Thyroid Problems: Everything You Need to Know with Hashimoto’s EXPERT Dr. Izabella Wentz

If you've been doing everything right, eating clean, exercising, but somehow you're still not feeling your best, your energy's dragging, your memory is slipping, and it's frustrating because you know there's more to your potential. Well, what if the issue isn't just in your routine, but it's deep down inside your cells? You know, you're investing in the best supplements, working out regularly, and sticking to a clean diet.. But if your cells are stuck in what's called cell danger response, all the hard work might not be paying off as it should. Think of your cells like a house under renovation. You can bring in the highest quality materials like the best supplements and clean foods. But if the workers inside the house are on lockdown because of a storm, nothing gets done. The materials just pile up unused. That's what happens when your cells are in CDR. They can't fully use the good stuff you're giving them. Getting out of CDR, the cell danger response, is the key to unlocking your body's full potential. When your cells are no longer in protective mode, they can finally use the nutrients, hormones, and energy you're working so hard to provide. That's when everything starts to click. Your energy improves, your workouts become more efficient, and you start to feel like yourself again. Go to beyondbloodwork.com to learn how to break free from cell danger response and make the effort pay off. Hey everyone, welcome to Dr. Axe Show. I am your host, Dr. Axe, and each and every week on this show, we dive into the science and principles and how to grow in body, mind, spirit, and take your health and your life to the next level. On today's episode, I'll be interviewing Dr. Isabella Wentz, and Dr. Isabella is somebody I have respected and admired for a long time. She's been on my podcast in the past. And, uh, again, we've known each other for, for probably going on 10, 12 years now. And she was one of the first people I saw who was just doing an incredible job getting to the root cause of hypothyroidism, Hashimoto's, and autoimmune disease. And Dr. Isabella is a New York Times bestselling author. She's a clinical, uh, pharmacist, which is a really unique perspective in terms of her understanding of sort of the biochemical interactions going on in the body. And today we'll be discussing the underlying root causes of thyroid disease, how to support thyroid health, and how there are tens of millions of people likely that have thyroid issues— hypothyroidism, Hashimoto's— and they don't know it. And we'll be talking about some of those common symptoms, also how to manage stress, and a whole lot more. Dr. Isabella, welcome to the show.

It's so great to be here with you, Dr. Axe. It's been too long.

It has been too long. You know, again, one of the things that I've always really admired about you is this focus, and this is what I've tried to do in my career as well, is getting to the root cause. And And oftentimes today, even in the natural world, you know, it's— sometimes there's a tendency to just say, well, here's one diet for everybody, or here are just 2 or 3 supplements, or go gluten-free, or cut this out. But a lot of it isn't necessarily personalized and tailored to the individual. This is something I've seen that you've really done more. Also, one of the things I love is that you also— you, you've done a lot of the research on and look— read a lot of the medical journals on what's causing thyroid issues today. One of my first questions for you is how prevalent are thyroid conditions, and also how many people maybe have a thyroid issue and don't know? What are those, those warning signs that somebody's thyroid isn't, uh, isn't healthy?

Gosh, uh, so many great questions there. So let's unpack this. Thyroid conditions are very, very common. I would say anytime looking at women, perhaps 1 in 5 women may be affected at some point in their lives. Typically pregnancy, puberty, and perimenopause are gonna be the 3 peak times when a woman might be diagnosed with a thyroid condition. It does occur in men as well, but generally we're gonna have for every man that's diagnosed, we might have anywhere from 3 to 5 women. So overall population studies have said anywhere from 20%, some as high as 30% of people might have hypothyroidism or markers of thyroid autoimmunity such as Hashimoto's. We'll get into what that is soon, I'm sure. But as far as symptoms go, thyroid hormones impact every single cell in the body, so the symptoms can be very nonspecific and widespread. And it takes an average of 10 years for a person to get diagnosed from the time they start having symptoms.

Wow.

Some of the things, um, we typically might find in a person with the early stages of thyroid disease is they might feel more anxious. They might say they have obsessive-compulsive disorder. They might feel a little bit off. They might have, if they're women, they might have multiple miscarriages. They might feel fatigued. Some of the more classical signs and symptoms when a person maybe has had hypothyroidism for quite some time and there's that progression of the autoimmunity in the thyroid gland, they might have start having some brain fog. They might start having hair loss, um, a loss of the eyebrows, especially the upper third here, and not from overplucking, is going to be the classical red flag symptom for hypothyroidism. Then we might see things like having a puffy face, having a hoarse voice, um, things like constipation, fatigue, carpal tunnel. These are all going to be potential symptoms that somebody might present with. Depression and pain are going to be common, oftentimes overlooked, but that's very much related to the thyroid. A lot of times women will notice that they have hair loss and weight gain, their skin becomes more dry. And again, this is a condition that impacts every cell in the body, and so we can end up with symptoms all over the place. Some of the— I guess the big telltale sign would be cold intolerance. So we know that the thyroid gland runs our metabolism in the body, and part of that is our heat production. So a person who's more cold than the average person— so if you have that, that aunt or cousin that's always wearing like a winter jacket and everybody else is in a t-shirt, or they're just always struggling to stay warm— this is going to be a really big red flag for me that this is a thyroid condition. Again, this is not somebody that But it's tricky because not everybody might have that cold intolerance. Some people might have heat intolerance, right? And so this could be actually just a sign that their temperature is dysregulated.

Yeah, you know, I remember my mom growing up. I remember— and my mom was later diagnosed with hypothyroid— I remember just always thinking, why is she cold all the time? Like, I would, you know, I'd be wearing a tank top, she'd be wearing a jacket. And, um, and obviously I, I And again, always wondered that growing up. And then, you know, again, lo and behold, years later she gets that diagnosis. But yeah, that, that's, um, I think that, uh, you hit on a lot of those symptoms. And I think a lot of these are symptoms somebody might say, well, I don't know that I have a thyroid issue, but I do have thinning hair or eyebrows, or I do have low energy, or I, I am cold all the time. And so again, these are all warning signs you could have a thyroid condition, as Dr. Isabel is talking about here. And it's really, uh, one other thing I wanted to point out, you mentioned statistically by far more women are diagnosed than men. What I always saw in practice was I felt like for a very similar type of condition— I think Chinese medicine backs this up— women will tend to get hypothyroidism, men will tend to get low testosterone, and there's actually a lot of parallel symptoms with those two conditions.

Well, what's really interesting too is that thyroid hormone levels can impact testosterone levels. So in some cases, just by correcting a thyroid hormone deficiency, you can correct low testosterone in men. And I primarily work with women, but I'll have male clients as well every now and then. And it's interesting because a lot of the symptoms that hypothyroid men report are correlated with that testosterone. So they'll say their libido is off, they're having a harder time growing a beard, they're just not putting on muscles as much. Whereas women might say, I'm tired and I'm gaining weight and I'm brain fogged and I'm losing my hair. So it can present a little bit differently in men and women. Fortunately, the same strategies do work for, for both.

Yeah, yeah, that's so good. I know when you look at the ancient China, sort of the Chinese medicine approach, one of the things they really want to address is warming that body internally um, is, is an important thing, you know, because I think that that's part— as you're sharing, that's part of that. They actually— it's interesting, in Chinese medicine they'll call it the thyroid, they call it the upper burner, you know, because it's that, you know, sort of burner for the, uh, it's, it's that closely tied to the, the metabolism. I know that this is such a personal thing for you. That's one of the things I, I really, um, I see in a lot of doctors who become the best in their field. I consider you to be that top 1% of, of thyroid experts in the world. And so, but I see that with a lot of these top experts is that, you know, this is something you battle. It was a personal battle for you. And so walk us through a little bit about how you were able to— your diagnosis, what you went through, and then how you were able to overcome, uh, your, your diagnosis.

Yeah, so in full disclosure, I was never interested in the thyroid gland during pharmacy school. I thought thyroid medications were very boring. There was just one type of medication that I learned about And I really thought that all you had to do is if you were hypothyroid was to take a pill every day and that's it, and maybe get your blood work monitored every few months. And so it came to me as a big shock and a big surprise when I was diagnosed with Hashimoto's, which is the main reason for thyroid disease in the United States and worldwide, affecting more than 90% of people who have hypothyroidism. And I had been sick for quite some time. So I started off with chronic fatigue, then I ended up with panic attacks and carpal tunnel in both arms. I had all kinds of allergies. I was bloated. My sweatpants weren't fitting. I was sleeping with 2 blankets in Southern California, and I, um, I was brain fogged. I was always like this very sharp person, top of my class, skipping grades, and all of a sudden my brain just wasn't working as well as it had been. And I guess I sort of tolerated all these things and I just ended up going to different doctors every year and I said, okay, now I've got, I've got these symptoms. And then I would get irritable bowel syndrome and then acid reflux and I would get all of these new symptoms and I would go to different doctors and they would be like, well, here's a medication, here's a medication. And finally, when I was a young practicing pharmacist, I was like on all of these medications and somehow I had this revelation that maybe not all doctors are created equally. At some point. And for me, the, I guess the end of it was when I started losing my hair. Being a Leo, I was like, this is not acceptable. What is going on? I really need to get to the bottom of this. And so I started going to different doctors and found somebody that was a little bit more comprehensive, and they were able to find that I had thyroid antibodies, which meant that I had an attack against my thyroid gland, which was responsible for all these symptoms. Now, being a pharmacist, I was like, great, I'll just take thyroid meds. This is amazing, right? This, I learned about this. This is easy. Enough. It wasn't that easy, unfortunately. So the thyroid medications helped a little bit, but I went from sleeping like 12 hours a night to 11 hours a night, and I still had the pain, the acid reflux, the carpal tunnel, the hair loss. All of the symptoms were still there. I was like a little bit less cold and a little bit less tired. And this is how I became a Hashimoto's expert slash a human guinea pig, was really trying to figure out what I could do to make myself feel better. I was still in my 20s at the time, and I thought, why am I getting this condition that I thought older women got? What am I doing in my life? I thought I was leading a very healthy lifestyle. I was exercising 5 days a week. I was eating lots of, um, yogurt and whey protein shakes, and I was having, um, whole grains and whole wheat and all of these things that I thought— all these habits that I thought were very healthy. And yet I have this autoimmune inflammatory condition. And so that's how I got into looking into Lifestyle changes and what are the actual drivers of disease in an individual and how to get back into a healthy body, right? And so it, it's, you know, to your point, there's like general advice out there that's just like, everybody should do this. It's like, well, no, not everybody. It depends on what's going on within your body, right? And it depends on what condition you have, your genetics, and your current lifestyle, what, what's gonna help you best. And this is why I love your website and your content because you really focus in on how do we get to specific advice for a particular person.

Yeah. Well, thanks so much. Well, I, you know, one of those sort of personalized things I think that's important to talk about is I'd love to hear your take on iodine. You know, I think there were years where people just said, take iodine. It's the solution. I think it helps some people, but I do think also maybe it's been bad for some people, um, maybe with specific conditions. So walk me through who typically actually needs iodine for thyroid conditions, or can you only tell on a blood test? And also, for some people with Graves' or Hashimoto's, could it actually be a not-so-good thing?

Iodine is one of the most controversial nutrients when it comes to thyroid health, and A lot of old-school practitioners have recommended high, high-dose iodine for every person with a thyroid condition. And in theory, it makes sense because iodine is needed to make thyroid hormones. It combines with tyrosine, which is an amino acid, to make thyroid hormones. And so, you know, when you look at it on paper, it's like, okay, you have low thyroid, then let's just give you more of these ingredients, right? Um, and in some cases it does work, especially when a person is iodine deficient. Then we give them iodine and eureka, now they're not, right? So they have more of the raw materials and now they can make more of that hormone. You know, public health officials saw this a long time ago and they said, huh, you know, we're seeing all these people with hypothyroidism, it's causing a lot of issues. Why don't we add iodine to the salt supply, right? This is gonna be great. It's gonna help everybody. Now, it did help some people. Wonderful, right? But unfortunately, in people who have these genetic predispositions, it also increased the rates of autoimmune hypothyroidism. So unfortunately, iodine, um, it does tend to be a Goldilocks nutrient. So we want to have the levels that are just right. When it's too low, we can have iodine deficiency-induced hypothyroidism. When it's too high, we can have autoimmune hypothyroidism, and it can also exacerbate autoimmune hyperthyroidism, which is Graves' disease in some cases. Um, I specialize in Hashimoto's, so I'm going to talk about some of the studies which showed school-aged children— the rates of Hashimoto's before and after iodine was added to the salt supply in a particular country in Eastern Europe showed that the rates tripled, doubled, tripled, and sometimes quadrupled. So you'd have just a handful of children maybe in a class with autoimmune hypothyroidism, and then 10 years after iodine's been added to the salt supply, then you see these higher levels. And really, you know, when you think about it, this is again that example of giving a person advice for every single person. Like, let's say running is great, right? So should everybody run and jog? It's like, yeah, maybe in theory, but what if you have a broken leg? Like, is it a good idea to jog? What if you have adrenal fatigue or adrenal burnout? Should you be jogging? What if you're a pregnant woman on bed rest? Should you be jogging? So these are like all of the nuances. And what's happening in this autoimmune thyroid condition is there's an attack against the thyroid glands, and then every time you add more iodine to that, that makes the thyroid gland more visible to the immune system. And so that can really increase the, the thyroid antibodies. Unfortunately, in my experience, I've seen clients who had just very mild hypothyroidism and just very mild levels of thyroid antibodies, and they were put on a high dose of iodine, and then their thyroid antibodies would go from maybe 20 to 30 to 5,000, 6,000 within a few weeks or a few months, and they'd be bedridden, and their thyroid function would just get really impacted by that. And so— oh, go ahead.

Well, I was going to tell you, I mean, I had somebody I know, somebody who was close to me, and they went in and they were diagnosed with hypothyroid. They started doing high-dose iodine, and then they ended up with Graves' disease about 6 months later and had a bit— and actually had a goiter, uh, pretty significant grow. I mean, so to your point, I've seen— I, you know, I've seen this in happen, you know, in real life as well.

Yeah, it absolutely can happen. And so I think the moral of the story is if you have hypothyroidism, it's really important to know where it's coming from. If it's coming from an iodine deficiency, if you're living in a country that doesn't add iodine to their salt supply, that might be a possibility, right? Or if you just are not exposed to iodine through your food, then potentially that's a possibility. And if you are like some, like 90 to 97% of people in the United States, in Europe, in Australia, the Western world, you're probably not going to be iodine deficient. And I would recommend testing for thyroid antibodies because those thyroid antibodies are probably, um, they're, they let, they're going to let you know that you're not going to be able to tolerate very high doses of iodine. And so what's a high dose versus a you know, a good dose, right, or an appropriate dose. Generally, the amount of iodine in a multivitamin or a prenatal vitamin, most people, even with Hashimoto's and high antibodies, this is going to be a dose that's helpful and not harmful. So their thyroid function will be improved if they take like 150 micrograms to 250 micrograms of iodine a day. What we're talking about is sometimes they get 5, 10, 15 milligrams of iodine, which is very, very high from, from some of the alternative practitioners, and that can be problematic. So anything above 300 micrograms can be inflammatory in a person with those thyroid antibodies.

And to your point, testing can be so beneficial to see if you have these antibodies, and it's a simple blood test. It's not, you know, it's not, uh, it's something you can go see, you know, a thyroid specialist like Dr. Isabella or someone else who does this sort of testing. And find out exactly where you're at. You know, one of the things that, uh, I've loved that you've done, um, is you've interviewed a lot of other experts. And so you're an expert in hypothyroid, Hashimoto's. You've interviewed a lot of experts. You did this great documentary called The Thyroid Secret, and I would love to hear from you. What are some of the most shocking things you heard and discovered while you were filming this, you know, this, this, this rock star documentary on thyroid health?

I think, man, I discovered so many different things throughout that process. I feel like one of the things that doesn't get enough credit is the emotional connection and that, that component of when we don't speak our truth, that thyroid conditions can manifest. And it sounds very woo-woo. It sounds kind of out there, right? But again, stress can drive different pathogens into our bodies, there's a pathogen known as H. pylori, and it becomes stronger when we're stressed out. And that's been correlated with both Hashimoto's and Graves' disease and also acid reflux. And this was probably one of the, you know, me being a pharmacist and a scientist, I'm sort of like, ah, this stuff, this woo-woo stuff is like over here in a box. So like, I don't really know how to unpack that, but that's been very relevant, something I learned throughout the documentary series. And that's been very relevant for many people that I've worked with. With is that stress connection, how much that can actually be the difference between you thriving and you just barely surviving.

First of all, I love this. And, you know, this is very tied to Chinese medicine. And so, you know, when I look at— just for everybody listening, you store— and again, I know that people could think this is, as Isabella put, woo-woo, but I think there's some good science to back some of these things. You know, when you look at anger, Chinese medicine-wise, that's stored in the liver. Fear, that's stored in the adrenals. Uh, grief, that's stored in the lungs and colon. If you also think about where the thyroid is located, it's in your throat, okay? It's where your voice basically, you know, comes out of. And so when you don't speak up, when you have something to say, when you kind of are always holding back, you start to store essentially this, this, you know, emotions in there that are not released. And that, that, that causes stagnation in the area. That's a big part in Chinese medicine what causes to be sick is, is that there's stagnation in the area. Imagine a swamp rather than a flowing river. And so I love that you brought that up. That's absolutely, absolutely fascinating. I love that. You know, you'd mentioned we talked about iodine a little bit. There's a lot of other critical nutrients that is essential for thyroid function. As you have done over the years with, with thousands and thousands of patients, done blood work, what do you see as some of the biggest deficiencies that you find when it comes to, to the thyroid, specifically hypothyroid and Hashimoto's?

Vitamin D deficiency, B12 deficiency, as well as ferritin, which is the iron storage protein. So these are like my 3 non-negotiables. If you have hypothyroidism, if you have Hashimoto's and you're coming to see me, we're going to make sure you get those 3 things tested. Because vitamin D low levels can cause all kinds of autoimmune conditions. Most of my ladies with Hashimoto's that are in remission, I like to see their vitamin D levels between 60 and 80. And now there's different reference ranges out there that will say, okay, for this, you know, we want above 30, or as long as you're above 30, you're fine. But in my experience, it's been you want to be closer to that 60 to 80 mark with your vitamin D. This can help your immune function, this can help your mood, this can help reduce your thyroid antibodies. Um, B12— this is something that's very, very commonly deficient. Some people have something known as pernicious anemia as well, where they do not absorb B12 properly from their foods. Something interesting is often— so, you know, they can be eating lots of meat. B12 is, is from primarily animal-based products and from supplements. So vegans and vegetarians are at risk, but also people that have this pernicious anemia. And this oftentimes is correlated with an H. pylori infection, which can cause parietal cell antibodies. So basically antibodies to your stomach part that absorbs B12, and that can cause Hashimoto's and Graves' disease and acid reflux, food sensitivities, all kinds of things like that. So I oftentimes like to screen for that because that's a very common infection in hypothyroidism, Hashimoto's, and oftentimes we do need to get those vitamin levels up, low levels. And again, ref— reference ranges will say above 200 or 300 is fine, but I like to see those about around 800 for B12 just because you can have neurological issues with any levels that are lower. You can have mood issues. A lot of different symptoms can be traced back to that B12 deficiency. And then probably one that gets, I guess, um, missed very frequently and can be a little bit more tricky is going to be ferritin. So not a lot of doctors test for ferritin. They might test you for other iron deficiency labs but might miss this one. And ferritin is one of the I guess, kind of first markers that you might be deficient in iron. Ferritin levels are going to correlate with, um, how well you can utilize your thyroid hormone. So I'll see lots of people who will take medications like Synthroid or levothyroxine, and they still have hair loss, they still have fatigue and brain fog and cold intolerance. And all of these symptoms that are kind of, kind of thyroid symptoms and kind of anemia symptoms at one— at the same time. And the research has shown that low ferritin levels essentially are going to lead to poor utilization of that thyroid hormone and even to poor conversion of T3— T4 to T3. Generally, functional medicine practitioners will use a medication like Armor Thyroid that contains the, the T3 hormone, which is like the active thyroid hormone that we need to convert from the traditional prescriptions. And so that actually kind of bypasses that ferritin system. And so people will get a relief of their symptoms when they're on something like an Armor or natural desiccated thyroid, but they still might have that low ferritin. And this is oftentimes something that even you know, the best functional medicine doctors miss. And so, you know, low ferritin— again, we need something like 80 to have our hair growing back, to have that— our brain working, to be able to properly generate heat.

Well, that's fascinating. So for everybody here, again, you mentioned vitamin D between 60 and 80. You mentioned the B12 levels. Also ferritin levels, critical. And, um, and then the, the ferritin isn't one that heard very many people talk about. I've heard, you know, D, B12, some ferritin. That's really interesting and makes a lot of sense. And there are— I mean, when you think about anemia and hypothyroid or borderline anemia, you're again, exhaustion, fatigue. Those are kind of those two of those big overlapping symptoms that so many people have today. I'll tell you, when I fully ran my functional medicine practice, which now I have more of an online clinic, but before when I was meeting people in person Like, when I was graduating, nobody told me that probably the number one condition I was going to see was hypothyroidism, you know. I mean, I think that was one of my biggest surprises of going into practice. I'm like, almost every woman I see— especially because it was a lot of women coming in in their 30s and 40s, you know, moms that were stressed and working hard— and every one of them said, I'm tired, I'm exhausted all the time, and, or my hair is thinning, or I've got dark circles under my eyes. A lot of saying, you know, I'm starting— my metabolism isn't what it used to be. All of these symptoms you're sharing, there are just so, so many women suffering with this, which is again why I love your mission and what you're doing. You know, when you look at sort of— let's go to the underlying causes. You know, you wrote a book that was a fantastic book. It was one of the first books I read really in depth on thyroid health, and it was called The Root Cause. It was really helping people get to the root cause of Hashimoto's and hypothyroid and thyroid conditions. What do you see as some of those underlying— you know, it could be your top 3, top 5, whatever it is. What are those top underlying causes today that are at the root of Hashimoto's and hypothyroid?

Oftentimes food sensitivities, nutrient deficiencies, poor stress response, detox backlog, and then some kind of gut infections or other kind of infections in their body that really set off that immune system. And so we talked a little bit about the nutrients. We can get into specifics of some of these other ones if you'd like.

Yeah, wow. Yeah, I mean, let's, let's get into a few of those there. Um, let's get into, uh, the first one you mentioned. Share a little bit more about, about, you know, that, that being a root cause.

So as far as food sensitivities go, food sensitivities are going to be a common driver of symptoms. I first came across the connection between gluten and Hashimoto's— there was a study done in people who had celiac disease and subclinical hypothyroidism, and the researchers found that when a certain percentage of these individuals were put on a gluten-free diet, their thyroid function normalized. And this was again at the beginning of my healing journey, so I thought, oh, I should get tested for celiac disease. Maybe this will be relevant for me. My celiac test was negative, and so I didn't go gluten-free. But then about after a year after that, I decided to utilize some food sensitivity testing that showed that I had sensitivity to gluten and dairy. And so I was like, okay, let's give this a try. And within 3 days of going gluten-free and dairy-free, my irritable bowel syndrome resolved. My carpal tunnel started resolving, and my acid reflux was like gone forever. And then I also, um, the bloating that I had resolved. And again, I didn't have celiac disease, but a lot of my quote-unquote thyroid-related symptoms improved. And then as time went on, my thyroid antibodies also improved. And this happens to a lot of individuals. I would say 80% of the people that I've that I've worked with and surveyed, they do feel better gluten-free. So some of them might go into complete remission, some of them might just feel a little bit better. There, you know, there's a big spectrum of what might happen, but for most of them, they do feel significantly better. And then about 80% of people feel better on a dairy-free diet. The, the kind of leading additional contender is going to be soy. Unfortunately, um, I learned this the hard way when I first went gluten-free. I was like, oh, this is a gluten-free food, this is a gluten-free food, and I ended up getting a lot more soy and processed foods into my diet versus, you know, actually thinking about like a real, real food diet, right? Rookie mistake. And so soy can actually be a potent driver of thyroid antibodies as well, um, as well as high sugar, you know, that low, low protein and low fat diet I know I grew up watching Subway commercials. They were like, get more carbs, get more carbs, and eating a lot of carbs and sending your body into these blood sugar swings. This is a real— another potent driver of that autoimmune thyroid response.

Wow. Let's talk about the last one now. You talked about the gut microbiome, the importance there in connection to the thyroid health. Talk to me about what, what are— what's the connection and what are some things people can do practically?

As far as gut health goes, in my experience working with, um, various people and testing their gut microbiome— so I've used tests like the GI Map, and which are DNA tests, and I've also used parasite tests to see exactly what they had growing in their system— about a decade ago I started seeing something called Blastocystis hominis, which is like a one-cell protozoa and I saw it in a large percentage of my clients with Hashimoto's, and I was like, okay, that's interesting. So I reached out to some of my mentors who were like, no, we're not seeing the same level in our client population. Um, when I started working with that particular protozoa, which has been tied to chronic urticaria, which are hives, and irritable bowel syndrome, as well as other skin issues I started noticing that people's thyroid antibodies were reducing, their food sensitivities were reducing, and some people— not everybody, but some people— were able to normalize their thyroid function. Um, and this has been really interesting now because researchers have now documented this link between Hashimoto's and Blastocystis hominis, that this particular protozoa can essentially shift our immune system, and getting rid of it can get a person to go into remission from Hashimoto's, irritable bowel syndrome, and then chronic hives. Now, when I first started off, people were, were really like, okay, there's nothing that can get rid of this, this thing is really hard to get rid of. Turns out it's not. Actually, utilizing a probiotic, a beneficial yeast known as Saccharomyces boulardii, can get rid of this in 1 to 2 months. Just utilizing that beneficial yeast in about 80% of cases. So this is something that's gentle. You don't have to necessarily take heavy-duty medications for it or do crazy cleanses or crazy kinds of herbs and tinctures and whatnot. Generally, a probiotic can help with restoring your gut flora and getting rid of a lot of these unwanted visitors that could really shift the immune response.

Yeah, it's so good. You know, I was doing a, um, I did an episode on thyroid here recently, and one of the things I talked about was this sort of gut relationship. And, um, and one of the things that I found fascinating was— and, and you know this as well— but it's just this, it is so important that our gut is healthy for so many reasons. One is nutrient absorption. So you mentioned B12 earlier. I know there's other nutrients tied to thyroid health, and I, I I know this from my own research. Also, I know you know this because I've read articles that you've written on this about vitamin B1, thiamine, riboflavin, folate, again B12 here. There are two studies here. One, if you're supplementing with— this was just a low-dose probiotic, this wasn't like a great brand, uh, great product, but, uh, it increased your absorption of B vitamins and utilization of them by 30%. Another study out of Stanford showed around 50%, and also it shows it helps to synthesize and create more of these vitamins that are critical for thyroid health. So to your point there, you know, getting your gut healthy is so important. I also think it's really interesting, you know, uh, when you talked about the H. pylori, that connection there as well, uh, in terms of, um, if your gut microbiome is not healthy, what starts to happen if that creeps up into a stomach with that B12 absorption, as you mentioned. And so, and I think that's obviously not just— it's, it's, it's probiotics are important, but stress reduction, as you mentioned, of course, is really big for that as well. But it's just so, so interesting. Talk to me a little bit more about— I'd love to hear. I, um, came across some really interesting research on birth control as a medication and developing hypothyroidism later on in life. In fact, the stats are really shocking to me, and I'm surprised more people don't talk about it. We know that birth control increases— you know, it has a big effect on estrogen. Talk to me about the relationship. Feel free to make, make a comment on birth control thing. If not, just skip over it. But my primary question there is talk to me about the relationship between estrogen and thyroid hormones.

So it's funny that you mentioned that. The very, very first blog I wrote on my website, Thyroid Pharmacist, in 2013, was about the birth control and thyroid connection, right? Wow. So, and I don't— I think the title is, can birth control sabotage our thyroid health? And there's a lot more research these days on this. At this time, at the time, there was some research regarding how it can impact different nutrient absorption, right? So we know that iron and zinc and all of the B vitamins, they're really going to be helpful for our thyroid hormone production and balancing our immune system. It can also shift our microbiome. It can shift our preference for mates, right? And the other interesting thing is, is it can put us in this bit of like a suspended state of our hormones, right? So it could really shift our hormones to a different, different kind of place. So we're getting synthetic estrogen and synthetic progesterone and it essentially suppresses our own production of hormones. And so it creates kind of this like quasi-pregnant state. And we know that there are certain antibodies that are driven and increased and changed during pregnancy, and various autoimmune conditions have been found to correlate more frequently with pregnancy. One of them is Hashimoto's and hypothyroidism. And so the birth control can really just I mean, it can act on so many different pathways, whether that's our microbiome or our nutrients or even shifting our immune response. And then, of course, there's that estrogen and thyroid connection. So whenever we have more estrogen on board, that's going to make— that's going to be binding some of our, our active thyroid hormone as well. And that can impact— that can increase our need for thyroid hormones.

Yeah, it really is amazing. And so I don't think that there are— so, and there are recent, you know, more recent and there are some really recent studies that I was blown away by. I mean, one of them showed— I mean, the, the increase was astronomical if you've been on birth control for about 10 years. And the amount of women that go in high school, late high school, get prescribed it, they're on it for 5 years, 10 years, and then end up with hypothyroidism 5 to 10 years later— it's, it's, it's very, very high. I know, I know, as you've seen. Um, you know, I, I— we've, we've covered a lot of different things here. I want to continue to talk a little bit more about, uh, we talked about nutrients. I do want to talk about diet a little bit. Um, there are a lot of dietary philosophies out there when it comes to hypothyroidism. I had a patient come in once who was on a paleo diet, and I think she was shocked to find out that I told her— and again, and by the way, we, you and I haven't talked for so long, I'm trying to remember exactly where you are on diet. I think we're probably pretty aligned, but I'm going to be interested to hear this. But she was on a, a paleo diet, eating lots of nuts, lots of seeds, things like that. And I told her, I said, this is not the best diet for you. I actually recommended she do some rice that made into congee, do some sweet potato, because she was doing almost no carbohydrates at all, almost keto/paleo. And she was really shocked by it, but we were able to, you know, just see amazing results. She was struggling with fertility, was actually the main thing, but hypothyroid with it, and was able to get pregnant. But I would love to hear your thoughts on what does the ideal diet look like. And maybe it's not the same for everybody with with Hashimoto's or hypothyroid. But what are some of the biggest food culprits? You, you just say— now you mentioned dairy and gluten. Okay, generally those need to be out. What are some other things that definitely need to be out of the diet? And what are some of those foods you think are really essential to, to thyroid function and health?

So I tend to be diagnostic. I think the right diet is going to be the right diet for the right person.

Yeah.

And there are definitely some people who would benefit from a paleo diet, and there are some people that do just fine on the standard American diet, right? Then there's others that really do well on a vegan diet. And so how do we tailor that to the individual? In my experience, is going to be looking at— you want to get rid of the foods that are inflammatory to you. Generally, for people with Hashimoto's, gluten, dairy, and soy can be very highly inflammatory. Those are kind of like my top 3 foods. I have seen some people that are also going to be sensitive to grains in general. They're going to be sensitive to corn. They're going to have issues with any kind of sugars. They're going to have issues— some people who have a lot of pain in their body, they might be sensitive to nightshades, or they might be sensitive to oxalates. Then there are, um, definitely some people who may react to nuts and seeds, so that might be just too challenging for them to digest. And so really, we're looking at the individual as a person and then what else they're doing. We want to make sure that we're focusing on a nutrient, nutrient-dense diet. So we're eating plenty of, of really, you know, optimized grass-fed meats. We're looking at organic fruits and vegetables for most people. We're really making sure that they're getting enough protein and fat in their diet. I love to use things like avocados, good fats, right? Um, olive oil— this is going to be really helpful for them. And generally, we're going to be doing lower carbs, um, than the standard American diet, and higher protein and higher fat. But not everybody does very well on keto, especially women. And not everybody does really well— some people do well intermittently fasting, but not everybody does, right? Um, and I think one thing that I'm big— like, I'm a big proponent of is really tailoring the diet to you. So oftentimes I'll be like, let's make sure we get off of the sugar, let's get off of inflammatory gluten, dairy, soy, and alcohol, and focus on eating more protein and fat. And that's going to be a really great starting point for most people. There are some advocates that might say let's go paleo or autoimmune paleo or keto. And I think it can work for some people, but it can also become a bit too restrictive. And I also, you know, I wanna talk about the limitations of diet. If you have a gut infection like H. pylori or, you know, Blasto, diet isn't gonna cure that, right? So you might need to do some additional interventions, whether that is gonna be some probiotics or herbs to really reset that so that you can actually tolerate more foods. 'Cause unfortunately I've seen people that just eliminate more and more foods and then they're just sensitive to whatever they're eating. And that's because of that gut infection that could be driving their sensitivities. H. pylori shuts down our stomach acid production so that we don't digest anything and we become sensitive to everything that we're eating. And we're also not absorbing nutrients from our diet. So this is gonna be, you know, a, a big thing for me is like, let's make sure we're addressing all of the pieces. We're not just focusing on diet as a standalone. And of course stress. Right? If you have— you could be eating the best diet in the world, but if you're just like, um, walking around because you're— and everybody— and you're just living a very stressful lifestyle, you're not sleeping, you're overworking, you're overextending, then that diet is, is not going to really be able to work as well in your body.

Yeah, that's so good. You know, when you— and, and I, I am very much in alignment with— I mean, everybody who needs something personalized for the most part. I even within specific conditions. I mean, there's of course some overlapping things, as you had mentioned. Uh, we need to keep sugar under control, insulin. Of course, that's going to impact thyroid hormones as well. Uh, more protein, making sure you're getting some healthy fats. I love that advice. Uh, talk to me about what you've noticed in practice, and maybe there's some studies to back this up. What are the most effective herbs and supplements that you've seen really help people with Hashimoto's and hypothyroid?

So aloe can be really great. So this is something that can reduce thyroid antibodies and in some cases normalize thyroid function when used for a very extended period of time. This was a new study that I was very shocked and excited to learn about within the last 5 years. Um, something that also can be incredibly helpful is utilizing myoinositol. This has been traditionally used for PCOS. And also obsessive-compulsive disorder and diabetes. But this is something that can actually optimize thyroid function in people with subclinical hypothyroidism. When they use that along with selenium, it can normalize the TSH, and it can also get the thyroid antibodies into remission— just those two nutrients alone. Um, the other thing that I really have found to be very helpful is berberine. So it does improve the tight junctions in the gut. It is an herb that has a lot of antimicrobial activity, so it can be helpful against H. pylori and Blasto and Candida, yeast, all of these other types of gut imbalances and infections. And it also can be very helpful for balancing blood sugar and for women that struggle with weight. This can be a big game changer too.

Wow, that's great. So great. What about lifestyle practices? Let's talk about sleep in particular. Um, and when, and when you have somebody come into your practice or you're virtually consulting with them, what's sort of the checklist? Okay, you might look at their blood work, you might look at their diet, you might look at some supplementation. I mentioned sleep. Along with sleep, are there any other lifestyle things that you or you know, give your recommendations for, for sleep, but also any other lifestyle adjustments you think are necessary.

One of the big things that I commonly see in people with Hashimoto's and hypothyroidism is this impaired stress response. And so their adrenals are going to be way off. Sometimes they might have, um, kind of like that adrenal burnout. Sometimes they might have cortisol that's too high. And so a big part of what we're doing is we're focusing on stress reduction and the drivers of stress in their lives. The fastest way to get into that adrenal dysfunction is, of course, sleep deprivation. So we're really focusing on getting sleep. You know, I know before I had my son, I was like, everybody should get more sleep. And it's not always easy, you know, if you have children or if you have— if you work the third shift. Right? So, so really the ideal would be 8 to 10 hours. And yes, research has shown that women need more sleep than men do, right? Typically a lot of the research on sleep has been done in men, and women, we do need more sleep. Getting that per night would be ideal. I know it's not always realistic, um, and this is why I wrote my book called The Adrenal Transformation Protocol, because there are other things you can do to really reset your stress response. Like, sleep is the easiest one, right? You get more sleep, you're gonna feel better. But there are other drivers of what I call safety in your body. So essentially, part of what happens with our adrenals is when we have too many danger signals— so we're overworked, we're underslept, we're eating inflammatory foods, we've got infections in our bodies, we're watching the news and it's all bad news, and we're we're dealing with, um, work drama or, you know, family drama, whatever drama we're dealing— toddler drama, whatever we're dealing with at the moment. And we just get this overwhelm message from, from our environment, right? And then our body picks up on that. And what is really helpful from an evolutionary standpoint when we are under a lot of stress is to hibernate and slow down thyroid function. And so This is what our body does when we're under so much stress. It basically will suppress some of these vital functions— their vitality functions, I guess I should say. So our, you know, we're going to put on weight because our body thinks that we're stressed. That must mean there's a famine going on, right? And we're going to have trouble with brain fog and we're going to, we're going to be exhausted. And so the way to shift that is to really focus on those safety signals. So what are the things you can do in your life that bring you pleasure and that make your body feel safe so that it can get into that thriving state. Um, typically I'll say like, let's cut out the news. So instead of watching the news, can you play some music that you really like, right? Instead of being stuck in traffic and being really miserable about it, maybe you could listen to an audiobook and that can kind of make your drive home enjoyable. Maybe you're doing chores that you hate. At home. So you turn on a podcast, and so you're listening to a podcast and maybe just cleaning up a little bit as you do that. And then probably the thing that shifts people's, I guess, from burnout into thriving really quickly is pleasurable activities. So this is essentially you just do things that you enjoy. I know it sounds so like so basic. It's good. But some of us need that permission because, you know, you're, you're a parent, you're a business owner, you have elderly parents to take care of, right? You've got all these responsibilities on you and you don't really take the time to do things that spark your joy and that give you that energy. And so I have, um, I've taken over 3,000 ladies through the Adrenal Transformation Protocol, and we really focus on let's just do things you love. What is it? Spending time in nature? Is it gardening? Is it browsing at a thrift store or going to a farmer's market? Take the time to do those things and try to incorporate that into your day-to-day life and you're going to feel better. Like, it just, it's remarkable. I, you know, I love supplements. I love food as medicine, but sometimes just this pleasurable activity can be the big shift in your life?

It's so big. It's probably the biggest thing we're overlooking today. I mean, I think that people are aware of diet. I don't think people realize sort of their emotional and mental and spiritual state, how much it affects our physiology. Obviously, there's a real strong connection between the mind, the spirit, and the body. And I agree with what you're saying. You know, I was— I was— there was a study I saw recently, and I want to say it was on cortisol specifically, um, but it was some sort of stress hormones. And they went and they looked at what are the activities that most lower exercise was very high on the list. Um, but the highest was dancing. I mean, you know, just going out there, dance with your spouse, dance with kids, dance by yourself, but just dancing actually was— and it was by far, I'm talking about like the greatest thing you could do in order to change, you know, shift yourself hormonally. It was really, really sort of incredible there. And so anyways, to your point there, do things you love, do things that bring you joy, uh, as a form of stress reduction, balancing hormones, I think is great. Last question for you: what are the 3 biggies? You know, we— there's oftentimes we hear so much information, even on a podcast like this, it's like kind of drinking out of a fire hydrant. There's a lot of things you covered, but if people want to shift their thyroid health, what are kind of the 3 big things you say, okay, if you can do these 3 things, I think, you know, I think you're going to see a big shift in improvement?

Definitely blood sugar balance is going to be key for most people. So eating more protein and more fat, fewer carbohydrates, getting off of the foods that are highly inflammatory— gluten, dairy, and soy— is a great place to start. And then addressing some of the core nutrients. So oftentimes vitamin D, B12, ferritin, and then I oftentimes will recommend selenium and myoinositol for most people. And then something, um, magnesium and thiamine. And magnesium can help people sleep, thiamine can help people have more energy. And this is really a great place, like a great starting point, where I would say 60 to 80% of people are going to feel significantly better just by doing those 3 things. Within, within 1 to 2 months, they should see a huge difference. And you can actually start seeing major changes in sometimes 3 to 5 days with the diet changes or some of the nutrients.

It's great advice. It's great advice. Um, again, Isabel, it's been so great talking today. I think that, again, I've admired your work for years. You're one of the world's leading experts. Again, I, I always believe, listen, if you want to get well or change your life in any area, you need to follow the top 1% of the 1% of the 1%. And that's Dr. Isabella here. So if you're saying to yourself, I need to get my thyroid healthy here. Follow her work, listen to her. She is, of all the people I've come across in my career, one of the top 1% of the 1% I mentioned when it comes to helping people heal their thyroid. Uh, Dr. Isabella, let us know some of the places, specifically, you know, a book that people could read that you've written, social where they can follow you in order to learn more.

Thank you so much for having me. What an honor and a joy to be here with you you today, and thank you for all the work that you're doing in the world helping to heal so many. Um, my website is thyroidpharmacist.com. You can find me on Instagram under Isabella Wentz PharmD, Thyroid Pharmacist on Facebook, and my books are on Amazon and wherever fine books are sold. My first book is Hashimoto's: The Root Cause. That goes into all of the research behind how to get Hashimoto's into remission. My second book is called The Hashimoto's Protocol, and that really focuses on specific, like, action steps that you can take. So it's got some of those specific supplement recommendations that people really love. And my most recent book is The Adrenal Transformation Protocol, which is really how to reset your stress response and shift things like anxiety, brain fog, fatigue Generally in 2 to 3 weeks, we can see huge transformations in those. If you, if you kind of give yourself enough of those safety signals.

It was so good. So good. Well, Dr. Isabella, thank you so much for coming on today. Everyone, thank you so much for listening here to the show, my show, The Dr. Josh Axe Show. Remember, each and every week I'm bringing amazing experts like Dr. Isabella here. Uh, and so, hey, don't forget to subscribe, like, and share this podcast. There are millions upon millions of people suffering with thyroid conditions. There are millions upon millions of people that don't know they even have a thyroid condition. So help be on mission with Dr. Izabella and I. Help spread the word on how to heal naturally. Uh, you know, text this to a friend, post on your social media, let people know, and make sure to tag myself and Dr. Izabella when you do as well. Uh, thanks everybody for being on mission with us. I hope this has added much value to you as it has to me. Me and my life as well. And, uh, again, hey, don't forget to subscribe as well so you don't miss another incredible episode like this. Thanks again to Dr. Isabella Wentz. If you're watching on Facebook, leave a comment. We'd love to hear what is your biggest takeaway from the wisdom that Dr. Isabella shared with us today. Thanks everybody, we'll see you on the next show.