Modern Thyroid and Wellness

What if chronic illness is rarely caused by just one thing?
In this episode of Modern Thyroid & Wellness, McCall McPherson sits down with Dr. Richard Horowitz, board-certified internist and longtime medical director of the Hudson Valley Healing Arts Center, to explore a very different way of thinking about chronic disease.
After more than four decades working with complex Lyme and tick-borne illness patients, Dr. Horowitz developed what he calls the MSIDS model, or Multiple Systemic Infectious Disease Syndrome. His framework looks at multiple overlapping drivers of inflammation rather than assuming one diagnosis has one cause and one treatment.
The conversation also explores his new book, Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation to Heal Chronic Disease, which brings together decades of clinical experience and research around Lyme disease, long COVID, chronic fatigue, neurological symptoms, immune dysfunction, toxins, gut health, hormones, mitochondrial dysfunction, sleep, and more.
🔑 In This Episode:
How Dr. Horowitz unexpectedly became immersed in Lyme disease
Why some patients remain sick after standard treatment
The origins of his 16-point MSIDS model
The “six rivers of inflammation”
Infections and co-infections
Environmental toxins, mold, and heavy metals
Gut dysfunction, leaky gut, and mast-cell activation
Vitamin and mineral deficiencies
Sleep disorders and chronic inflammation
Mitochondrial dysfunction and energy production
Hormonal dysregulation and the thyroid-adrenal axis
Immune dysfunction and autoimmunity
POTS and autonomic nervous system dysfunction
Liver health, fatty liver, insulin, and metabolic syndrome
Neurological and psychological symptoms
Why Dr. Horowitz believes the one-disease, one-treatment model often falls short in complex chronic illness
Early signs that may warrant a deeper evaluation
His approach to Lyme symptom screening and testing
Genetics, oxidative stress, and inflammatory pathways
Lifestyle strategies for prevention and longevity
Diet, exercise, sleep, meditation, gut health, and stress reduction
His perspective on GLP-1s and inflammation
Why his new book represents what he calls his life’s work

The Six Rivers of Inflammation
Dr. Horowitz describes six major upstream areas he believes can contribute to chronic inflammation:
Infections
Environmental toxins
Gut microbiome dysfunction
Intestinal permeability and mast-cell issues
Vitamin and mineral deficiencies
Sleep disorders

He then connects those upstream factors with downstream effects involving mitochondria, hormones, immune function, the autonomic nervous system, the liver, metabolism, neurological function, and more.
Thyroid, Hormones & Chronic Inflammation
For thyroid patients, one of the most relevant parts of the discussion is Dr. Horowitz’s view that chronic inflammation can influence the hypothalamic-pituitary-hormonal system.
He discusses low testosterone, adrenal dysfunction, autoimmune thyroid antibodies, metabolic syndrome, POTS, and other downstream effects he sees in complex chronic illness.
Lifestyle Still Matters
Despite the complexity of his framework, Dr. Horowitz repeatedly returns to the fundamentals:
Mediterranean-style nutrition personalized to the individual
Exercise
Adequate sleep
Supporting the microbiome
Stress reduction and meditation
Reducing relevant environmental exposures
Addressing metabolic health

📘 Get Ending Chronic Illness
Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation to Heal Chronic Disease
By Dr. Richard Horowitz
Available through:
cangetbetter.com
Dr. Horowitz is specifically asking the chronic illness community to purchase the book between November 1 and November 7 to support its bestseller launch.
Connect With Dr. Richard Horowitz
Website:
cangetbetter.com
Substack:
Medical Detective
Facebook:
Dr. Richard Horowitz
📖 Pre-Order Take Back Your Thyroid + Get a Free Bonus
Pre-order McCall McPherson’s new book, Take Back Your Thyroid, and choose one free bonus:
🎓 Thyroid Empowered Course — a $399 value
OR
🩺 $150 off a new patient visit at Modern Thyroid Clinic
https://book.modernthyroidclinic.com/?utm_source=chatgpt.com
📲 Follow McCall McPherson & Modern Thyroid and Wellness
Modern Thyroid Clinic:
https://modernthyroidclinic.com/
McCall McPherson:
https://www.mccallmcpherson.com/
Instagram:
https://www.instagram.com/mccallmcphersonpa/
YouTube:
https://www.youtube.com/channel/UC0_JyQdBAJwYT3rMDsvyriw
Facebook:
https://www.facebook.com/McCallMcPhersonPAC/
X / Twitter:
https://x.com/thyroidexpert
This episode is for educational and informational purposes only. Statements about EWOT, red light therapy, Lyme disease, inflammation, cancer, detoxification, or other health conditions reflect the guest’s personal experience and discussion and should not be interpreted as medical advice or a substitute for individualized medical care.

What if one of the simplest tools for supporting energy and recovery was something your body already depends on every second of the day: oxygen?
In this episode of Modern Thyroid & Wellness, McCall McPherson sits down with Brad Pitzele, founder and CEO of One Thousand Roads, to explore EWOT, Exercise With Oxygen Therapy, and the personal health journey that led Brad to build his own system.
Brad’s story began long before One Thousand Roads. After years of dealing with psoriasis, psoriatic arthritis, severe pain, fatigue, brain fog, melanoma, and eventually a Lyme disease diagnosis, he found himself trying treatment after treatment without getting the recovery he was looking for. Eventually, a functional medicine doctor suggested he investigate oxygen therapy.
When commercial options felt too expensive and impractical, Brad put his engineering background to work and built his own EWOT system. What started as a personal experiment ultimately became the foundation for One Thousand Roads.
🔑 In This Episode:
Brad’s journey with autoimmune arthritis, melanoma, Lyme disease, pain, fatigue, and brain fog
Why conventional treatments eventually left him searching for another path
How he discovered Exercise With Oxygen Therapy
What EWOT actually is and how a typical session works
Why exercise changes the body’s demand for oxygen
Oxygen, cellular energy, mitochondria, and ATP production
Brad’s perspective on oxygen, inflammation, and microcirculation
How he gradually rebuilt his cardiovascular capacity
Why some people notice improvements in energy, sleep, or exercise tolerance first
How EWOT can be adapted for people with lower exercise capacity
Why Brad pairs EWOT with red and near-infrared light
His typical sequence: exercise with oxygen followed immediately by red light
Using EWOT at home versus visiting a clinic
Brad’s personal view on oxygen therapy, recovery, aging, and detoxification

What Is EWOT?
EWOT stands for Exercise With Oxygen Therapy.
Brad describes it as approximately 15 minutes of cardiovascular exercise while breathing concentrated oxygen through a mask. His system uses an oxygen concentrator to fill a reservoir so enough oxygen is available while someone is exercising and breathing at a much higher rate.
Brad says the idea is to combine the physiological changes of exercise, including faster breathing, increased circulation, and greater oxygen demand, with higher oxygen availability.
From Barely Walking to Rebuilding His Capacity
One of the most striking parts of Brad’s story is how limited he had become physically.
At one point, foot pain was so severe that he needed heavily cushioned support simply to exercise. Over time, as his health improved, he says his endurance changed dramatically and he later measured a VO2 max that placed him near the top of his age group.
Brad presents this as his personal experience, not as a guarantee of what EWOT will do for another person.
Why Pair EWOT With Red Light?
Brad also combines EWOT with red and near-infrared light therapy.
His protocol is typically:
15 minutes of EWOT
followed immediately by
8–10 minutes of red light therapy
Brad believes the combination may support mitochondrial energy production by pairing increased oxygen availability with the cellular signaling effects associated with red and near-infrared light.
Connect With Brad Pitzele & One Thousand Roads
Special Listener Offer:
https://www.onethousandroads.com/modern-thyroid
One Thousand Roads:
https://www.onethousandroads.com/
YouTube:
https://www.youtube.com/@OneThousandRoadsHQ
Follow Brad Pitzele on Instagram:
http://instagram.com/bradpitzele
Learn More About Exercise With Oxygen Therapy, EWOT:
https://www.onethousandroads.com/pages/exercise-with-oxygen-therapy
Learn More About Red Light Therapy & Infrared Light Therapy:
https://www.onethousandroads.com/pages/red-light-therapy-education
📖 Pre-Order Take Back Your Thyroid + Get a Free Bonus
Pre-order McCall McPherson’s new book, Take Back Your Thyroid, and choose one free bonus:
🎓 Thyroid Empowered Course — a $399 value
OR
🩺 $150 off a new patient visit at Modern Thyroid Clinic
👉 https://book.modernthyroidclinic.com/
📱 Follow McCall McPherson & Modern Thyroid and Wellness
Modern Thyroid Clinic:
https://modernthyroidclinic.com/
McCall McPherson:
https://www.mccallmcpherson.com/
Instagram:
https://www.instagram.com/mccallmcphersonpa/
YouTube:
https://www.youtube.com/channel/UC0_JyQdBAJwYT3rMDsvyriw
Facebook:
https://www.facebook.com/McCallMcPhersonPAC/
X / Twitter:
https://x.com/thyroidexpert
This episode is for educational and informational purposes only. Statements about EWOT, red light therapy, Lyme disease, inflammation, cancer, detoxification, or other health conditions reflect the guest’s personal experience and discussion and should not be interpreted as medical advice or a substitute for individualized medical care.

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

Fertility, PCOS & GLP-1s
Dr. Natalie Crawford explains that fertility is more than simply the ability to become pregnant—it can also reflect hormonal and metabolic health.
For patients with PCOS and insulin resistance, improving metabolic health may help restore ovulation and support fertility. However, Dr. Crawford emphasizes that GLP-1 medications are not intended to be used while actively trying to conceive or during pregnancy and discusses stopping them before conception under medical guidance.
She also highlights resistance training and skeletal muscle as powerful tools for glucose utilization, insulin sensitivity, inflammation, and reproductive health.
Thyroid Health, Inflammation & Microdosing
McCall shares how her approach evolved toward lower, individualized doses after seeing patients struggle with nausea, inadequate nutrition, and difficulty consuming enough protein on standard dosing.
The goal, she explains, is not simply appetite suppression or rapid weight loss. It is finding a dose that allows patients to nourish themselves, preserve muscle, and improve metabolic health while minimizing side effects.
Menopause & Midlife Metabolic Health
Dr. Jessica Shepherd explores how declining estrogen, progesterone, and testosterone during perimenopause and menopause influence the entire body—not just reproductive health.
The panel discusses the relationship between hormone changes, glucose regulation, insulin, inflammation, visceral fat, joint symptoms, and the potential role GLP-1s may have alongside other individualized midlife interventions.
Protecting Muscle on a GLP-1
Dr. Shannon Ritchey emphasizes that simply “lifting weights” is not always enough to preserve or build muscle.
The panel discusses adequate protein and calories, monitoring body composition, potentially using tools such as DEXA scans, and performing resistance training with enough intensity to stimulate muscle adaptation.
📖 Pre-Order Take Back Your Thyroid + Get a Free Bonus
Pre-order McCall McPherson’s new book, Take Back Your Thyroid, and choose one free bonus:
🎓 Thyroid Empowered Course — a $399 value
OR
🩺 $150 off a new patient visit at Modern Thyroid Clinic
👉 https://book.modernthyroidclinic.com/
Featured Panelists
McCall McPherson, PA-C
Founder, Modern Thyroid Clinic
Thyroid & metabolic health
Dr. Natalie Crawford, MD
Fertility specialist and co-founder of Fora Fertility
Author of The Fertility Formula
Dr. Jessica Shepherd, MD
OB-GYN and women’s health expert
Author of Generation M
Dr. Shannon Ritchey, PT, DPT
Founder of Evlo Fitness
Strength training and muscle-preservation expert
📲 Follow McCall McPherson & Modern Thyroid and Wellness
Modern Thyroid Clinic:
https://modernthyroidclinic.com/
McCall McPherson:
https://www.mccallmcpherson.com/
Instagram:
https://www.instagram.com/mccallmcphersonpa/
YouTube:
https://www.youtube.com/channel/UC0_JyQdBAJwYT3rMDsvyriw
Facebook:
https://www.facebook.com/McCallMcPhersonPAC/
X / Twitter:
https://x.com/thyroidexpert
This episode is for educational purposes only. GLP-1 medications are prescription medications and treatment decisions should be made with a qualified healthcare professional based on individual history, risks, goals, and current evidence.

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

🏃‍♀️ Improving Insulin Sensitivity
Dr. Roehnelt and McCall discuss foundational strategies including:
Consistent, restorative sleep
Strength and resistance training
Reducing refined carbohydrates
Pairing carbohydrates with protein and fat
Using continuous glucose monitors to better understand personal responses
Strategic intermittent fasting when appropriate

💊 Medications Discussed
Metformin
Improves insulin sensitivity
Has a long history of clinical use
Can be a cost-effective early intervention

GLP-1 receptor agonists
Reduce appetite and slow gastric emptying
Lower liver glucose production
Improve insulin signaling
May help reduce inflammation in appropriate patients

🌿 Key Takeaways
Insulin resistance can often be improved when identified early.
“Normal” lab values do not always tell the entire story, and weight gain is far more complex than calories in versus calories out.
One of the biggest themes in this episode is that inflammation connects metabolic dysfunction, thyroid disease, and autoimmunity, making individualized, whole-body evaluation incredibly important.
📖 Pre-Order Take Back Your Thyroid + Get a Free Bonus
Pre-order McCall McPherson’s new book, Take Back Your Thyroid, and choose one free bonus:
🎓 Thyroid Empowered Course — a $399 value
OR
🩺 $150 off a new patient visit at Modern Thyroid Clinic
👉 https://book.modernthyroidclinic.com/

📍 Connect with Dr. Alessia Roehnelt
Website & Practice:
https://www.endohealthdoc.com
Instagram:
https://www.instagram.com/endohealthdoc/
Facebook:
https://www.facebook.com/alessia.roehnelt
📲 Follow McCall McPherson & Modern Thyroid and Wellness
Modern Thyroid Clinic:
https://modernthyroidclinic.com/
McCall McPherson:
https://www.mccallmcpherson.com/
Instagram:
https://www.instagram.com/mccallmcphersonpa/
YouTube:
https://www.youtube.com/channel/UC0_JyQdBAJwYT3rMDsvyriw
Facebook:
https://www.facebook.com/McCallMcPhersonPAC/
X / Twitter:
https://x.com/thyroidexpert

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

ADHD or Hypothyroidism?
One of the most important conversations in this episode is the overlap between ADHD and low thyroid function.
Dr. Brighten explains that hypothyroidism can affect brain energy, memory, attention, neurotransmitters, and executive function. Her approach is to address hypothyroidism first when it could be contributing to new ADHD-like symptoms.
If difficulties with planning, organization, emotional regulation, focus, or executive function persist—especially when similar patterns have existed since childhood—it may be worth investigating another layer.
Why Hormones Matter
Dr. Brighten discusses important hormonal windows when ADHD symptoms may change or become more obvious: puberty, postpartum, the pill, perimenopause, and postmenopause.
During perimenopause in particular, shifts in estrogen, progesterone, testosterone, cortisol, insulin regulation, mitochondrial function, and brain energy may make brain fog, sleep problems, emotional dysregulation, and executive dysfunction more difficult.
📖 AVAILABLE NOW: ADHD and Women
Dr. Brighten’s new book, ADHD and Women: A Guide to Optimizing Your Hormones and Thriving with ADHD, is available now.
The book explores female ADHD through a hormone-focused lens and includes guidance on gut health, sleep, exercise, nutrition, supplements, hormones, quizzes, and a 14-day reset.
👉 https://drbrighten.com/adhd-and-women/
📖 Pre-Order Take Back Your Thyroid + Get a Free Bonus
Pre-order McCall McPherson’s new book, Take Back Your Thyroid, and choose one free bonus:
🎓 Thyroid Empowered Course — a $399 value
OR
🩺 $150 off a new patient visit at Modern Thyroid Clinic
👉 https://book.modernthyroidclinic.com/
Connect with Dr. Jolene Brighten
Website:
https://drbrighten.com/
📲 Follow McCall McPherson & Modern Thyroid and Wellness
💻 Website: modernthyroidclinic.com
🐦 X / Twitter: @thyroidexpert
🌐 Host Website: mccallmcpherson.com
📺 YouTube: McCall McPherson Channel
📘 Facebook: McCall McPherson PAC
📸 Instagram: @mccallmcphersonpa
This episode is for educational and informational purposes only and is not intended to diagnose, treat, cure, or prevent disease or replace individualized medical care.