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This episode unpacks one of the most overlooked root causes behind perimenopausal fatigue and weight changes: the thyroid. Dr. Greg explains how shifts in estrogen, nutrient depletion, and chronic stress create a metabolic slowdown, leaving women cold, sluggish, and frustrated — even when thyroid labs come back “normal.” By the end, listeners will understand how thyroid health interlocks with hormone balance, why conversion matters more than a single lab number, and what simple, functional steps can begin restoring energy, metabolism, and vitality. Key Takeaways: Many women have sub-optimal thyroid function despite “normal” TSH labs. Common symptoms include fatigue, cold intolerance, weight gain, hair loss, dry skin, constipation, and brain fog. The thyroid is a rate-limiting step in hormone production and metabolic energy. T4 must convert into active T3 — a process driven largely by the liver and gut. Stress, estrogen shifts, immune activation, and poor drainage can block thyroid effectiveness. True thyroid support focuses on conversion, detox, immunity, and stress, not just medication. Resources & Next Steps: Initial Eval Link: https://drgreg.practicebetter.io/#/5e... Hormone Symptom Tracker: Use our comprehensive tracker to map symptoms related to estrogen, progesterone, testosterone, cortisol, insulin, thyroid, vitamin D, and more. https://drgreg.practicebetter.io/#/5e... Testing, Functional Hormone Panels & More: Want to explore your functional lab markers more closely? Wondering about working with Dr. Greg and the team? Learn more about our functional medicine approach and care options at www.vitaefm.com Ask Dr. Greg a Question: Have a question you’d like Dr. Greg to answer on a future episode? Email us at support@vitaefm.com. Subscribe & Contact: Subscribe for weekly insights on hormones, gut health, detox, and women’s wellness. Got a question or want to inquire about becoming a patient? Send a message to our team! Email us at support@vitaefm.com. Keywords: perimenopause symptoms, thyroid dysfunction women, normal TSH but hypothyroid, low thyroid symptoms, fatigue and weight gain, hormone imbalance, women’s health podcast, functional medicine, Dr Greg Mongeon, thyroid antibodies, reverse T3, liver gut thyroid connection, menopause support