still have dry skin. It doesn’t always resolve all of those symptoms because your thyroid is highly dependent on other hormones for signaling how it’s going to function in the body.

 

Jamie Martin

Right, and so that’s where it’s dependent in order for those receptors to be able to utilize it.

 

Jim LaValle

That’s right.

 

Jamie Martin

Got it.

 

Jim LaValle

So one of the biggest things that happen is that you get under stress and cortisol will cause you to make less T3, which is the active thyroid hormone that is what helps you to burn calories and do everything that thyroid hormone is supposed to do for you. And you make more of something called reverse T3. And all reverse T3 is, it’s a space holder.

 

It occupies the T3 receptor without sending a signal. And now why would it do that? This is the part that I just get fascinated that our body has this incredible check and balance system. So when your cortisol is high, your heart rate’s usually gonna go higher, right? Because you make more adrenaline. Well, your body’s wisdom is we’re gonna turn down thyroid hormone, because thyroid hormone is what dictates heart rate.

 

Jamie Martin

Got it. So it’s trying to correct —

 

Jim LaValle

It’s trying to correct it, but in the correction, other parts of your metabolism are going in the wrong direction, right?

 

Jamie Martin

You’re literally taking up space that’s not being used. Like that needs to be used, but then now there’s not room for it.

 

Jim LaValle

You can’t drive burning of fats anymore. You’re not gonna absorb nutrients, right? All the things that thyroid’s supposed to do, it can’t do now. But it’s doing that in order to spare you running out of heartbeats, because all mammals, we only get so many heartbeats. So your body’s intelligence is, whoa, slow this down. But it has a lot of downstream effects that I know your questions will get to.

 

Jamie Martin

I know we’re going to go there. Okay, so do you have to have a diagnosed thyroid disorder to have an underperforming thyroid?

 

Jim LaValle

Well, there’s a topic that’s been around for a long time called subclinical hypothyroidism, meaning that, gee, your numbers aren’t that bad, but you sure have a lot of symptoms. And this would frustrate people for a long time because they go into their doctor and their doc goes, wow, dry skin, brittle nails, you’re tired. You’ve got all the signs. Your mood’s flat. But your numbers aren’t that bad yet. So we’re not gonna medicate you yet because you don’t follow that range. We’re gonna wait until next year when you come in and you cross that threshold, it’s like, time to put in the medication.

 

So ideally what we try to do is let’s look at those trends before you go down the waterfall. Let’s look at it before then and then see if you can create countermeasures in correction so that you get your thyroid back on track.

 

Jamie Martin

Before you become clinical with it, right?

 

Jim LaValle

Exactly.

 

Jamie Martin

If you’re subclinical, there’s still things you can do to prevent going, crossing that threshold towards clinical.

 

Jim LaValle

Absolutely. And if you’re clinically now hypothyroid, there’s a lot that you can do.

 

Jamie Martin

Yeah, and that’s what’s good news about a lot of this is that there are actions we can take and we’re going to get to that. Okay, next question. How does poor thyroid function affect metabolism? You already alluded to this a little bit.

 

Jim LaValle

Yeah, mean, the most basic way is that T3 is supposed to enter the cell and it needs ferritin to do that. So if you’re anemic or you have low ferritin, you can’t transport that thyroid into the cell to trigger oxidative phosphorylation of fats and to trigger the burning of fuel in order to make energy. At the most basic level, your metabolism slows down.

 

Jamie Martin

So when you’re not, when that T3 is not entering, it’s kind of just, you’re kind of like starting to slow down, so it doesn’t have the fuel it needs.

 

Jim LaValle

And so basically from one of our other episodes, we talked about the mitochondria. When you don’t have enough T3, you can’t stimulate the mitochondria, and in fact, you make less mitochondria in your cell. And mitochondria, the powerhouses of your cell, that’s why you’re fatigued. And a lot of times, cognitively not as sharp, because you don’t have any energy being produced in your cells to do those basic functions of thinking clearly, being able to move, having the energy to get through your day. So that’s related to metabolism.

 

Jamie Martin

Got it. Okay, how does poor thyroid function affect exercise recovery?

 

Jim LaValle

Oh gosh, that’s a big deal. Yeah, it’s a couple things on exercise one The harder you train so they did this study where they looked at t4 and t3 and people exercising and We hear about training to your you know max heart rate, right? So when when you were moving between like 30% to 70% No big shifts occurring in your thyroid is related to heart rate, but when you moved to 90%, so say it’s someone doing an endurance event where they’re pushing at their max, T3 went down significantly. Now why is that important? We hear about distance runners as they’re aging, they get what’s called left ventricle failure.

 

Jamie Martin

It ties back to heart health.

 

Jim LaValle

It gets enlarged, and that’s because you don’t have enough. And that’s because — you’ve trained your body to not have enough T3 signaling and that means the heart muscle has to grow in order to try to pump but then it becomes less efficient. So one of the big things for all endurance athletes, I always encourage them, I’m not here to tell you don’t, people love to do endurance.

 

Jamie Martin

Run or whatever your long distance.

 

Jim LaValle

That’s what you’re dialed into, it’s really good. But you should be doing yearly checks at least on your labs to make sure that A, your cortisol levels aren’t too high because cortisol is another thing that causes that T4 to T3 goes down. And B, that your thyroid hormones are staying in sync so that you can maintain cardiovascular health and heart health. Then if you have low thyroid function, you’re gonna make more lactic acid.

 

Jamie Martin

You’re gonna be sore for —

 

Jim LaValle

You’re going to be sore for longer. So low thyroid, I don’t have the energy, even if you’re training with weights, I don’t have the energy to kind of drive getting that progression of resistance that you look for with weights. And then secondly, you’re making more lactic acid and that means you’re going to stay sore or longer.

 

Jamie Martin

Okay. my gosh, there’s so much in this already. We got more. We got more to get to. Tell us about the connection between gut health and thyroid health.

 

Jim LaValle

Intimately involved that is so important to have good gut health. So when you have your microbiome and the microbiome is healthy and the gut is not permeable. So you’re not getting you know, everybody calls it leaky gut. Yeah call it got permeability. That’s pretty good sign that the gut health isn’t gonna throw off the thyroid too much but when you start to break down your microbiome, so because of poor blood flow or maybe you’re on certain medications or whatever reason, your gut microbiome is breaking down and bacteria are dying off. Dying off too quick. They release something called lipopolysaccharide. I’ll use the, easier word for it is endotoxin, but they’re the same. And when that circulates in your body, because the gut is now broken down, and now the lipopolysaccharide can slip through the cells of the intestine and get into general circulation. The liver and lymph are supposed to get rid of it. You’re supposed to detoxify it. But when you overwhelm that chronically, the lipopolysaccharide attaches to the follicles of the thyroid and triggers inflammation. In addition to that, when your gut is permeable, you start to create more food reactivity.

 

So you get what’s called Hashimoto’s food antigen induced thyroiditis. So one of the big ones for that is gluten. So in fact, when you have Hashimoto’s thyroid, you have an autoimmune. So you have two specific targets that are measured. Thyroid peroxidase, which is an enzyme thyroid, and then thyroglobulin antibodies.

 

So you measure these and if they’re elevated, more than likely, you have a permeable gut. But interestingly, this is where things cross together and lot of people don’t realize it. Do you know what people with autoimmune thyroid need to be screened for every, or should be at least every two years? Celiac.

 

Jamie Martin

Okay, because it could progress to that?

 

Jim LaValle

You’ve progressed to having that big of a sensitivity. And the other one is type 1 diabetes.

 

Jamie Martin

That’s so interesting because you hear about people developing type 2 diabetes, but type 1 is autoimmune.

 

Jim LaValle

That’s right. That’s exactly right. And if you have one of those, the other ones, if you have Celiac, you’re supposed to be getting screened for autoimmune thyroid.

 

It’s connected because once the gut breaks down and you’re creating that inflammatory signal, because lipopolysaccharide attaches to your cell and it turns the switches of inflammation on in your tissues. And the thyroid is very vulnerable to that. But the interesting thing is, I know it’s maybe not popular to say this, but we have cases of this where

 

We had people that had antibodies and were considered to be, oh, you have autoimmune thyroid. But by correcting their gut function, we moved them back out of having as antibodies.

 

Jamie Martin

So you can theoretically correct it with the right protocol.

 

Jim LaValle

Clinically, we’ve seen that happen. And I think it’s becoming now more accepted that that can happen. If you ask someone even five years ago, I mean, I your autoimmune thyroid. You’re just, you know, you’re going to have those things. Don’t worry about it. You have that. Now, I also want to mention that your immune system, just Epstein-Barr virus, is closely tied to kind of triggering autoimmune thyroid too. So it’s not always just the gut, but gut health?

I don’t know that you can have good thyroid health without good health, gut health. when your thyroid health is off, it’s affecting your gut because it affects how you absorb your nutrients.

 

Jamie Martin

It’s a two-way street. Interconnectedness. As always. Yeah. Oh gosh. Okay. Well, we kind of already got to this last one. We had already talked about how high heart rates and exercise can disrupt T3 levels. So I’m going to just jump right over that because you covered that already. You’ve stated that you can absorb 50% fewer nutrients when the thyroid is low functioning. Why is that? And what are the implications of that for our health?

 

Jim LaValle

Well, you I run into people all the time, you know, obviously, even teaching, you know, how to read labs to thousands and thousands of docs that people are taking nutrients. They’re taking them. They’re I’m taking magnesium. I’m taking zinc. I’m taking vitamin D. I’m doing it all. If you have low thyroid thyroid hormone is involved in absorption directly involved in absorption of your nutrients. So you need thyroid hormone for absorption of nutrients. And so when you don’t have enough thyroid, you don’t absorb your nutrients as well. So you can be taking all the supplements you want you got a whole counter full of them. And it’s not getting the benefit that you should have because your thyroid functions low. And so and it’s just important to understand that all of this works together. It’s great to take nutrients It’s even better if you evaluate well, where’s my body status at in terms of my ability to absorb them because there’s two things that happen. One, your gut’s permeable and therefore you don’t absorb them. So that’s a whole leaky gut. You won’t absorb your nutrients. And then thyroid hormone also signals that. Thyroid hormone also signals hydrochloric acid production.

 

Jamie Martin

Okay. So that’s that enzyme right for digestion.

 

Jim LaValle

And you need hydrochloric acid to break down proteins in particular so that you can get the proteins to be broken down to peptides and the peptides get broken down to amino acids and the amino acids get absorbed into your bloodstream and now you can build everything you need. You’ve got the building blocks. When you have low thyroid, you can’t make the building blocks as effective.

 

Jamie Martin

Yep. So no matter what, mean, and that just that you want to be sure that you actually are making the most of everything that you’re putting your body if you can.

 

Jim LaValle

Why wouldn’t you?

 

Jamie Martin

All right. Couple more questions for you. What are other big implications of thyroid health on living an active lifestyle? know, or, you know, what are some other things that might be affecting it?

 

Jim LaValle

Well, I mean, obviously, lack of sleep is — when you don’t sleep, so let’s say you’re, I don’t need to sleep, right? You have people that are like, I get by —

 

Jamie Martin

Yeah, four to five.

 

Jim LaValle

You hear that one all the time. You get by, that’s right. And then you have big baggy bags in your eyes. That’s great, you know? But when you don’t sleep, you make something called thyroid binding globulin. So you make something that binds up your thyroid. So even though you have plenty of thyroid circulating, so that’s why you measure total and free. You can measure total and free. Most of the time you measure free. But when you have thyroid binding globulin and it’s being circulated, why is it doing it? I always like to think of why. Well, because your body is getting the message, you’re not sleeping enough, we should turn down your ability to make energy.

 

Jamie Martin

Because it’s kind of putting you almost into survival mode in some ways, right?

 

Jim LaValle

Yeah. That’s it. It’s all your body always will will make decisions towards survival But sometimes those decisions have consequences, right? Right versus staying in homeostasis So I’m gonna turn down thyroid hormones so that hey, you’re not running so strong for a five-hour night — you’re gonna you’re gonna get tired so that you need to go to bed with seven hours to go, right, so that thyroid binding globulins incredibly important. Sleep has a huge impact on that.

 

The other one, of course, which I mentioned earlier is cortisol. So, you know cortisol and thyroid have a very direct relationship and what you’ll find a lot of times is people will have plenty of T4 and T3. Free T4, free T3, it’s perfect in their blood. Looks great, but their TSH is off. And why is their thyroid stimulating hormone going up? Meaning I need to stimulate the thyroid hormone more. It’s because cortisol has turned off the thyroid receptor. It basically saying, nope, we’re not gonna signal that.

 

So then what’s your brain pick up? Hey, there’s no signal. We better make more thyroid stimulating hormone. So a lot of times the first step for people is getting their cortisol corrected. Now, and that’s if they have plenty of free T4 and free T3. Now, if they just don’t have enough T4, that could be, you need medication, but it could be, well, you may be low in those essential nutrients that are needed to make thyroid hormone.

 

You can’t make it because you don’t have selenium, you don’t have iodine, you don’t have enough tyrosine. And I would say the other thing really important in terms of lifestyle that people don’t realize is thyroid is so involved in mood. They actually did a study. This was, I mean, once again, fascinating. They gave people that were on an antidepressant, because some people will relapse, know, just times where they don’t feel as well. When they gave them T3 with their antidepressant they had less relapse, less rates of recidivism, but because the thyroid hormone is a co-activator, it’s a co-signal. It’s a lever you gotta pull to make the receptor open up and accept that serotonin or dopamine or noradrenaline.

 

Jamie Martin

And so that kind of goes to almost like the thyroid brain health connection, right? Like it’s all interconnected.

 

Jim LaValle

Absolutely interconnected. And I think these are big things. How many people, I know just from seeing so many people in clinic, they’re on antidepressant, but it’s not really all that effective for them. And what was missed was the fact that they’re on antidepressant because they were really stressed out and the stress has really influenced how their thyroid is able to function. So if you can help them balance out that stress, maybe give them a little bit of thyroid support it may be a medication and I failed to mention if you have antibodies to your thyroid there’s two kinds of medication that are used — one are gland based, so you hear people talk about armor thyroid or nature throid or MP thyroid — all derived from a gland.

 

Jamie Martin

So they’re trying to get rid of those antibodies. Is that what they’re intended for?

 

Jim LaValle

No, not even. So this is for people who do not have antibodies. They don’t have them. All they have is a low function of thyroid. People a lot of times prefer to use a natural. That’s a natural source of thyroid hormone replacement. Very popular. People like the way they feel on it. Once you have antibodies. So what’s an antibody mean? It means that your immune system is attacking thyroid tissue.

 

You’re not going to give someone thyroid tissue so that your immune system can watch it go all the way through your intestine and attack it, right? You don’t want to do that instead what they will do is use bioidentical, it’s synthetic but it’s bioidentical, T4. And typically MIORA at Life Time, MIORA Docs will use combinations of T4 and T3 depending on what your numbers look like, right?

 

And you’re doing that because now the immune system doesn’t react. You get the benefit to thyroid hormone. And when people talk about, it’s synthetic thyroid, it’s the same thing as bioidentical testosterone, estradiol, or progesterone. It’s a bioidentical thyroid hormone that your body’s not making enough of.

 

Jamie Martin

So it’s that supportive element.

 

Jim LaValle

It’s supportive. You may need that. And then they sustain release it so that it’s able to over time, first four hours of your metabolism in the day you take it. And then one more thing that’s noted, people out there listening or already on thyroid, they have to make sure they’re taking it on an empty stomach.

 

Jamie Martin

Okay, because that’s going to improve absorbability of it?

 

Jim LaValle

Yeah. If you drink coffee with it, reduces the absorption. If you eat food, it’s going to reduce the absorption. So it’s better to take it and at least wait a half hour. If you’re going to be on thyroid medication, if you’re taking the nutrients, iodine, selenium, amino acids, you’re using whey protein to get amino acids or you’re, know, something like that. Those don’t have to be taken away from many other foods you’d be taking, but only in the medication.

 

Jamie Martin

Okay, so that’s an empty stomach.

 

Jim LaValle

Best.

 

Jamie Martin

Make the most of it.

 

Jim LaValle

Yep.

 

Jamie Martin

Okay. So somebody’s listening to this episode. What blood work should they ask for to make sure they’re getting the most comprehensive look at their thyroid function?

 

Jim LaValle

Yeah, I like when people get free T4, free T3, they get TSH, they have to get a TSH, and then get thyroid antibodies. Find out, are you reactive? Because why that’s important is if you did need medication, you would want to know, hey, am I somebody with antibodies and I need to be over here with the bioidenticals? Or am I able to use natural thyroid as my first step? Or even a step back from that, a nutritional thyroid that you could use to get started on the journey.

 

So that’s why labs are important as it relates to that. And the other thing that you keep in mind is when you’re going on thyroid medication is where’s your resting heart rate at? Is it bumping up too high? If it is, if you’re feeling anxious, feeling nervous, body temperature’s warm, well then you should talk to your provider. Once again, why you want a proactive provider experience is so that as you’re optimizing your health, you’re dialing in the correct dosages for what you need. Now, it could take a little bit of adjustment for a while, but the better you get the rest of your body functioning, at least what I’ve seen in the clinics that I’ve been involved in over the last 40 years, the less you have to adjust your thyroid. A lot of times people are adjusting them up and down and up and down. The other thing to keep in mind is you can take too much and your TSH gets really small. That could lead to bone loss. That’s the other reason you don’t want to just rely on that.

 

Jamie Martin

There’s a lot there, but all great info. The very last question I have for you, kind of, is what are some of the strategies that you’d suggest for someone who’s looking to optimize their thyroid function? Let’s say they’ve got good lab markers, but are there things we can do to optimize it so it keeps functioning that way?

 

Jim LaValle

Well, one is manage your stress. when we say manage stress, means manage, you know, what am I doing with my workouts? know, being consistent about what you’re doing, making sure you’re keeping that resting heart rate down. you know, iodized salt. mean, people, I love Himalayan salt. I love all the cool salts that are out there, but they’re not very high in iodine.

 

Jamie Martin

Which is a primary source for in many of our diets, right?

 

Jim LaValle

Yeah, you’ve heard of the goiter belt, right? That’s because a lot of people aren’t getting iodine in their diet and therefore they get an enlarged thyroid. So iodine, I’m a big fan of mixing it up and making sure you’re using some iodized salt. In addition, love all the other black salts and truffle salts and Himalayan salt. Love that for flavor, but you do have to get some iodine in. You could choose to just take iodine.

 

If you need if you wanted to but I would just diet wise, know iodine eat fish right? Fish have iodine. As long as you don’t have a reaction to iodine because there are some people that are allergic to it.

 

The other one is good night’s sleep. I’m telling you right now that is massive for you know promoting, know good thyroid health. And then If you don’t mind stopping and doing some box breathing a couple times a day, you know reset the nervous system, that’s quite good for just kind of keeping thyroid and maintenance health.

 

Jamie Martin

It’s a good practice just for day-to-day life, right?

 

Jim LaValle

Yeah. Breathing is good. Especially deep.

 

Jamie Martin

And we always go back to it. It’s one thing that’s always available to you. You just have to be willing to slow down and do it, right?

 

Jim LaValle

Yeah. Right, exactly.

 

Jamie Martin

1. All good tips, Jim. Anything else we missed? That’s truly my last question.

 

Jim LaValle

No, I don’t think so. I think that once again, another important aspect of your metabolism, I hope what people came away from it though is it’s all working together. That’s why we create a full thought of your whole body metabolism, your personal needs to organize all the signals that create longevity and performance health for the individual.

 

Jamie Martin

Awesome. All right. If people want to learn more, they can visit miora.lifetime.life. And we’ve got all sorts of resources at experiencelife.com from Jim and other providers on this topic and more. Thanks, Jim.

 

Jim LaValle

You’re welcome.