Hashimoto’s Hypothyroidism: How to Finally Heal the Root Cause and Reclaim Your Energy | Dr. Izabella Wentz

Dr. Izabella Wentz: [00:00:00] About 25% of people with irritable bowel syndrome were studied to have subclinical hypothyroidism. Acid reflux could be a symptom of Hashimoto's. Carpal tunnel could be a symptom of Hashimoto's. Reproductive issues, so multiple miscarriages, trouble getting pregnant. These are actually the very first symptoms of Hashimoto's.

Dr. Brighten: You twice said like you weren't told about the cause and you wanted to know about what caused this. I think that's so relatable. I think anytime we have something going on, we're like, why? I, I just need to know why. What causes Hashimoto's? What's behind it? Every person with an 

Dr. Izabella Wentz: autoimmune condition has to have three things present, as well 

Narrator: as 

Narrator 2: Dr.

Isabella Wetz 

Narrator: is a trailblazing pharmacist turned thyroid expert who has redefined the approach to autoimmune thyroid care. 

Narrator 2: After being diagnosed with Hashimoto's thyroiditis, she used her clinical expertise to uncover the root causes of her condition, transforming her findings into [00:01:00] bestselling books like Hashimoto's Protocol and Adrenal Transformation Protocol 

Narrator: with a mission to empower others.

She's launched documentaries, built an online platform, and created life-changing resources to help millions take control of their thyroid health. 

Dr. Brighten: As a pharmacist, what do you wish that doctors said to patients? When they were writing that prescription for hypothyroidism, treatment, 

Dr. Izabella Wentz: medications might help just a little bit.

But if it's not the right medication, it's the medication not dosed correctly, then that can just really not do much for the person. And of course there's a lot of lifestyle changes. What a lot of times people don't realize and even a lot of healthcare professionals don't realize is. 

Dr. Brighten: Welcome back to the Dr.

Brighton Show. I'm your host, Dr. Jolene Brighton. I'm board certified in Naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist. As always, I'm bringing you the latest, most up-to-date information to help [00:02:00] you take charge of your health and take back your hormones.

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Don't forget to subscribe, leave a comment, or share this with a friend because it helps this podcast. Get out to everyone who needs it. Alright, let's dive in. Dr. Isabella Wenz, welcome 

Dr. Izabella Wentz: to the podcast. Hello, Dr. Brighton. Thank you so much for [00:03:00] having me today. It's always such a bright day for me to be with you.

Dr. Brighten: I love that though. But still people now we know each other in real life. We've known each other for like 10 years or so, but it's been a long time. So, uh, I'm Jolene and you're Isabella. Um, but I wanted to do formal at first so everyone knows you're a doctor, right? That sounds perfect. Yeah. Well, I wanna start with that actually.

You being a pharmacist. So as a pharmacist, what do you wish doctors would say to patients when they write them a prescription for hypothyroidism treatment? 

Dr. Izabella Wentz: Wow. One of the things I wish that doctors would say is that this little tiny pill can't do everything for you. Right? So what a lot of times people don't realize, and even a lot of healthcare professionals don't realize is levothyroxine the most commonly prescribed thyroid medication.

This can be very, very helpful for some people, but others may not properly utilize it. [00:04:00] Levothyroxine is known as a pro-drug because it actually has to be converted in the body to a more active version known as T three, the T three thyroid hormone, which has a lot more biological activity compared to.

Levothyroxine, which is sometimes called T four. So that's kind of a big thing, uh, big letdown that a lot of people have when they start on thyroid medications. They think the medications are gonna take away all of their symptoms and all of their problems mm-hmm. Where the medications might help just a little bit.

But if it's not the right medication, it's the medication not dosed correctly, then that can just really not do much for the person. And of course there's a lot of lifestyle changes that can mm-hmm. Be a big difference and can be the reason why a person feels incredible and like themselves, or even a better version of themselves versus still struggling, although patients.

Dr. Brighten: We're gonna get into, I got a lot of diet and lifestyle questions for you [00:05:00] today, so we're gonna get into all of that. But what you mentioned is really interesting. So we're giving T four. It's inactive thyroid hormone. The body then has to activate it to that T three, which is our energy, our metabolism, our mood, our period, our gut motility.

It's involved in so many things. Now, it could be helpful to give someone T three, but a lot of doctors are resistant to that. For somebody listening right now who's like, I'm on T four, what can I do to support my body to convert that to T three to actually activate it? 

Dr. Izabella Wentz: One of the things you can do is really focus on your stress response.

A lot of the time, we don't properly convert T four to T three because we're under significant stress. 

Dr. Brighten: Hmm. This is 

Dr. Izabella Wentz: a great place to start for many people. Some of the other things might be nutritional deficiencies, specifically zinc, selenium, as well as ferritin. The iron storage protein is where I would start for most people to try to really get their bodies to use that levothyroxine much better.

And, and it's also [00:06:00] not a avail. It's, it's harder to get some of sometimes the T three containing medications, depending on where you are in the world too. 

Dr. Brighten: Absolutely. You know, I was in uh, Paris as you know, you knew me. Then when my son got sick, I was so dumb. I only took enough thyroid medication 'cause I was like, I'm going to Paris for like a week.

I'll just take like two weeks with me. And this is the first time I've never just taken the full thing. Um, and when I was there and I had to go see a pharmacist and get more thyroid medication, they give only T four, T three. And they were appalled of like, what is anything? Why would you not give T three with it?

Um, and so it really just depends. And so everybody got like that standard. In the US everybody usually gets levothyroxine. We do have others available, but you're absolutely right, depending on where you're at in the world. Accessing other medications may not be feasible. And so knowing these ways to activate T three I think is super important.

Now I have Hashimoto's hypothyroidism. You have Hashimoto's. [00:07:00] Hypothyroidism. What were you told when you were diagnosed? What did your, what information did your doctor provide you? 

Dr. Izabella Wentz: Wow. Such a long time ago. One of the things was basically that this just sort of happens and eventually that my thyroid gland was gonna burn itself out and then I would take some medications for that, and that was pretty much all the information that I was given.

Other than you're also a greater risk for other autoimmune conditions. There was really no education about like what caused this. Is what, how, how do you make yourself feel better? Are there lifestyle changes you can utilize? Can diet help? Can nutrition help? Can you look at the root causes? Is there a way to get this condition into remission?

So there was none of that. And I was like a bright-eyed and bushy-tailed pharmacist at the time had it just finished pharmacy school. And a lot of my professors, they really talked about lifestyle interventions as like first line therapy for a lot of the chronic health [00:08:00] conditions. Maybe they weren't like the most knowledgeable lifestyle interventions, but there was always like, okay, if you have diet diabetes, you can do some diet and exercise, right?

And maybe that you won't need as much medicine. Right? But there was nothing like that for hypothyroidism. It wasn't like sleep more, sleep less, you know, like drink, don't drink, run around, don't run around. There was, there was really no advice. And really I think that lit my passion for. For becoming the thyroid pharmacist, um, becoming a Hashimoto's expert slash human Guinea pig, because I wanted to know was there, why did I get this condition?

What caused it to become expressed in my body? Is there anything I can do to get it into remission? Is there anything I can do to make myself feel better? 

Dr. Brighten: Mm-hmm. Well, with your primary question that you brought up, you, you twice said like you weren't told about the cause and you wanted to know about what caused this.

I think that's so relatable. I think anytime we have something going on, we're like, why? I, I just need to [00:09:00] know why. So for people listening who are also having that, why, what causes Hashimoto's? What's behind it? So we know that 

Dr. Izabella Wentz: Hashimoto's is an autoimmune condition. It causes, it is something that results in hypothyroidism where the thyroid gland isn't able to make.

Thyroid hormone when you've had it long enough because the immune system recognizes the thyroid gland as some kind of a foreign invader and launches an attack against the thyroid gland. The various things can cause it. I spent a lot of times time pouring through the research behind that and I came across, um, first it was research on gluten and celiac disease.

Researchers found that people who had celiac disease but were not on a gluten-free diet, many of them also had Hashimoto's and hypothyroidism and antibodies against their thyroid gland. And they found that a percentage [00:10:00] of people, once they went gluten-free, that helped them get the symptoms of celiac disease into remission as well as some of them were able to get their Hashimoto's into remission.

Um, lowering thyroid antibodies, normalizing thyroid function, not in every case, but in some cases. And so I started just to work through PubMed and work with integrative doctors, test various things on myself, was trained in functional medicine and just couldn't, anything I could really get my hands on to try to figure out what were some of the driving, driving factors.

And what I came across was food sensitivities, nutrient deficiencies, impaired stress response, poor processing of toxins, generally some kind of a toxic backlog. Chronic infections as well as intestinal permeability. Um, Dr. Alessio Fasano, he is like a, kind of like an OG in the autoimmune space.

Everybody's like, totally Dr. Fasano, if you're in functional medicine or [00:11:00] gut health or integrative medicine. It's like, you know, he's, he's kind of, um, been a really big trailblazer in our industry. But what he found is that every person with an autoimmune condition has to have three things present. They have to have a genetic predisposition, some kind of a trigger, whether that be a toxin or infection or a nutrient deficiency.

As well as that third piece is the intestinal permeability or leaky gut. And the amazing thing is all three of those things need to be present for the autoimmune condition to manifest. If you can, you know, change your genes or if you can, maybe, maybe one day we can do that. If we can remove the triggers, if we could find and remove them.

Yeah. And or if we can address the intestinal permeability, we can get the condition into remission. You'll still have the genetic predisposition. So if let's say, mm-hmm your root cause was a gut infection and you treat that and you go into remission, but then you get a gut infection again, then you can of course get the condition again.

But in, for all intents [00:12:00] and purposes, if you find and treat the root cause, you can get a condition to get into remission and you can feel significantly better. And I've seen this in myself and time and time again in clients and uh, readers from all over the world. 

Dr. Brighten: Mm-hmm. Remission versus cure. This is something that's like a big debate online, and I often see people who are not, they're not licensed providers, so I think it's, you know, in part that they don't have that education, but they're promising that they can cure Hashimoto's, they can cure PCOS, they can cure pc, uh, endometriosis.

They're promising all of these cures. What do you have to say about the difference between curing versus remission when it comes to Hashimoto's? 

Dr. Izabella Wentz: I think if you catch Hashimoto's in the early stages, you can prevent damage to the thyroid gland. And then let's say it was caused by an infection and you treated that infection and you never get the infection again, [00:13:00] and there was no damage to your thyroid gland.

I guess you can consider that, you know, potentially a cure, right? But it, unfortunately, I feel like most people, they don't. Catch Hashimoto's in the early stages. So the early stages, you're just gonna have a little bit of infiltration in your thyroid gland. Maybe a tiny bit of damage, but your thyroid gland can still produce enough thyroid hormones for a majority of people when they're diagnosed like myself.

And, um, I think likely you, we've already had some damage to our thyroid gland, so we're still gonna need to take the thyroid hormones, right, because it's not, uh, we don't necessarily have the technology to regrow thyroid. Tissue? Um, not yet. Gosh, I hope I have seen some people having great results with red light therapy over their thyroid gland and then myo acetol and selenium in, um, subclinical states where we, we have seen thyroid function normalize.

But for majority of people, [00:14:00] they're gonna be diagnosed where a big percentage of their thyroid is damaged. And so you can, at that point, you can still be free of all of your symptoms and you can still potentially lower or eliminate your thyroid antibodies or sort of a attack against your thyroid gland.

But you know, you may still require thyroid medications. And I really think it's depends on what your causes are and where you were on your journey when you were diagnosed, whether, um, whether you can, like I would say if you get into remission and you stay in remission forever, is that a cure? Right? Like.

I mean, I don't know. I, I guess it could be, but I prefer to use the term remission because I feel like a cure can be misleading. And you, I guess you always have the genetic predisposition. So if gluten was your trigger and you, your cure was going gluten free, but then you start eating a whole bunch of gluten, right, and then you have the condition again, [00:15:00] then that's not really a cure.

That's, I would, I would consider that a remission. I, anything is possible, but I think to be more accurate remission would be the more correct term for most people. 

Dr. Brighten: I absolutely agree. And you know, to your point, you're like, if it was an infection, okay, you never get that infection again. But things happen, and as we know with autoimmunity, there can be multiple triggers going on.

So it may have initially been triggered by an infection in your gut, and then later it's triggered again by a stressful event. Maybe you have a divorce, maybe you get in a car accident, maybe you lose your job. So there are multiple triggers that can exist and it doesn't mean that anyone did anything wrong.

And, and, and why I like to be more precise with this language is because I find too often people feel there's like morality attached to it. Like they're a failure in some way if those antibodies come back. But it could be as simple as you're making the menopause transition, which if you live long enough, you will.

And that's fantastic. Like we want that for you, but that's out of your control. [00:16:00] And that may be a trigger. And then you may need to reexamine at that period of your life. What interventions do you need now? And I just love that you know, every book that you have put out, and there's been many, everyone, you always give so much hope.

And we're gonna talk more about, you know, the particular things that people can do for thyroid health. But for people who are listening right now, it may be like, okay, Hashimoto's check autoimmune disease leads to hypothyroidism, not enough thyroid hormone. What are the symptoms that people may experience?

And I'm also interested in like what are the often overlooked symptoms? 

Dr. Izabella Wentz: Hmm. Such a good question. I think really big symptoms that people are aware of would be hair loss and weight gain, maybe some depression, fatigue. Cold intolerance. Those are generally like if you were to walk into a doctor's office with those symptoms, they would think about testing your thyroid.

I mean, if they were a good [00:17:00] doctor. We all know that not all doctors are created equally, right? Um, but those are some of the red flag symptoms. What I think a lot of people are just not aware of, including many healthcare professionals, that there can be symptoms across a spectrum. So irritable bowel syndrome, that can be a symptom of Hashimoto's.

About 25% of people with irritable bowel syndrome were studied to have subclinical hypothyroidism. Acid reflux could be a symptom of Hashimoto's. Carpal tunnel could be a symptom of Hashimoto's. Um, I did a reel on Instagram about moody teenagers, so oftentimes mood swings, obsessive impulsive disorder, anxiety disorders for many people, these are actually the very first.

Symptoms of Hashimoto's. I know for myself, I had panic attacks like randomly starting at my twenties, and I'd never had panic attacks before. Um, so OCD [00:18:00] is one of the most, I guess, underappreciated manifestations of, um, Hashimoto's and, and that anxiety in, you know, going through some additional symptoms, I feel like reproductive issues, so multiple miscarriages, trouble getting pregnant.

I think it's an absolute shame that women of childbearing age aren't getting full thyroid panels before they start their fertility or, you know, baby making journey. This is such a common overlooked issue. And then of course we've got like. The eyebrow loss. This is gonna be common, having a puffy or swollen face brain fog.

So feeling like you're just forgetting everything and you're not quite there. This is also gonna be a very common side effect or very common symptom of hypothyroidism. 

Dr. Brighten: Yeah, I, this is a really comprehensive list and yet there's definitely [00:19:00] more ways it can manifest. So I'd encourage anybody, like, track your symptoms and if you're resonating with some of this, then it's important to get testing.

You brought up a full thyroid panel. What should people be asking their doctor for? 

Dr. Izabella Wentz: So, um, the TSH test, thyroid stimulating hormone is the screening test for thyroid disease. And a lot of times people, when they bring up thyroid disease or thyroid symptoms, their doctor will be like, okay, great, we'll test it.

And they run this TSH test, which is a pituitary hormone that becomes elevated. When our body senses that it needs more thyroid hormone, but it's not a direct measure of thyroid hormone levels in the body. So there could be a communication breakdown between pituitary and the thyroid gland, the rest of the body, what, what, whatnot.

That could be one issue. So in addition to TSHI oftentimes will remen recommend free T three and free T four levels. The other thing is the TSH free T three and free T four levels [00:20:00] can be normal for like the first 5, 10, 15 years when you have Hashimoto's or, um, those levels can fluctuate as the thyroid gland is under attack and it dumps thyroid hormone into the bloodstream, and then that gets cleared out.

So depending on the day you test, you might have a normal TSH, you might have a high TSH, you might have a low TSH. Um, this becomes elevated again, like we said, when your thyroid gland has been damaged enough. To the point where it's no longer able to compensate and make enough thyroid hormone. And so the other tests I really advocate for are thyroid antibody tests for hypothyroidism and Hashimoto's, TPO antibodies and TG antibodies.

Um, I think if anybody's taking notes, write those down. The, you know, thyroid peroxidase antibodies and thro globulin antibodies are like the official names, but you can abbreviate it as that. And then I think last but not least, for a lot of people, some of people may [00:21:00] have thyroid symptoms, but they might not have thyroid disease.

They might have secondary thyroid symptoms because, uh, reverse T three might be elevated usually because of high stress, sometimes because of very low iron or ferritin levels. And this is a. Thyroid hormone that blocks thyroid receptors, right? And so it basically tells the body to slow down. And sometimes some people, you know, I definitely say people with adrenal issues, they're gonna have reverse T three that's elevated, where everything else on their thyroid panel might be normal.

And then they're gonna have, you know, thyroid symptoms all over the place. But taking thyroid hormone might not be the best. Approach for them. And so they might need to have a different approach to explain their symptoms. 

Dr. Brighten: Absolutely. That's a good cocktail for making someone crash as if they're having adrenal issues than the [00:22:00] elevated reverse T three.

I like to call reverse T three, the hibernation hormone. 'cause you're like, I just wanna gain weight, go to sleep. I'm cranky. I'm gonna be like a bear in winter. Like, leave me to my room. And it serves a purpose. Uh, it is usually a, a sign you need to heal, you need to slow down. So it's not your body just betraying you and and misleading you.

It's usually your body saying, we need to pause here. Unfortunately, our current lifestyle doesn't usually allow for that. 

Dr. Izabella Wentz: Yeah, the struggle is real. Um, so interestingly, speaking of bears, I was reading about giant panda bears. Did you know that they're actually hypothyroid and that allows them to just eat ba bamboo.

Yeah. That's crazy. Yeah, apparently. And then sloths have also also have altered thyroid function as do hibernating bears. So a little, little, oh my gosh. Back for, for the 

Dr. Brighten: day. Well that makes sense. And I actually didn't know that. [00:23:00] I've been using that analogy for years and now I'm like, ah, well maybe, yeah, maybe I picked it up along the way.

I just didn't know it. It's also interesting too, we're gonna, uh, I definitely wanna talk about environmental toxins and I, I just feel like as long as we're talking about animals, I'm gonna bring this up because something that's very interesting is if you look at veterinary medicine and you look at the research on that, they knew for a long time that flame retardants in our furniture, which drops down our pets are, um, being exposed to that are in our pet's beds themselves.

They knew that these endocrine disruptors could lead to hyperthyroidism, which is Graves disease in cats and hypothyroidism, which is Hashimoto's in dogs. And I remember finding these studies and being like, why in humans. Are there still doctors? And you know, like scientific experts out there telling us, don't worry about it.

The dose makes the poison, it doesn't affect you. It's such a small amount. And yet our pets have been impacted. They've known for decades this, and [00:24:00] nobody stopped to think about like, what about the infant that crawls on the floor? Yes. Now that I've scared everybody, that wasn't my intention. I wanna talk about environmental toxins.

What do we know about their impact on thyroid? And we'll talk about things that people can do because I think, um, all that information comes very scary if you can't take action. Yeah, 

Dr. Izabella Wentz: yeah, absolutely. And if anybody's thinking about searching out there, I think it was the New York Times that did an article on hyperthyroid cats.

Um, that is very, very interesting. Experience now. It's not just flame retardants. The thyroid gland is very sensitive to a whole host of different chemicals. Fluoride has been making the rounds, um, lately as something that's been shown to suppress the IQ of children. It also can suppress thyroid function.

It used to be used for hyperthyroidism to, I guess, slow down thyroid function before there were medications for hyperthyroidism, um, back in the day. And they found, they've done [00:25:00] studies in communities with higher dosages of fluoride in the water supply in the UK and compared them to like NHS data of communities with lower dosages of fluoride.

And they found, you know, sure enough, and I mean, it's not like a. Definitive study, but they, they've definitely found higher rates of hypothyroidism in the Fluor, higher fluoridated communities. Um, so this is something that can be very, very relevant for people. Then there's like rocket fuel, mold, mycotoxins, um, you know, I iodine in excessive dosages.

I know people think of it as a nutrient, it's absolutely mm-hmm. Nutrient, but, you know, you did say the dose makes the poison and in this case it's true, the fat gland, um, does require iodine, but kind of like a, it's a narrow therapeutic index amount. And so mm-hmm. Adding, you know, public health officials, they're always looking out for us, always trying to do the right thing.

Yeah. And they were like, okay, we see that, um, iodine deficiency can cause [00:26:00] hypothyroidism. Let's just put iodine in the salt supplies and then everybody will be happy and healthy and have no thyroid issues. Um, of course, you know, things don't always. Turn out the way that we hope and they're all not always black and white.

And so the studies done in communities after they added iodine to the salt supply, they've seen rates of Hashimoto's and autoimmune thyroid issues, double, triple, sometimes quadruple. So this is something that's very relevant. Um, BPA in plastics, there was triple laan that was available in our toothpaste.

Um, and 

Dr. Brighten: on, I have to say, I was just ranting about that to my husband and I was like. Like talking about how everybody's like, oh, you know, you have to prove stuff causes harm before we'll take it outta the environment. I'm like, Trian. I remember when it was the rage and it was at everyone's toothpaste and like everybody was being exposed to it.

And then like a decade later they're like, whoops, this is really bad for you. Um, yeah. You think decimating that microbiome's bad. Yes. [00:27:00] But like also it's an endocrine disruptor, and yet we went so, so long with that. So I just, if anybody's listening and you are a Trian person too. I was as well. We're all switching to hydroxy appetite now, but I'll let you keep going.

But I just had to bring up that I'm like, I was, I was just ranting about Triglycine being leashed on us. 

Dr. Izabella Wentz: Yeah. And I mean, it was like, I mean, I was like a bath and Body Works girl, and it was like your lotion and we're just gonna add like, antibacterial stuff on it for no apparent reason other than it's a good marketing thing.

And so everybody was overexposed to that and a few years down the road. They're finding that yes, indeed it does cause issues, as does the BPA in plastics. Now, you know, this can feel very intimidating for people I know for myself personally, like, and when I first started working with clients, I would be like, Ooh, let's do a bunch of tests and see like, are you, do you have this level of toxins?

Could it be this, could it be this, could it be that? And I will say none [00:28:00] of them were like, as excited about doing the tests as I was like, I'm like a data nerd and science nerd, and I'm like, Ooh, testing is so cool. Like this is my hypothesis and let's see what the test results show. Um, and that, that was kind of a non-starter for a lot of my clients.

And we were spending a lot of time and resources trying various things and not getting better until I came across liver support. So utilizing just like amino acids and acetylcysteine, things like milk thistle, liver and gallbladder support, sweating and sauna, just sort of. You know, we're all exposed to toxins, right?

They're like everywhere. There could be in our homes, there could be indoors, outdoors. Yeah. How do we like reduce that toxic burden? Like we can't live in a bubble. Believe me, I've tried. It's not fun. Um, you know, doing a little bit of cleanup in your personal care routine I think is a great place to start.

So I'll recommend like cleaner [00:29:00] cosmetics and not, you know, not microwaving your spaghetti and plastic and then licking the plastic bowl, right? Like doing some glass storage. And you can, you can do like low key lifestyle changes to have a cleaner routine. You can get an air purifier, you can get a water filter, you can switch out your toothpaste to be fluoride free and have HPA instead.

Um, but, uh, the other thing is helping the body process that backlog. And that's gonna be through some of that liver support and through sweating. So, anytime. You know, my, my kind of standard dose is sauna four times a week for 30 minutes a day. Yeah. Four times a week for 30 minutes per session. That can be really great for clearing out some of that toxic backlog.

And you know, lo and behold, I've had clients who just, nothing helped. They were sensitive to everything and we would put them on, on just like a simple liver, liver support protocol, cleaning up personal rou, routine sauna therapy, [00:30:00] and a little bit of nutrients to support their liver. And they're like, oh my gosh, I'm feeling so much better.

I used to like feel like I was dying every time I walked past the Yankee Candle store. Yeah. Or I can go to the mall again, like, I don't feel like horrific anymore. And it's just, you know, I think. I think the toxins like, yeah, like a little bit here and there isn't as big of a deal, but it's not just like a little bit here and there.

So we've got like the flame retardants and then we've got the fluoride and then we've got like the BPA and it's like, and then the cosmetics, like we'd even talk about cosmetics, but all of that like really builds up and starts to compound and then you've got this toxic backlog. That's when it becomes an issue for, for most people in my experience.

Dr. Brighten: Yeah, absolutely. And so what I'm hearing from you is reduce your exposure, but support your monies, which is the ways that you eliminate all of these toxins coming in to the liver support. Yeah, the sweating. I'm sure you would, you know, I, I want people to understand you would also be talking about [00:31:00] gut health as well in all of this.

If people are like, well, what about pooping? Yes. All, all of this is good. And so, um, you brought up something I think is also really important. If you are the person. So I still avoid the fragrance counters 'cause I just think they're just, I just hate it so much. My senses get overwhelmed. But if you are the person who gets a headache, like you're like, I'm so sensitive, I get into the Uber and I'm feeling sick and I have a headache because of that error fragrance coming through, that can be a sign that you need to support these systems.

And you know, the things that you said. They're pretty simple. Maybe not everybody has a sauna, but there's other ways to sweat. Mm-hmm. You can run, you can, you know, go outside. There's lots of other ways to sweat, but I do just wanna dovetail on the sauna you send four times a week, and that happens to be the sweet spot where we see dramatic drops in cardiovascular events for people.

These studies have primarily been done on men, but I just think it's fascinating that it, it tends to be like, so saunas is [00:32:00] like one of the things where like frequency more is better. Not necessarily more time is better, but frequency more is better. And so I love that you brought up like the, the four times a week because times for everybody listening, if you wanna go on a little research exploration, that is the, a science-backed recommendation that it can benefit you in so many ways.

Dr. Izabella Wentz: Mm-hmm. Yeah. I love that. Um, funny story. So I started using sauna when I lived in the Netherlands. And in the Netherlands, people don't wear clothes in the sauna and they're co-eds. So then I got my own sauna. 

Dr. Brighten: Yeah. It's so funny, like how, how different, uh, countries are about nudity. Um, they're just, you know, so open about it and then you're from the United States and you're just like ex, excuse me.

Um, I was actually just in Iceland earlier this year and they had like the whole sauna and steam room and uh, cold plunges were in the lake. And uh, that was fantastic and everybody wore clothes, so I was just like, it was not an [00:33:00] issue for me here, but, um, but I think if you can get your own sauna, I think it is a worthwhile investment when you look at the outcomes in terms of your cardiometabolic health and certainly.

You know, if you are somebody who you know, resonates with having an autoimmune disease, I think it can have benefits. But there's also, you know, your gym might have one there might find that there's other ones in your area. So there's other options. And then like I said, there's other ways to sweat. Um, so we've talked a little bit about environmental toxins.

And I, I just wanna point out though, as you were talking about fluoride iodine, uh, bromine, which that can be in flame retardants, um, also can be in your bread. Uh, these are all halogen. And part of the problem is, is that, so if y'all, I have a chemistry degree, I like to use it sometimes, but if you, if you go down the halogen list, like all of these have the potential to also [00:34:00] impact iodine and to basically put it off of where it needs to be in the body.

And so, as you were saying, it's not just about the thyroid disease, it's also about the function of the thyroid as well. And I appreciate how many examples that you brought up. I wanna shift gears 'cause you wrote a cookbook for those with Hashimoto's, those with thyroid disease overall. So share with us, what role does diet play in Hashimoto's and what are some of the top things that you've seen or that you recommend when it comes to food?

Dr. Izabella Wentz: Definitely diet can play a big impact on Hashimoto's. And I think we've already talked about gluten and celiac disease, so obviously if somebody has celiac disease, they do need to be off of gluten. Um, 

Dr. Brighten: I know, wait, let's stop there for a second. We talked about celiac disease, we didn't define it, so I want everyone to be on the same page.

What is celiac disease? Explain it so everybody knows celiac disease 

Dr. Izabella Wentz: is an autoimmune response to a protein found in in [00:35:00] gluten and wheat products known as gliadin. Um, and what happens is essentially every time somebody eats, um, a product containing that, which is, you know, in so many foods, from breads to cereals, to pasta to cookies, um, and some processed foods, they're gonna have, um, an attack on their gut.

And so this can be quite a, um, serious, I guess, condition with people, you know, requiring hospitalization with, having numerous digestive symptoms, with having numerous autoimmune conditions. And it can also be silent where they may not know or feel the inflammation, but there might be something else and something weird going on within their bodies that they just may not even connect to their digestion.

It's a very, very common, um, autoimmune condition. 

Dr. Brighten: Mm-hmm. And so for people to understand that when they get exposed, when celiac disease, they get exposed to gluten, it has a tremendous impact. It [00:36:00] makes it so you can't absorb food. We see that children can't develop like, and so it's a very serious interaction with gluten.

So this is why it is a hard and fast. You have celiac disease, you avoid gluten. Um, but I wanna let you keep going about other foods, 

Dr. Izabella Wentz: so, sure. And I think for people with Hashimoto's, they do not actually need to have celiac disease to feel better off of gluten. So there's also non celiac gluten sensitivity.

There's also reactions to the fructans found in wheat. Um, a whole host of conditions that could make a person gluten sensitive. In my experience, I found about. 88 to 90% of people with Hashimoto's, they do tend to feel better going gluten free. And anywhere from one to 10% of them might have celiac disease.

So, so this is one of my common top recommendations. The other common reactive foods are gonna be dairy and soy with about 80% of people [00:37:00] reacting to those foods. Nobody likes to hear that. Dairy and Greek yogurt and butter and ghee. And I, I hear you girl. Like I, I hear you, but I. It, it's a thing. Oh, man. 

Dr. Brighten: Um, I, I just, I have to just say that like everybody out there, like, I definitely feel you if you're like, I couldn't give up butter, I couldn't give up those things.

But I think that, um, as you're just saying this there, if it, if this is what's true for you, it can have a tremendous impact. 

Dr. Izabella Wentz: You know, it can have a tremendous impact. I've seen people with allergy symptoms, IBS symptoms, acid reflux, asthma symptoms, like I had carpal tunnel in both arms that was triggered by dairy.

And this can be very, very relevant for some people. Dairy's the bigger driver than the gluten and just getting off of dairy, um, can help them get the condition into remission. My generally, my three big foods are gluten, dairy, and soy to get off of, and then focusing [00:38:00] on blood sugar balance. What does that look like?

That means you're eating. Generally speaking, fewer carbs, more protein and more fat than like a standard western diet to really focus on balancing your blood sugar. And people have said like, I thought I had anxiety and panic attacks. I thought like I was bipolar. I thought like, you know, I, I had narcolepsy or some other thing and it turns out that I just had blood sugar swings.

Like it's just makes a really big difference. And the blood sugar swings can cause high blood sugar, but also like that low blood sugar, sometimes hypoglycemia, sometimes reactive hypoglycemia that can cause anxiety attacks and really a lot of inflammation in the body. It caused those 3:00 AM wakings, um, 3:00 PM slumps.

So those are kind of the big places where I like to start people. 

Dr. Brighten: Mm-hmm. And what are the best foods? What are the foods that people should be thinking about bringing in to support their thyroid health? 

Dr. Izabella Wentz: [00:39:00] You know, generally speaking, good fats. I really love avocados and olive oil, salmon fish. Um, these are gonna be great places to start.

Not a lot of people wanna hear this, but red meat. Red meat does contain carnitine, which can be sort of a, um, sort of have a balancing effect on the thyroid, whether you have an underactive or an overactive thyroid. I have a lot of people do very well with getting more red meat into their routine. Um, really protein rich foods.

Uh, bone broth can be a really great healing food and plenty of like vegetables. I know some people, there's like this myth that, um, cruciferous vegetables might be bad for the thyroid. I actually really think they're a great food for people with hypothyroidism. Um. Right. You know, eat real food, lots of good stuff, not too much.

Um, make sure you focus on your blood sugar [00:40:00] balance. Get plenty of good fats and proteins is kind of where I, um, where I like to take people. And that might look a little bit different depending on the person, their, their preferences, their sensitivities, what's going on within their microbiome. But generally speaking, plenty of veggies.

Um, sometimes they have to be well cooked and plenty of like organic grass fed, wild caught fish meats is going to be great for a lot of people. 

Dr. Brighten: The goitrogens, this is what everyone gets concerned about. So there was like, once upon a time, you know, this information came out saying there's goergen in your cruciferous vegetables.

If you eat them with hypothyroidism, that could impair your thyroid function and you could end up with, you know, worsening hypothyroidism. And what we've really come to understand is that. Nobody's going to eat that much raw, cruciferous vegetables. And if you do, nobody's gonna sleep next to you in bed.

They're not gonna [00:41:00] sit next to you in the office. They won't sit next to you anywhere because you're gonna have so much gas and so much GI distress from it. And so I do want people to understand that. 'cause you know, as you talked about detoxification, these cruciferous vegetables, so things like cabbage, kale.

Broccoli, cauliflower, right? They're all coming kind of from the same family. But all of these Christopher's vegetables are so powerful with their dim and sulforaphane to help you process not only environmental toxins, but your own endogenous waste you create and keeping your estrogen in check. And as we know, if estrogen's too high and progesterone isn't at the right level, that can impact thyroid function at the cellular level as well.

So I'm team cruciferous vegetables. I am your backup mike on that as well. Um, and I know some people are gonna be upset about the red meat, I have to say. Um, this is anecdotally, but I was a vegetarian for 10 years at a bit of a journey when I decided not to be vegetarian anymore. But it was later that I [00:42:00] found out I had thyroid disease, Hashimoto's.

And ever since then I'm like. I have to eat meat. This is something that like, I just know that like if I go multiple meals, I've, I've been places where they're like, oh, it's only vegan or vegetarian and my blood sugar is like bestie. No, we're not doing this. And so that's all to say that I know this is what's true for me.

And so I have to honor that. And if you are somebody who's like, that's not true for me, we respect that about you as well. 

Dr. Izabella Wentz: Absolutely. Like I tend to be diet agnostic. I really don't care what kind of diet anybody is eating. Like I just want people to have the information to empower themselves. Like if I had to design my perfect diet, it would be like mojitos.

Like, and you know what I mean? Like, it would be like spring break in college, 

Dr. Brighten: whatever. It'd be like nachos, mojitos. We are good to go. Yeah. Yeah. So, and then you're at our age, our, our liver is just like, no, I have done enough for you. [00:43:00] 

Dr. Izabella Wentz: Yeah. At, at my age. It's like, if I have a glass of wine, I regret it. I regret it for three weeks.

So, um, yeah. So yeah, that. That's, that's not the vibe these days, but 

Dr. Brighten: No, but you know, if we, if we all could live in our fantasy world, maybe. Um, you've brought up, you brought up my acetol. You talked about iron, you talked about selenium. You've even dabbled a little bit about iodine being problematic at too high of doses.

What supplements have you seen in your practice, in your research that are generally pretty good for those with hypothyroidism or Hashimoto's? One 

Dr. Izabella Wentz: of the really big game changers for people has been using selenium. I've seen doses of about 200 micrograms reduce thyroid antibodies by about half over the course of three to six months.

Generally speaking, people will say their anxiety gets better, their hair loss really, really improves. Um, interestingly, in the last few years, some research has come out about using selenium together with myo acetol. They seem to have a [00:44:00] synergistic effect when you use them together. Things just get a bit more balanced, more quickly, and you also require a lower dose of selenium, so about 83 micrograms of selenium random dose.

But this is what was studied along with 600 milligrams of myo and acetol. For some people, this can induce a remission of Hashimoto's. In subclinical hypothyroidism where let's say their TSH was up to a 10, we want that TSH somewhere between 0.5 and two. Um, and their TSH would lower back into that normal range.

And then their thyroid antibodies would also, um, get into the remission range. And so this is something that I'm personally very excited about because it wasn't available when I was diagnosed with Hashimoto's and subclinical hypothyroidism. Um, another big supplement that I like to recommend for a lot of people is benfotiamine.

It's the solu fat-soluble version of thiamine. [00:45:00] There was like this tiny, tiny study, I think it was like three people, right? And they got women out of thyroid fatigue within like three days, like debilitating thyroid fatigue by using 600 milligrams of thiamine. And I share that with the world, and I can't, like, I have people, random people coming up to give me hugs on the street because.

Just utilizing thymine for a few days, and generally you do need to use it longer, but you'll see the effects in three to five days has brought people out of like disability and not being able to work because of their chronic fatigue to having like functioning and having like brain function and tons of energy.

I don't know if this is because lactic acid can build up when we have a thiamine deficiency or whatnot, or if there's some other mechanism at play, but this is a really big game changer for people that have brain fog fatigue and low blood pressure. So if you're kind of like in that category, then that's [00:46:00] something to look into.

Um. Um, you know, magnesium, like, are there any conditions where magnesium doesn't help? Like I know, right? Magnesium is always winning. It's, it's just so helpful. Um, I recommend, you know, there's so many versions out there and people are like, why do you recommend citrate? Like, there's so many other versions and they're better.

And I'll tell you why. Because a lot of times women with hypothyroidism, they have constipation and citrate can support constipation. So that's one reason. Another reason is that a lot of times, um. Some of them might have issues with the glycinate version where for whatever reason, they over converted to glutamate and instead of feeling really relaxed and happy, they start having anxiety and panic attacks and they're restless and unable to sleep.

So the citrate version doesn't tend to do that for a lot of people. And then it's also the version that was studied to normalize thyroid function when it was utilized over the, or normalized with the [00:47:00] appearance of the thyroid gland in autoimmune hypothyroidism when it was used for long term, like three to five years.

So, so that's why I recommend that. But I, I know that there are people that have opinions on different versions of a magnesium and what might be best for, for which kind of condition in person. 

Dr. Brighten: Yeah, and I think, you know, this again comes to the individualized approach. Like I use magnesium glycinate a lot because with my practice we are usually seeing severe menstrual cramps, superior pain, which by the way, thymine can help with that as well.

Um, so the menstrual cramps, we're seeing insomnia before your period. So we're seeing these things that I can help with. But you're absolutely right. Some people are going to feel more spun up from it. That's literally people will be like, I feel like I'm spun out. Like, what's happening? And so that might not be right for you.

And then additionally, if you are some, I am like, if you're traveling, that's when I'm like, definitely magnesium citrate is your bestie. People usually get [00:48:00] constipated when they're traveling and it is so great for helping with that gut motility. But if you're somebody, for example, that has like. Migraines, cyclical migraines.

And I'm telling you, do 600 milligrams of magnesium. If it's citrate, you're gonna probably poop your pants. We've gotta go with like a glycinate. So again, it's like, it's all about how does it impact you, what's true for you? And then what are we actually trying to address? What are we hoping to accomplish with this?

Um, I also just wanna say, I love that you brought up up my acetol because so many people are like, that's just for PCOS myNO. It is the one of the most extensively studied supplements for PCOS. And yes, it does work and it rivals a lot of medications out there. Uh, but what I'll say with, um, my acetol is that it's also great for sleep.

I wanna talk about the impact of poor quality sleep on thyroid health, and maybe some sleep tips that you can offer people. 

Dr. Izabella Wentz: Yeah. Um, so interestingly, people that work third shift when they [00:49:00] work the night shift and people that have sleep apnea have higher levels of h hypothyroidism and Hashimoto's antibodies.

So, I mean, again, is there any condition not impacted by, by poor sleep? Right. Um, so I'm a big proponent of people getting more sleep. I know for some people it's like a choice. It's like, oh, well I'm just gonna burn the midnight fuel, or like revenge, scroll my phone all night because I didn't get to, you know, do what I wanted to do in the day.

And it's like you just tell them to get more sleep and they're like, okay, fine, I'm gonna do it. Um, then there's people that have like trouble falling asleep, right? For the people that have trouble falling asleep. I generally do like a lifestyle overhaul where we're focusing on getting the right kind of input into your body to really rebalance your circadian rhythm.

Oftentimes this looks like. We're getting bright light first thing in the morning within the first [00:50:00] minutes of when you wake up and throughout the day. And we're avoiding, you know, artificial light in the evening. So first people, this can look like, um, maybe you live in Chicago and it's the middle of the winter, so you don't, you're not gonna step outside and get bright lights.

And in the evening time we really wanna focus on our avoiding that blue light and that artificial light. So maybe that looks like blue light blocking glasses that we wear in the evening time. If you are somebody that lives in a very cold climate, you know, you might not be the person that's able to spend a lot of time outdoors or get your first dose of morning sunshine.

So you might do something like a dawn stimulator or you might do some kind of bright light therapy throughout your day, especially first thing in the morning to really set up that circadian rhythm so that your brain knows, hey, this is time to be bright eyed and bushy tilled, and that this is the time for us to produce melatonin.

And, um, you know, that the light and dark signals that of [00:51:00] course, having a bedtime routine. So whether that's taking some magnesium or doing, you know, my favorite is an Epsom salt bath. You do that. Meaning it warms up your body and that kind of relaxes you. And then you get out of the bath and you have a little bit of a cold, um, sensation, and that, that helps us fall asleep.

Sleeping in a dark room, a room that's a bit cooler for people will say like six to 65 degrees. For women with thyroid issues, it might be like 70 to 75 degrees depending on what your preference is. But generally people are gonna fall asleep in a cooler room and feel better in that kind of environment.

And then there's also, you know, looking at what patterns people might have. Like if they're waking up frequently at 3:00 AM we're really gonna be focusing on balancing blood sugar, um, because that would be a blood sugar issue. If they're, um, waking up numerous times throughout the night and they're feeling restless, then we're gonna be looking at potentially.

[00:52:00] Protein maldigestion or ammonia toxicity. And so, um, doing some, taking something like l ornithine can help with that to support, um, really an all night sleep when you've got a bit of that, I guess. Um, protein, liver, digestive backlog, so de depends on the person. I, I like did a really deep dive on this and I ended up, uh, writing about it all in my adrenal book and I have a blog on my website about it, but it's, um, I would say majority of people, it's like your daily rhythm and taking some magnesium is gonna do the trick for you.

Dr. Brighten: Mm-hmm. Yeah. You just mentioned adrenal, you wrote a book all about adrenal health. What's the connection between adrenal health and thyroid? So many 

Dr. Izabella Wentz: people with hypothyroidism and Hashimoto's actually have adrenal dysfunction where, um, I just feel like you might as well address the two together because if you don't.

[00:53:00] Oftentimes a person might crash. What I find is, in my experience with doing lab testing, whether it's Dutch or um, saliva tests for adrenal function is majority of women have have more of an advanced adrenal dysfunction where they have low levels of cortisol throughout the day. Um, I know people oftentimes talk about cortisol.

We have too much of it and it's bad. Right. We want cortisol, like we want to have it. It's an anti-inflammatory. It has a lot of important roles in their body. If we didn't have cortisol, we would be dead. We would not be alive. Yes. But we didn't have it. Yes. What we do want see also Addison's disease.

Exactly. Exactly. Um, what we want is we want to have a balanced cortisol. Um, rhythm. And so we wanna have higher levels of cortisol when we wake up so that it gives us an energy kick. And then throughout the day, we wanna have the levels gradually declining so that we could sleep well [00:54:00] at night. So people that at 3:00 AM like, you know, anxious and unable to sleep, it's like your cortisol's going off at 3:00 AM that's, that could be causing you to wake up.

And so this is very much like, pretty much for everybody. I focus on that. Um, adrenal issues, cortisol issues, impaired stress response. There's, there's so many different, I guess, names for it. And I think there's a lot, there's a lot of controversy in, in the adrenal fatigue term. Um, but it's a real thing and it does impact people.

I. 

Dr. Brighten: Yeah, I think the controversy, you know, stems from the fact, it's like anytime patients kind of adopt this language and they're saying things, it, I, it sometimes just feels like one more way to have a practitioner knock you down, a peg to let you know that, like, you know, to gaslight you more, to make you re remind you that like there's a jargon that they know that you don't get to have access to because you, [00:55:00] you don't wear a white coat, you don't have these credentials and that's where you think it's really problematic.

It's the, it is the same thing with like adrenal fatigue, hormone IMB balance. Um. You know, these terms that patients say, I always say it's up to us as the providers to figure out what that means. If somebody says, I have adrenal fatigue, those symptoms are absolutely real. Only in Addison's disease do your adrenal glands give out, which is an autoimmune disease that destroys them.

So maybe it's not completely accurate and it's not what the research is using, but is that the most important thing to tell that person who's coming to you that has that problem? It's the same when someone says, oh, I have a hormone imbalance, and their doctor's like, that's not real. Oh, okay. Except that they're falling asleep at work.

Their hair is falling out, they're gaining weight, they're totally constipated. What is that? That hypothyroidism. It's a hormone imbalance. It's an imbalance of thyroid hormone. They were not being inaccurate. You are just being a jerk and you didn't have to be. So, you're absolutely right. There's, there's all this needless controversy and it really [00:56:00] gets born out of ego.

And at the end of the day, like we just wanna help people. And if you just wanna help people meet them where they're at. And so, yes, adrenal fatigue may not be real in how it happens, but if you use that term, your doctor should meet you with curiosity, not with conflict. 

Dr. Izabella Wentz: Hmm. 

Dr. Brighten: So well said. I'm a little ranty about it.

I just get really irritated where I'm like, why do you have to like, talk down to people? Like they're coming, they trust you. They're coming to you for health. Um, we were talking about adrenal health, we talked about adrenal fatigue. We talked about, uh, you know, this adrenal thyroid component. What can people do to care for their adrenal glands?

You talked about blood sugar balance. You talked about sleep. Are there other things that you've found that have been really helpful for people 

Dr. Izabella Wentz: from a lifestyle perspective? I really love scheduling pleasurable activities. So do, oh, I like this. That you really enjoy. This is gonna be like, incredibly helpful.

I mean. I love supplements. I love all like all of these lifestyle hacks and things to [00:57:00] do, but the women that I've supported through this, um, through an adrenal dysfunctional jour journey, one of the biggest things they appreciate and they love and they feel that helps them is doing things that they love throughout their day.

Like really making that a priority. I think, you know, a lot of women, if there's a lot of pressure, whether you're working in your career or whether you have children or you're caring for your aging parents or maybe some, some freeloading pets, right? That, that require a lot of 

Dr. Brighten: your effort, right? Um, there's, uh, we love our pets, but we all know what that means.

Yeah, 

Dr. Izabella Wentz: we know. Um, but there's a lot of pressure on women and I think sometimes we have these instincts to care for others without taking that time to care for ourselves and do things that we really, really, you know, that really light us up and that give us energy. So just doing that can be a really, really big game changer for people.

Um, as far [00:58:00] as like, you know, supplements, people can get herbs that have, um, adaptogenic potential. I know, I know you're like the queen of adaptogens and so 

Dr. Brighten: that, like I've always been obsessed with them. I'm like, oh, I can, I can hack my mood and my energy and my, how, my, well my brain works. 

Dr. Izabella Wentz: I, you know, my thing is like, everybody around you just gets a lot less annoying when you take, it's like I stay the same, like I'm still my amazing self, but everybody else is like less annoying.

Um, so true. Um, I think people just like, sometimes we don't notice that we're feeling very irritable. Right. And that like other people mm-hmm. Trigger us just by being themselves. For me, it's, yeah, just by eating, breathing, breathing and like, so freaking loud. Like without thinking about you. Yeah. Um, you know, my kind of rule of thumb is like, it's like if my husband annoys me and then my dog would be annoying me and then my mother would call and then I'd be like, why are you [00:59:00] calling me?

I'd be like, you know what? I think I need to take some adaptogens. And so sometimes when it seems like everybody around you as an idiot, it's like, oh wait, I probably need to take some adaptogens. It, it just really balances your stress response. 

Dr. Brighten: Totally. You have to tell people what adaptogens are. What are your favorites that you use?

Um, I'm just cracking up because I'm like, all of this is truth. And if anybody's in perimenopause now, they're like, absolutely this is truth. And if you're not, if you're like in your early thirties, your twenties, you're like, yeah, this is true for me. Fred, get a handle on that now. 'cause perimenopause will be like stink eye in everybody.

And I 

Dr. Izabella Wentz: also, so I wanna 

Dr. Brighten: talk 

Dr. Izabella Wentz: about this because there's different adaptogens depending on your season, right? Your season of life. So, um, I know in perimenopause I've really leaned into like MAA and Vitex, right? Um, when I was in my thirties, it was more about the ashwagandha and ginsengs. If you're somebody that's like a breastfeeding mama, you might wanna lean into more of like the [01:00:00] raisi or um, holy basal.

So it really just depends on what stage of life you're in. I know, um, one of my favorite ones for women with libido issues. And just overwhelm is Ari and I and I think what it means is like woman of a hundred husbands, and it just always makes me giggle, but it like kind of depends on what your profile is and where you are in life.

Right. 

Dr. Brighten: Absolutely. And you know, I'll say with Maca it can be a great one for perimenopause and menopause, but if you take it and you feel like I'm overstimulated, that speaks volumes to what you need to like clean up in the lifestyle and your stress and your life, because it might be that you're on hyper drive and that adaptogen pushes you a little bit further.

I, I think I'll always be rhodiola for life. I. All the ones you mentioned. I do use like different concoctions. I love doing mocktails with like different herbs and things. My dream is to have like a whole bar one day that's like nothing but like [01:01:00] tinctures and like have all my own recipes. But with Rhodiola, that's so much about mental and physical endurance.

Um, discovering later in life I have a DHD I'm like, no wonder, no wonder I've been a Rola fan because it can help so much, um, with that as well. And I'm just somebody who's like, you know, high energy, very physically active. Um, and it always like is supportive, but you're absolutely right. Uh, interesting. Um.

Ashwagandha has been shown to be helpful with breastfeeding moms to help with, uh, milk supply, which really comes to like, what's going on with your stress. Um, and I wanna just, since we're kind of, you brought up, uh, seasons of life, so losing your milk supply can actually be one of the first signs of hypothyroidism postpartum.

So having trouble establishing your milk, losing your milk supply. Um, I wanna just have you talk a little bit about that risk of being postpartum and the connection with thyroid disease. 

Dr. Izabella Wentz: Yeah. So if you are somebody [01:02:00] that goes into pregnancy knowing that your hypothyroid, you're gonna wanna make sure that you adjust your dosage of thyroid medications.

I remember when I was. First pregnant, I think I called you and I was like, Hey, can you do this math with me? I wanna make sure I get it right. You know, so we, we make sure that we are getting enough thyroid hormone on board to support the baby's brain. And then postpartum. Some women may need to reduce their dosages.

Some women may need to keep on the same dosages. And some people, some women may need to increase their dosages. It just, it just varies. I guess the key point is that you do wanna monitor it if you have a history of thyroid issues. Um, interestingly, selenium can reduce incidents of postpartum thyroiditis.

Just a little side note out there. But you do want to, like, check in and test your thyroid function after giving birth anywhere from six to 12 weeks after that. And a drop in your milk supply could be an indication that you know, if you're, if you already know you had hypothyroidism, perhaps you need a [01:03:00] higher dosage of thyroid hormone.

And if you are somebody that is, um. You know, has postpartum thyroiditis where, which is like a new thing for you. You've never had thyroid disease before and all of a sudden postpartum, you just feel like, you know, everybody feels like they got hit by a bus postpartum. So, um, but you just feel like something is, is just totally wrong and you're, you know, you're not able to, your milk supply just dips.

Usually around six weeks postpartum is when you might start to see that. If you are somebody that has trouble producing milk from the beginning, there is something, um, something for women to consider with PCOS and hypothyroidism. It is insufficient glandular tissue. So women who may have gone through puberty while having Hashimoto's hypothyroidism or PCOS, even in the early stages, they may not develop a [01:04:00] proper amounts.

Of, um, breast tissue. So they may not be, they may struggle with making breast milk, um, right after, and they may need to work with a lactation consultant. And really, um, some women may not be able to get a full milk supply. There are some methods to induce, um, goats through for, for that instance is gonna be probably your best bet.

Dr. Brighten: Mm-hmm. And postpartum depression is also one that, uh, for anyone who has been diagnosed with postpartum depression, that, um, suspects that I'm always like, run a thyroid panel. And most psychiatrists, if you are somebody who develops postpartum, uh, depression and the medications are not helping you, they will look at thyroid sometimes even before that.

But what I find is. The average gynecologist or PCP is not going to do that. So if you are seeing the milk supply or the symptoms you talked about before and, and you're starting to have depression, it's worth just [01:05:00] getting that panel done. It's worth just looking at it because this, we know is one of those sweet spots where many women develop hypothyroidism.

The other is when we reach that like 35 to like 45 when we're going into that perimenopause. So can you talk a little bit about perimenopause and thyroid disease? I don't want to, I'm kidding.

Dr. Izabella Wentz: The face. So, yes. Um, definitely. Um, something that personally threw me on a curve, just when you think you have everything figured out. So I got myself into remission from Hashimoto's in my twenties and I was like, this is great. I'm living life. And then 38 hit and I was like, what is happening? Where is my body?

Where, where are all of the things that work for me? What happened to them? Why are they no longer working? Um, and so there's obviously a big connection. All of our hormones talk to each other, right? And so whenever we have that drip [01:06:00] dip and progesterone and more estrogen on board or estrogen dominance, um, just relative because, because of the fluctuations in the progesterone, then you're gonna have an impact on your immune system, on your thyroid hormone binding, and on how your body utilizes thyroid hormone.

So for some women, they, you know, pregnancy, puberty and perimenopause are definitely the times that women might have new onset of Hashimoto's and thyroid disease. And then women who were previously well controlled. With hypothyroidism, you know, those times just might take them on a wild ride. And so what does that look like for, for us in perimenopause, oftentimes we're gonna have to look at adjusting our lifestyle changes even more so, um, adjusting thyroid medications.

Our dosages of thyroid medications may become higher. We might need to really [01:07:00] focus on the whole picture, getting more progesterone on board. We might have to really focus on, um, our metabolism, getting that strength training in, getting more fiber into our diet. So it, it's a, it's a whole nother thing. I think.

Um, I, yeah, it, it, it's a big change. I feel like that catches a lot of women off guard. So, thank you. Thank you for asking about it. Even though I'm still slightly triggered by it. 

Dr. Brighten: I mean, it's such an important conversation though, because there are so many people out there who are talking about perimenopause.

They're talking about menopause, and I see them saying like, oh, it's mostly estrogen. They talk about, and then some testosterone, and then like progesterone gets a little play, but thyroid is almost never discussed. And what you brought up of how important progesterone is. So in early perimenopause. That is when progesterone begins as decline, that is the first hormone to leave you because ovulation is what's leaving you.

And progesterone helps with thyroid hormone at the receptor [01:08:00] level so that you can utilize that. So you may be finding that you need more. And then as you were saying with estrogen, estrogen's, anti-inflammatory. So if you take somebody who already has autoimmune disease and they go without estrogen, now I see so often there is inflammation that we, this is when, this is generally, you know what I see when someone is not getting adequate treatment, which might be estrogen hormone replacement therapy, that now they're developing more autoimmune diseases because estrogen helps us regulate our immune system, as does testosterone.

And so I don't think we can have these conversations about perimenopause and about all this HRT and not. Talk about thyroid as well, because it's so interconnected and hypothyroidism can look a lot like perimenopause. Can you talk about some of the symptoms that cross over? Gosh, so many of them. So 

Dr. Izabella Wentz: the weight gain, the brain fog, the fatigue, the [01:09:00] irritability.

I mean, if you, if you were to take a look at both of them, there's, there's a lot of symptoms that overlap with it. Um, one, one random thing I wanted to include in there too is DHEA too, right? And so our levels of DHEA decline with age and starting at 25, everyone, it's not fair. It's the youth hormone, right?

Yeah. We get robbed. And DHEA is one of the substances that can also, like, I think a lot of times people focus on testosterone, but it's also DHEA is also an androgen that can be very, very helpful. And it's been, um, studied in helping induce remission in Hashimoto's too. 

Dr. Brighten: Yeah. That's a great one. Um, and DHEA for people listening that comes from the adrenal glands is a precursor to estrogen and testosterone.

So sometimes we'll use this intravaginally because it can help with the pelvic floor. Um, it can help with the mucosa of the tissue of the vagina. There are, um, instances. That you [01:10:00] can use it orally. I say be cautious because if you are somebody who pushes that into DHT DI Hydrotestosterone, if you're one of those people that just rapidly goes down there, you are gonna lose hair on your head.

You are gonna grow it on your chin. You are gonna maybe grow it around your chest as well. Uh, and you might end up with a oily skin and acne and then you will curse our names. So I just wanna just an error of caution there. But you're absolutely right. That can be a helpful one. And you know, another symptom.

They see a lot of crossover is heart palpitations and heart flutters, um, between the two. And so women are thinking like, oh, I'm suddenly having cardiovascular issues. And you know, here's the thing about it. Uh, no one said you can't have both things going on at once. You can't have th you know, you could have hypothyroidism and have perimenopause at the same time, but we always just wanna be cautious.

I think as providers it's easy to get a bias of like, oh, you are just in this stage and everyone I see at this stage is perimenopause without recognizing, [01:11:00] well, it could be hypothyroidism as well. Yeah. If you're lucky, you can get both Right. No, I know that's gonna be us, you know? Which brings me to the concept of thyroid medication.

Thyroid medication is, for all intents and purposes, bioidentical hormone replacement therapy. You can't live without it. It's non-negotiable. Yet there are people out there who are so resistant, they like have their like, where they're just like, absolutely not. I do not wanna be on a medication. I will not take thyroid hormone.

What do you say to that? I mean, I 

Dr. Izabella Wentz: respect people's opinions into Each's own all. And I, you know, I think a lot of people are very anti-medication in general. Me being a pharmacist, I'm like. You know, it's kind of like there's the good ones, there's the bad ones, there's the ugly ones, right? And so I wouldn't, there's the, oh, thank God if we need it, it's their ones.

Yeah. And I wouldn't put every medication in the same category. So [01:12:00] like you said, thyroid hormone is bioidentical. So even if it is synthetic thyroid hormone, it's like the exact structure that your body would make and when your body isn't making it, I think, um, you know, like taking it externally is such a gift to yourself.

I know some, like, I, I, I worked with some people that have a lot of dogmas about like, oh, I don't wanna change my diet, or I don't wanna ever take a medication, or, I am not trying hard enough if I take a medication, or all medications are bad. And I really caution people against that kind of thinking just because like, start with like being kind to yourself and like what is, if you're super hypothyroid, the kindest thing to be for yourself is to help yourself get some thyroid hormone on board.

You're gonna feel so much better. Could you do some red light therapy? And could that help heal your thyroid gland potentially? Could you take some My acetol and selenium potentially in the early stages there are things you can [01:13:00] absolutely do to support your body. And like, just because you take thyroid hormone, it's not like you're giving up on yourself, right?

So you can still have the other things and take thyroid hormones. And I think for most people you'll have the best kind of results. I, I know I've had so many clients that are just like super resistant to taking thyroid hormones and why did I like not do this? Like, oh my gosh, my hair looks amazing, like for the first time 10 years, and I try all the things and I have more energy and.

Just, um, you know, I'm losing weight effortlessly and I'm not a proponent of like, oh, like everybody take thyroid medications. Like, I'm not a proponent of that, but I'm like, if you have a physical need to take thyroid medications, I. And thyroid hormones, I should say, then this is absolutely gonna be great for you.

Um, as long as it's like the right dosage and the right type for you. 

Dr. Brighten: Yeah. And you know, as you said at the top of this, that that one pill isn't gonna fix everything. It's [01:14:00] not an either or conversation. It's a yes. And like you may need the medication by the time, you know, mine was caught and we did an ultrasound on my thyroid, we saw the infiltration and, and my symptoms.

It was like, okay, I'm gonna need medication. That didn't mean that, I didn't also look at like, okay, I need to also exercise. I need to manage my blood sugar, my stress has to be in check, like all of these other aspects of health. And so I really appreciate you speaking to that because it, it is a really common thing.

And there's groups who absolutely judge and put people down if they ever leverage a medication. And the reality is, is that. Every single cell in your body has receptors for thyroid hormone, which means that it's a non-negotiable. No one would judge a diabetic, a type one diabetic for needing insulin. No one would be like, oh yeah, like, I can't believe you're using a medication.

It is the same. It is the same. You cannot live without thyroid. Now without insulin, you die pretty quickly without thyroid hormone, you die very slowly [01:15:00] and not fun. Congestive heart failure, like you stop being able to even walk down the hall of your own house, like there's a lot of sequelae that come out of that.

So I. And just for everyone listening, thyroid medication's not right for everybody, but if it is something that's indicated for you, you should never feel shame or guilt for needing to utilize that. I want to talk about a few of the options that are out there. So you mentioned levothyroxine, I alluded to like T three being available.

You are the pharmacist. Let's break it down. What are the types of thyroid medications available? 

Dr. Izabella Wentz: Sure. The, the types are gonna be, um, T four containing medications. Some of the brand names, um, would be like Synthroid or Levothyroxine or Lael. Terin is like a gel cap formulation that can be very helpful for people with.

Absorption issues. Thyroid medications are like notorious for having like every single drug interaction on the planet. So many of them you can't take, you [01:16:00] can't have coffee within a few hours of taking them. Otherwise you absorb them or you can't eat them. You can't take them with food or calcium or iron supplements.

Um, so this is kind of what most people and most endocrinologists, conventional doctors will prescribe. Then there are T three only medications. Um, cytomel tine are some of the common names, and these are gonna be, um, sometimes done as an add-on to the synthroids, the lox levothyroxine. Some people advocate for using them, um, as standalone therapies.

I think this is very rarely required. Um, for most people, but there are those that swear by utilizing them as standalone therapies. Um, then there are natural, you 

Dr. Brighten: mean the T three all on its own? Exactly. Just to clarify. Yeah, yeah, yeah. And I just wanna caution people that if you [01:17:00] are pregnant or you're wanting to conceive, that's an absolute non-negotiable because T four crosses the placenta and baby needs it, and T four has been found in the follicular fluid of developing eggs.

And so we understand that if thyroid hormone is there, it is gonna play a crucial role in your egg development. And so I just wanna chime in there 'cause I know there's groups that are like, no matter what, it should be fine. And um, it will not in fact be fine. 

Dr. Izabella Wentz: Absolutely. And that's another thing is, um, for women of childbearing age, we do wanna make sure.

People are like, I wanna try to get pregnant, and I have hypothyroidism and I don't wanna be on medications. And I would strongly advocate, you know, this is probably a great time for you to be on thyroid hormones because the baby needs them, right? It's not just you, but for your requirements are gonna go up when you're pregnant and, and it's gonna be so important to their development.

Um, the other, the other type of medications that are oftentimes prescribed, they're [01:18:00] gonna be na, natural desiccated thyroid medications, um, often prescribed by like naturopathic doctors, functional medicine doctors, and more doctors that work in natural medicine or bioidentical medicine. They are derived from the glands, thyroid glands of animals.

And so they are meant to be bioidentical. They contain a little bit of T four and a little bit of T three. In, um, in a specific ratio. And so a lot of times people that have trouble converting that, um, T four into the active thyroid hormone, they might like to utilize, um, those types of medications. And then there's also, you know, various component thyroid medications that might be available, some hypoallergenic options for, for people.

Um, I know there's some innovation coming out with like injectables and then there was liquid thyroid medication. But for, I think for most people, those are, those are gonna be the kind of, um, kind of things [01:19:00] they're gonna encounter. 

Dr. Brighten: Mm-hmm. What is your opinion as a pharmacist about the recalls that have happened with the natural desiccated thyroid hormone?

Because I know that's why some practitioners are hesitant to prescribe them. 

Dr. Izabella Wentz: Yeah. I think recalls happen and they've happened across the board with every type of medication, so I'm not, I'm not necessarily gonna say that. Um. You know that that's a reason not to trust the natural products, but tricky thing is with thyroid hormones that they are Goldilocks hormones.

So it's really important to make sure that you get the dosage just right. And I, I'm a big advocate for testing your levels, especially when you're first getting started on them, to make sure that you are not overdosed or underdosed. So sometimes, you know, every six weeks or so, every four to eight weeks, I would probably say every six weeks when you're dosing up, and then just testing your function, thyroid function throughout, anytime.

Um, you know, I [01:20:00] would say like at least once a year, if you're symptomatic more frequently than that, if you have symptoms like palpitations, panic attacks, anxiety, hair loss, irritability, um, that might be an indication that you're overmedicated and. You know, if you have any kind of symptoms like fatigue and hair loss and just, um, maybe just feeling more cold, that could be an, an indication that you might be under medicated.

And sometimes, you know, your, your need for a thyroid medications may increase. Sometimes it may decrease. Sometimes you might not be absorbing them correctly. So it's, it's not something that you just kind of start and forget about. 

Dr. Brighten: Yeah, it is something that has to be monitored and that you need to have a good relationship with your provider.

Um, you use the Goldilocks analogy. I often like to say it's like Cinderella, and sometimes like, you know, you're the slipper and you're having to try these medications and see [01:21:00] how does it, how does it actually work for you? And, and sometimes it shifts where it's like medications. Something was working before and now it's not, and you just have to honor what is true for you and all of that.

I wanna ask, you brought up like doing something pleasurable every day. What are your pleasurable things that you like to do to help de-stress and feel better in your body? 

Dr. Izabella Wentz: Um, I like to swim. I like to lay out by my pool. I like to go on hikes in nature. Um, I like to go browsing at Marshalls. That's like one of my favorite stores, so I, I enjoy doing that.

Um, just talking to a friend, getting together with friends. I try to schedule things like that. Um, and I, I'm, I'm really into self care. I'm a big fan of Epsom salt baths. Like, if I'm under a lot of stress, like, you know, my, um, you know, my husband Michael, he'll be like, Isabella, get out of the bath. You've been in there for two hours.

I'm like, I'm not done [01:22:00] yet. I'm not done yet. Uh, oh man. So try incorporate little things like that that just bring me a lot of joy. Um, and for me, honestly, it's like the little things like just being out in sunshine for a little bit or going for a walk or, or, you know, doing something funny. Right. 

Dr. Brighten: Yeah.

Okay. This is like a little bit of a tangent, but um, as you say, like just being in the bath and soaking forever, uh, people will just have to comment. Are you a thrown a glass fan? So it's this. Fantasy book series and she's an assassin and she's always in a bath like indulging. And every time she's getting in a bath and she's sitting there for, I'm like, yeah girl, you are so stressed.

Like you need to take that bath. And I always wonder, is anyone else reading this? Being like, yes, she's an assassin. Life is stressful. She needs these baths, like the downtime. Um, so if you are someone who reads, thrown, thrown a glass, let me know. And then, um, also let me know, are you gonna take a page out of Alan or Selena?

I don't know which one we're calling her right now. 'cause I'm not far enough in the books. [01:23:00] Uh, are you someone who takes baths as well? I appreciate you sharing all of that because I think as you were saying, women care for a lot of people and things in their life and they don't often get. Permission to take that time for themselves and seeing someone who is a working mom take that permission, hearing the ways that you pause for yourself so that you can optimize your health.

You can keep your Hashimoto's in check and really fill your best. I think that's super inspiring. And I just wanna thank you for being here. I have, um, you know, just really enjoyed our time together. I always enjoy hanging out with you. As you know, I need to come to Austin soon. Are there any parting words that you would love to leave people with?

Dr. Izabella Wentz: Oh my gosh. Well, thank you so much for having me. It's just been such a pleasure to be here with you and for everybody listening. I think sometimes it can feel overwhelming to have a chronic health condition, and you might hear about a lot of lifestyle changes. I say, just pick one and pick one that feels the [01:24:00] most appealing to you, and start there and see how it makes you feel.

I, um, I'm a big proponent of taking like a piece of paper and writing down all of the things that make you feel better and all of the things that make you feel worse. And just really focusing on doing a little bit less of the things that make you feel worse and a little bit more of the things that make you feel better.

And just kind of start there and you'll start seeing major improvements in your health and happiness. 

Dr. Brighten: That's a fantastic tip, a great way to not get overwhelmed, but also to take inventory. And I think that sometimes we can gaslight ourselves into thinking that we can do it all. That everything is great and it's fine.

Um, not talking about myself personally. Um, I either absolutely am, but I I do love the inventory method of like, write it all down and put it in front of you. And, and really I think what I wanna just say about that checklist is this is also something that when you are in different seasons of life, you revisit it as you brought up before.

So thank you [01:25:00] again so much. I really appreciated this or conversation. I know it's gonna help a lot of people. Thank you so much. I hope you enjoyed this episode. If this is the kind of content you're into, then I highly recommend checking out this.