How To Be WellnStrong

91: The Thyroid-Adrenal Connection: Balancing Both for Vitality | Isabella Wentz, PharmD

• Jacqueline Genova • Episode 91

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Join me in today’s episode as I sit down and speak with Isabella Wentz as we dive deep into the world of thyroid health, specifically Hashimoto’s, and the often-overlooked role of adrenal health. We talk about practical, evidence-based ways to support your body’s natural healing processes—things like nourishing your gut, balancing hormones, and making lifestyle changes that truly work. If you’re tired of quick fixes and want to understand how to address these complex issues from a root-cause perspective, this episode is for you. Dr. Wentz is an internationally acclaimed thyroid specialist and licensed pharmacist, who has dedicated her career to addressing the root cause of thyroid dysfunction after being diagnosed with Hashimoto's thyroiditis in 2009. 

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*Unedited Transcript*

Jac: Welcome to the podcast, how to Be Well and Strong. I'm your host, Jacqueline and Genova, and I'm excited to have you join me as I speak with some of the leading figures in the fields of wellness, integrative medicine, and mental health, as we discover what it truly means to be well and strong in both body and mind.

Get ready to be empowered, inspired, and motivated about being an advocate for your own health.

Join me in today's episode. As I sit down and speak with Isabella Wentz, as we dive deep into the world of thyroid health, specifically Hashimoto's and the often overlooked role of adrenal health, we talk about practical evidence-based ways to support your body's natural healing processes. Things like nourishing your gut, balancing hormones and making lifestyle changes that truly work.

If you're tired of quick fixes and want to understand how to address these complex issues from a root cause perspective, this episode is for you. Dr. Wentz is an internationally acclaimed thyroid specialist and licensed [00:01:00] pharmacist who has dedicated her career to addressing the root cause of thyroid dysfunction.

After being diagnosed with Hashimoto's Thyroiditis in 2009, her new book, adrenal Transformation Protocol, a four week plan to release stress symptoms and go from surviving to thriving is out now. This was such an awesome conversation, Dr. We is truly a wealth of information. I learned a ton, and I hope you guys will too.

Let's get into it. Well, to kick things off, Dr. Wenz, I've heard your name across so many different podcasts, and I love everything you do. I love your mission. I was like, I need to have her on the show because I have yet to talk about thyroid and adrenal health in my two years of doing this podcast. And this is certainly a topic that a lot of women, you know, in particular struggle with.

So I'd love to just do. A whole episode, again dedicated to this. It's gonna be probably the first of many 'cause there's so much to cover within the hour. But with that, Dr. Wenz, I'd love to just kick things off in asking how did you find yourself in this space? Well, in full disclosure, I was [00:02:00] never

Izabella: interested in the thyroid space, I guess, or thyroid disorders.

During pharmacy school, I took a, I think a one hour lecture about thyroid disorders where we covered hypothyroidism. And hyperthyroidism, which is underactive and overactive, and I thought they were just these boring conditions that people develop sometime in their lives and that this treatment options were pretty straightforward.

It wasn't until I was diagnosed myself with Hashimoto's after 10 years of like mystery symptoms ranging from irritable bowel syndrome to hair loss, to acid reflux, to like debilitating fatigue and panic attacks, where I realized that. The current treatment approaches for hypothyroidism, most of which is caused by an autoimmune condition known as Hashimoto's.

Were just very underwhelming. Hmm. So in conventional medicine, essentially if you have an autoimmune attack against your thyroid gland, you do nothing. You just kind of [00:03:00] wait until it destroys your thyroid and then you can start taking thyroid hormones. And I really was like, I was in my twenties, I was like, why am I.

Having an autoimmune condition. This oftentimes happens to women later in life, right? What have I done in my life to bring this on, and is there anything I can do to make myself feel better? Because although I took the medications, they were not working, and then I soon discovered from patient forums and.

Um, other patient advocates that most people actually that took the thyroid medication still did not feel better. Hmm. And so I started just really peeling back the layers of the onion and figuring out what was contributing to my autoimmune condition and figuring out how to get myself to feel better.

So I would say I became a Hashimoto's and thyroid expert by ways of being a human Guinea pig. 'cause I just wanted to feel better when I was in my twenties.

Jac: Yeah, no, that makes complete sense. Going back to to symptoms, so you mentioned a few [00:04:00] pretty debilitating symptoms in terms of testing, doctor once, and I know obviously like a conventional testing approach probably differs from a more integrative testing approach.

But what are some of the things that patients should, should be looking for in terms of blood work to see if they have Hashimoto's or other thyroid disorders? This

Izabella: is such an important question because a lot of times people might hear about thyroid symptoms like hair loss or fatigue or weight gain or cold intolerance, and they will go see their doctors and ask for their thyroid to be tested.

But if doctors only do. One typical test, the thyroid screening test, so many cases are missed, and so conventional medicine will typically recommend a screening test, which is known as TSH, thyroid Stimulating Hormone. When this is elevated, that means that your. Body doesn't have enough thyroid hormone on board because, um, the [00:05:00] TSH is released by the pituitary.

And this means basically that the pituitary has sensed that the body needs to produce more thyroid hormone. And so oftentimes people with who have had thyroid disease for 5, 10, 15 years will have an elevated TSH. Now, here's the problem with this screening test. One is, a lot of times the reference ranges are overly lax.

So a woman of childbearing age should have a TSH somewhere right around one where I know I had done this test and my, my levels were like 4.5 or five, and doctors were like, oh, this is considered normal. This isn't an issue where I felt like a sloth, right? But, uh, the reference ranges have been as lax as up to 10.

On what lab you do where really, like if you do not have a thyroid condition. Your thyroid function, your TSH should be somewhere between 0.5 and two. The other issue is the TSH can fluctuate in the early [00:06:00] stages of the condition, maybe the first five to 10 years. Mm-hmm. So one day it might show up high and then the thyroid gland begins to compensate and then it might show up normal, and then the next day it might actually show too low.

And so depending on the day you test, you might miss the condition. And then the third reason is essentially because. You have this autoimmune destruction against your thyroid and the TSH isn't going to pick that up. And so the tests I actually recommend are gonna be thyroid peroxidase antibodies and thyroid globulin antibodies.

If somebody's taking notes, I would just say, write TPO and TG antibodies and your doctor will know what those are. And these are. Indicators that your body has recognized the thyroid gland as a foreign invader of some sort, and is launching an autoimmune attack against the thyroid. And so these are elevated for 5, 10, 15 years before you'll see a change in TSH.

Wow. And they can be [00:07:00] responsible for a lot of symptoms. And when you have them, you can start really addressing your health. Many cases, get rid of all of your symptoms, lower the antibodies to undetectable limits, and then prevent the need for thyroid hormone. And some people, even with those elevated antibodies, they actually might need to start thyroid hormone, depending.

If, for example, they're trying to conceive or um, already are very symptomatic, so they're just, it's really, really good information to know.

Jac: Yeah. I'm taking notes as you're talking. So if it's between, if our TSH is between 0.5 and two, that doesn't necessarily require us having to go to do like a TPO and TG test, I would still do

Izabella: it just because if your TSH is between 0.5 and two.

It could just be the day that you tested it. It might have been. Oh, interesting. Yeah, because that TSH can fluctuate in the first five to 10 years.

Jac: Right, right. And then

Izabella: the other tests would be your actual thyroid hormones. So free T three and free T four are the levels of thyroid hormones we have [00:08:00] in our blood that could be tested, because sometimes there's a communication breakdown between the pituitary and what's actually going on in the body.

And so I've seen people that have low. Actual thyroid hormones, low T three, low T four, but their pituitary is not sensing that, and they might have a normal or even a suppressed TSH. And then last but not least, would be reverse T three. For, it's kind of a weird, kind of a weird name, but it's non thyroidal thyroid illness.

So essentially you have thyroid symptoms, but they're probably not coming from your thyroid per se. They're usually coming from a nutrient deficiency or that, um, stress component, like adrenal dysfunction can drive your reverse T three. And then typically I see if somebody is anemic. They can have high reverse T three and they'll have every thyroid symptom in the book, but they won't have those [00:09:00] thyroid antibodies and they will not, will have a normal TSH.

And then everybody's like scratching their heads, uh, that isn't functionally trained, wondering like, why does this person have every symptom in the book, but not, not an actual thyroid condition. And it's essentially how your body. Utilizes and converts thyroid hormones. Um, reverse T three will tell you if you, um, if you have high levels of it, that essentially your body is blocking your actual thyroid hormones.

Ability to interact with your thyroid hormone receptors.

Jac: Hmm, interesting. And the free T three and T four, does that also vary across like the span of, of 10 years? Or if someone takes it at a snapshot in time and it's normal, can we pretty much accurately say that like they're within a normal range? Does that make sense?

Izabella: Yeah, it depends because if you're, so what's happening in the early stages of thyroid dysfunction, you would have. [00:10:00] Your, let's say your thyroid gland is under attack by the immune system, and so a part of it is damaged. But when that TSH raises up, this is actually a signal to the thyroid to make more thyroid hormones.

And so then the thyroid gland overcompensates and starts making more hormones. And it can do that for a while where it overcompensates. So like let's say you have a part of it that's damaged, but then the non damaged part just kind of goes into hyperdrive, right? And so the T three and T four levels can fluctuate and then.

When, um, at a certain point, when advanced conditions, they're just always gonna be low unless you add in more thyroid hormone. And that's typically when your thyroid gland is damaged to the point where it can't compensate anymore, if that makes sense. And that's when were diagnosed. But it's like this process is happening for like 5, 10, 15 years.

Yeah,

Jac: I was [00:11:00] gonna say like, what's the average, I guess, like. Age where, where women actually are diagnosed with it. You said like it could happen on later in life, typically. Well, it's tricky

Izabella: because I find that a lot of women are diagnosed in like perimenopause. So typically, you know, age 35 to 50 is when they get that diagnosis and they have more of a classical presentation where they have that weight gain.

Right? And a lot of times for women, that's a red flag or weight gain or hair loss that I need to, I. Really get a comprehensive checkup and doctors are really taught to look for that. In my case, for example, I had, um, been losing weight and that can happen in the early stages of thyroid dysfunction. And, and in younger women they can actually present this way.

And my doctor was like. One of my two doctors was like, oh my gosh, I would've never suspected that this was what was going on with you. I'm gonna actually look at my other [00:12:00] patients now, my younger patients, and test their function thoroughly, because I just didn't realize how it can present differently in different people.

So the diagnosis might happen later on in life, but the condition can be happening in younger women. So typically what I'll see is. People that were very moody teenagers, that can be a sign of thyroid dysfunction, anxiety, depression. Obsessive compulsive disorder. These are all associated with early thyroid dysfunction.

When you have those high thyroid antibodies, then women in their twenties, they might present with symptoms like irritable bowel syndrome, and 25% of people with irritable bowel syndrome actually have hypothyroidism according to one study that early stage. Then women get a little bit, you know, maybe 25 to 35, and they start.

Maybe they wanna start families and they have multiple miscarriages and they can't get pregnant. And this is oftentimes due to thyroid dysfunction. But it [00:13:00] just, it really breaks my heart because I wish every moody teenager, I wish every woman with IBS. And I wish every woman that was thinking about having a baby would have her thyroid function tested because it is very much under.

Um, underdiagnosed. It, it like, I think these days we are seeing more diagnoses, but I was just gonna ask you that. Yeah. Yeah. I think we're raising a lot more awareness now and women are advocating for themselves. People listen to podcasts, they have TikTok, they have socially Right. And we're better able to advocate for ourselves.

But I know when I was in my twenties and I, I was in pharmacy school, so you would think I would have. A little bit more knowledge than the average person. Um, but still I was not getting the correct testing done and I went undiagnosed for probably 10 to 15 years. And I had all of these symptoms that doctors were like, oh, [00:14:00] you're a college student, you're stressed out.

College students are stressed out, therefore you're gonna have X, Y, and Z. Right. I really do wish, um. W diagnoses were happening earlier. Um, at this rate, I think one in five women will be diagnosed at some point in their lives with hyperthyroidism, and generally speaking, they do get diagnosed a little bit later in life where unfortunately, many of them have been struggling for five to Right.

Years before they get that diagnosis.

Jac: Yeah. Is that a condition that's reversible?

Izabella: It is. If you catch it early. So if you catch it early enough, you can absolutely get rid of your symptoms. You can get those thyroid antibodies to such a low range that your thyroid is essentially able to. It. It's like the body's always being destroyed and it's fixing itself, right?

There's like a fine balance there. When the thyroid antibodies are very high, or there's an aggressive autoimmune attack against the thyroid gland, the body [00:15:00] can't keep up with like that cell turnover, and so you get to a point where you're just gonna have more and more damage. If you get them low enough, then you're not gonna have that progression to eating thyroid hormone and you're not gonna have the symptoms.

So. There's five stages to Hashimoto's and I would say the, um, fourth stage is typically when people are diagnosed. If you're in stage two or three, wow. It's generally gonna be more reversible.

Jac: So with that doctor once, what are some lifestyle modifications that folks could take to, to hopefully reverse that condition?

Izabella: One of the biggest things is gonna be focusing on nutrition, and this is something that most people can do themselves in their own homes, is figuring out if you have triggering foods. For about 88% of the people I've worked with, gluten tends to be a really big trigger. About 80% of people. They might also be sensitive to dairy proteins and then, uh, somewhere be [00:16:00] somewhere in between that blood sugar issues, blood sugar imbalances.

So you might be somebody that has, um. If, if you're eating like a high carbohydrate diet, AKA, the standard western diet, standard American diet, switching your diet around to have more fat and more protein, less processed carbs, less processed food overall mm-hmm. Can really dramatically impact the thyroid antibodies and the thyroid symptoms really in a pretty relatively short amount of time.

Sometimes five to seven days where people will just start seeing, wow, I feel, feel more calm. And they can actually start testing their thyroid antibodies and seeing how they can get lowered within a few weeks. And then the other thing I advocate for, for people to look into doing themselves, and oftentimes it helps to have a doctor, but you don't always need one, is making sure your nutrient.

Status is addressed. Vitamin [00:17:00] D deficiency is a really, really big common root cause of autoimmune conditions. Most of my ladies who have Hashimoto's in remission, we aim for vitamin D levels to be between 60 and 80. I know a lot of times people get tested and it might be like 29 or 30 or 31, and their doctors are like, this is fine, this is normal.

Right. Um, we do wanna make sure we address that, making sure addressing any kind of anemia or iron deficiency. Iron is really important for proper utilization of thyroid hormone and I do see some women, they actually become. Hypothyroid because of a longstanding anemia. And so getting your ferritin tested would be the first step, and making sure that somewhere in the 90 to 100 range is another important thing I recommend.

And then looking into B12 deficiency, this is another common co-occurring. [00:18:00] Uh, deficiency generally levels you want to have around 700. These are things you'd wanna test and not really guess, right? And then there's other nutrients you can take supportively such as selenium that's been found to reduce thyroid antibodies.

I. In the range of 83 micrograms to 200 micrograms a day. Myo acetol, when combined with selenium in the early stages, can normalize thyroid function and get people into remission, just those two nutrients alone.

Jac: Interesting. I've heard about an acetol, I mean primarily in the use for, for women with PCOS, um, and it's been very, very helpful with Selenium two.

Dr. Wentz, are you a fan of Brazil nuts? Like could that be a good supplement or rather substitute for a Selenium supplement, or are you a fan of just supplementing with an actual like Selenium supplement?

Izabella: Uh, that's a good question. I get. Uh, I get why people would wanna use Brazil nuts, but I would say from all the people that I've worked with, if they're doing Brazil nuts and we test their thyroid antibodies, they don't really move the [00:19:00] needle when we do an actual, like, dose hydrated supplement 'cause, 'cause you, it's a narrow therapeutic index nutrient, so you need to have just the right for it to work.

When you have amounts that are above, then it's not really gonna, then it's toxic, right? And so. I will see people use Selenium at like 200 micrograms within three months. I can predict that their thyroid antibodies are gonna go down by 40 to 50% if they're eating to Brazil. That's a day in three months. I, I can't guarantee that.

Yeah. You know what I mean? So it's like, I wish it was like that. And I know it's, I get kind of like, okay, people try to make clever, fun videos about using food, and I love food as medicine and I love clean organic foods and. Getting your nutrients from food, but sometimes you just really need to be precise with these things, right?

Jac: Yeah. All right. So then in terms of supplements for thyroid health, so you mentioned my acetol, selenium, vitamin B, [00:20:00] B12,

Izabella: B12. Um, magnesium can be a really big game changer. Long-term studies have shown that using magnesium citrate long term can normalize the thyroid gland. Um, on an ultrasound, it's usually a few years of, of using it, but I really like that form for a lot of women that tend to be constipated, that have.

Menstrual cramps, anxiety, insomnia, sleep issues. Right. It does make a really big difference for them.

Jac: So interesting. In terms of a timeline, Dr. We like after, you know, abiding by these lifestyle modifications, changing your diet, introducing these supplements, when can women expect to see a turnaround? And I know obviously this, you know, may vary, but just in general, like how many months would you say.

Izabella: It's been really interesting for me to work with a lot of women and and see the timelines that they're on. Sometimes when you change your diet or initiate a supplement, you could see symptom resolution in [00:21:00] like three to five days. It's really, really incredible. Sometimes you get that one thing that really moves the needle, and I found that to be the case with gluten-free diet, dairy-free diet.

Sometimes a thiamine supplement for fatigue can turn that around very, very quickly. Um, magnesium can work relatively quickly too, but generally speaking, I would give people one to three months to see the full benefits and the full effects of their interventions. People. Can start testing their thyroid antibodies as well within, you know, I would say one to three months and see a trend to see if those are reducing with time.

Hmm. Because a lot of, um. A lot of things do take some time, but I would say if it's been three months and you're doing things and you're not seeing a difference, it's time to get on plan.

Jac: You mentioned adrenals before and I'm so curious. What is the connection between our adrenal health and thyroid function?[00:22:00]

Uh, you know, the body works

Izabella: as a whole, so there's this feedback loop between our adrenals and thyroid gland and. A lot of our other hormones like have these feedback loops built in the thyroid gland and adrenals are, have a very intimate relationship where if we have, we don't have enough thyroid hormone on, on board.

Then our cortisol clearance, which is one of the main. Hormones made by the adrenals will slow down. So then our body will sort of keep more cortisol around. Mm-hmm. And it's kind of like, okay, thyroid gives you energy, cortisol gives you energy, you don't have enough thyroid. So the body's like, I'm gonna kick in and give you some of that extra cortisol.

Now, unfortunately, cortisol energy is kind of like I drank eight cups of coffee. Right, right. Um, when you have too much of it. And so a lot of times we'll see that connection. Where women will have excess cortisol levels when they're hypothyroid. And then the tricky part is when a woman gets thyroid hormone replacement.[00:23:00]

Mm-hmm. Oftentimes their cortisol production will, or their cortisol clearance will normalize and then they end up being cortisol deficient. So they'll be like, okay, well I started thyroid hormone. And I thought I was gonna feel better. Initially I did, but now all of a sudden I'm very tired and I just kind of crashed.

Mm-hmm.

Izabella: Cortisol, um, is something I commonly see in women with thyroid dysfunction. Oftentimes adrenal adrenals are like our stress glands, and so a lot of excessive stress can bring on autoimmunity and thyroid dysfunction. And I guess all that to say you, generally speaking, if you're supporting a person's thyroid, you also.

I would say nine outta 10 times. You do need to support their adrenal health as well to make sure that they're. Their output of adrenal hormones is properly balanced. That, that their stress response is right,

Jac: is balanced. Here's a question for you. Let's say someone's cortisol is very elevated from a [00:24:00] blood test, and I'm curious again of your thoughts on proper testing for cortisol, because obviously I think that.

That one prick in the morning for a blood test might result in probably higher than anticipated cortisol levels. So I know there are those 24 hour, um, cortisol tests, but let's say someone's cortisol levels are very elevated, but they're free T three, free T four, TSH, everything else looks normal. What would you think of that?

Izabella: I would really dig deeper into why the cortisol was elevated in the morning. So generally speaking, your cortisol should be higher. In the morning, then it's gonna be throughout the rest of the day. But if, if on a blood test it's coming up high, that could suggest, uh, a condition maybe like Cushings or, um, perhaps like the early stages of it.

Maybe they're overusing things like caffeine. Maybe there's some chronic stress going on. I would definitely follow through with that to get screened and ruled out for Cushing's [00:25:00] disease, and if that comes back normal, there's also. More, I guess, nuanced cortisol patterns that can happen, which is more of the functional medicine realm.

And that would typically be either like a saliva test or a Dutch test. And then you could look at like what your body is putting out throughout the day. Um, uh, sometimes I'll see people with very high cortisol in the morning and then they kind of. Crash later on in the day. Sometimes I see people with high cortisol all day.

Sometimes people have low cortisol in the morning and high cortisol at night. And then we can essentially, we can use substances to like adjust cortisol levels to directly. So there are things like. Phospho sine to lower the cortisol. We can also use things like hydrocortisone or licorice drops to increase the cortisol directly and that can be helpful.

But what I really like to do is essentially focus on stress [00:26:00] reduction 'cause that will help whether your cortisol is high, low bouncing all around the place and things like making sure you get bright light exposure throughout the day. That you're avoiding blue lights after sunset, you're getting really good sleep at night.

These are gonna be really good key steps to balancing that cortisol pattern. Cortisol is very, very adaptive to our circadian rhythm, and so when we are. Um, not in balance with that when we spend a lot of time indoors, right? I have, um, recording a podcast and I have this bright light on me and I'm in a brightly lit room.

But the lights that are outside are so much more powerful and they let your eyes and your brain know that it's time to rise and shine and be bright eyed and bushy tailed. When people miss that message from the sun, they end up. Sometimes being chronically fatigued because of it and having insomnia because your body just doesn't, it doesn't have kind of a [00:27:00] compass to let you know when it's day or nighttime.

Jac: Right. No, I couldn't agree more that those first 10 minutes of morning sun exposure have become a staple for me. Doctor once, like if I do not get my morning sun exposure, I feel it throughout the day. Um, it just, you know, and again, people think if it's cloudy outside, they're not gonna get the same benefit, but I'm like, no, the sun still shine through the clouds.

Just go outside. I, I've had

Izabella: some very skeptical clients that are like, this sounds so basic, there's no way this can help my fatigue and insomnia. And I'm like, please just try it. And they're like, yeah, this was pretty basic. But it, it actually does help. And it's just the way we're wired as we get these messages.

I, when I was in a young pharmacist, I remember, um, having some clients with cortical blindness and they essentially. When, um, you have this, you can't receive the messages from the sun through your retinas, and then you don't end up producing melatonin at the right times. So these clients, they really [00:28:00] struggled with sleep, right?

And so they had to melatonin at bedtime to let their bodies know it was time for sleep. But our bodies do that naturally unless we have some kind of a, you know, genetic disorder or something that we're born with that prevents us from that, right?

Jac: Yeah. So interesting. And I know that the term like adrenal fatigue, right, is not technically like accepted in the conventional realm.

Is that still, is that still true? Well, I think it's very

Izabella: confusing because there is, um, adrenal insufficiency mm-hmm. Which is a conventionally conventional medical term used to describe like Addison's disease where your adrenals are damaged and they're not able to produce cortisol. This is a life-threatening condition.

And this is not the same as like this adrenal fatigue, which was coined by a naturopathic doctor plus years ago. What I think what he was meaning to his theory was that there was something wrong with the adrenals and that's why they weren't putting up cortisol. [00:29:00] With more research being done on this, it seems like it's more of a hypothalmic pituitary access dysfunction, where basically your adrenals.

Are healthy, but they're not receiving the message from the pituitary to make cortisol at the right times. And one of the things that can bring this on is actually like long-term trauma or um, childhood trauma or any of these kind of adverse childhood events, they can bring on this disconnection. But even things like having excess stress overworking over exercising.

Not sleeping enough, undereating, a lot of these things can actually bring that about as well.

Jac: Yeah. I'm so glad you touched on exercise because this is certainly a very nuanced area as well, and I know folks have very strong opinions on this, but let's say for the woman out there who is looking to recover her adrenal health and who also has thyroid issues, 'cause as you said, they're both intimately related.

What would a [00:30:00] proper exercise regimen look like for her?

Izabella: This is gonna

Jac: depend on where

Izabella: she is in that adrenal journey. So a lot of times women might start off with high cortisol levels and for these individuals doing things like exercise. That's high intensity or aerobic exercise like running. This can actually help to lower those cortisol levels and bring you back into balance.

Now, on the flip side of that, a lot of the women that I work with with autoimmunity, chronic fatigue syndrome, Hashimoto's, fibromyalgia, I. Hypothyroidism. They might be on the other spectrum where they have low cortisol and these amazing high intensity aerobic exercises and running are gonna make them feel more depleted and worse.

And so for them, things like strength training or yoga or even like. Foregoing exercise and getting more rest for not, not for the rest of their lives. Right? Just for a time period, maybe a four week reset might be [00:31:00] the answer. And I think one of the things you can do is you can, one, you could test your cortisol to see where you're at and see which protocol would work best for you.

And the other thing you can do is just really listen to your body. It's like. You should be feeling good after exercise. Yeah, you might be sore and you might feel tender, but you should feel accomplished. You shouldn't feel like I just need to take three days to recover this and, and that's kind of a rule of thumb is checking in with your body.

The, I know that's tricky because for many of us, we've conditioned two. Quiet our bodies, if we're in pain, we take painkillers. If our body is, you know, allergic to something, trying to tell us something and our environment's not working, we take allergy meds and so on and so forth. Um, so sometimes it can be tricky to make that connection.

'cause some women might think they actually have high cortisol when they have cortisol and vice versa.

Jac: Right. What would, what would a high Cortis level look like numerically? [00:32:00]

Izabella: You know, it's gonna depend on, on the testing that you do with, you know, with like a blood test that you would get, you know, I would look at, I would defer to the lab that you're gonna get and see what your reference ranges are gonna be.

So you would actually get a lab test and I always advocate for that. And it would say hi, right.

Right. It

Izabella: would let you know if it was high or not, and I would defer that to your doctor to see if that's something that might be a one-off, or if it's, you really need to do more testing for something like Cushing's Disease with the, um, with the functional testing.

I will say it's a little bit tricky 'cause I've worked with a few companies over the last years where the way that the, the companies can set up is. Is, let's say they have, um, a whole bunch of values and then they'll set the normal reference ranges, and then they get a whole bunch of values from people who have low [00:33:00] cortisol.

Then the reference ranges may adjust. So a few things that I've worked with, I would be able to say, look at a lab test, and it would be abnormal, and then I would be able to talk to a person and they'd be like, yes, I'm feeling this way, I'm feeling this way. And the ranges would correlate, but when some of the labs redo their reference ranges, I would be like, yeah, this test says you're normal, but you're clearly not feeling normal.

Oftentimes, like to use, I like to use ZRT lab for adrenal saliva and the Dutch test

for the urine

Izabella: testing and follow their reference ranges for the most part. But I also would give people an assessment. So I would say, do you have trouble waking up in the morning? Are you sluggish in the morning? If you do, that's typically gonna let me know that you have low cortisol, you have trouble sleeping at night, for example.

That's gonna let me know that you generally probably have high cortisol, right? And so if the test doesn't reflect that, then I'm [00:34:00] asking questions. For example, did you drink a whole bunch of coffee before you took your saliva test when you woke up in the morning? Or you know, was there something I. Out of your routine that you did at bedtime?

'cause you're telling me that you sleep just fine, but this is coming up high. So it's a little bit of a, I would say like a bit of an art and science and these days a lot of the, what I've started doing with clients is I actually have them do an assessment because I've had this experience of giving people like functional medicine lab kits and it's like they sit at their house for three years and I'm.

Like an assessment, then we could figure out what's out of balance and then we could start making some lifestyle changes. 'cause a lot of the life changes are gonna. The same whether you have high or low cortisol. It's like your cortisol gets dysregulated because of stress or inflammation, and so let's focus on stress and inflammation.

Jac: Right. No, that makes complete sense. You mentioned caffeine. This is something I struggle with. I [00:35:00] used to be a two three cup. Caffeine coffee person every morning. I'm trying to cut back, but would you recommend perhaps completely omitting caffeine for someone who's suffering from adrenal insufficiency or adrenal fatigue?

I think for people that have

Izabella: high cortisol, it can increase their cortisol further. For people who have low cortisol. It can actually be kind of therapeutic. And so I know when I first started working with people, I would be like, let's give your body a reset and get off of that caffeine. And then I would have some very angry clients that would be like, you know, I just feel worse now.

Thank you. Like and, and I have like no caffeine and I'm still fatigued. So I do think caffeine can interfere with some of that circadian rhythm and. What my goal for most people is, I wouldn't say you need a quick cold Turkey. 'cause I have tried that and I, it can backfire is a lot of times we work on getting their energy levels up first and then we [00:36:00] focus on how do we get you into a healthy relationship with caffeine.

And so that might mean one or two cups of coffee in the morning when your cortisol is supposed to be high, but then you cut it off before. 3:00 PM Some people it's, yeah. So it doesn't affect your sleep. Mm-hmm. And generally speaking, I, I feel like most people with healthy, most people should be able to tolerate one to two cups of coffee per day or caffeine per day.

Um, once we support these other systems in their bodies. Some people do need to go off of caffeine, but I wouldn't do it cold Turkey. Generally speaking, I would do like a. Uh, gradual reduction.

Jac: That makes sense. In terms of supplements, Dr. Once, what are some of your favorite supplements for adrenal fatigue?

I'm a huge fan of adaptogens. Um, I've found, like Ashwagandha has, has certainly helped me over the past few years. But do you have any favorites? I. I

Izabella: love the

Jac: ABCs

Izabella: for adrenal support. These include [00:37:00] adaptogenic herbs, like Ashwagandha is one of my favorites. Lemon balm, holy Basil or tulsi are some of the other ones I like to use.

Sometimes. Reishi is really great as well for people that might have trouble, um, sleeping, for example, and they don't wanna take something too stimulating but need a little bit of an energy boost. Then there's a B vitamins, which include. Thiamine, um, B five, B six, all of these can be incredibly helpful for our adrenals and our neurotransmitters.

And then high dose vitamin C is, is like fuel for our adrenals, and that can be incredibly helpful for many people with supporting their immune function and energy levels. So these would be like a great place to start for most people.

Jac: When you say high dose, do you mean like liposomal vitamin C or. Does it matter the form we take it in?

Izabella: I'm not too picky about the form. For some people, they, they do like orange juice and [00:38:00] that even Yeah. Helps them. Um, generally speaking, something above 500 milligrams per day is gonna be helpful for people. Interesting.

Jac: I the thing, first thing that came to mind when you said orange juice was those afternoon adrenal cocktails.

Have your patients tried those and found those helpful? Oh my gosh,

Izabella: I love them. So we, we have an adrenal kickstart that we recommend for people who are struggling with that morning fatigue. And it has orange juice, it's got a little bit of coconut milk to support blood sugar balance, uh, some electrolytes and um, a little bit of sea salt.

And I also would do, I have this electrolyte blend that has high levels of vitamin C in it. And so it tastes like an orange creamsicle. People never, oh, I love that.

Jac: Is that a

Izabella: brand or do you make it yourself? The electrolyte blend. Um, it's the virology. You can use any kind of electrolytes you want, and you can also use vitamin C powder and then you would just get organic orange juice, maybe some [00:39:00] organic coconut milk.

I also like to add a little bit of protein powder, like hydrolyzed beef, vanilla protein, to really just give you yourself a nice morning smoothie that, yeah, gives protein fat, it's blood sugar balancing. It gives you that vitamin C gives you some of that, um, orange juice to support your blood sugar levels so they, they're not too low.

A lot of times people with adrenal issues might have low blood sugar, which everybody's always like, high blood sugar is bad, but a lot of, a lot of them actually have low blood sugar and we need. Healthy amounts of blood sugar to be able to have good energy. Right. So it's, it's delicious. But I wish, so interesting.

Wish could take it as a product. Could just I was gonna

Jac: say that would be, that would be brilliant. Yeah. I love that. And I'm so curious too, Dr. Wetz, what's like your typical. Like daily regimen when it comes to, first of all, what's on your plate for breakfast, lunch, and dinner, um, and supplements that you personally take

Izabella: for [00:40:00] breakfast.

I usually will have like a smoothie or I might have eggs for lunch. I would have either a salad with some healthy veggies or I like soups a lot, so even, even in the hot, I'll drink some bone broth. And then for dinner I generally will eat a healthy protein with um, healthy. Um, like, you know, like salmon or, or chicken or grass fed beef.

Yeah. And then

Jac: with cooked veggies. Interesting. Also too, in terms of fasting, there certainly is a lot of information out there right around intermittent fasting for someone who is looking to recover from adrenal dysfunction. What would you like not recommend surpassing in terms of fasting hours?

Depends on the person where

Izabella: they are. Sometimes we have to meet them where they are and they might have to eat snacks every two to three hours until we get their blood sugar balance, until we get that fat and protein ratio up and that carb ratio down. Sometimes I even have them put like a banana next to their [00:41:00] bed when they wake up, um, initially.

And then our goal is for them to have a healthy overnight fast. Right? And so. Maybe we move that dinner window smaller.

Mm-hmm.

Izabella: So maybe we move the dinner a little bit earlier in the day. So let's say they were having dinner at seven or eight. We move that a little bit earlier. We might move that to six, five or four.

Yeah, initially, but we generally don't want to be like doing three day water fast when we have renal dysfunction. You really, generally speaking, you kind of wanna get into a, a state where you have more protein and fats if you're eating the standard American diet before you start jumping into. Like intermittent fasting because that can really backfire if you are somebody that is eating a very carb heavy diet.

'cause you can just get on this blood sugar rollercoaster and feel a lot worse.

Jac: Yeah. Do you recommend people use CGMs to track blood sugar?

Izabella: I love CGMs for tracking blood sugar. That can be your really big game changer to see [00:42:00] what your body is doing with

mm-hmm.

Izabella: Regard to your food or alcohol intake or even stress.

So you might have hypoglycemia and that could be causing you to wake up in the middle of the night and then you can say, okay, I need to adjust my bedtime routine, or I need to adjust the way that I eat throughout the day. Or you might be going super high with your blood sugar depending on some of the foods you eat.

I know I've had some clients that were very surprised that Rice was spiking their blood sugar, where they thought this was a healthy gluten-free grain for them.

Jac: Very interesting. Yeah, I've experimented quite a few times and I've found that things that I, again, thought were healthy, which technically are still healthy, but my body doesn't necessarily have the best reaction to it.

Um, like steel cuts, for example. But again, if you pair it right with a fat or a protein, like I'll throw some almond butter in there and that'll help mitigate the spike. Uh. But it's truly about testing at the end of the day.

Izabella: Yeah. I think he makes such a great point because I think we can get caught up into like what's healthy and what's not healthy, and at the end of the day, yeah, it, it really depends on [00:43:00] what's healthy for our bodies and how our bodies respond to things.

Yes, of course. I will say that having a grass fed. Burger is gonna be healthier than a McDonald's burger. We can kind of make those generalities, right? Or that organic foods are gonna be generally healthier for us than processed foods. Um, but at the same time, it could be a really amazing food for one person and another person might respond completely differently.

Jac: Right. And also too, I mean, you mentioned stress earlier, right? And I feel like sometimes the stress, like the orthorexia, is that the term component where like you're scared of what to eat, essentially. The stress of that can be worse than the thing itself. Um, and certainly stress is a big factor behind everything that we're talking about today.

That's so true. I know

Izabella: that can be very challenging for a lot of people when they essentially get to the point where they believe that taking out more foods from their diet is gonna cure them, and so they become very much stressed out about living life, going anywhere, leaving their house, going to restaurants, going to.

Visit [00:44:00] family and friends. And the worst part is oftentimes it doesn't really help and they just keep eliminating more foods and more foods and they, um, they just become sicker. Um, we didn't really talk about this, but a lot of times I say, if you're on a clean diet for three months and it's not working, it's time to dig a little bit deeper.

My book s protocol has some advanced protocols to look into. For example, if you're sensitive to a ton of different foods. Besides like gluten and dairy, there's a chance that you've got a gut infection and that gut infection could be causing you to be sensitive to blueberries or, yeah, cleanly healthy innocent foods.

And sometimes clearing that gut infection can be a big game changer for. Your thyroid function, your thyroid antibodies, and a ton of your symptoms and yeah. You know, it's not something I would recommend people necessarily do on their own, but they can definitely get educated about that and realize that, hey, this is gonna be something very relevant.

And there are herbal protocols, medications that people can [00:45:00] use to get rid of these infections.

Jac: Yeah. Over 70% right of our immune system is located in our gut. Is that true?

Izabella: Yes, absolutely. Our gut is, is quite interesting because it can really impact our autoimmune response.

Jac: Yeah. One diet, Dr. We, I did, this was back in 2018.

I did the GAPS protocol, which I'm sure you're familiar with. Mm-hmm. Um, and interestingly enough, I did it because at the time I, I started breaking out, um, in hives in high school for no apparent reason. Went to a bunch of different allergists. They all were like, oh, it's idiopathic urticaria, just.

Continue to take your Allegra and your Zyrtec every day. So I myself dug a bit more into gut health. I actually had the chance to visit Dr. Alessio Ano at Massachusetts General Hospital because when I lived in Boston, I lived actually right across the street from there. Um, so that was such a fun conversation, um, to sit down and chat with him.

And for listeners, he's basically like the founder of what we call, you know, leaky gut syndrome. Um. [00:46:00] As I dove more into that world, doctor, once I discovered the GAPS diet, and for listeners out there, it's basically like this six stage very intensive diet where it's like on the elimination diet, so to speak.

But I remember stage one was just bone broth and cooked vegetables and you know. Cooked meat and you know, you're on it for two weeks and at first you feel horrible, but then you start to see the light at the end of the tunnel. And when I tell you my skin cleared up, like acne wise, my hives disappeared.

I never had to go on Allegra again. Um. I was like, there is something to this diet and there is certainly something to improving our gut health when it comes to addressing, again, allergies, other autoimmune conditions. Um, not to say everyone has to go on the gaps diet, but I do think there are elements of that diet.

Right. And you mentioned bone broth earlier. I'm a huge bone broth enthusiast. I cook my own bone broth in my Instapot. Um. Incorporating fermented foods, probiotics, um, trying to avoid gluten and dairy. I'm gluten intolerant, so things that, you know, people can start to introduce in their [00:47:00] diet if they don't wanna go like completely, completely into something as extensive as that.

But, um, it was definitely a very interesting and healing experience for me.

Izabella: That's amazing. You were able to heal your skin and hives. I know that can be quite challenging and I think people are, in this day and age, they're very used to saying like, okay, let's just take more medications for something. And they might say that diets are extreme right.

And in my experience, I mean I was on six or seven medications in my twenties. I think that's kind of extreme when you think about it for acid reflux, where it ended up being food sensitivity and. I would, I'd rather, I'm not dairy sensitive anymore, but for a while I was a hundred percent dairy free and I felt so much better than taking five different drugs for acid reflux.

I felt amazing just being dairy free and I think it can be intimidating to start on a healing diet and sometimes people are like, then I can never eat anything I like again. Right. But [00:48:00] your taste buds do reset and a lot of times you get a lot of the foods back. I dunno if that's been your experience with the GAP study.

Definitely. Yeah,

Jac: you were

Izabella: able to get a lot of things back, right?

Jac: Yeah. The first time I reintroduced fruit, I was like, this tastes like ice cream. Like it's so extreme, but your taste buds do change. Um, and your body certainly adjusts, but I, I love that.

Izabella: And it makes sense for long-term health, right?

Because if you were to take, uh, Benadryl for 20, 30 years, you might end up with some cognitive decline, right? You might end up with a lot of challenges around constipation there. The drugs do have side effects. As a pharmacist, I'm a big believer in using medications when appropriate, but when there's a dietary trigger or there's kind of an infectious trigger or some kind of a stress.

Impact, like medications can be amazing bandaids for short term, but generally speaking Yeah, yeah. Of health conditions. We really need to figure out what's the root cause.

Jac: Yeah. Going back to the foundations where truly everything's at. Right. And I feel like the more and more, you know, the more science and research comes [00:49:00] out, the more we're realizing.

It really is about going back to the foundations, right Morning, sunlight, whole foods, managing stress, keeping it simple. Absolutely. I love that. Well, Dr. Wentz, I can't believe we're almost at the hour again. I told you I'm gonna have to have you back on at some point 'cause there's so much to discuss. But this was certainly a wonderful foundational debrief and I'm really excited to share this with listeners with that.

Where can they find you? Thank you so much for having me. It's been such a

Izabella: pleasure to be here with you. My website is thyroid pharmacist.com, and you can find me across various social media channels under Isabella Wentz or Thyroid Pharmacist. And I actually have a podcast that focuses on thyroid health and reversing various autoimmune conditions and it's thyroid pharmacist healing conversations.

If you guys wanna check that out. It's on Apple, Spotify, and YouTube.

Jac: Awesome. Well, I'll be including the links to all of those in the show notes, but my last question for you, Dr. Once, and this is always my favorite one to ask, and that is, what does being well and strong mean to you? [00:50:00] I think being well and strong means

Izabella: having the clarity and the balance in your life to be able to do things that you enjoy and pursue.

It's being able to show up. For people you care about. It's being able to show up for things you care about. It's not being bedridden and it's not, it's about not being dictated by your health. Right. It's not being, it's not letting your poor health affect your ability to live your best life.

Jac: Yeah. I love that.

Beautiful. Well, thank you so much for your time. I'm really looking forward to sharing this and yeah, I hope to have you on again at some point soon. Thank you so much for having me. It's been such a pleasure. I hope you enjoyed this episode. If you would like to support the show, please subscribe, leave a rating and review and share it with others.

Be sure to visit wellnstrong.com to access notes from the show and to stay current with new content. I'm so grateful you join me. Be well and [00:51:00] be strong.

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