Get ready for an enlightening conversation as I welcome Dr. Izabella Wentz, renowned Thyroid Pharmacist and an accomplished author, to New Frontiers. We’ll talk about her new book and dive into the often underappreciated and enigmatic connection between adrenal dysfunction and hypothyroidism, and how extreme stress can accelerate aging and impact immunity.
Dr. Wentz provides invaluable insights into her personally crafted transformation techniques that can pave the way for enhanced mental and physical well-being, spanning dietary adjustments, lifestyle modifications, targeted supplementation, circadian rhythm optimization, and the power of a resilient mindset. We also chat about the pivotal role of community support in effectively managing adrenal imbalances. Whether you’re an experienced practitioner or someone navigating your own health journey, this conversation promises to be both riveting and profoundly enlightening. So, let’s dive right in!~DrKF
The Role of Adrenal Function in Thyroid Health and Longevity with Dr. Izabella Wentz
When our body is completely stressed out and depleted, even daily tasks can feel like a marathon. The internationally acclaimed thyroid specialist Dr. Izabella Wentz, also known as the Thyroid Pharmacist, gets that and has developed a program to help people nourish their body and shift away from things that our body interprets as “danger” so we can calm the stress response and repair HPA axis dysfunction. Join us for this fascinating episode where we dive into the relationship between thyroid hormone levels and cortisol clearance, the prevalence of hypothyroidism in individuals with adrenal dysfunction, and the effects of stress on aging and immunity. We’ll also cover the personal transformation techniques Dr. Wentz developed to guide patients back to a more energized life.
In this episode of New Frontiers, learn about:
- [00:03:20 The importance of addressing adrenal imbalances in individuals with Hashimoto’s and hypothyroidism.
- [00:06:08] A new approach to adrenal healing for individuals who cannot tolerate traditional adrenal protocols.
- [00:10:01] The impact of low cortisol state on thyroid hormone metabolism and how hypothyroidism can affect cortisol clearance and lead to a low cortisol state.
- [00:11:18] Different patterns of adrenal dysfunction, including flatlined cortisol, a flipped cortisol curve and a roller coaster pattern.
- [00:12:03] The theory of HPA axis dysfunction and how it can lead to cortisol receptor resistance, similar to insulin resistance.
- [00:19:06] The effects of stress on aging and immunity: Stress can accelerate aging, alter immunity, and increase susceptibility to illnesses.
- [00:23:19] The importance of understanding and addressing our body’s perceived threats and stressors in order to improve HPA function.
- [00:24:38] The approach to addressing adrenal imbalances through safety theory, adaptogens, and mitochondrial support.
- [00:31:13] The importance of self-care for new moms and thoughts on strategies such as using adaptogens and replenishing nutrients.
- [00:35:54] Addressing postpartum thyroid issues: The need to monitor thyroid health postpartum, especially for women with Hashimoto’s, plus functional medicine testing and treatment options.
- [00:37:07] The connection between hypothyroidism, Hashimoto’s, HPA dysfunction, postpartum thyrotoxicosis, and postpartum depression.
- [00:40:45] The importance of shifting caloric intake and balancing macros in the morning for blood sugar regulation and supporting adrenal function.
- [00:42:19] The ABCs of adrenal support – adaptogens, B vitamins, vitamin C, carnitine and other supplements to support adrenal health throughout the day.
- [00:52:55] Thoughts on the effects of intermittent fasting and intense exercise training versus weightlifting, yoga and more anabolic exercises to shift out of that catabolic adrenal dysfunction state for people with HPA dysfunction.
Dr. Kara Fitzgerald: Hi everybody. Welcome to a new Frontiers in Functional Medicine where we are interviewing the best minds in functional medicine. And of course, today is no exception. You can see who I’m with. She is really famous in our world. Let me give you her background and then we’re going to jump right in and talk about her newest book. Izabella Wentz is a PharmD, so Dr. Izabella Wentz, FASCP. She’s an internationally acclaimed thyroid specialist and a licensed pharmacist who has dedicated her career to addressing root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s herself in 2009. She’s the author of three books on Hashimoto’s, including Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, Hashimoto’s Food Pharmacology, and Hashimoto’s Protocol, which became a number one New York Times bestseller. Congratulations on that! Dr. Wentz lives in Texas with her husband Michael and their son, Dimitri. Izabella, welcome, welcome, welcome to New Frontiers. It’s so great to have you here.
Dr. Izabella Wentz: Thank you so much for having me. It’s such a pleasure to be here with you.
Dr. Kara Fitzgerald: Yeah, likewise. I remember our paths crossed, you interviewed me for your summit many moons ago. Many moons ago, and it was really neat to discover the amazing work that you were doing in the world, and I’ve certainly been aware of it since that time, and I appreciate you coming forward with shining the light on adrenal imbalances in your book, Adrenal Transformation Protocol. I want to first start with why you’re writing about adrenals. Why this book?
[03:20] Dr. Izabella Wentz: I’ve been talking about adrenals for the last decade, so this is a really important component of getting a person with Hashimoto’s and hypothyroidism into balance is addressing that HPA axis dysfunction piece of it. And for me, this is something that I’ve been aware of for the last decade and talking about it in all of my books. I personally have gone through my own healing journey with adrenal dysfunction three times exactly.
My first time I utilized some of the protocols of pregnenolone and DHEA, using glandulars, and just really looking at what my cortisol pattern looked like, where I would try to lift up my cortisol in the morning and try to lower it in the evening. And those were the protocols that helped me get better and thrive, and I utilized them with my clients over the years. And of course, there were always clients that were like, well, I can’t do DHEA because I over convert it to that one thing that makes me grow chest hair, chin hair, and “bacne” (back acne), or with it over converting to estrogen and someone leading to estrogen dominance.
Then I started going into more of the deep lifestyle route where I was saying, “Okay, you can’t do hormones, let’s focus on giving up caffeine, really focusing on getting rid of as much stress in your life as we can, and can you sleep for 10 to 12 hours for the next 30 days? Can you commit to that?” I did this for myself personally after releasing a documentary series where I was overworked, and I released a book at the same time, and it worked really well for me. So, I was sharing these methods with some of the women and men in my community and within my own clients, and I’m sure you’ve seen this as a clinician, there’s always people that do really well with your protocols, and then there are some people that do your protocols- and I had one woman in particular who was like, I’m anxious, I can’t sleep at night. I’m constantly waking up to go pee. I’m in a lot of pain. And I was looking at her history, I’m like, you drink six cups of coffee a day. I think you just need to quit the coffee and you’ll feel better. And she said, yeah, let me try that. And she actually quit the coffee. She was so incredible.
And then she’s like, you know what? I’m still tired. I still can’t sleep at night. I’m peeing all night long and now I’ve lost my joy in life because I can’t drink my coffee anymore. And I always keep these individuals in the back of my head and I think about them in the evenings if I can’t sleep. Is there another path?
[06:08] And I came across another path to healing. Desperation always breeds innovation. When I was a new mom eight months postpartum, and I read that children are supposed to sleep through the night at around three months of age. My son did not read that book.
Dr. Kara Fitzgerald: Yeah. No way.
Dr. Izabella Wentz: He definitely did not read that book. I also had other sources of stress in my life. My husband started having some health challenges. My support system kind of fell apart and I felt like it was me taking care of my son and trying to take care of my family. And I knew that my adrenals were flatlined. I got a DUTCH test to confirm, and wow… I know why I’m exhausted all the time. But wait, what am I going to do? I don’t want to take DHEA. I was nursing. I don’t even know if pregnenolone- I’m just not comfortable with it. What if my son grows an extra, I don’t know- I don’t want my baby to have chest hair. I just don’t know. I don’t want to jeopardize this. I can’t do that, and then I can’t do the lifestyle things. I am waking up every two to three hours to care for my son, so I can’t sleep for 10 to 12 hours a night for 30 days. And I had just started drinking coffee for the first time really in my adult life regularly. I’m drinking this because I need it. This did not cause my adrenal issues.
[I knew I had to come up with a new plan. We all have these people that are the nursing moms or the people with stress that they can’t let go of, the people that aren’t able to sleep, the shift workers, people who can’t tolerate hormones. And we’ve got to find a new way. And so I did, and then I ended up sharing this with my online community. I usually will do group programs for people where the first time I will launch a program, it’ll be a small group where I’ll have the program as the main event, and then people can add on a consultation with testing with me, and then we kind of wean off of that and then offer it to more people.
And now this program has reached 3,500 people and we’ve gotten such incredible results with it, with 92% of people saying they have less brain fog in three to four weeks, 80 to 90% of people having less fatigue, better sleep, a lot of these adrenal issues just kind of getting better and people have more energy. Then I’m like, okay, it’s time to write another book and I want to get this message out there for the people who can’t do traditional adrenal protocols, or maybe just give them some additional tips and resources.
Dr. Kara Fitzgerald: So you could layer this into a traditional protocol with what we use, maybe glandulars, hormones as you outlined, adaptogens, even some cortisol, some Cortef. But you could layer these in. All right, so let’s talk about what you figured out. One doesn’t need to do labs, as you and I were talking about beforehand. One can actually diagnose this imbalance using your book. I want to walk us through what that is, and then I want to obviously hear about the intervention that these 3,500 people have responded to so well.
And also too, I’m curious in the original cohort, in your original group of people where you were directly involved in their care and running some labs, and sort of getting the background biochemistry, what kind of patterns emerged? And then take us through how you evolved that into something that one could do themselves just through some of the questionnaires you’ve developed.
[10:01] Dr. Izabella Wentz: Sure. So, in my experience with people with hypothyroidism, majority of them looking at their adrenal saliva tests, majority of them, like 62%, will present with flatlined cortisol patterns. Something like about 4 – 4.5% actually had high cortisol. And then the rest of them fall in that either cortisol rollercoaster pattern or the flipped cortisol curve. That’s been my experience with it and my theory with it, why so many people have that low cortisol state is because when we have not enough thyroid hormone, when we’re hypothyroid, that’s going to impact our cortisol clearance. So it’s going to be the metabolism of cortisol is going to change and slow down. And then these individuals, they get on thyroid hormones and they end up normalizing their cortisol clearance, which means increasing, right? And a lot of times they would come and they would say, I felt better on thyroid meds, and then all of a sudden I crashed. I feel more tired, what’s going on? I went back to my doctor and it was like, do I need more thyroid meds? And that’s not usually the answer.
[00:11:18] And I know some of the old school thyroid advocates would say, okay, just you need to megadose on your thyroid hormones. And I’m like, that is not safe, right? I’m a pharmacist that can cause heart issues, so many health issues to be over a medicated on thyroid hormone. That’s not the answer. What I’ve found in my experience over the last decade is, if you have hypothyroidism, if you have Hashimoto’s, there’s going to be a really good chance that you have some degree of adrenal dysfunction and we really need to address that. And again, it’s not always low cortisol. Sometimes it might be a flipped cortisol curve, or it might be that rollercoaster, even high cortisol. And again, I used to just-
[00:12:03] Dr. Kara Fitzgerald: Well, and what you and I were talking about earlier, like a glucocorticoid receptor resistance. So normal cortisol, or maybe even high cortisol, but it’s not able to exert any influence. There’s a receptor resistance almost akin to insulin resistance.
Dr. Izabella Wentz: It’s really interesting, because kind of studying the whole HPA axis over the years, and I know when the term adrenal fatigue was first coined by Dr. James Wilson, it’s 25 years ago already, I can’t believe that. His theory was that it was a mild version of Addison’s (disease). He believed it was maybe an early stage of Addison’s, and I think that might be true for some people. But it turns out that’s not the case for most people who are in this state. For a lot of them, in my experience, I feel like the theory that kind of matches up best is that HPA axis dysfunction, that disconnect between our brain and our adrenal glands where the body is flooded with cortisol for so long that we start adapting to that, and then we try to prevent this huge cortisol release. So we pull back on that, and then people will end up in that cortisol rollercoaster pattern. So this is really my theory that I’ve seen out there that I feel matches best what’s actually happening in these individuals. And then there’s also the parts of that cortisol, the receptors where they just become desensitized because you’re pushing so much cortisol into them that there’s, of course, we have protective feedback loops.
Dr. Kara Fitzgerald: Yeah, that’s really interesting.
Dr. Kara Fitzgerald: So earlier you said that you see hypothyroidism as a precursor to the overall HPA access dysfunction, to the adrenal fatigue picture. You see hypothyroid. And so my question is, do you always see that? What percentage of the time are you seeing thyroid?
Dr. Izabella Wentz: As a thyroid pharmacist, most of the people that come to me have thyroid issues. So that’s usually the majority of the people that I’ve worked with. I also have had people that have come to me that say, “I have every thyroid symptom and I have the weight gain, I have fatigue, I have all these symptoms. I don’t have a thyroid disorder.” They will have a thyroid ultrasound and there’s no evidence of Hashimoto’s. They will have no thyroid antibodies. Their TSH might be a two or three or something like that. But then they might have low T3 and/or high reverse T3. And now we know where this is coming from, and usually it’s going to be because of their adrenal dysfunction, their HPA axis dysregulation.
So I’ll have some clients like that. And then I’ve had people with fibromyalgia and chronic fatigue syndrome that have come to me. And you have your specialty, but then you’ll have random friends of friends, and friends of clients that say, you helped me so much, can you help this person? And they have IBS, or they have depression, or they have this other condition. And my programs have started to get out into those other kinds of conditions. I would say 90% of the people I’ve worked with have hypothyroidism, but there’s also been people with other kinds of health conditions who I’ve done tests with and who I’ve supported on their healing journeys.
As far as the statistics, I have statistics for people with Hashimoto’s hypothyroidism that are symptomatic in what their adrenal patterns look like, but I don’t have stats for other conditions. I try to get at least a hundred tests within a specific panel to feel confident talking about it. So I do see a lot of the chronic fatigue people and fibromyalgia, they do tend to have more of a low cortisol presentation, in my experience.
Dr. Kara Fitzgerald: I think anybody, I mean, wouldn’t intuitively it make sense that anybody with any chronic condition really weighing on the body, eventually we would see some HPA dysfunction kick in. Would you agree?
Dr. Izabella Wentz: Yeah. The research has shown that. What degree of it? That’s always a question where it’s helpful to do testing and it’s helpful to do a really good history of symptoms. But generally, from the research standpoint, the HPA axis dysfunction has been connected to depression, to heart disease, chronic pelvic pain, rheumatoid arthritis, osteoporosis, just a whole list of conditions. Some of them I’ve never even heard of. And wow. Just doing some of the research for my book to make it approachable to a bigger audience than just my thyroid community I’ve been so surprised, but also not surprised, to learn about all these other conditions where HPA axis may play a role.
Dr. Kara Fitzgerald: I want to say a couple of things and then I want to ask you about the conventional community and how they’re metabolizing this information. If there’s consideration of this HPA dysfunction. We were talking a little bit before about koala syndrome (koala immune deficiency syndrome/KIDS). I wrote about this some years ago. It just struck me as really so fascinating. So koala bears have vestigial adrenal glands. They don’t have adrenal glands. So if they get stressed out, they basically, they can die. And so, people in ICU who’ve got modest hypoadrenalism or low cortisol, not frank Addison’s, can die. This is a cause of increased morbidity and mortality and it’s been termed koala syndrome. So just to your point, I think it’s everywhere. And I think the influence, the impact of imbalanced adrenal and HPA function just can’t be understated.
And then I want to say one other thing, because it’s interesting, and I don’t want to forget. In my research looking at biological age, response elements, these sites on the epigenome that will influence different genes, 25% in the clock that we use to measure biological age are glucocorticoid response elements. Meaning glucocorticoids are influencing whether these genes are on or not in the aging process, which is extraordinary to me. The stress experience is such a major player in accelerated aging. So, if you have any thoughts on that, speak, and then I want to ask you about the conventional community. So I’ll stop.
[00:19:06] Dr. Izabella Wentz: Absolutely. And you think about when you see a president going into office with a full head of dark hair, and then you see the effects of extreme stress on aging. You see they come out of office with a complete gray head of hair. So it’s very relevant. Accelerated aging. Altered immunity. People will catch illnesses more frequently if they are stressed out and depleted. And one of the things I came across recently was with suicide attempters versus people with suicidal ideation. If you are a suicide attempter, you tend to have lower cortisol secretion throughout your day. And this makes so much sense to me because these are the individuals that are just overwhelmed with day-to-day life, that taking their own life seems like the answer. And that’s never the answer, right? So we want to make sure anybody that’s struggling, that’s my big passion, is to help people thrive and feel well and let them know that symptoms are temporary.
We can absolutely get back to feeling like we’re thriving and having good mood and not having pain in our bodies. The conventional medicine approach is just really frustrating to me, because a lot of times people will come across something online and they’ll resonate with the adrenal fatigue syndrome that’s been described 25 plus years ago. And they’ll go see their doctors and the doctors will say, well, this doesn’t exist. Or they’ll say, this is something that even if it did exist, we couldn’t do anything for you. So we have Addison’s disease or we could have Cushing’s disease. There’s nothing else out there. And for me, that’s just super frustrating whenever I see people be told this is in their heads, or it doesn’t exist, or everybody’s tired, nothing can be done for you.
Kara Fitzgerald: And I think that there’s sufficient evidence to suggest that there is this in-between. Well, and as you were talking to me earlier, most people who you identify HPA imbalance don’t eventually become Addison. They don’t develop frank adrenal insufficiency. So there’s this massive area of imbalance that exists in so many different individuals, in so many conditions, and it’s still just simply not recognized by the greater medical community.
Dr. Izabella Wentz: I think psychologists have started to recognize it, and there’s a lot of research on ACEs, adverse childhood events, such as parental divorce or abuse that really can impact people’s HPA axis. And that’s been really well established. And I always scratch my head because doctors will say adrenal fatigue doesn’t exist, but can you go on PubMed and look up HPA axis dysfunction because it is a thing, right? It’s a real thing.
Dr. Kara Fitzgerald: Yeah, or burnout as you were talking about. I mean, all of those things. There’s plenty of research looking at salivary cortisol in the presence of different stressors. It’s a real entity. So I mean, again, you’re bringing it forward and I think it’s important for us to be able to acknowledge it and to keep knocking on the door, and eventually the greater medical community, hopefully, will open it. But in the meantime, we’re here and you’re here. I want to know what this protocol is and how you’re guiding people to figure it out.
[00:23:19] Dr. Izabella Wentz: My theory and a lot of my work has been based in Safety Theory and focusing on how to get a person to feel they’re safe. We know we have danger signals and our body is very tuned into the stressors. So anytime we perceive stress, we’re going to feel that in our brains, and that’s going to send a signal to our adrenal glands to release cortisol and stress hormones. And so, my approach was essentially, what are people doing in their lives right now that can make a body feel like they’re in a famine, that they’re in a war, that they’re under threat? And I really try to focus in on that. And this is something that I did for myself as a new mom. And obviously, sleep deprivation can be a big driver of HPA axis dysfunction. I read a study that talked about how sleep deprivation is one way scientists induce HPA axis dysfunction in rats and mice to have experimental models of this. And this isn’t really getting better. Sleep isn’t really available to me. So what are some other safety signals? What are some other ways that we can send that safety into our bodies?
[00:24:42] And to tip the scale from we’re in survival mode and this is what we’re perceiving, so we’re going to turn on our survival response where we’re asking the body to make more cortisol. And perhaps that communication pathway gets broken down. How do we shift into more of a thriving state? And some of the things are taken from the traditional functional medicine approach. We look at adrenal adaptogens, where no matter if you have cortisol that’s too high or that’s too low, we’re going to be utilizing them to help with balancing that stress response. Some of the ones that I use also have some side benefits for mitochondrial support. I love utilizing rhodiola.
The other thing, a lot of times in people with adrenal dysfunction, and I think in the functional medicine world, there’s always an argument about is it really adrenals or is it mitochondrial dysfunction? Is it adrenals or is it mold toxicity? Is it adrenals or is it childhood trauma? And it could be all of it. One doesn’t have to exclude the other. Anything that overwhelms the stress response is going to get a person into that adrenal dysfunction state. Many of the patterns that I’ve seen too, is people will have some degree of mitochondrial dysfunction. One of the reasons I think my programs work so well for the brain fog and fatigue individuals, is because we focus on mitochondrial support. We really focus on realigning with the circadian rhythm. We’re doing bright light exposure throughout the day. We’re making sure you’re not overexposing yourself to lights in the evenings. And then I love utilizing carnitine and d-ribose in addition to utilizing things like the B-vitamins, vitamin C, and magnesium, some of the nutrients that have multipurpose effect on our neurotransmitters, on our stress response, that support adrenal hormone production. They can also support healthy mitochondrial function.
Dr. Kara Fitzgerald: Awesome. I love it. Yeah. Nice. Very holistic.
What worked for you? And what did you do? I mean, honestly, I was that sleep-deprived… I actually had such a struggle with sleep. I leaned on a sleep nanny for a couple of nights a week early on, because I was going to lose my mind. In fact, I chuckled with a friend of mine about sleep deprivation research. They do it in men and they do it in the military and stuff like that. And I’m like, this doesn’t hold a candle to what new parents go through with sleep deprivation, and particularly moms. It doesn’t even hold a candle. The sleep deprivation was so insane. So thank God I was able to get a little bit of support then. But you weren’t able to, and so you had to look elsewhere. I mean micro-naps, I became a really expert napper. I’m actually not as good as I was, but I could get a lot of sleep in a very concentrated chunk of sleep in a very short period of time when I was a new mom. But what worked for you?
Dr. Izabella Wentz: That could work really, really well. And I will just say that night nannies are worth their weight in gold. So absolutely, if you can get a night nanny, that could be incredibly helpful. Grandparents worth their weight.
Dr. Kara Fitzgerald: Yes, that’s right. Family.
[00:31:13] Dr. Izabella Wentz: I have parents nearby and all of these outsourcing things. So getting any help with meal prep. I did take some time off of working. I was like, okay, brain, you’re going to need a little bit of extra. Everybody says sleep when the baby sleeps, right? If you can take a nap with your child, that can work really, really well. Not accessible to everybody. Not everybody has these amazing resources at hand. So some of the things you can do is you can use some of the adaptogens that have maybe been studied as galactagogues. And of course, if you have an oversupply, maybe not the best idea, always check with a lactation consult. But something like Holy Basil, you can drink that as Tulsi Tea throughout the day, and that can help you get a little bit more of that good cortisol production throughout the day. Very gentle. Most mamas and babies can tolerate that just fine.
Really replenishing those nutrients. Getting your vitamin C on board. B-vitamins, you don’t want to do P5P above 50 because that could suppress your prolactin levels, if we go B6 above 50. Sometimes progesterone can help, but some women will say that can suppress their milk supply. And then really looking at the nutrients that get depleted when we’re sleep-deprived. This works for tired mommies, tired daddies, and night shift workers. I’m talking about a lot of the mitochondrial support. So carnitine, benfotiamine, choline, fish oil can be incredibly helpful. And then some of the mushrooms, like reishi can be incredibly helpful for repairing your brain when you’ve been so sleep-deprived. When I got on that protocol, I remember going out with friends and they’re like, oh, your baby must be sleeping better. I’m like, nope. And they’re like, how do you look so good? How you are not so tired? And it’s a matter of doing those things. And also just really being mindful of what you put into your world.
So for me, a lot of it was fueled by fears and some of the new parenting anxiety. So just trying to cut some of that out. Spending a lot of time in nature, that was really great for me and for my son. Being outside with him a little bit more was incredibly helpful. And specifically going on stroller walks in the morning. For a while I was just sitting on my patio and drinking coffee and putting him in his stroller. I couldn’t do much more.
Dr. Kara Fitzgerald: That’s awesome.
Dr. Izabella Wentz: Really getting that light into my eyes was a really, really big game changer for my energy levels. I tried to spend as much time in nature as I could, and that was so healing, so replenishing. And then a little thing that I utilize throughout the program is myo-inositol, and also some people can use d-chiro inositol. That helped with my blood sugar issues. And that actually helped my son sleep a little bit better when that got into my breast milk. And I of course want to make sure everybody is talking to lactation consultants and pediatricians and all of that before doing a lot of supplements and herbs. But generally, some of the adaptogenic herbs, the more gentle ones, the reishi, is going to be okay, or the Holy Basil, and a lot of the vitamins. Like the benfotiamine, choline, fish oils, carnitine, a lot of these can be very helpful for baby’s brain development as well.
Something else that is a really big game changer, and I know Dr. Oscar Serrallach is a big advocate of this, is making sure that you don’t have a depletion of ferritin after you have the baby. This can be a really common sign of fatigue with postpartum moms. And then being the thyroid pharmacist, you do want to make sure you keep your thyroid in balance.
[00:35:54] Typically, we can have a flare up postpartum of Hashimoto’s and we could have new onset Hashimoto’s. So looking from a functional medicine perspective, is Hashimoto’s a part of what’s going on with you? Do you have elevated thyroid antibodies? If you do, how are your thyroid numbers? Do you need more thyroid meds? And part of that is making sure if you do have elevated antibodies, looking at functional medicine testing. You’re not just tired because you’re a new mom. You can have other things going on in your body when you’re in that depleted state. So definitely advocate for functional medicine work if a woman is not doing well. And do a GI-MAP test if a woman has an exacerbation. In my case, I had H. pylori four months postpartum and that was something that’s causing my hair loss. And I got the H. pylori under control and the hair loss and my Hashimoto’s antibodies went into remission again.
[00:37:07] Dr. Kara Fitzgerald: Awesome. That’s so fascinating. This would be an antidote, not that we were intending to be talking about the postpartum period, but I know that there’s, I’m sure there are a lot of our listeners who are interested in it, and it’s not a topic that I get to cover very often, so it’s cool to do it. We were talking earlier about HPA axis imbalance and depression and suicide. And postpartum depression is massive, and I have to believe that it’s informed by some of these imbalances that you’re talking about. And then this is also the solution. Or at least a piece of the solution.
Dr. Izabella Wentz: Oh, absolutely. I mean, hypothyroidism, Hashimoto’s, postpartum thyrotoxicosis, there’s a lot of research connecting that to the postpartum depression, postpartum psychosis, things that people go through. And my heart breaks. It’s just devastating that some women have to suffer so much without answers.
Dr. Kara Fitzgerald: Oh yeah. And in a minute we’ll move past this, but especially because there’s this new brain that kicks in when you’re a new mom. You’re just looking at the world through entirely different lenses, and that can come with a loud voice saying this is what I should be doing. There’s a new phenomenon of guilt that I hadn’t experienced ever in my life until I became a mom. There’s just this crazy brain that sort of happens simultaneously that could make good self-care hard, at least initially, and then you kind of get your sea legs.
Dr. Izabella Wentz: By the time you have six or seven kids, you’re like, you got this, right?
Dr. Kara Fitzgerald: Yeah, right.
Dr. Izabella Wentz: The first one’s always the hardest.
But yeah, totally. Part of the reason why I created this book is I’ve realized this new approach for adrenal dysfunction and realized it’s hard. When you’re a 20-year-old influencer, you can drink tequila every night and go out dancing, and you can still be fit and have lots of energy. And then there are certain points in our lifetime where we maybe don’t have as much room and capability for self-care, getting good sleep, or some of the things just become unrealistic. We can’t quit our jobs, right? Yes, that’s a source of stress for us, but we can’t quit. We need to make a living.
My protocol is very comprehensive and it also talks a lot about personal transformation techniques. Because you can do all of the healthy eating, you can do all of these herbs and supplements and spend time in nature, but if you still have some of these danger signals that are coming from the way that you’re talking to yourself in your own head, then you’re constantly going to be sending off stress signals in your body. So a big part of the transformation is really working on some of these traumatic experiences that people have had and rewiring some of the patterns that let them to get into that adrenal dysfunction.
Kara Fitzgerald: Yes. Incredible. Good. That’s really good. I want to hear about the day in the life of someone on the protocol. Anybody, we’re out of the postpartum period. So anyone. Men, women, young, older, what that looks like. And I also want to hear some of your techniques for working with those danger signals.
[00:40:45] Dr. Izabella Wentz: So definitely one of the things that I have found in individuals that are in the depleted state, they might not be hungry in the morning and they will end up waking up in the middle of the night and feel hungry. So, what we’re trying to do is shift their caloric intake through daytime. And so, you’re not hungry in the morning, but why don’t you have this delicious orange creamsicle smoothie? This is going to be orange juice with vitamin C. We’re going to add a little bit of electrolytes for healthy blood pressure support. The orange juice is going to, of course, raise glucose levels, because if you have low cortisol in the morning, you probably have low blood pressure, low glucose, right? And then we’re going to add some protein powder and coconut milk so that you don’t have this huge blood sugar rise from the OJ, followed by a crash where you need more cortisol to try to save you. And that’s going to be where we start off.
[00:41:44] We will ideally have this smoothie outside so that we can get some sunshine into our eyes, ideally before 11 o’clock. If we live in a cold climate, then I’m utilizing seasonal effective disorder lamps, or bright light simulation lamps, daylight simulation lamps to help people really understand that their bodies understand that it’s daytime, right? The indoor lighting, of course, doesn’t have enough of the right wavelengths to help with that. And then as we go about our day, I talk about the ABCs of adrenal support. Adaptogens, B-vitamins, vitamin C. We’ll utilize carnitine, that can be incredibly helpful for energy production, brain function, mitochondrial support, as well as the d-ribose and other kind of mitochondrial supports throughout the morning.
As the day goes on, we’re focused on eating every few hours initially for individuals who are on that blood sugar roller coaster. I’m trying to rewire them to feel hungry throughout the day and not hungry at night. And we’re doing that with protein, getting them more protein and more fat. Generally, lower carb eating throughout the day. And then in the evening, I’ll generally recommend an Epsom salt bath, maybe a myo-inositol supplement, magnesium supplement, if you don’t do the Epsom salt bath, and Saccharomyces boulardii. Boulardii helps with raising our secretory IgA levels. I’ve known from testing, so many people have low secretory IgA when they have low cortisol and when they’re stressed out. And so, this means that they’re going to be more sensitive to the foods they’re eating. This means they’re not fighting off infections as well within their gut, and they’re more susceptible to going for sushi and catching something than the person with them that has a healthy adrenal response. So we’re utilizing that typically at bedtime so that people can sleep better.
Initially, I might recommend something like a gentle chamomile tea to help people sleep a little bit better. But a lot of it is focused on the lifestyle components. It’s dark after dark. We’re putting on stickers on our blue lights in our bedrooms. We can use blue blocker glasses. We try not to watch Netflix and chill all night until 11 o’clock in the evening. And it’s just a solid kind of lifestyle realignment with the circadian rhythm throughout the day.
And this is kind of the foundation, and as we build on that, I work on – How do you get gratitude into your life? How do you shift your mindset so you’re focusing on doing pleasurable activities throughout the day rather than being on a self-induced rat wheel where you have so many things to do?
One of the things I’ve noticed in my work with clients, sometimes they’re tired because they’re doing too many things. Sometimes they’re tired because they’re not doing enough of the right things. They’re not filling up their own cups, whether that’s making art or spending time with animals, spending time in nature. A lot of these things can really help fuel people and give them something to look forward to. I know some of it is borrowed from psychologists of utilizing pleasurable activities to help with overcoming depression and mood issues, but it really does work pretty well.
Kara Fitzgerald: Yeah, it really does. I love it. Time to benefit. If somebody really gives themselves to this protocol, when should they begin to be able to identify that it’s working?
Dr. Izabella Wentz: If you’ve been high carb eating and a lot of sugar, you’re going to notice the benefits of the blood sugar balancing diet in three to five days when I know a lot of people are like, I thought I had anxiety, it turns out I just had blood sugar swings. So that can take effect pretty quickly. The way that I’ve done it in the program, I’ll have them start the diet one week, the next week I’ll have them start the supplements. And so, these things kind of build on one another. So the second week I’ll have them starting supplements. Again, these take three to five days to work. The carnitine and the adaptogens, I mean, these can kick in quite quickly for a lot of people. The Epsom, salt baths, I mean, sometimes you just need one and you can feel the difference of the pain is gone. I feel so much calm, I’m sleeping better, I feel refreshed in the morning.
And then this builds upon it. Then we have some of the deeper work, overcoming traumas and working on setting boundaries and some of that deep transformational work. And sometimes I feel like you need a really solid foundation of the lifestyle and supporting yourself nutritionally before you can get there. And that can be a lifelong journey. But generally, people within the program, they’ll say within three to four weeks, they feel like their life has transformed.
Dr. Kara Fitzgerald: And having the community that you’ve developed; I would imagine that that’s huge for the mutual support.
Dr. Izabella Wentz: It’s incredible. I usually will do a Facebook group so people can meet each other and talk to one another, and it can be incredibly helpful. It’s actually a very positive community. So we’ve had to actually work on that because some people would post pictures of like, I ate a whole cake today, and that would trigger others who were trying to follow the plan and follow the program. So we’ve curated a very, I guess, supportive experience for people where we encourage them to share their success stories. If you started off with 20 symptoms and you maybe only have 19, please tell us about it. Please share what you did. And that will help encourage others. And I know sometimes people will have, I’m sure you’ve worked with people like this, they all have 25 symptoms and you get rid of 24 of them while working together, and they don’t take that time to celebrate. And they don’t take that time to congratulate themselves for all their hard work. So the environment we create is very positive, and uplifting to help people help themselves and feel good in the process and believe in themselves.
Dr. Kara Fitzgerald: And community, just again, going back to some of my research and thinking about epigenetics these days, and longevity, I mean, community is essential. The data is just so strong. And so, that community interconnection for supporting and overcoming, not feeling alone as you’re working on your trauma, all of it’s just, it’s massive.
Dr. Izabella Wentz: It is so beautiful when people support one another, and it’s hard because in the pandemic I feel like a lot of us have been in our own little bubbles and maybe not reaching out to as many people. And the program came out in March of 2020. It was the pilot program. And this was the worst timing because everybody’s anxious and everybody’s struggling right now. But it actually even worked during the peak of the pandemic. And it’s been working the last few years that we’ve been releasing with people feeling better through it all. And I think a big piece of that is community and hearing that you’re not crazy and being validated. I think so many people go through life with these symptoms and they’re just brushed off and they’re told to suck it up, or this is just normal. You are just this anxious person. You’re high strung, this is your personality. And I’m like no, it doesn’t have to be.
Dr. Kara Fitzgerald: Yeah. We’re just wrapping up here, but I know that people are going to be wondering about intermittent fasting and exercise, and it just seems that that’s not going to be out the gate in this program. Anything too extreme. But I want to hear your thoughts on those.
Dr. Izabella Wentz: So, we’re not quitting caffeine, we’re not doing cold plunges, we’re not doing cryotherapy. It’s just things that I can do, because I’m healed that I couldn’t do when I was a sleep-deprived new mom. It’s a balance. If you have somebody that’s got really depleted cortisol, everything feels overwhelming to them. Cleaning the house feels like a marathon, right? Or walking around the block to get the mail feels like a marathon to you, so you’re not doing marathon training.
And a big part of that is that mitochondrial dysfunction that prevents us from being able to tolerate exercise, from being able to tolerate fasting. A lot of the women that I start working with, they’ll say, I’m trying to do fasting, but I feel worse. Or I’m trying to spend time with loved ones because community’s supposed to feel so healing, but I have to take three days off to recover. Or aerobic exercise. So, we’re really shifting out of some of even the positive stressors. We’re allowing you just to feel a lot of joy. And this is why I’m not going to have them quit caffeine, because they’ll be miserable. So we’re focusing on pleasure, replenishing, building oxytocin, helping you receive and just feel super nourished and super loved on by yourself. Probably my mommy days is my maternal instincts. Just really embracing yourself and having that healing time for yourself.
And this can work so well in just a few weeks. And then people can tolerate more of the positive stressors. So they can actually tolerate- Initially, I’m like keep a banana by your bed, so when you wake up at 3:00 AM you can snack on that banana that’ll help you go back to sleep. If you need a snack at 9:00 PM do it. If you need a snack at 3:00 PM do it. This is my initial plan. As we go on. You can actually shrink your eating window. My goal is for you not to be hungry at 3:00 AM and a lot of the women, if they skip breakfast, if they don’t get enough protein throughout the day, if they try fasting, they’re like, I can’t sleep at night. I’m waking up in the middle of the night. I gain weight and my hormones are just falling apart.
[00:52:55] And so people are like, are you against it? And I’m not against it. I think to each his own. You’ve got to find your medicine and your dose for you at the right time. And marathon training if you have flat lined adrenals? Not a good time. Versus somebody that has a high cortisol, doing more aerobic exercise is going to help you to clear that out. Most of the strategies are really tailored to that stress response and are adaptogenic in nature. And then I have a section on building resilience that talks about what you can do as far as weightlifting, if you can tolerate that, and yoga and more of the anabolic exercises to shift out of that catabolic adrenal dysfunction state. That can be incredibly helpful for people.
And then I talk about if you have these kinds of symptoms, let’s say if you have high blood pressure, that’s a sign of high cortisol. You don’t want more licorice, right? Because that can increase your blood pressure, and that’s going to prolong your cortisol in the body. And same with the types of exercise. If you are doing aerobic exercise and you feel exhausted after the exercise, probably not your right medicine, not in the right dose for you at this time.
Dr. Kara Fitzgerald: Yeah. Well, Izabella, this has been fabulous. I love it. I love what you’re doing. I love your community. We’re going to link to it in the show notes. But any final words that you want to share and maybe just let folks know where they can find you.
Dr. Izabella Wentz: Oh, absolutely. Just wanted to thank everybody for dialing in and thank you for having me. And for everybody that is passionate about helping their patients feel better I so appreciate your work in the world, and I love that you’re learning about new protocols. Hopefully I could be a part of that journey. My website is thyroidpharmacist.com, and my books can be found on Amazon and Barnes & Noble, wherever fine books are sold.
Dr. Kara Fitzgerald: Well, congratulations on your newest book, and I wish you all the best success for this and just to continue to take your good work into the world. Thanks for joining me.
Dr. Kara Fitzgerald: As always, thank you for listening to New Frontiers in Functional Medicine, where our sponsors help bring the very best minds in functional medicine, and today is no exception. Not everyone can be a sponsor on my platform, and I so appreciate the good work, relentless research, and generous support from my friends at Rupa Health, Biotics and Integrative Therapeutics. These are brands I know and trust in my own clinic and can confidently recommend to you. Visit them at RupaHealth.com, BioticsResearch.com and IntregrativePro.com, and please, tell them you learned about them on New Frontiers.
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Izabella Wentz, PharmD, FASCP, is an internationally acclaimed thyroid specialist and a licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009. She is the author of three books on Hashimoto’s: Hashimoto’s Thyroiditis Lifestyle Interventions for Finding and Treating the Root Cause, Hashimoto’s Food Pharmacology, and Hashimoto’s Protocol, which became a #1 New York Times bestseller. Dr. Wentz currently lives in Texas with her husband, Michael, and their son, Dimitry.