Is your thyroid medication actually working for you?

Do you take Synthroid or levothyroxine but continue to have symptoms of hypothyroidism?

One of the most common reasons that many people don’t feel great on T4 only medications (such as Synthroid or levothyroxine) is that their body is doing a poor job turning their medication (T4) in the active thyroid hormone T3. In order to feel energized, maintain your weight, and feel your best, you need high levels of T3 hormone which is the active thyroid hormone.

You can take medications which make your TSH and even T4 levels “normal” but if no one is testing your Free T3 levels you have no idea if your body is actually converting your medication into the active hormone.

Why do so many women struggle to convert their medication to T3? Well, there are several factors which can quickly derail conversion of T4 to T3.

Here are the most common factors that reduce conversion of T4 to T3:

  • Deficiencies of selenium, iodine, zinc, vitamin A, and vitamins B2, B6 & B12
  • Increased stress and high cortisol
  • High levels of cadmium, mercury, lead and fluoride
  • Starvation or very restrictive eating patterns
  • High carb/low protein diet OR very low carb diets
  • Chronic illness
  • Kidney or liver disease
  • Certain medications: beta blockers, birth control pills, estrogen

Wondering if you’re having a problem converting your medications properly? Find a practitioner who will test your Free T3 and Reverse T3 levels. Click here to read by article about my 5 Essential Thyroid Tests.

Want to learn more about my approach to thyroid health?

Book your FREE, no obligation, 15-minute Meet & Greet consultation with me.

Why testing your TSH alone isn’t telling you much about your thyroid

If you or your doctor suspect that you have a thyroid imbalance, the standard course of action is to run a TSH test. TSH stands for “thyroid stimulating hormone” and it’s made in the pituitary gland. Yes, that’s right, TSH is not made by the thyroid, it’s made by a gland in the brain. Now you might be wondering- why are we looking at a hormone made in the brain to assess the thyroid? That’s a great question!

TSH is an indirect way to look at your thyroid. I like to describe TSH as a doorbell. It’s a signal from the brain (ding-dong!) to the thyroid to make thyroid hormones (T4 and T3- which we’ll talk about in a minute). The assumption is that when your thyroid hormone levels drop, TSH will rise to stimulate the thyroid. The problem is that a TSH test on its own doesn’t tell us much. Is the thyroid responding properly to TSH and making T4 and T3?

T4 is the main hormone produced by the thyroid gland so it is a much more direct way to see how your actual thyroid is doing. If T4 levels are low, it means your thyroid is sluggish and isn’t making enough thyroid hormone. Keep in mind that T4 is a weak and mostly inactive hormone. Its main goal is to be converted into T3 which is the active thyroid hormone which gives you energy, helps you maintain a healthy weight, balances your mood and regulates body temperature. In my opinion, T3 is the MOST IMPORTANT thyroid hormone to test because it’s the one that is actually doing all the work and helping you feel good. TSH is just a signal. It has no direct impact on your weight, energy or mood.

Woman thyroid gland control isolated on white backgroundWoman thyroid gland control isolated on white backgroundLow T3 levels are incredible common and I can’t tell you how many women I see in my practice who have a low T3 hormone but their TSH is perfectly normal. So, if your doctor is only checking your TSH levels, they could tell you that everything looks great when in reality you may have low T4 and T3 hormone levels causing symptoms of hypothyroidism.Woman thyroid gland control isolated on white background

For a full picture of how your thyroid is working, I recommend getting a full thyroid panel that includes the following tests:

  • TSH
  • Free T4
  • Free T3
  • TPO (thyroid peroxidase) antibodies
  • TG (thyroglobulin) antibodies
  • Reverse T3

To learn more about each of these tests and the optimal ranges to look for, check out my 5 Essential Thyroid Tests for Women.

 To learn more about thyroid testing and treatment options,
book a complimentary 15-minute
Meet & Greet Consultation
with me at Docere Naturopathic Clinic + IV Lounge.

3 Natural Treatment Options for Vaginal Dryness

Vaginal dryness is a common complaint during peri-menopause and menopause but it can happen at any age.  As estrogen levels start to drop, vaginal moisture dries up which can result in vaginal atrophy, painful intercourse and an increased risk for vaginal infections. The hormonal changes following childbirth can also cause vaginal dryness and painful intercourse.

The good news is there are a variety of natural treatment options for vaginal dryness.

1. Hydrate your vagina from the inside out

Keeping your body hydrated and moist is crucial to combat vaginal dryness. Drink at least 2L of water each and every day. Increase your intake of healthy oils including cold-pressed olive oil, coconut oil, avocado oil, flax oil etc. Aim for at least 1 tsp with every meal. If you’re still experiencing vaginal dryness, consider adding a Sea Buckthorne supplement. Sea Buckthorne is an omega-7 fatty acid which specifically helps relieve vaginal dryness (and it makes your skin look great as an added bonus). I love NFH’s Sea Buckthorne SAP which is available at Docere Naturopathic Clinic + IV Lounge and through our online dispensary.

2. Try Dr. Sarah’s compounded vaginal cream

This non-hormonal option is great for younger women with vaginal dryness or women who can’t or prefer not to use hormones. It combines hyaluronic acid (which helps to attract and retain moisture) and vitamins A and E to help hydrate and heal the tissues. Apply it every night for 2 weeks then 2 times per week or as needed. Just ask for a prescription at your next appointment! Another option is the over-the-counter product Cala-Gel by St. Francis Herb Farm.

3. Ask about bio-identical estrogen cream

Estriol is the weakest of our 3 naturally made forms of estrogen. It can be applied as a cream vaginally which is extremely safe and poses minimal risk. Estriol is so safe that it’s actually being used in women who have a history of breast cancer. Ask Dr. Sarah if this product may be right for you. It’s also applied nightly for 2 weeks, then 2 times a week for 2 weeks then as needed.

Is Stress Shutting Down Your Sex Drive?

One of the most frequent complaints that I hear from women in my office is that they have no sex drive. Like zero. Nada. Nothing. It’s as if that part of their brain has turned off and doesn’t seem to want to turn back on anytime soon.

There are many reasons why women experience a low sex drive including side effects from birth control pills, low estrogen and low testosterone. But, in my experience, the number one cause of low libido is STRESS.

The reality is that our sex drive is turned down as a PROTECTIVE MECHANISM. What you need to understand is that stress shuts down our sex drive for good reason.

When the body is under stress, it activates the sympathetic nervous system which is also known as our “fight or flight” response. When this response is activated, our body engages in a variety of activities that help us to survive and cope with that stress. We send lots of blood to our brain (so we can respond quickly and appropriately) and lungs and muscles (so we can run away). We may not be fighting off saber tooth tigers anymore but our body still responds in the same way. And let’s face it ladies, between family, work, and social obligations, we’re under low-grade stress all the time.

Another side-effect of this stress response is a reduction of blood flow to your reproductive organs and putting a major damper on your sex drive. WHY? The last thing your body needs when it’s under stress is another human being to take care off (aka a baby). You see, when you are under stress, your body shuts down your sex drive to limit the chances you’ll become pregnant in an effort to try to help you.

Even if you’re post-menopausal or on birth control and technically can’t get pregnant, your body will still shut down your libido because it doesn’t know any better. It’s a automatic response that is hard wired into us that actually helped keep our ancestors alive.

So, if you want that part of your brain to wake up and re-activate, you need to practice getting out of that sympathetic “fight or flight” response and start hanging out in a more relaxed parasympathetic “rest and digest” state. This is when the body is relaxed, feels safe and can start to warm that fire in your loins. (PS. men also need to be in this state to achieve and maintain an erection).

My best strategies for tapping into “rest and digest”:

  • Get at least 7 hours of sleep every night (this is the ultimate relaxed state)
  • Take 10 deep abdominal breaths before each meal
  • Learn to say “no” (and not feel guilty about it!)
  • Start a daily meditation practice such as the HeadSpace App (and come try our new service: MUSE Biofeedback Meditation)
  • Cultivate mindfulness (try to enjoy the present moment.) Start with simple activities such as mindfully brushing your teeth. Keep your mind focused by paying attention to the smell and taste of your toothpaste, the feeling of the brush against your teeth, the sounds it’s making. It’s simple but it works!

Wondering if stress is really affecting your sex drive and overall health?

Get your stress hormone levels test with our Adrenal Function Panel. It’s a simple at home saliva test that maps out your cortisol and DHEAS. You can learn more about it here. Test Cost = $220.

When it comes to your period, what’s normal?





 2. Your flow length (aka how long you bleed)


 3. How much you bleed

  • NORMAL: You should lose about 50 mL of blood.
    • One soaked regular pad or tampon = 5 mL
    • One super tampon = 10 mL

 4. What your blood looks like


 5. PMS & Cramping

    deficiency, inflammation, hormone imbalance, endometriosis or fibroids.

 6. Spotting





Vitamin D Deficiency: the missing key to your optimal health?

Vitamin D is best known for its role in forming strong, healthy bones, however, it also plays a critical role in the following areas:

  • Immune system
  • Hormone balance
  • Muscle function
  • Cardiovascular function
  • Respiratory function
  • Brain development
  • Anti-cancer effects

What are the best ways to get vitamin D?

Commonly known as “the sunshine vitamin,” the skin is able to make vitamin D when it is exposed to sunlight. There are also small amounts of vitamin D in foods such as fortified milk, and yogurt, cheese, eggs, cod liver oil, beef liver, and fatty fish such as salmon, trout, and tuna. However, it is very difficult to meet you requirements through diet alone.

How much vitamin D do I need?

The Recommended Dietary Allowance (RDA) for adults is 600 international units (IU) for adults, and 800 IU for seniors over the age of 70. These are the bare minimum amounts you need to prevent rickets but they are FAR from enough for most adults to optimize vitamin D levels to get all of its benefits (including anti-cancer effects).

According to the Vitamin D Council (and based on my clinical experience), most adults require 4000 IU or more during the winter months depending on their blood levels. Many adults who supplement the recommended 1000-2000 IU per day are still deficient when their blood levels are tested.

Factors that affect vitamin D status:

  1. Insufficient sun exposure: If you work 9-5 or are wary of the sun, and therefore don’t spend much time outside, or cover-up and use sunblock, you likely aren’t getting enough vitamin D from sun exposure. And if you live in Canada, it’s essentially impossible to make vitamin D during the winter, even on sunny days.
  2. Skin pigmentation: People with darker skin tones have more melanin in their skin, which can interfere with the amount of vitamin D that the skin can produce. While fifteen minutes in the sun may be enough for a fair-skinned individual, someone with a deep complexion may require as much as six times the amount of sun exposure.
  3. Age: Seniors have an increased risk of developing vitamin D deficiency for a few different reasons. As we age, we lose some of the ability to synthesize vitamin D from sunlight. Vitamin D also needs to be activated in the kidneys, which also decrease in function with age. Lastly, many seniors are housebound and therefore aren’t able to get adequate sun exposure outdoors.
  4. Kidney dysfunction: With age, the kidneys lose some of their ability to convert vitamin D into its active form.
  5. Digestive disorders/diseases: When the digestive tract is unable to absorb vitamin D, for instance, due to conditions such as Crohn’s disease, cystic fibrosis, and celiac disease.
  6. Obesity: Vitamin D is extracted from the blood by fat cells, thereby reducing its circulation throughout the body. Obese individuals typically require higher amounts of vitamin D supplements to prevent deficiency.

What are the symptoms of vitamin D deficiency?

  • Joint and muscle pain
  • Muscle weakness
  • Fatigue
  • Brain fog/Difficulty thinking clearly
  • Fatigue
  • Mood changes
  • Frequent infections or slow healing time

How can I get my vitamin D levels tested?

A simple blood test can be used to see if you have vitamin D deficiency. Your results can indicate the following:

vitamin D capsule

  • Severe Deficiency = less than 30 nmol/L
  • Deficiency = between 30 nmol/L and 75 nmol/L
  • Normal levels = between 75 nmol/L  and 100 nmol/L
  • Optimal levels = between 100-200 nmol/mL

How can I raise my vitamin D levels if I’m deficient?

  1. Get outside: practice safe sun exposure but don’t be afraid of the sun!
  2. Take a vitamin D3 supplement (dosing will be based on your blood levels)- gelcaps or drops are best for absorption.
  3. Get a series of vitamin D injections to raise your levels more quickly (as your Naturopathic Doctor if they offer these.


Sleep Hygiene Tips for Restful Sleep

What is Sleep Hygiene?



Why is Sleep Hygiene Important?



Why is Sleep Loss So Common? 


Quantity Versus Quality:


How Hormones Affect Sleep:


Simple Ways to Get a Better Sleep:


  5. Limit caffeine intake to before noon



5 Essential Thyroid Tests for Women


  • Very slow or very fast heart rate
  • Change in menstrual cycles (irregular periods, heavy periods)
  • Fatigue
  • Hair loss
  • Elevated LDL cholesterol level
  • Depression

5 Essential Thyroid Tests to ask for:

  1. TSH (thyroid stimulating hormone)
  2. Free T4
  3. Free T3
  4. TPO-antibodies & TG-antibodies
  5. Reverse T3

Understanding Your Test Results



  • Normal Range: 0.4-5 mIU/L
  • Optimal Range: 0.4 -2.5 mIU/L
  • Hypothyroidism = TSH > 5 mIU/L
  • Hyperthyroidism = TSH < 0.4 mIU/L


  • Normal Range: 9-22 pm/L
  • Optimal Range: 14-18 pm/L
  • Hypothyroidism = < 9 pm/L
  • Hyperthyroidism =  > 20 pm/L


  • Normal Range: 3.4-5.9 mIU/L
  • Optimal Range: 4.5-5.5 mIU/L
  • Hypothyroidism =  <3.4
  • Hyperthyroidism =  > 6


  • Normal Range: < 35 kIU/L


  • Normal Range = < 9-24 ng/dL
  • Optimal Range = less than 18 ng/dL


Is Estrogen Dominance causing your weight gain, heavy periods, and breast tenderness?

digestive-upsetWhat is estrogen dominance?

Estrogen is one of the primary female sex hormones. In women, estrogen helps initiate sexual development, regulates menstruation, and effects the entire reproductive system. Normally, estrogen is in delicate balance with another primary sex hormone, progesterone. This balance is necessary for both to function efficiently, and can be susceptible to disruption if levels in either shift.

There are two ways that estrogen dominance can present itself in the body. When the body has either too much estrogen from overproduction, or a lack of progesterone, it enters a state referred to as “estrogen dominance.” That is, too much estrogen relative to progesterone.

The body produces three main types of estrogen: estrone, estradiol, and estriol. Many women’s ailments, including breast cancer, uterine fibroids and cancer, ovarian cysts and cancer, endometriosis, polycystic ovary syndrome, and hypothyroidism are caused or promoted by excesses of estradiol, estrone, environmental estrogens, and synthetic estrogens.

Estrogen in our bodies comes from five possible sources:

  • FROM INSIDE THE BODY: estrogen is made in the ovaries, placenta, adrenal glands, and fat cells.
    • Estrogen-like foods and herbs (e.g. soy, legumes, pumpkin seeds, licorice root, etc.)
    • Animal products that has been raised using hormones (e.g. meat, poultry, fish, dairy.)
    • Environmental chemicals or xenoestrogens (e.g. pesticides, plastics, parabens, cleaning products, personal care products, etc.)
    • Synthetic estrogens (e.g. birth control, fertility drugs, hormone replacement therapy.)

What Causes Estrogen Dominance?

During the course of a normal menstrual cycle, estrogen is the dominant hormone for the first two weeks leading up to ovulation. Estrogen is balanced by progesterone during the last two weeks. However, as a woman approaches perimenopause and begins to experience anovulatory cycles (i.e. cycles where no ovulation occurs), estrogen can often go unopposed, thus causing symptoms. Skipping ovulation, however, is only one potential factor in estrogen dominance. Other causes may include:

  • Being overweight (i.e. body fat greater than 28%) since fat cells produce estrogen
  • Having a burdened liver, which leads to estrogen not being broken down and eliminated from the body efficiently. The result is estrogen recirculating and accumulating.
  • Being overstressed. This results in excess amounts of cortisol, insulin, and norepinephrine, which can lead to adrenal exhaustion and adversely affect your overall hormonal balance.
  • A low-fibre diet containing too many refined carbohydrates, and not enough nutrients and high quality fats. Fibre helps eliminate estrogen through bowel movements.
  • Environmental exposure to estrogen-like compounds such as phthalates and BPA.

Estrogen dominance has also been linked to allergies, autoimmune disorders, breast cancer, uterine cancer, infertility, ovarian cysts, endometriosis, polycystic ovary syndrome, and increased blood clotting, and is also associated with acceleration of the aging process.

Signs and Symptoms of Estrogen Dominance:

Estrogen dominance can result in serious long-term complications, as well as other signs and symptoms, such as:

  • Weight gain (especially in the hips and thighs)
  • Irregular/abnormal menstruation (heavy bleeding, large clots)
  • Insomnia (especially waking up in the middle of the night)
  • Thyroid dysfunction
  • Fibrocystic breasts, breast swelling and tenderness
  • Low libido
  • Sluggish metabolism
  • Foggy thinking, memory loss
  • Acne
  • Mood swings
  • Menstrual cramps
  • Headaches

Ways to Decrease Estrogen Dominance:

  • Follow a hormone-balancing diet (i.e. eat lots of fresh fruits and vegetables, enough protein, and healthy fats.)
  • Increase your fibre intake to help the excretion of estrogen, which can also prevent its reabsorption through the bowel
  • Consume cruciferous veggies (such as cauliflower, cabbage, broccoli, kale, Brussel sprouts) daily to help with estrogen metabolism and clearance
  • Choose organic meat and dairy to reduce your exposure to environmental hormones used in farming
  • Reduce excess body fat and exercise regularly to promote detoxification and circulation
  • Manage daily stress
  • Reduce your exposure to hormones, pesticides, and antibiotics in your environment and diet
  • Avoid synthetic estrogens (e.g. birth control pills, synthetic hormone replacement therapy)
  • Switch your personal care products to those that are free of phthalates, fragrances, parabens and other hormone disrupting chemicals
  • Get rid of plastic water bottles and food storage containers. Replace them with ceraminc, glass or stainless steel.


7 Common Causes of Fatigue


Persistent exhaustion, however, is prolonged, profound, and is not relieved by rest alone. Described as a near-constant state of weariness, fatigue develops over time and diminishes energy levels, motivation, and concentration, while also impacting emotional and psychological well-being.

Below are some of the top causes of fatigue and their symptoms.

1. Low Protein Intake:

Protein is an essential building block of the human body. Vital organs, muscles, tissues, and even some hormones are made of protein. Proteins are involved in nearly every bodily function from regulating blood sugar levels to healing wounds and fighting infection. Because they are used to develop, grow, and maintain nearly every part of the body – from skin and hair, to digestive enzymes and antibodies – they are constantly being broken down and must be replaced through diet. While each person is unique in terms of their specific protein needs (based on body weight, gender, age, and activity level), on average, the recommended daily minimum intake of protein for men is 56 grams, and 46 grams for women. Symptoms of low protein intake include: low energy/fatigue, sluggish metabolism, poor concentration, moodiness, difficulty losing weight, muscle, bone and joint pain, blood sugar changes, slow wound healing, low immunity. Vegetarians and vegans, as well as those on weight loss diets, are among the groups that may be at risk of protein deficiency.

2. Iron Deficiency:

The signs and symptoms of low iron or iron-deficiency vary depending on its severity. Mild to moderate iron deficiency can have little or no symptoms. However, if the body continues to be deficient in iron, it can lead to anemia, and symptoms then intensify. The most common symptom of iron deficiency is extreme fatigue. This is because iron is critical in the production hemoglobin, a protein that helps red blood cells deliver oxygen throughout the body. Without adequate levels of iron, the body cannot produce hemoglobin, and as a result can leave you feeling fatigued. Iron defieciency is the most common nutrient deficiency worldwide.

3. Vitamin B12 Deficiency:

The human body requires B12 to make red blood cells, nerves, DNA, and carry out various functions. Like most vitamins, B12 cannot be produced by the body and must be obtained from food and/or supplements. However, many people do not consume enough B12 to meet their needs, due to dietary habits or restrictions (e.g. strict vegetarians) or because they have existing medical conditions that interfere with food absorption (e.g. celiac or Crohn’s disease). As a result, B12 deficiency is relatively common.

4. Vitamin D Deficiency: 

Vitamin D is essential for strong bones, and it also appears to play a role in insulin resistance, high blood pressure, and immune function. Canadians are at risk because of our long winters and it is essentially impossible to get sufficient vitamin D from your diet. Those who avoid the sun, have darker skin complexions, are strict vegans, or who are obese, may be at even higher risk of developing a vitamin D deficiency. According to recent research, roughly three-quarters of American adolescents and adults are vitamin D deficient.

5. Hypothyroidism:

Hypothyroidism, or underactive thyroid, stems from an underproduction of thyroid hormones. Since the body’s energy production requires certain amounts of thyroid hormones, a drop in hormone production leads to lower energy levels, causing you to feel weak and tired. Approximately 25 million people suffer with hypothyroidism and about half are undiagnosed. Older adults, particularly women, are more likely to develop hypothyroidism.

6. Insomnia/Non-restorative Sleep:

How much sleep a person needs varies but most adults require roughly seven to eight hours each night in order to function optimally. Insomnia is a common sleep disorder that can make it hard to fall asleep, stay asleep, or cause one to wake up too early and not be able to fall back asleep. Insomnia can be caused by psychiatric and medical conditions, unhealthy sleep habits, specific substances, and/or certain biological factors. Nonrestorative sleep (NRS) is defined as the subjective experience that sleep has not been sufficiently refreshing or restorative. NRS is conventionally recognized as a symptom of insomnia or as a feature of medical conditions such as chronic fatigue syndrome. In the case of both insomnia and NRS, you may still feel tired when you wake up, which can impact not only your energy level and mood, but also your health, work performance, and quality of life.

7. Adrenal Fatigue/Burnout:

Adrenal glands play a significant role in stress response, as well as in balancing hormones. Adrenal fatigue is a condition where the body and adrenal glands cannot keep up with the amount of stress that many people experience daily as part of modern life. Acute stress and/or chronic stress, lack of sleep, and poor diet and exercise can cause adrenals glands to become overloaded and ineffective. Symptoms of adrenal fatigue include:

  • Unrelenting tiredness
  • Fatigue despite adequate sleep
  • Body ache, muscle weakness, muscle tension
  • Poor focus, racing thoughts
  • Moodiness, irritability
  • Feeling overwhelmed
  • Difficulty sleeping
  • Dizzyness or feeling unsteady with position changes
  • Difficulty exercising or poor exercise recovery