These are the questions I get asked. These are actually the answers I give…
I built this practice because the system doesn't have time for these conversations. Fifteen minutes isn't enough to explain why your testosterone number alone doesn't tell the full story, or what the new cholesterol guidelines actually changed, or how much protein you need and when.
These are also the questions I get at dinner parties, in parking lots, from friends who text me on a Sunday.
So I'm writing them down.
I was just diagnosed with hypothyroidism. Is there anything I can do naturally?
No food treats hypothyroidism. Your thyroid is not producing enough hormone. That requires medication, not a dietary overhaul.
Gluten-free is the most common thing I hear. Eliminating gluten will not change your thyroid function. If you have celiac disease, going gluten-free will help you feel better, but that's the celiac, not the thyroid. The internet has collapsed that distinction entirely, and there are a lot of people making money off that confusion.
What actually works: levothyroxine on an empty stomach, 30 to 60 minutes before food or coffee. Calcium and iron block absorption, so timing matters.
Okay, but I am taking my medication and still don't feel well. What now?
This is the follow-up I get every week, and it is a legitimate clinical question.
Make sure the basics are right first: absorption, dose, consistency. TSH in range means the dose is doing what it should for most people. But other things drive the same symptoms. Iron deficiency. Vitamin D. Perimenopause, where estrogen shifts change thyroid binding proteins. Sleep and chronic stress. And this is where diet actually matters: not a special thyroid protocol, but enough overall nutrition and protein to support how your body uses the hormone you're giving it.
Is something else compounding it? Do you need T3 alongside T4? Those are conversations worth having with a doctor who will listen. What they are not is a reason to spend $30 a month on a "thyroid support" supplement from someone online who diagnosed you via quiz.
I think I have low T. Where do I even start?
Most men arrive with one number. A total testosterone drawn at 2pm, sometimes fasted, sometimes not. That tells me almost nothing.
A real workup means morning total testosterone on two separate days. Testosterone peaks between 7 and 10am, and an afternoon draw can run 25 to 30% lower, sending you straight to the wrong diagnosis. Free testosterone. LH and FSH, to understand whether the problem is in the testes or in the brain's signaling to them. Prolactin, which when elevated suppresses the entire axis.
Then beyond the sex hormones: iron, vitamin D, thyroid, sleep, body weight. Untreated sleep apnea suppresses testosterone on its own. Fat tissue converts testosterone to estrogen. Most men have only ever gotten the number
My doctor said my testosterone is low but not low enough to treat. What does that mean?
It means the conversation stopped too early.
The reference range tells you where most men fall. It does not tell you how you feel at that number. A man at 280 ng/dL with fatigue, low libido, and muscle loss is a different picture than a man at 280 who feels fine. There is no universal treatment cutoff. The decision is biochemistry plus symptoms plus everything else that might be driving it.
"Not low enough to treat" is not a clinical conclusion. It's where the conversation should have started.
Lilly just got a GLP-1 pill approved. Should I switch?
Two oral GLP-1s exist now and they are not the same drug.
The Wegovy pill must be taken first thing in the morning, empty stomach, small sip of water, 30-minute wait before eating or drinking anything. Miss the window and you've lost the dose. Foundayo is Lilly's orforglipron, FDA-approved April 1. It's a small molecule. Any time of day, no food or water restrictions.
The tradeoff is efficacy. Foundayo
If any of these hit close to home and you want to work through the full picture, I'm happy to talk.
Have a question you want answered in the next issue? Hit reply. I read every response.
Dr. Sobia Sadiq
119 E. Ogden Avenue, Suite 211C
