You may know Miki Agrawal from the company she founded, Thinx, which is taking menstrual realness to new heights with its period-ready panties (one of the first major steps forward in feminine products since 1929, when the modern-day tampon was invented) and edgy, in-your-face ad campaigns.

But what you may not know is that Agrawal built her buzzy New York City-based company while she was dealing with major health challenges.

After suffering from heart palpitations so intense, they caused massive sweating, in 2013 Agrawal sought the help of an endocrinologist, who diagnosed her with acute hyperthyroidism—a condition in which the thyroid gland is overactive, essentially speeding up everything in your body, leading to weight loss, anxiety, sleep problems, and more.

Then he delivered a devastating prognosis.

“He said you have two options: one is to take your thyroid out, or two, is to do radioactive iodine therapy. And with either one of these scenarios, you’ll have to take medication the rest of your life,” she recalls.

“I was like, ‘Those are my two options? That’s it?'” says Agrawal, who was 33 at the time.

“I thought, oh my God am I going to have to be reliant on medication forever? What if I’m stuck on a desert island? Am I going to die? I had to take control of the rest of my life and really just double down on my health. So I decided to dive in and become a student of my body.”

She took on the figure-it-out-ness of this health mission with the zeal of a serial entrepreneur (which she is—before founding Thinx in 2014, she started a chain of gluten-free pizza restaurants called Wild, which is still thriving).

First she adjusted her diet to eliminate all sugar, dairy, gluten, and processed foods for three months, inspired by Clean, the book by Alejandro Junger, MD.  And the sweat sesh lover (and ex-college soccer player) kept up a regular yoga practice, as well as a 20-minute daily meditation.

“It was so empowering to just say, ‘I am taking control of my health and I’m doing it. I don’t care how fucking long it takes.'”

“I did it for three months, and we did bloodwork again, and my thyroid levels had really improved,” she says. Encouraged by the progress, she dove headfirst into the holistic world: “I saw a seer, I went to see a hypnotist, I did sound healing—I went to three different sound healers! I got regular massages, I went to my life coach. If it was out there, I tried it.”

In 2015, she began seeing functional medicine bigwig Mark Hyman, MD, who did a full battery of tests to look for any food allergies—and actually discovered that she had acquired giardia (a parasitic infection in the gut). He was able to resolve it with medication, which further helped her overall health.

Today, Agrawal says her thyroid levels have almost normalized, and the medication she takes—originally prescribed at four pills a day—has now been reduced by her doctors to half a pill per day.

“It was so empowering to just say, ‘I am taking control of my health and I’m doing it. I don’t care how fucking long it takes. And whatever lifestyle changes I have to make, I’m doing it,'” she says.

“And I did it, and it worked. And it’s undeniable because your blood levels don’t lie.”

How did she do it? Read on for five of the things Agrawal credits with helping her get her health back.

1. Speak and act with integrity

More than anything, Agrawal credits her recovery to emotional healing, which started with an idea that has become a mantra for her: doing things “in integrity with” her whole self.

“Sometimes my mouth is saying, ‘Hi! How’s it going?’ but my heart is saying, ‘You were mean to me. Or you’re a jerk.’ And so the channel isn’t clear,” Agrawal says, echoing the experience of many women who believe that people-pleasing can literally make you sick.

“When this channel is blocked—this is your thyroid right here,” she says, pointing to her throat, “If your throat chakra is blocked, you’re going to be in conflict with yourself.”

Since she began working with life coach Lauren Zander in 2014, Agrawal says that she has made huge progress in integrating what she thinks, feels, and says—and she’s seen her physical health improve along with it.

“I feel like the biggest transition I made has really been in clearing that channel; really, truly owning what I’m saying and what I’m feeling and thinking,” she says.

2. Follow the 12-hour food rule

In addition to eating a fruit- and veggie-heavy diet (“I’d say I’m i’m 95 percent no sugar, no gluten, no dairy”), Agrawal pays attention to when she eats. “I always make sure there’s 12 hours between dinner and breakfast,” she says. “It takes eight hours for your body to digest the food and it takes four hours for the body to clean itself. I’ve been doing that since the beginning, when I did the Dr. Junger elimination diet—and that small rule makes a huge difference.”

3. Find the supplements for you

“I’m taking vitamin B12 and D3, and a lot of people with thyroid issues are deficient in those,” she says. “My doctor didn’t really tell me that. In the last six months, I’ve started taking those and it’s really improved.”

4. Take breath breaks

In addition to being dedicated to a daily meditation practice, Agrawal is a big believer in the power of breathing exercises: “I have three reminders on my phone, four times a day to take three long deep breaths. I just let my shoulders soften and focus on my thyroid. And in just three deep breaths, I’m just calmer.”

5. Let go of negative people in your life

“In 2015 I had a lot of really hard conversations,” she says. “I just faced everybody, and I eliminated the negative people in my life, both professionally and personally. And since then my thyroid levels have normalized.”

And Agrawal says 2015 was a year of breakthroughs, both in her recovery and for Thinx (the company burst onto the scene that year with its battle to advertise in New York City subways) and for her recovery.

Agrawal—whose 20something staffers buzz around her at Thinx’s New York City office, excitedly updating her with ideas she needs to hear—has clearly cultivated a culture of positivity at the start-up, an outgrowth of the gratitude she feels for her healthy business and her healthy body.

“When you’re in the throes of your business and you’re [wondering], are we going to succeed, are we going to fail? I’m having these challenging relationships, I’m having all these health things, and it’s just like: don’t forget that you’re alive. I get to be alive in this incredible world right now. Holy shit, that’s remarkable. That’s miraculous.”

Another thyroid-challenged woman in the public eye? Gina Rodriguez, who shares her wellness advice. And if you want to live “in integrity” like Agrawal, you might start with conquering your inner mean girl.