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You Are Not Broken

353. Thyroid, Gut and More

You Are Not Broken

Kelly Casperson, MD

Medicine, Health & Fitness

4.81.1K Ratings

🗓️ 11 January 2026

⏱️ 61 minutes

🧾️ Download transcript

Summary

In this episode of the You Are Not Broken podcast, Dr. Kelly Casperson sits down with Dr. Christine Maren to explore one of the most under-recognized truths about women’s bodies: female physiology is exceptionally adaptable—and that adaptability comes with trade-offs. Women’s bodies evolved to support reproduction, and that evolutionary priority shaped a physiology that can adjust rapidly to stress, environment, and demand. But that same flexibility can come at a cost, especially in today’s world of chronic stress, environmental exposures, and constant pressure. Together, Dr. Casperson and Dr. Maren unpack how this rapid adaptability may contribute to issues like thyroid dysfunction, hormone imbalance, gut disruption, and infertility—and why understanding these patterns is essential for improving women’s health care. Why female physiology is uniquely adaptable—and how reproduction shaped that design How rapid physiological adaptation can stress systems like the thyroid The links between chronic stress, hormones, gut health, and fertility How environmental factors interact with women’s biology Why adaptability can be both a powerful strength and a vulnerability The importance of recognizing these trade-offs in modern women’s health care Women’s bodies are not “broken.” They are highly responsive systems doing exactly what they evolved to do—often in environments that no longer support them. Understanding the costs of adaptation is the first step toward more compassionate, effective, and science-based care. Dr. Maren's Website To my fellow clinicians: listen to the You Are Not Broken podcast on ⁠⁠⁠Pinnacle's network to earn FREE CME credit⁠⁠⁠ Listen to my Tedx Talk: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Why we need adult sex ed⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠List is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ Learn more about your ad choices. Visit podcastchoices.com/adchoices

Transcript

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0:00.0

Welcome to the You Are Not Broken Podcast. I'm your host, Dr. Kelly Casperson, a board-certified

0:09.9

jurologist, thought leader, and conversation starter on midlife living, hormones, and sexuality.

0:16.6

Enjoy the show. Welcome, everybody, back to the You're Not Broken podcast. Today we're going to talk

0:20.9

with Dr. Christine Marin. We are like six years into the podcast now, and I don't think I've had a

0:26.1

thyroid episode, so this is long overdue. And welcome, and thanks for joining us to talk about this.

0:33.0

I'm so excited to be here. We met on stage in the green room, on stage in Denver at Stephanie Travers

0:39.9

Menopause Summit, October was that, maybe? It was super fun and super awesome. And I know it's not

0:47.0

going to be the only Denver event. So Denver listeners continue to follow what's happening

0:51.8

in the menopause hormone world in Colorado because you guys are

0:54.8

stepping it up. Yes, we are. I love it. So tell us your unique position in being able to talk about

1:00.4

this in midlife and we'll go from there. Yeah, so thyroid is a ignored piece sometimes in the

1:07.8

metapause conversation. A lot of women don't know about it. And a lot of people

1:12.4

who are practicing metapause medicine often don't address thyroid function, simply because

1:17.5

that's not part of the training that we get with the menopause society. And my unique position

1:23.1

is I come to medicine with a board certification by the American Board of Family Medicine.

1:28.9

So I've had my conventional training. I understand the conventional mindset and what we look at.

1:35.3

But I also have this other unique lens, which is functional medicine.

1:38.8

And in functional medicine, there's a different take around thyroid and around Hashimoto's in particular, which is

1:45.8

an autoimmune condition that many women and midwife have, and it is the number one cause of

1:50.8

hypothyroidism among women in America. And so with these two lenses, you know, I meet in the middle

1:56.7

in a place where I'm optimizing thyroid function, working on all the other systems that influence

2:03.9

thyroid function, and in the conventional perspective, I feel like sometimes it's forgotten about,

...

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