The Functional Nurse Academy Podcast

The Root Cause Approach to Thyroid and Autoimmunity with Dr. Izabella Wentz

• Melissa Schreibfeder • Episode 19

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This episode is brought to you by Functional Nurse Academy

In this episode, Melissa is joined by one of FNA's top referenced experts Dr. Izabella Wentz, PharmD, to explore the root causes of thyroid dysfunction and her evolution from a conventionally trained pharmacist to a leader in integrative pharmacy. They discuss the widespread mismanagement of hypothyroidism, including why many patients do not feel better on T4-only medications like levothyroxine. Dr. Wentz explains the critical connection between gut health and thyroid function, including how IBS may be a symptom of deeper issues like SIBO and intestinal permeability. The conversation also highlights key triggers of Hashimoto’s and the role of nutrients like selenium and myo-inositol in lowering thyroid antibodies. This episode emphasizes the importance of looking beyond standard lab ranges to truly optimize patient outcomes. 

Dr. Izabella Wentz's Books:

Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause

Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back

Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health.

Adrenal Transformation Protocol

IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, 

Dr. Izabella Wentz's Links

https://thyroidpharmacist.com/

https://www.facebook.com/ThyroidLifestyle

https://www.instagram.com/izabellawentzpharmd/

https://www.youtube.com/user/ThyroidPharmacist


Functional medicine training for all other healthcare specialties and health and wellness coaches:

This show is also syndicated every Tuesday at 10am EST on The Nurses Report on America Out Loud Talk Radio 


SPEAKER_01

Hello, and welcome to the Functional Nurse Academy podcast. This is your host, Melissa Schreifetter, owner and founder of the Functional Nurse Academy. Welcome everyone. I know every week I'm like, I'm really excited about this guest, guys, but I am super, super excited about this guest because I have joining me one of the experts that I frequently reference in my educational programs in regards to thyroid and Hashimoto's, and also in regards to gut issues, because she has been doing so much to just pioneer this movement, bringing functional medicine to these conditions that are so underserved in conventional medicine. So I am so excited to have joining me today Dr. Isabella Wentz, also known as the thyroid pharmacist. Welcome, Dr. Wentz. Melissa, thank you so much for having me. It's wonderful to be here with you today. Absolutely. Yeah, I had emailed you, oh gosh, it was like a month ago, and I was like, oh, well, I wonder if she'll get back to me. And your team was so wonderful. They got back to me immediately. And so I'm so excited to have you on and then to be able to go on your platform as well and discuss all of these wonderful things. And um, I've always been really inspired by your story because, you know, again, I interview a lot of nurses on here and we talk about how they go from conventional to functional. And it's so interesting. Like what really changes people? And I would love for you to tell our audience. So, um, what brought you to the field of functional medicine and to doing all of this great work that you're doing today?

SPEAKER_00

Well, of course, like many of us, for me, it was my personal health challenges. I wasn't necessarily interested in like integrative medicine or natural remedies or even like supplements. During pharmacy school, I became a pharmacist or I wanted to become a pharmacist because I wanted to find a new drug for some kind of like weird disease, right? And throughout the process of going to school, I quickly began to realize that wow, like we're kind of just like medicating people when lifestyle, if we had taught them about lifestyle earlier on, they might be healthier. And and a big big thing that I was really focused on was diabetes. Like that was like a lot of my training during pharmacy school is like how to um lifestyle changes for diabetes and what kind of medications to use and so on and so forth. And I got very, very little training on actual thyroid disorders. I had like a one-hour lecture, and it was essentially if you have an underactive thyroid, then you need to take thyroid hormones and levothyroxine or synthroid, is where it's at. You don't want to have anybody on armor unless they've been on it for a long time. And, you know, that's an old school medication that doesn't work as well. And there was really nothing about lifestyle changes and um for thyroid disorders that I learned about during pharmacy school. And so I actually struggled with symptoms with when I was in school and a new pharmacist. I had a chronic fatigue. I had irritable bowel syndrome. I then this kind of kept progressing. I ended up with like acid reflux, a chronic cough, hair loss, carpal tunnel, bloating, um, gosh, awful, awful fatigue, anxiety attacks, panic attacks, and so on and so forth. Where I was in my 20s and I'm like, I'm losing my mind, I'm forgetful. What is happening here? And finally I was diagnosed with Hashimoto's. And being a pharmacist, I was like, great, I can start on medications, right? But the medications were not that helpful. Like I went from sleeping 12 hours a night and feeling exhausted to sleeping 11 hours a night and still feeling exhausted. So, and all of my other symptoms were still present, even with medications. And so that's how I got into functional medicine because I was like, what is what caused all my symptoms? What caused me to have an autoimmune condition at such a young age? And is there anything I can do about this now? Like, are there any lifestyle changes? And so I became, I guess, a bit of a human guinea pig. I started going on patient forums, integrative um doctors, and I started attending some functional medicine trainings. Um, and that's how I was able to get myself into remission from Hashimoto's. Uh, became an expert slash human guinea pig.

SPEAKER_01

Yeah, and your story is so wonderful because there are so, and again, we know that there is a lot of gaslighting in the healthcare system because again, conventional medicine, we know that that system is not set up to spend enough time with people. And then we know there's a lot of issues with uh standard standard of care guidelines being outdated. And for years, you know, when you were mentioning all of your symptoms, I was like, oh yeah, like I'm pretty sure I had all of those symptoms myself. And also in my 20s, I had all kinds of signs that something was wrong, but I was being told it was in my head. And then I remember when I did get the diagnosis of Hashimoto's, I was like, finally, I'm not crazy. There is something wrong with me. But then I'm like, well, that's not good to have something wrong with me. And I would love to touch on the medications. So this is something that I teach my students that many individuals who do have hypothyroidism, because we do have a population of people that they do require thyroid hormone. Like me. My uh by the time I got diagnosed with Hashimoto's, uh, my thyroid basically looked like Swiss cheese, like it is just not doing well. Like I need some thyroid hormone. But a lot of individuals go on thyroid hormone and they still feel awful. And then so many people are only being offered levothyroxine. Can you explain why so many of those people still feel bad and then what the issues may be with levothhyroxine?

SPEAKER_00

Yeah, absolutely. And so definitely you want to be very transparent that if somebody has had Hashimoto's and autoimmune thyroid disease for a while, usually people get diagnosed when they've had it for five, 10 years, which means their thyroid gland has been under attack for that long. They may really benefit from medications. Um, they really may need that additional thyroid hormone. And that can be a part of their healing journey, but oftentimes they need to do a bit more than that to really get rid of their symptoms and get the condition into remission and sort of like stop the inflammation and attack in their bodies. Now, the challenges with medication therapy is that levothyroxine being the most commonly prescribed drug for hypothyroidism, it's also, um, I think GLP1s have beat it out, but for many years it was the number one prescribed drug in all of the United States. Um, this medication is known as a prodrug. So it basically is the T4 thyroid hormone that is metabolically active, but our T3 hormone is the more metabolically active one. T4 to T3 conversion happens really well on paper every single time. Like you just take off an iodine molecule and then you have T3. This doesn't necessarily always happen in the body. And so, what can happen when somebody gets levothyroxine, their doctors and the, I guess, conventional medicine might assume that they're gonna turn it into the more active thyroid hormone in the amount that they need, but this doesn't always happen. So people can have genetic variations uh for why they can not convert make that conversion happen. They can have nutrient deficiencies such as selenium and zinc that can prevent that conversion from happening. They might have some liver backlog issues or gut issues. So a lot of the conversion does happen in the periphery. And this is again, a lot of times people will get on this medication and they're like, I still have a ton of different symptoms. So one particular reason is that you're not converting that medication properly. Another issue that I oftentimes see that's underappreciated is people might not be absorbing the medication properly. So even if they were to convert it really well, they might be um chugging their medication with coffee and levothyroxine. Um, most versions of it are poorly absorbed in the GI tract. And anytime you have even a little bit of food, anything other than water within 30 minutes to an hour, certain supplements, this can really impair your absorption. Even if you have something like gastritis or um lactose intolerance, this can actually impair the absorption of your medications and you can be getting inconsistent levels. The way to bypass that is to use like a gel cap formulation known as tyrosint. And then there's also all of these other imbalances. So there are reasons a person may develop autoimmunity, and a lot of times these reasons, like let's say a chronic infection, they can persist in the body, and you still need to treat that. You don't just give a person more hormone, right? If there's an infection that we have there, there are consequences of having low thyroid hormone. So let's say a person who has had hypothyroidism for quite some time, they're oftentimes going to have um low stomach acid. This can lead to them having low levels of B12 for protein absorption. And this can also lead them to have um issues with not enough iron or ferritin. Uh, ferritin is the iron storage protein, and this is oftentimes going to be low in people with hypothyroidism. And the thing here is that you need it for proper conversion of T4 to T3, and you need enough iron to carry the thyroid hormones into cells. So sometimes people will be on that levothyroxine, but they're still uh iron deficient or anemic, and they're not going to feel good, right? And so we do need to correct anemias, we do need to correct a lot of nutrient deficiencies, blood sugar imbalances. There's a whole bunch of different things that are happening when a person gets to the point of having autoimmune disease. It doesn't just like turn on one day at random.

SPEAKER_01

And also, it is not normal to see all these individuals that are just falling apart. And I say all the time, I'm like, your thyroid, God designed our thyroids to last us for like a hundred years. You know, I mean, my thyroid um basically cracked out when I was 31 after I had my first baby. That's not normal. There's reasons why it is happening. And something else, there's so much of what you said that I am just like, yes, I am so glad that we have a pharmacist that is well versed in this that can really speak about this with authority because I think that there are so many individuals that have Hashimoto's, hypothyroid disease, and then they have other symptoms. They may have depression. So they go on an SSRI, or they again they may have anemia, but then the provider is like, well, take iron, which again, that's okay when we're correcting deficiencies, but we always want to ask the question why? You know, we shouldn't just be dependent on more medications or even more supplements. Um, dependencies just shouldn't be the answer, you know. But I also wanted to touch base on the you mentioned about level thyroxine and about how there are issues with absorption. And we know that so many individuals with Hashimoto's also have gastritis, and we pretty much all have gut issues because we know that leaky gut intestinal permeability is a precursor to developing a thyroid condition. So I think it is very interesting that that tends to be the first recommendation. And then there's so many patients that they are diagnosed with hypothyroidism, but they're really only offered levothyroxine and they're not being provided with that informed consent about other options. Um, quick story about what happened with me. I, okay, so my personality, I am so bubbly, it's like kind of annoying, okay? When I was on levothhyroxine only, T4 only, I was a different person. Like I was legitimately struggling with depression and not feeling like myself. And that immediately, immediately it went away when I went on combination of a higher quality T4 and T3. So can you speak to that? Like, do you also see that in women where they may have depression and anxiety? And then it improves when they're properly uh medicated on thyroid hormone. And then also, do you have feedback as to why we see so many people feeling the T4 only therapy? Like, why is that still the initial go-to in the standard of care guidelines?

SPEAKER_00

Yeah, absolutely. What you described is so, so common that women will get prescribed levothyroxine or synthroid. And they think this is the treatment option that is like the one treatment option. And that's maybe what their endocrinologists and their primaries, their pharmacists and nurses tell them. And they're like, okay, I'm on this medication, but I'm not really feeling that much better. So they may struggle with hair loss, they may struggle with depression, they may struggle with excess weight gain, ongoing fatigue, like a really like a part of themselves is missing. And this is again, these are symptoms of hypothyroidism or underactive thyroid. And uh the T4 medications, they don't always convert to that T3. But guess what? There are T3 containing medications that patients can get on directly to kind of bypass that system of conversion if for whatever reason they're not doing that conversion on their own really well. And um like people can get on something like Cytomel, which is an addition to their T4 medication, they can get on compounded T4, T3 medications, they can get compounded T3, or they can get natural desiccated thyroid medications, which um contain T4 and T3 already, kind of as a mix that people can just take as one daily pill. And these are generally going to be derived from the glands of animals. So I feel like lethhyroxine became the standard of care, the synthetic version, because for a while the animal-derived thyroid products were the mainstream of therapy, but the way that they were analyzing how much thyroid hormone was in them was based on iodine content, which can vary depending on like the the source of the of the glands. And what was happening is that there was inconsistency between batches. So you would get your natural desiccated thyroid medication one month, and you'd get stabilized, and then you would get a refill, and then your levels would be unstable. Now, since that time, we have had we now have better assays to really measure the amount of T4 and T3 that are within the glands, and so we can standardize that much better. But you know, pharmaceutical companies they were really um, once synthetic thyroid hormone became available, they were really doing their due diligence to market that as a superior, more predictable, more stable option. And so I feel like that was something that really fell into favor. The other thing, and an old, an older um pharmacist that I know that who is now retired, Carter Black, had told me that back in the day, doctors used to use T3 in like the weight loss kind of extremes where they would give people T3 who did not have thyroid hormone issues to kind of induce an overactive thyroid. And as we know, that can be very, very dangerous. And so a lot of the older doctors who had seen that happening were led to believe that T3 was dangerous. And it absolutely can be if you overdose it in a person that does not have thyroid disease, right? So you do want to utilize um somebody that knows what they're doing. One, you want to work with a practitioner that knows how to dose all of the different thyroid hormone options. Oftentimes I'll have people say, like, how do I get my doctor to prescribe this for me? And I'm like, you don't want to. You don't want to be their first patient on something. Like, you want to go to somebody that knows what they're doing because um hormones and especially thyroid hormones, they are nuanced. They are dosed in micrograms. So having too little is gonna be a problem, and having too much can be a problem too.

SPEAKER_01

And it really is so important to have a supportive health care provider on board. And again, in my business, I am very clear that I am a registered nurse. I am not a nurse practitioner. I cannot write prescriptions for anything. But one of the top reasons why I am reaching out to the primary care provider of a client that I'm working with is because I am advocating for someone's thyroid hormone to be re adjusted. And I have seen so many of these cases where individuals are having all kinds of gut issues, fatigue, anxiety, depression. And again, thyroid hormone, there are so many functions for thyroid hormone in the body. There's even a role that thyroid hormone plays in our production of stomach acid. I mean, there are, and this is one of the reasons the thyroid is so important. There's like over 200 symptoms associated with low thyroid. It's really significant. But I have seen just miraculous, wonderful changes in the individuals I work with by, you know, advocating for them to ensure that they are properly managed. Because again, if we're working with people to get them well and their thyroid is sluggish, no matter there, there's no amount of like the right supplements or the right nutrition that's gonna fix that if the thyroid is low. And that puts a lot of stress on the body too. And one thing that I tell my uh students is I'm like, okay, if you are looking for a thyroid savvy provider to refer to, I actually recommend reaching out to the local compounding pharmacies and then asking the pharmacist there, hey, do you have a list of the providers that are prescribing compounded thyroid hormone? Because those are the ones that are savvy. And yes, that that's true. I mean, I think there might be a lot of good, very um well-intentioned providers. And they're like, sure, you want natural desiccated thyroid hormone. That sounds great, but then they don't know how to properly dose it. And I've seen that as well, where there are, you know, side effects to individuals going on these medications, but it wasn't because it wasn't necessarily a good fit. It wasn't the correct dosage.

SPEAKER_00

So yeah, I use that, I use that recommendation too, because if somebody knows how to utilize compounded thyroid meds, that probably means that they know what they're doing with um with utilizing all the different types of thyroid meds.

SPEAKER_01

Yes. And now that I recall, I've read so many of your books, that probably is a recommendation I got from you. So I do also tell my students, I actually have it in the resource guide, because again, if we're going to be good practitioners, we are always, we are always learning. And there are individuals that have integrity and have been doing a lot of solid research in these areas, like Dr. Isabella Wentz. And I mean, you've just contributed really. I think if you put in, you have so many articles published on this. I mean, if you put in anything thyroid related and just put in Wentz, I mean, there's so much information out there. And I would also love to touch on endocrinologists real quick. And again, like I'm sure there are and the endocrinologist that diagnosed me was extremely kind, you know, but um my antibodies were in the 7000s, and she told me it was mild to moderate, and that there was really nothing I could do on my own to get the antibodies down. And I am seeing in my business, the clients I have who have hypothyroidism, the ones that are being managed by endocrinologists consistently are the sickest ones. And that is where I see the most mismanagement of thyroid medications. Uh, do you have any insight on that? Because when we think endocrinologists, we think like, oh, well, this is the go-to specialist in this field.

SPEAKER_00

I feel like many endocrinist endocrinologists can be incredibly helpful for diagnosing a person with Hashima. Potentially doing a thyroid ultrasound, but a lot of them are actually like diabetes specialists and then not necessarily thyroid specialists. There are endocrinologists out there that are integrative and that do focus on lifestyle changes and utilize a whole array of different medications. But I will say that they are few and far between. I have met some really kind practitioners on my healing journey and um very kind, generous, beautiful hearts, healers. They definitely wanted to help, but that doesn't mean that they necessarily had the tools and resources to help. Unfortunately, that's the case with conventional medicine. Um, my own story was that I had a primary care doctor. I was having all these symptoms, and then I was found to have a mitral valve prolapse, I had acid reflux and hair loss, and then um an elevated TSH and elevated thyroid antibodies. And so I went to the endocrinologist who said told me three things. My hair loss was not related to my thyroid, that I should start on levothyroxine, the my heart issues I should see a cardiologist for, and um recommended that I see a dermatologist for my hair loss. He told me that diet wasn't going to make any difference. He told me he tested me for celiac disease. Um, very kind, very generous, spent a lot of time with me. But then I went to the cardiologist who then told me that my heart issue was indeed related to my thyroid. And then I went, I also had carpal tunnel. Then I went to another doctor and he said the carpal tunnel was related to the thyroid. The endocrinologist said it wasn't. The dermatologist said my hair loss was related to the thyroid. And I was like, oh my God, like I have the left-hand doctor and the right hand doctor, and they're telling me two different things. I'm like, I don't, I don't know what to do. And I I was like, I feel like all of this is related, right? But we do have endocrinologists that will just look at the thyroid gland. And I remember going to an endocrinology conference and asking them about the um an article that I saw in a gastroenterology journal about intestinal permeability connecting with autoimmune thyroid disease. And they were like, What? I don't know anything about that. And I was like, oh, they don't read like gastroenterology journals. They they read endocrinology journals, and endocrinology journals don't cover this. And it was like, it was just such a huge aha moment because they get so specialized, but it's almost like they they have tunnel vision and only see your neck. And they're like, they don't realize that the neck is connected to your brain and that it's connected to your gut, and then you know, that the whole body is a system.

SPEAKER_01

Yeah, and that you said all of that, that like reminds me how I'm teaching my children, you know. Uh everything is connected. And then when you go through, like it really is. And especially with both of us go going through this, and we are in healthcare, like we know how to talk to physicians. And this happened to us where we're just getting bounced around. And I I remember also having carpal tunnel and showing up at work. I had like both of my like my braces on my wrist. I also had chest pain and uh premature ventricular um contractions, which again, like it is common, but that it all, it all went away when I got properly managed on my thyroid. And then I started taking care of my gut and actually eating real food and taking care of myself. It's amazing how many symptoms really start to just diminish. And uh yes, I have seen, and again, I know I am biased because I am a nurse. I really love nurse practitioners as primary care providers. I mean, I have had so many wonderful experiences with nurse practitioners actually being very interested in holistic modalities and then being open for collaboration. And again, when I work with my clients, um, I am they are the ones that are in charge of their health. They are the CEO. I am just, I am a helper. And I, if they want me to collaborate with their endocrinologist, I will attempt. But I will say, with specialists, I do find, again, many of them may be well intentioned, but I find that many of them are just really, they're very fixated on what they learned in school. Like things don't change, you know, and a lot of times they're not open to other avenues or even other collaborations. Well, we are about halfway through the show, so we're going to cut to break. But when we come back, I'd love to talk more, you know, Hashimoto's and talk the gut. So, to our listeners, if you are a fat up nurse, just want to remind you, I can absolutely help you. At the Functional Nurse Academy, I am offering the most comprehensive functional training on the market, specifically designed for nurses. And all of our students receive 90 nursing CEs, and there are also multiple board certification eligibilities in functional medicine. So be sure that you check that out at functional nurseacademy.com. This show is also syndicated on America Outloud Talk Radio, on the Nurses Report Radio show and podcast. So you can also find me there on any major app. Welcome back to the Nurse's Report on America Out Loud Talk Radio. This is your host, Melissa Schreibvetter. I am honored to be joined today by Dr. Isabella Wentz, who is also known as the thyroid pharmacist, and she has really done so much work in this area, uh, such an underserved population. So welcome back, Dr. Wentz.

SPEAKER_00

Thank you so much for having me. I'm having so much fun.

SPEAKER_01

Anytime. No, it is so fun. Like I love to talk thyroid because there's just so much. I mean, I we could probably uh we could probably do like a whole series on this because there's just so much to know. But I would love to talk, well, touch on Hashimoto's disease. Um, you know, for our non-medical listeners, that is the autoimmune condition that can lead to hypothyroidism. And I wanted to ask you, Dr. Wentz. So I have heard numbers as high as 90% of hypothyroid cases may be due to Hashimoto's. Have you heard the similar those similar figures?

SPEAKER_00

Yes, correct. I've heard that, and even higher, as many as 97% of the time, that uh when a person is diagnosed with hypothyroidism, especially in developed countries like the United States, that it is gonna be due to Hashimoto's and autoimmune attack against the thyroid.

SPEAKER_01

And so for years I had all of these random symptoms. And then they were like, oh, Melissa, it's in your head. Just take this anxiety pill, which I really feel like God was like, no, don't take that anxiety pill. I had a very strong, like, no, I'm not gonna do that. Um, but anyway, I later learned that the test that they use to diagnose Hashimoto's is a if you're not using your insurance, it's literally a$14 out-of-pocket antibody test. Um, do you have insight as to if Hashimoto's is so incredibly common, if it is causing the vast majority of hypothyroid cases, like why why aren't we why isn't it standard to check for thyroid antibodies?

SPEAKER_00

I really feel like it should be. And I think our medical system tends to look at the TSH test, the thyroid stimulating hormone, as the initial screening test. If a person comes in with thyroid symptoms, let's say they're losing hair, they're cold intolerant, they are struggling with fatigue or brain fog and weight gain, uh, they will have their TSH tested. But the tricky part is that the TSH can actually be fluctuating in the first five, 10, 15 years that we have an attack on the thyroid gland. And so you might test it on Monday and it might come out normal. You might test it on Tuesday, it might be low. You might test it on Wednesday and it might be high. And so it's not necessarily a reliable diagnostic until you've had a significant amount of damage to your thyroid gland. And at that point, it is going to be persistently elevated. So that's one issue I see with it. The other issue is that um thyroid disease and hypothyroidism is so common. So when they determine reference ranges for what your lab value should be, what lab values should look like in a healthy person, they inadvertently had people with thyroid dysfunction in the pool of quote unquote healthy blood. And so they had the reference ranges very, very lax where a TSH of like eight would have been considered normal. Where we know a person, most most women of childbearing age should have a TSH somewhere right around one for optimal proper thyroid function if they're not medicated, right? Um, women that tend to take thyroid hormones, I feel like they do best with a TSH between 0.5 and 2 once they have had thyroid abnormalities. And so I just think it's it doesn't make sense. I feel like women and I feel like all women of childbearing age, first of all, should be screened for thyroid issues and specifically thyroid antibodies. They can become elevated for five, 10, 15 years before we see a TSH. They are an indication that the immune system has recognized the thyroid as a foreign invader. They have been associated with a lot of symptoms, including anxiety, panic attacks, feeling unwell, late gain, also fertility challenges, too, which I feel like um is super heartbreaking as a mom because I've seen women who had multiple miscarriages, were never able to have a baby. And they're in their 50s and 60s when somebody tests their um thyroid antibodies. And you know, it just makes me want to cry because if somebody had tested their thyroid antibodies, potentially given them a little bit of thyroid hormone, maybe some selenium, a few additional recommendations, they would be, they would have been able to become mothers.

SPEAKER_01

And um that is so, so heartbreaking to me. And I just did a show a couple of weeks ago on fertility where we talked about a lot of the missing piece of that is thyroid. The thyroid is so important. And I hear about so many of these cases where women are having difficulty conceiving, or they are having recurrent miscarriages, and no one is properly evaluating the thyroid. Or, you know, it's just uh and when I was pregnant, now the first pregnancy, I was all about, I was, you know, a very much so conventionally trained and doctorated nurse. I just believed everything that my doctor said. And my TSH was a four when I was pregnant. And they were like, that's okay, you know, and that was the pregnancy that I had severe postpartum thyroid dietis. Cause even though my TSH was a four throughout my pregnancy, they did zero follow-up testing on my thyroid, which I later learned that they were not even following the basic guidelines. Because during pregnancy, if it's above two, you need to be monitoring that and you definitely need to be checking it postpartum. And something else I think about as well is the conventional medical model still is not recognizing that there's things that we can do for autoimmune conditions besides pharmaceuticals. So I think that that's why many providers do not believe that checking for antibodies will be important because they don't believe that there's anything that you can do to lower antibodies. So could you give us insight on that? I know that you have, you've written so much on your books about how there are so, there's so much evidence and there's so many, you know, tools and resources that we can use to reduce thyroid antibodies.

SPEAKER_00

Yeah, I'm very baffled by practitioners that say that. And I've seen some conventional and integrative practitioners say that once you have thyroid antibodies, that you don't need to test them again because there's nothing that you can do to lower them and that lowering them doesn't make a difference. And I'd like to differ because I have seen plenty of interventions that can lower them, even can get them to go away in many cases. And I do find that symptomatically, a lot of people do feel better when they get their antibodies lowered. So I won't say like every single person I can correlate each symptom to thyroid antibodies, but overall, I will say the the overall clinical picture for that person improves where they feel better and their numbers are looking better. Now, okay, a lot of different pathways to resolving thyroid antibodies. I think I wrote an article about like 63 different ways to do so, right? And so one of the, I guess, fastest and simplest things that I recommend for people to do is to consider a selenium supplement. 200 micrograms per day has been found to reduce thyroid antibodies by about 40% over the course of like three to four months. Combining selenium with myoinocetol for some reason, 83 micrograms of selenium. I have no idea how they came up with that dose. And then 600 milligrams of myoinocetol. When used together, they work synergistically. Some women have been able to normalize their TSH when they had subclinical hypothyroidism. So when it was like a little bit elevated, up to 10. And they've been able to get rid of their thyroid antibodies using these two synergistic nutrients. On top of that, addressing vitamin D levels, I like to keep them in the 60 to 80 range. This for some women can get them completely into remission with Hashimoto's. Sometimes when you use these three nutrients, they do work in synergy with one another. And so a lot of my ladies, um, with their Hashimoto's and remission, a lot of times we do focus on those three things, getting them optimized. Beyond that, there are triggers that you should also know about. So, for example, blood sugar swings can trigger elevated thyroid antibodies. And if that's a trigger for you, then you would want to focus on blood sugar balance. Gluten, dairy, and soy are some of the foods that can trigger elevated thyroid antibodies. Again, eliminating those foods, if they happen to be a trigger for you, is gonna help you reduce your thyroid antibodies. Um, chronic infections, I do see H. pylori tends to be a trigger for people who have really high thyroid antibodies if they're over like a few thousand. I'm always thinking H. pyrori. Um, different types of protozoal infections can also be triggering for Hashimoto's. I have seen um blastocystis huminus, especially in the thyroid population, and treating that can get some people into remission with their thyroid numbers improving. And again, there's just there's there are like supplements you could take too, like systemic enzymes that can be very helpful, just whatever your cause is. Um, however, finding the cause, I think, is always what I like to do.

SPEAKER_01

Yes, I I love that. And and again, it is published in the literature. Like we know this, like we know that intestinal permeability is a precursor. We know that infections and toxins and certain foods and of course a genetic susceptibility can um all play a role in triggering an autoimmune activation. And also, you know, I think that it is irresponsible when, you know, within the system, someone like for an example, I had fibroid antibodies of 7,000. Like I have never even seen antibodies that high on anyone ever. And that is basically an immune system gone wild. And it's just like, why would we not even look at why is the immune system going wild like this? And I like that you mentioned the nutrients as well because those are very simple interventions. And and for an example, you know, vitamin D, we know vitamin D is so important for the immune system. It's actually a hormone in the body. When I finally had my vitamin D levels checked, I never, I only had it checked. They only checked it because of pregnancy. And my vitamin D was 18. And then, okay, so I was pregnant, and then they only told me to take 1000 IU of vitamin D. They never checked it again. And then they were like, oh, just go get something from Walmart. Um, what is wrong about that? Like when it's that low and we don't even have any curiosity about retesting it or even evaluating why it's so low.

SPEAKER_00

Wow, where do we start? So um, so that is a very low amount of vitamin D. And like you said, it's so important for immune function. It's also helpful for mood. Um, I am a big proponent of utilizing testing. And so, generally speaking, vitamin D is one of these nutrients that you can overdo. And so you always want to test, I would say, within three months of supplementing. As far as what it takes to take a level of 18 to like this 50, 60, 70, 80, 1000 micrograms or 1,000 IUs is not going to be enough. So you you probably need like five to 10,000 IUs, generally speaking. And then the Walmart supplements don't even get me started there. So, not all supplements are created equally. And I am a big proponent of quality brands that uh typically healthcare professionals, uh, healthcare professional brands that have higher quality manufacturing practices, right? So a lot of the stuff you might get at Walmart, you don't really know that you're getting what is on the label. They might have additives and fillers that can prevent proper absorption. So I'm not um, I loved Walmart for their Legos and toys, but not as much for supplements.

SPEAKER_01

Yes. And I was a bit surprised that so many healthcare professionals didn't understand that because again, when we talk about the supplement industry, it is a bit unregulated. So that's why I always say make sure that the bottle at least says good manufacturing practices as in GMP verified. And then also a lot of times when there are studies on things like supplements or vitamins, things that we know work. A lot of times I see that the trials will be designed in a way to where they will either underdose the supplement, they will not use it for enough time, or they will use a very poor quality supplement, and then they will use that trial to justify that it doesn't work. And look, but you know, the pharmaceuticals work. So there's just a lot of unfair, there's just a lot of unfair published scientific science on the, you know, safe use of nutraceuticals. And I also would like to touch, I know that you mentioned certain gut infections can really trigger Hashimoto's and autoimmune activation. And I absolutely agree with that. And I think that's one of the reasons why I got so healthy is because I took care of self-infections. You know, for me personally, I did have chronic Lyme disease, which is like throwing a wrench in your immune system when you have that much of a burden. Then you're going to, of course, end up with other dysfunctions in your gut. Like you're going to have other things overgrown in the gut. You're going to have more gut dysbiosis because the immune system is so incredibly stressed. And I really like that you are also talking about IBS because, oh my goodness, is there like a gut thyroid connection? It is so important. And I have also worked with individuals who I've been able to help with this. Um, there's so many people that have thyroid conditions. They also have IDS, or even these young individuals really suffering with IBS and they're not getting the proper help with that. Now, um, I would love to hear from you. Like, what do you think is causing a lot of these issues with IDS? Like, do you see that people can be helped functionally with this as well?

SPEAKER_00

Yeah, definitely. So chronic infections can lead to a whole host of different symptoms. When somebody has something like Lyme, for example, the borelia uh bacteria has 16 different protein structures that have been found to cross-react with thyroid proteins, right? So let's say five of them might cross-react with the TSH receptor antibodies, two cross-react with thyroglobulin antibodies. Some of them interact with thyroid peroxidase antibodies. And um, what's happening is when you have this infection in your system, your immune system starts to launch an attack against the infection and everything that looks like it. And so your immune system might be attacking your thyroid gland if there are cross-reactive proteins. It might also be attacking your gut. It might also be attacking another part of your anatomy. And we typically do see people who start off with one autoimmune condition and they end up progressing. To additional autoimmune conditions. When I went through functional medicine training, one of the really interesting things I learned was that IBS can precede autoimmunity by five, 10, 15 years. In my case, I got an IBS diagnosis. And then six years later, I got a Hashimoto's diagnosis. And what can be happening with IBS is that we have, generally speaking, intestinal permeability. And this is going to be a component of most autoimmune conditions where you have the genetic predisposition, you have some kind of a triggering event, could be an infection, and then you have intestinal permeability. And so many people that I've worked with with thyroid issues, they do have a really important and relevant gut component that needs to be treated and addressed. Treating their Hashimoto's, a lot of times we I've gotten people's irritable bowel syndrome into remission as well, where conventional medicine will have like a 25% success rate of a person being asymptomatic. There are root causes and triggers that can be identified in like over, I would say over 95% of the time. There was one study done by Dr. Haba and colleagues in 2011, and you found like 98% of the time with an IBS diagnosis, there was an under underlying cause, a treatable cause. So that you find the root cause, you treat it, and you don't have IBS anymore. And for me, I'm excited to get the word out because if we can reach people when they have IBS and autoimmunity, we can help both conditions, right? If we can reach them when they just have IBS, we can help the IBS, but also prevent autoimmunity too.

SPEAKER_01

And, you know, again, there are just so many people unnecessarily suffering. And again, back to informed consent. A lot of people, when they get this diagnosis, well, they get a diagnosis and they start to kind of identify with that diagnosis, but they're not being told that this is even an option, that that these sick, that it is possible to have a success rate that high to get it into remission. And I've even seen research saying that it about approximately 70% of the IBS cases could actually be SIBO, small intestinal bacterial overgrowth. Do you see that as well?

SPEAKER_00

Yes. And about 50% of people with hypothyroidism will have SIBO as well. So there's like this big connection. It's kind of like a, you know, a big loop that is happening. So SIBO could be an underlying cause of intestinal permeability and irritable bowel syndrome. There's also protozoal infections. One study showed about 72% of people can have blastocystis hominus, which has been tied to irritable bowel syndrome, chronic hives, as well as Hashimoto's. There are additional causes. Let's say out of everybody that's been diagnosed with irritable bowel syndrome, that's received that label, up to 25% of them might actually have celiac disease, right? And then there are things like pancreatic enzyme insufficiencies that can be the underlying cause for IBS. So I really love the functional medicine approach to IBS because we really focus on what's driving this. We're not just talking about how do we label these symptoms. We're talking about like what's actually causing them. And it can be 30 different things. It could be a nutrient deficiency, it could be a toxin, it could be an infection. And we really want to do the due diligence to figure out what is actually causing the symptoms.

SPEAKER_01

And that is why I just am such a believer of functional medicine. When when, of course, when it is done appropriately and we are properly evaluating what could be potential triggers and root causes. And, you know, it is really so rewarding to have a career where you work with people and they actually get better. And I remember when I was working in the system, I was just told that a lot of these chronic health conditions, they're just progressive and they're just gonna get worse. And we can manage it and keep them comfortable with medications. And something else that uh I have seen is that low-dose SSRIs are being used in the treatment of IBS. And we know that SSRIs have a lot of really serious side effects, including things like permanent sexual dysfunction. Um, as a pharmacist, what is your feedback on prescribing those for IBS?

SPEAKER_00

Well, I feel like it makes sense because the gut is our second brain. And so we do produce serotonin in the gut, and the gut has serotonin receptors. And so it would make sense that these medications would be utilized. However, I don't love the side effects, and I do think we have better ways. Like probiotics can actually help us produce serotonin too. So uh I am a big proponent of figuring out what's out of balance. If you have too many pathogenic bacteria and not enough beneficial bacteria, you can actually re-replenish your gut with beneficial bacteria. There is a strain of E. coli, E. coli nissle, the beneficial strain that actually helps us produce serotonin. And so we can do that more naturally and more natively without the side effect.

SPEAKER_01

Yeah, and I feel like the SSRIs, it's like a very high-risk band-aid that could potentially help with the symptoms. But then we're, again, we're just going back to ignoring what is actually causing it. And I would love to hear about your new book. So you mentioned that you have a new book out on IBS.

SPEAKER_00

Yes. So I have three books about Hashimoto's, my most popular one being Hashimoto's Protocol. And I have a book about the stress response called the Adrenal Transformation Protocol that came out three years ago. And my latest book is finding and treating the root cause of irritable bowel syndrome. And it really goes into a root cause approach to help people figure out what's driving their symptoms once and for all. So they no longer have to have IBS symptoms and they can have healthy digestion and they can hopefully get rid of a lot of other co-occurring symptoms and conditions that come with an impaired digestive system. We do know that our immunity comes from our digestive system. And so getting that digestive system handled can really help with a lot of other conditions.

SPEAKER_01

Wonderful. And again, for our listeners, I cannot tell you how many times I have pulled out the Hashimoto's protocol. Like it is, you could probably see it. It's like on my uh bookshelf behind me. But it it is so nice to have just a desk reference where, and you have everything cited so beautifully. And yeah, I definitely will be getting the book on IBS as well, because there's a lot, there's so many people struggling with gut dysfunction, and you do such a good job breaking things down, not just for just the lay person to be able, I feel like when I was very chronically fatigued and sick and overwhelmed, your books were easy for me to read. But then also for practitioners, it's really nice to have because again, it is an easy read with everything sourced appropriately. And it's such a great tool that we can use to help people, help people to figure out what is going on and what can we do to help them. So, um, and also I know we will have a lot of listeners that will want to find you and learn more about all of the work that you are doing. So, where can our audience go to find you?

SPEAKER_00

Sure, my website is thyroidpharmacist.com and they could learn more about me there. I'm also on Instagram, I'm on um YouTube, and I have a podcast called Thyroid Pharmacist Healing Conversations. So they can definitely find me there. And my books are on Amazon and Barnes Noble.

SPEAKER_01

Okay, wonderful. Well, I will be posting all of Dr. Wentz's links in the show notes. And again, thank you so much for finding the time out of your busy day with your beautiful moo baby to sit down and come on the show. I really appreciate it. Thank you so much for having me. It's been such a joy to be here with you. Absolutely. That is all the time that we have today. Thank you so much for tuning in. And again, if you want to learn more about the Functional Nurse Academy, please feel free to register for our next live webinar. And you will see that link in the show notes. You can also check out Functional Nurse Academy on our social media platforms or on our website at functional nurseacademy.com. Until next time, be safe, be well, and God bless.