Ep. 266 Optimizing Adrenal Health: The Power of Lifestyle Changes with Dr. Izabella Wentz

I’m delighted to connect with Dr. Izabella Wentz today! She is a PharmD, an internationally acclaimed thyroid specialist, and a licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease. She is also the author of three books. Her most recent book is The Adrenal Transformation Protocol.

Dr. Wentz joins me to dive into how to identify what is going on with our adrenal health and why adrenal issues tend to occur along with thyroid issues. We speak about her background and how it influenced her life’s work, the myth of adrenal fatigue, and HPA dysfunction. We also discuss the physiology of the adrenals, acute versus chronic stress, signs of a dysregulated HPA axis, lifestyle, the impact of trauma, and how Dr. Wentz’s protocol works.

“Every autoimmune condition starts in the gut.”

– Dr. Izabella Wentz

IN THIS EPISODE YOU WILL LEARN:

• Dr. Wentz explains what led her to write The Adrenal Protocol.
• What happens in the body when we experience significant amounts of fatigue?
• How the physical impact of acute stress differs from that of chronic stress.
• Symptoms of adrenal dysfunction (other than chronic fatigue).
• How does sleep apnea tie to Hashimoto’s and mitochondrial health?
• Lifestyle factors that may contribute to adrenal fatigue.
• Adaptogens and supplements that can assist in balancing cortisol levels.
• How to know when to cut back on exercise.
• Foods that support thyroid and adrenal health, and foods that could negatively impact thyroid and adrenal health.
• What is molecular mimicry?
• How does trauma impact adrenal health?
• Dr. Wentz talks about her latest book, The Adrenal Transformation Protocol.
• Something you can do right now to improve your adrenal health.

Bio:

Izabella Wentz, PharmD, FASCP, is an internationally acclaimed thyroid specialist and a licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009. She is the author of three books on Hashimoto’s: Hashimoto’s Thyroiditis Lifestyle Interventions for Finding and Treating the Root Cause, Hashimoto’s Food Pharmacology, and Hashimoto’s Protocol, which became a #1 New York Times bestseller. Dr. Wentz currently lives in Texas with her husband, Michael, and their son, Dimitry.

Connect with Cynthia Thurlow

• Follow on Twitter, Instagram & LinkedIn
• Check out Cynthia’s website

Connect with Dr. Izabella Wentz

On her website

On Facebook and Instagram

Get Dr. Wentz’s adrenal healing guide: The ABCs of Adrenal Support

Find Dr. Wentz’s new book, The Adrenal Transformation Protocol 

Books mentioned:

From Fatigued to Fantastic by Jacob Teitelbaum

Transcript:

Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, I had the honor of connecting with Dr. Izabella Wentz. She is a PharmD and an internationally acclaimed thyroid specialist and a licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease. She is also the author of three books, most recently the Adrenal Transformation Protocol. Today, we spoke at length about her background, how that has influenced her life’s work, the myth of adrenal fatigue and the role of HPA dysfunction, hypothalamus-pituitary-adrenal dysfunction, physiology of the adrenals, acute versus chronic stress, signs of a dysregulated HPA axis, common symptoms, the role of lifestyle, the impact of trauma, and how her protocol works. I hope you will enjoy our conversation as much as I did recording it.

Dr. Wentz, it is such a pleasure to connect with you. I’ve been a huge supporter and follower for many years, so it’s such an honor to have you on the podcast.

Izabella Wentz: Cynthia, thank you so much for having me. I’m such a fan of your work, and I’m excited to be here with you.

Cynthia Thurlow: Absolutely. So, I think a lot of individuals make the association that a lot of your work is really focused on your thyroid health journey. Perhaps if there are listeners here that are not familiar with your work, if we can just provide some context of where your work really stemmed from, your own process of dealing with Hashimoto’s, and how it came today that you’re now writing a book talking about adrenal health, which is one of my favorite topics.

Izabella Wentz: Sure. So, in full disclosure, I was never interested in the thyroid gland or [Cynthia laughs] Hashimoto’s when I was in pharmacy school. I was like, I want to learn about the conditions that have all these other crazy medications that could be used for them. And my own sort of journey into becoming a Hashimoto’s expert came through being a Hashimoto’s guinea pig. So, I was diagnosed with Hashimoto’s in my 20s, after working as a pharmacist and after already having maybe a 10-plus year journey of having some very unique symptoms or common symptoms or symptoms that may be just get brushed off without, like, a real diagnosis. So, I had panic attacks, I had anxiety, I had carpal tunnel in both arms, I had acid reflux, I had irritable bowel syndrome, fatigue, hair loss, cold intolerance, and a little bit of extra weight that just kept kind of happening no matter what I was doing.

When I finally got that Hashimoto’s diagnosis, it had been after probably going to dozens of different doctors saying, like, hey, there’s something going on with me and being offered antidepressants or being offered stimulants or being told that it’s just in my head, or that everybody just feels this way as they get older. Mind you, I was 25 at the time and so I finally got that diagnosis, and I thought to myself, is there anything I can do in addition to taking medications or in place of taking medications? I started to learn more about lifestyle changes that could help me get myself into remission. That’s what I’ve dedicated my life’s work to, is after getting myself into remission with Hashimoto’s and I was the skeptical pharmacist, but then I found out that there’s more to healing than medications. And I just wanted to shout it from the rooftops because medications for thyroid health helped me in a significant yet small way.

I went from sleeping 12 hours a night to 11 hours a night and was a little bit less cold. But then I still had the whole laundry list of symptoms. And really the way that I got rid of those was through functional medicine and lifestyle changes. So, that’s been the big focus of my work and really a big passion of mine. How that relates to the adrenals is that on my own journey, I was initially starting these lifestyle changes, starting some dietary changes, and they helped some things as well, but the fatigue remained. I came across adrenal fatigue, adrenal dysfunction and somebody said, okay, you need to look into this and of course I googled it and it said that it wasn’t like a real condition, that it was made up, but yet I had all the symptoms, and so I thought I would give it a try, and I thought I would perhaps try some of the interventions.

And lo and behold, I got so much better when I tried the recommendations for adrenal fatigue, which didn’t exist. What I found in my work is that more than 90% of people with Hashimoto’s, with hypothyroidism, but also people with chronic fatigue syndrome and a whole host of other fatigue-related conditions have some degree of “adrenal dysfunction.” We could talk about why that’s not necessarily an accurate description of what’s going on in the body. But it’s also a convenient way to describe the constellation of symptoms that occur when people are just tired but wired and overwhelmed and just not healing the way that they should be even though they’re doing some of the right things.

Cynthia Thurlow: Well, I think it’s so inspiring when you have a clinician that has experienced, being diagnosed with an underactive thyroid and an autoimmune condition and identifying that, yes, that medication was helpful per se. But it’s really this lifestyle piece, this functional slant, really looking very differently at the thyroid gland and thyroid health, and then also looking at what’s going on with the adrenals, because I remind my own patients that our bodies are this beautiful orchestration of hormonal regulation. But when things are off and we don’t feel well or feel vibrant or feel like ourselves, we are sometimes dependent on lab work to justify being prescribed medication or supplementation and how validating it is. If you’re listening to this, and I’m certainly one of these people, I have Hashimoto’s. I’ve been on a two-year journey trying to get my thyroid medication properly regulated to address my labs. And I’m working with someone new.

And so, everything we’re using now is compounded as an example. But he left me thinking about something most recently. He said I wonder how much of this is your adrenals? And so, we’re going to talk today about how do we identify what’s going on with the health of our adrenals, why this tends to be coming along concurrently with thyroid issues, how it’s not at all uncommon, but we may not be looking at it that way, we as clinicians. So, you mentioned the term adrenal fatigue. I know many people in traditional allopathic Western medicine kind of bristle when they hear that term.

But it is talking about a constellation of symptoms. So, what is really going on with our bodies when we are dealing with such significant amounts of fatigue? And for anyone that’s listening, that’s been through this, I certainly have, I remind people it took a whole year to feel like my body was really able to undergo the amount of stress, physical stress, emotional stress that I’d experienced before. So, let’s really start the conversation there because I think that would be super helpful for listeners.

Izabella Wentz: Sure. So, a lot of times people will say, okay, and I just love it because say, well, adrenal fatigue doesn’t exist and to go back through the history of adrenal fatigue, the term was initially coined by a very wise naturopathic doctor. And his theory, this is Dr. James Wilson, was that the adrenals were kind of in a subclinical state of Addison’s, where they were either maybe just a little bit destroyed or not functioning properly. And that’s what was causing the constellation of symptoms, the most significant one being chronic fatigue and difficulty getting up in the morning. Now, as we’ve evolved and we’ve learned a lot more and a lot more studies have been done, we know that terminology isn’t necessarily accurate because the adrenals– and I guess the correct term is HPA axis dysfunction. It’s quite a mouthful if you don’t abbreviate it, it’s hypothalamic-pituitary-adrenal axis dysfunction.

And there are research studies that will support it. If you go to PubMed and you look for that, it’s a thing. And this is what happens when our stress response gets dysregulated. In very simple terms, that means that our brain, which is the command center for telling our adrenals to make stress hormones, there’s a breakdown in that communication pathway. And so, the adrenals might be capable of producing just the right amount of stress hormones at the right times throughout the day because the circadian timing of when the hormones are produced is super, super important. But for whatever reason, there’s this communication breakdown and the reason not to give it away is usually because of chronic stress.

Cynthia Thurlow: Yeah. And it’s interesting because I think we’re three years out of the pandemic. In the pandemic, I think the three years for many women in particular have been enlightening in terms of emotional, physical, psychological stress. I always say we have dealt with more stress over the past three years than most of us have probably dealt with over the last 10 or 15. And so, what happens in our bodies in terms of our stress response? In normal healthy adrenal physiology let’s talk about what’s happening in our bodies. Whether it’s the stress of trying to hit a deadline for work or you’re late to something or maybe you have a discussion with someone that’s upsetting, kind of acute stress. What’s going on physiologically in our bodies that impacts the adrenal glands and how does that differentiate it from chronic stress?

Izabella Wentz: Sure. So, whenever we’re exposed to an acute stressor and that maybe is a deadline or we’re rushing for something, or in the olden times, it was a bear chasing us or something like that, is our body releases our stress hormone cortisol. That can help us increase our blood pressure, heart rate, glucose levels, and kind of gives us little bit of fuel to get through that intense stressor. At the same time, it suppresses our digestion, suppresses like our repair of the body and our reproductive activities. This is usually a positive because we’re being chased by a bear that’s not the right time to think about fun things to do in the bedroom. [Cynthia laughs] And so we end up in this survival state. In acute settings, this is super helpful to have. And initially, we kind of get past the bear, get past the deadline, what not? And we kind of decompress, we shake it off, whatever our process is and then our body goes back to its normal cortisol rhythm which is secreting a little bit of cortisol or secreting more cortisol in the morning and then gradually flows down throughout the day until we have very little amounts of cortisol in the evening and this is what’s called a healthy cortisol curve.

For many people, you have this acute stress and that happens and things go back to norm. You get lots of cortisol and then you get over it. You go on with your life and then you’re back to feeling healthy and fixing your body and thinking about reproduction and all these fun things that we’re meant to do as humans. But what happens with chronic stress and chronic stress I know when we hear the word stress, we think of psychological stress. I feel like our society has that really well covered, so if we’re arguing with somebody or we have a boss that maybe isn’t the kindest or the most thoughtful, that can be super, super stressful, but it’s also past stress. So, if we have trauma that we’ve been carrying in our bodies, many people don’t realize how big of a factor that can play in our stress response.

Then there’s physiological stress, such as sleep deprivation. Sleep deprivation is one of the fastest ways to dysregulate our adrenals. And I can talk to that, being a new mom, and I know anybody that has children can certainly talk to that when that goes prolonged, we can get stuck in a prolonged stress response, and then we have inflammatory issues in the body. So, these could be chronic infections, these could be injuries, this could be the type of food that we’re eating, stress from blood sugar imbalances and autoimmunity, so on and so forth, that can create “stress,” in our bodies. When we’ve been on this prolonged stress journey, the body will initially release cortisol. Cortisol has anti-inflammatory properties, which is fabulous, and that’s great.

But what happens over time is our body is wise enough to know that too much cortisol for too long a time is going to be problematic, because then we’re breaking down the body too much to fuel that stress response. And we need to bring that back in. So, there’s the feedback loop system within the body that will say, “You know what Hon, we’ve had too much cortisol. Now we need to pull that back.” And we get into something that’s known as a dysregulated circadian rhythm, dysregulated cortisol cycle, dysregulated HPA axis, where our body will– in many cases, and the people that I see with autoimmunity, chronic fatigue and Hashimoto’s, their body actually doesn’t produce enough cortisol. There’re various theories to that some of them are the cortisol receptors. They’ve just become saturated and then they’re over responsive and they’re providing the body, the brain the feedback. “No, no, no, we don’t need any more cortisol let’s keep it low.”

Cynthia Thurlow: Yeah, and it’s really interesting because I feel like cortisol, much like insulin, sometimes gets a really bad rap and I have to remind people that it’s all about keeping things balanced. Our body is always effortlessly trying to find balance within our bodies and I think the sweet piece for many individuals, like moms with young kids or elementary school-age kids, moms with teenagers as an example my 17-year-old is now dating, and I was trying to explain to him, we don’t go to bed until you come home. So, for me, I’m usually in bed by 9:30 or 10:00. On Saturday night I was up until 11:30 because I had to wait for him to get home and he talked a little bit about his date. And then my husband and I went to bed and I just know that for many of my followers and listeners, they’re in perimenopause, menopause years and you start having a stressful event and you’re just not as stress resilient to begin with given some of the hormonal fluctuations. I think anyone that’s listening has very likely experienced these circadian imbalances. It’s being up late, feeding a sick child or feeding a newborn or dealing with teenagers who are up really late at night. I’ve just kind of given up. If they’re home, I just go to bed.

[laughter]

Because it’s too challenging to try to stay. I can’t beat them, so I might as well just go to bed. So, when we’re talking about fatigue and some of these more common symptoms that you will see your patients experience, beyond fatigue what are some of the other common complaints or concerns you’ll see expressed by your patients or people that reach out to you on social media, that give you insights into what’s likely going on with their adrenal health?

Izabella Wentz: Sure. So, people that tend to feel overwhelmed and so day-to-day life just feels overwhelming to them. So, they get a phone call from somebody and they’re like, what does this person want from me? It’s a friend calling to say hello or just doing the daily activities of life. Some of my clients will say like “I live in a house with stairs and I just cannot go up the stairs again to I forgot something.” And it’s just so overwhelming, where normal in healthy individuals when we’re under a little bit of stress that can kind of drive us and we get this nice boost of cortisol in these individuals, a little bit of stress rather than like motivating them, it just makes them feel worse. Oh my gosh, I’m feeling stressed out and I’m even more tired by this stress.

And they have things like brain fog. Of course, the fatigue, generally trouble waking up in the morning is going to be a big red flag for me. If they are feeling wired but tired, they might have a 03:00 PM. slump. They might have anxiety and blood sugar swings throughout the day. Low blood sugar and low cortisol kind of go hand in hand as does anxiety and feeling hangry. They’re the people that get a second win. So, they’re like so tired and then nighttime comes and they’re like I can’t sleep, what is happening? My mind is racing and I’m just wired but tired.

They might have night wakings throughout the night. They might be emotional, irritable, have anxiety, have mood swings. I know I’ve had some people misdiagnosed with bipolar disorder where they were just on a cortisol roller coaster and blood sugar roller coaster. Some of the more objective things would be things like sensitivity to bright lights. If you step outside and you’re like, oh my gosh, why is it so bright? What is going on?

If they have salt cravings or cravings for sugar, I see a lot of people self-medicating with caffeine addiction throughout the early parts of the day and then self-medicating with wine or alcohol in the evenings to wind themselves down. These are some of the big things that people oftentimes will let me know that they’re struggling with. And that’s a really good sign that they likely have some sort of adrenal dysfunction.

Cynthia Thurlow: I think it’s so common, especially over the last three years that many of us have created some seemingly benign habits that really are identifiers that there’s something deeper going on. I think about salt cravings in particular. The alcohol to wind down is one. I also think about the interrelationship of– and we talk a lot about mitochondrial health. For so many people understanding that these pieces of fatigue can be many interrelated pieces, it may be adrenal fatigue and a little bit of mitochondrial dysfunction and maybe your sleep is really bad. But it’s also because physiologically, you don’t have to be a big person to have sleep apnea. In fact, I’m more oftentimes surprised. In cardiology, we used to say if a man has a neck that’s more than 17 inches in diameter, we’re like they need a sleep study.

But I’m starting to realize that this is common even in thinner people just based on physiologically the way that our anatomy is designed. Are you seeing a lot of sleep apnea people or are people surprised to know that there’s that interrelationship with adrenal health and getting really poor-quality sleep, not just for the circadian imbalances, but also having periods of apnea where you’re either having periods where you’re not breathing properly or you’re just not breathing at all?

Izabella Wentz: It’s really fascinating because there’s a huge connection between sleep apnea and Hashimoto’s. People with sleep apnea are more likely to have Hashimoto’s antibodies and those with Hashimoto’s antibodies are more likely to have sleep apnea. One of the key factors, if you have a scalloped tongue with Hashimoto’s with any kind of condition, is this could be a red flag for you that you might have sleep apnea potentially from your anatomy, physiology in your body, or the other things that I’m really glad you mentioned mitochondrial health. So, sleep apnea can be tied to mitochondrial health. It could be living at too high of elevation, which is something that I learned after living at elevation for some time. But the really key thing about adrenal fatigue and adrenal dysfunction, again, it’s not necessarily a diagnosis. It’s sort of what the body does when it senses stress. And this is how the body responds to being under stress.

And that stress could be from sleep deprivation, from sleep apnea. It could be because of mitochondrial damage because you’re exposed to mold toxins or glyphosate. It could be because you’re eating inflammatory foods. It could be because you have H. pylori in your gut and that could be causing inflammation, that could be causing mitochondrial damage. So really, when people talk about, oh, I’ve had some people say like, “Oh, no, no, no, there’s no such thing as adrenal fatigue, it’s actually always copper toxicity.” Or they’re like, “No, no, no, there’s no adrenal fatigue, this is like mitochondrial issues.” And then really the adrenal fatigue, adrenal dysfunction, it’s just a cluster of symptoms and this is what your body does when it senses stress, this is how it adapts.

It makes you just want to crawl back into your hole, into your cave. It slows down your metabolism, it’s trying to get you to survive and a lot of different things can cause, “adrenal dysfunction.” The beauty of it is that there’s actually a very predictable way of getting out of it and shifting the body from that survival mode into more of a thriving state. And part of that is supporting the adrenals. It’s supporting some of the nutrients that get depleted. It’s supporting lowering inflammation in your body and getting some fabulous sleep and balancing blood sugar.

Cynthia Thurlow: Well, and I think I love that your book really speaks to the lifestyle because we all know that as traditional allopathic-trained providers, that there’re medications that we can utilize to treat symptoms. But really at the foundation is the lifestyle piece. So, let’s unpack some of the lifestyle pieces. You’ve alluded to some of it. I always say it all, I’ll start with sleep, but you have this ABCs kind of methodology that I thought was really brilliant in terms of specific supplements. And for anyone that’s listening, the supplements are helpful but listen to the big picture because if you’re still not sleeping well and you’re not managing your stress and you’re eating a standard American diet, adding in supplements is not going to take the place of these foundational approaches that we’re going to allude to.

Izabella Wentz: Absolutely. I really love to start people with the ABCs and we focus on adrenal adaptogens. I really love using adaptogens, and these are herbs that can help us balance our cortisol levels. If cortisol is too high, then it’ll bring it down. If cortisol is too low, it’ll bring it up. We talked about people think cortisol, “Ooh, it’s bad.” Well, it’s not necessarily good or bad. The issue is when we have too much of it or not too little. We actually do need cortisol for survival. We do need a cortisol boost in the morning to help us wake up and have good energy in the morning. And so, adaptogens are a brilliant way to support the body in doing that. I love ashwagandha, I love Rhodiola. These are some of my favorite adaptogens to utilize as well as holy basil is one that I really love to recommend and drink as a tea because it’s just very tasty to drink.

Then I focused on some of the nutrients that are going to be depleted through a chronic stress response. We know when we’re under stress, our body burns through the B vitamins, vitamin C, and magnesium. And so, part of the program, part of what I recommend is increasing your intake of B vitamins as well as vitamin C. Potentially if you can do this through food, is fabulous for a lot of people. I do recommend supplements just because oftentimes it’s hard to get enough of the Bs from our food. And then another thing is magnesium. So, magnesium is a really fabulous nutrient. It helps to support so many different pathways. I’ll have people who say it has helped them sleep better, it helps them poop better, reduces their anxiety, it reduces their cramps and pains throughout the body. Part of what I like to do is give people a prescription for an Epsom salt bath.

This is a fabulous way to wind down in the evenings. People with dysregulated cortisol curves and cortisol patterns oftentimes they have trouble waking up in the morning, and then they have trouble falling asleep. Having a little bit of a wind-down routine. Going into a warm bath is going to set your body up for relaxation. You may come into the bath anxious and achy and frustrated. If you give yourself enough time, usually 10, 15, 20 minutes of being in an Epsom salt bath, you’re going to come out relaxed, you’re going to come out ready to start your evening routine and get some refreshing sleep.

Cynthia Thurlow: Well, it’s interesting because if you look at the sleep research, it talks about how if you raise your core body temperature before bed, it’ll help induce a better night’s sleep. And I love magnesium, in fact, because I worked in cardiology for so many years, I got very savvy. I had so many patients with arrhythmias and all sorts of issues surrounding low magnesium levels. And I would oftentimes say you have to check magnesium in every single patient. I think people understand there’re lots of creative ways to get more magnesium in our lives. So, I love the Epsom salt bath.

Let’s talk a little bit about kind of the dual-edged sword that is exercise, because for someone that has HPA dysregulation, has stressed adrenals, I sometimes have to caution people about overdoing it with exercise and understanding that cortisol can be this catabolic, so it can break down muscle. I think a lot of people are sometimes surprised. It’s another reason why I always say, like, check in with yourself. If you wake up tired, don’t force yourself to go to CrossFit or don’t force yourself to go to Orangetheory Fitness. Maybe it’s the day to walk in nature, walk outside, get some sunshine, but let’s talk about exercise.

Izabella Wentz: Yes, that’s such a key thing. I know a lot of people when have cortisol issues that can lead to weight gain. A lot of the women that I work with are very motivated to lose weight. And they’ll do things like not eat enough food and they’ll do intensive cardio exercise and try to lose weight that way. I’ve had a few people that were horrified, probably more than one, probably more than 10, probably more than 15 when I said, actually, looking at your cortisol pattern, I think you need to cut back on exercise. We want to kind of avoid the catabolic exercise, so things like biking, running, all of these kinds of long endurance events. And actually, if we’re going to focus on our time, let’s focus on things that can build our resilience and build our muscle that helps to support the metabolism. So, things like strength training exercises that can help reduce our stress response.

Some things like yoga and tai chi, some gentle exercises. And of course, it just depends on the person. If you are somebody that’s like, “Oh my gosh, my daily run makes me feel so much better.” Great, that’s your thing. But if you’re somebody and I know I’ve been at that point when I was pregnant where I was like, “Oh man, just walking around the block, that’s too much for me.” You want to tune into your body, and generally, the rule of thumb is if your exercise that you’re doing is making you feel better after you’ve completed it, good, you’ve done it right. If you’re feeling worse with it, then that’s a sign that you’ve done too much. Generally, I like to say you should be able to do the whole exercise routine one more time to know if it’s the right kind of fit for your adrenals.

Cynthia Thurlow: Yeah, I think it’s really important to encourage everyone to tune into what the cues their bodies are telling them. Another good example or rule of thumb is that if you exercise intensely and then you need a nap, you’ve overdone. Very likely your body is kind of telling you, that was way too intense. I know certainly in my own circumstances when I’m working with my patients and clients and I’m looking at the DUTCH or I’m looking at serum labs, blood labs, and their cortisol levels are low, it’s like we have to be kind and gingerly to our bodies. That doesn’t mean forever, but maybe we don’t do such long intense activities. Maybe we’re exercising intensely for a short period of time and then kind of reassessing how we feel.

Now. I know we’ve kind of alluded to anti-inflammatory nutrition. What do you think is important for individuals that are listening to the podcast to understand about the role of nutrition and how it can support thyroid and adrenal health or how it can negatively impact that?

Izabella Wentz: Yeah, absolutely. We know that there are certain inflammatory foods for individuals and when we eat foods that are inflammatory to us, that’s going to be problematic for the body. What I found in people with Hashimoto’s, it’s generally going to be gluten, dairy, and soy are some of the most inflammatory foods, and then just remarkable what happens if a person has Hashimoto’s and they get off of gluten? They’re going to have more energy. Their brain fog goes away, their weight starts to stabilize, digestive issues disappear. So, I’ve been a big proponent of that for at least a decade, right, plus. And then the other key component of it is eating blood-sugar balanced. So, when people have Hashimoto’s and when people have adrenal dysfunction, a lot of times with autoimmunity, if you’re feeling moody throughout the day, your energy levels are off, you’re irritable, having trouble with sleep, there’s a really good chance that your body is just not able to tolerate carbohydrates as well. And there’s a chance you might need more protein and fat.

So, part of what I oftentimes will recommend is following a blood sugar balance plan, what this means for most people, more protein than you think you need and eating fewer carbs than you think you need. That said, everybody has to get tolerance. So, some people are like, “Oh my gosh, I’m doing keto, I feel amazing.” Other people are like, “Oh my gosh, I can absolutely not do keto. I need my carbs in the evening. I need to do this throughout the day.” I give people a template and then I give them advice on how to adjust, depending on how they’re feeling that into their bodies.

Cynthia Thurlow: I love that you brought up the key components of inflammation for the thyroid patient, gluten, dairy, and soy. Are you comfortable talking a little bit about molecular mimicry? because I sometimes will talk about this, but it’s always helpful to have another expert addressing this because I sometimes will get pushback. They’ll say, “I don’t really want to give up the gluten, I don’t really want to give up the dairy.” And I said, well, if you understand the way these receptors fit in and how there’s a composition in each one of these inflammatory foods that can offset those thyroid receptors, it makes a great deal of sense. And I agree with you that for many women in particular, they feel completely different when they eliminate some of these less friendly thyroid foods.

Izabella Wentz: It’s really, really fascinating. So, when I first was diagnosed with Hashimoto’s, I was shocked that Hashimoto’s is actually a condition that starts in the gut. Every autoimmune condition starts in the gut, and there’s the three-legged stool of autoimmunity. So, you have the genetic predisposition, and so you have to have the right genes to develop this condition. Then you have some sort of trigger, and then you have to have another piece of intestinal permeability, also known as leaky gut.

Now you have to have all three of these things for autoimmunity to manifest and for autoimmunity to go into remission. We can’t really change our genes. We can oftentimes sometimes figure out the trigger, get rid of that trigger, and that might get Hashimoto’s into remission. We can always work on the gut and figure out why is the gut leaky. What’s causing it to be permeable? We could still have those genes and even be walking around with all the triggers.

But as long as our gut is sealed up, we’re going to be in remission. Our symptoms are going to be significantly diminished. And so, one of the things about gluten is that it can cause intestinal permeability in most people. In some people, like those with celiac disease, this can go on for weeks, maybe even months just from one gluten exposure. In most healthy individuals, this could be seconds, maybe minutes. People with Hashimoto’s and autoimmunity tend to be somewhere in between. So, there’s one thing that gluten can do. It can cause intestinal permeability.

Then there’s another autoimmune mechanism known as molecular mimicry. So, essentially, the immune system recognizes something as a foreign invader and tells the body to react to it. Now the issue is when there are protein sequences, so when I think of what the immune system is doing, it’s like it takes little snapshots of what something looks like and it shows it around, and so there’s protein sequences on gluten that are similar to the protein sequences on the thyroid gland. Whenever we’re exposed to gluten, the immune system will kind of be like, “Oh, this looks like gluten, let’s attack the thyroid gland.”

And so, for many people, it could be because of that molecular mimicry piece where for whatever reason, the body has recognized gluten as a foreign invader. Oftentimes it does go back to that leaky gut component because when we have a leaky gut, then we have these huge food molecules that get into our circulation. And then the immune system is like, “What is this thing in here? What am I going to do with it? I need to attack it.” And so like, 88% of the women that I’ve worked with and I’ve done outcome, surveys with people throughout the years and 88% of people will say, I feel so much better off gluten. If you’re going to just try one thing, if you have Hashimoto’s, I would say like, just go for it. Just try going gluten-free for a few weeks and you can always go back to eating gluten. Like, just give it a chance, see what happens.

Cynthia Thurlow: I think that’s a really encouraging way to look at it as opposed to saying, we’re going to remove all these things, let’s just focus one at a time and certainly, that can have huge net benefits. Let’s talk a little bit about the impact of trauma and you do talk about this in the book I’ve started talking more about this on the podcast with different guests, the role of trauma, and how these adverse childhood events. And for anyone that’s listening, you can get online and you can actually go pull up one of these tools. They’re free to utilize with those of us that have higher scores, it actually puts us at greater risk for developing autoimmune issues, can actually impact our ability to be able to manage and mitigate stress throughout our lifetime, because we sometimes have this exaggerated stress response because our bodies, we just get provoked and our bodies aren’t able to kind of dampen down that sympathetic response. In your clinical experience, what have been the interrelationship between trauma and adrenal health or adrenal dysfunction?

Izabella Wentz: It’s so significant and I’m not a psychologist or a psychiatrist or this isn’t something that’s very, I guess commonly thought about in just functional medicine. Even I feel like it’s just we’re doing people a disservice by not talking about it because when people are exposed to traumatic events, be it in childhood and even in adult life, that just shifts the body into this fight or flight mode and then that can alter our cortisol response. There’s just so many studies that have linked this to HPA axis dysregulation and especially in women this has been linked to various kinds of autoimmune conditions, inflammatory conditions, asthma, inflammation in the body and it’s just so prevalent what I have found, and I talk to women all the time and I ask them like, what was going on in your body before you got sick? And a lot of times it’s something that they’ve gone through that’s very traumatic in their life.

So, it’s maybe a loss of a loved one or a divorce or something going on and really what happens is we can do all the things right. We can eat a perfect diet and we can exercise and we can put a smile on our faces. But if we’re walking around with that pain and that suffering in their bodies and that trauma that hasn’t been processed, it’s like carrying such a heavy burden. So that’s a big part of what I recommend. If you are somebody that has trauma, you’re going to be triggered by things that– they say like if you don’t heal, what cut you you’re going to bleed on everybody around you, right. And I’ll see people that get really easily triggered. Somebody will say something that’s completely benign, but that kind of sends them into this trauma response where their heart starts racing and they get into this really horrific stance.

I personally lost somebody to suicide in my early 20s. And I remember before I went through trauma therapy, I would see skull and crossbones and that would send my heart racing or just the mention of somebody mentioning somebody dying or somebody being like “Oh, I’m just going to kill myself, I had a tough day, blah blah, blah, blah.” I would just go into fight or flight mode with anybody just saying things like that and so working through that trauma really helps you become more resilient. It helps you get rid of that 500 bags of potatoes that you’ve been dragging around behind you and a lot of times this might be a reason why somebody gets stuck with Hashimoto’s and they’re doing all the right things or autoimmunity or fatigue. One of my mentors, Dr. Jacob Teitelbaum. He has a book called From Fatigued to Fantastic! He talked about how if a person hasn’t worked on their trauma and they’ll do all the things to support their mitochondria, they’ll do all the things to support their health, but they’ll find another way to get tired.

They’ll get hit by a bus or something will happen where they’ll kind of come back into that space. Perhaps their body feels safer when it’s more tired because they’re not exposed to things that could hurt them. We could talk about this all day. One of the things I really recommend for this is EMDR therapy. This can be tremendously healing in just a few sessions for a lot of people to overcome traumatic events.

Cynthia Thurlow: Yeah. Thank you for your transparency, and thank you for sharing what has been a very personal journey in this area as well. Let’s make sure we talk about your book and make sure we talk about the Adrenal Transformation Protocol, for which I think is a really insightful, helpful, well-organized way to get your adrenal health back on board. And I think that for everyone, I don’t want to keep harping on this, but the last three years we’ve lived with unprecedented amounts of stress. Nearly everyone I interact with, whether it’s in a group or just people online, it’s evident that everyone needs to give their adrenal glands a bit more love. To your point, this hypothalamus-pituitary-adrenal axis needs a little bit of love and support. So, let’s talk about your protocol.

Izabella Wentz: Sure. My book, the Adrenal Transformation Protocol, is based on a four-week plan to help keep people go from surviving to thriving. We really just focus on loving the body and nourishing it back to healing. And so, a big part of what I do is I focus on eating a blood sugar balanced diet, eliminating the most common inflammatory foods, making sure a person is super nourished, and then also giving them some key targeted supplements to support their stress response. So, we talked about the ABCs, right? So, adaptogens to make a person more resilient, B vitamins, vitamin C to help support that stress response, as well as magnesium. I also focus on electrolytes, which are really underappreciated for what they do to help us recover from stress and trauma, as well as focusing on mitochondrial support. Mitochondrial support is going to be incredibly helpful because most people with adrenal dysfunction are going to have some degree of mitochondrial damage, some mitochondrial dysfunction as well.

And then I also focus on supporting gut health, because whenever we’ve been under adrenal dysfunction for some period of time, this actually weakens our immune response in the gut, and we’re more susceptible to reacting to whatever we’re eating and catching various types of infections that can cause inflammation. So, I focus on just clearing some of that inflammation out in a very gentle way. And I think what’s been a favorite for many people is focusing on adding more pleasurable activities to the day-to-day life. Something really simple that I have people focus on is taking a sheet of paper and putting a mark halfway down the middle and writing down, “This makes me feel better, this makes me feel worse.”

Coming up with your own healing plan to incorporate more of the pleasurable activities into your life because that’s going to really rewire how we feel very, very quickly. Like, I used to recommend a lot of hormones and I used to recommend for people to really sleep 12 hours a night and had all of these kinds of intense interventions. And I developed this program when I was postpartum with my son, and I was like, I can’t do the hormones and I obviously can’t sleep because I’m taking care of a newborn. So, I wanted to find other ways to send my body safety signals and the book’s broken down into various safety signals that focus on essentially self-care and to shift your body into that sympathetic state from that breaking itself down, fight or flight to building itself back up sympathetic, that relaxing parasympathetic state.

Cynthia Thurlow: Well, I think that’s such a beautiful message because we want to keep things uncomplicated. We want people to be able to follow directions. We want things to not feel so overwhelming because I know that when I kind of pivoted from my traditional kind of cardiology job to starting a business, I think sometimes when we’re well-meaning, we will give patients, like, all the information upfront, and then they’re totally overwhelmed and they can’t make a decision about what to do first. And so, I like that you have a much more kind of gentle approach because that’s really what our adrenals need or the HPA axis really needs, is for us to slow down a little bit, do a little less, focus more on taking care of ourselves as opposed to taking care of everyone else.

I know everyone listening to this podcast, we’re all very loving, compassionate individuals, but sometimes we forget that we have to start with ourselves first. What would be one thing that you have found to be super effective in terms of nourishing your adrenal glands that costs nothing? I’m thinking of something in my mind right now as I was asking you this question that people could walk away with today before buying your book, that they could improve their adrenal health right away. What would be your best recommendation?

Izabella Wentz: Gosh. Hard to choose just one. But one of the things that if you struggle with morning fatigue, just going outside and getting some of that morning sunshine in your eyes can wake you up. I know this sounds so, like, basic right and it sounds so like, oh, my gosh, that sounds so simple. But it really works. So, just like, when you wake up and whether that’s at 10:00 AM or 06:00 AM right, if there’s an opportunity to catch a little bit of sunshine, that’s going to let your body know that it’s time to produce cortisol. As a bonus, if you could move your caffeine a little bit later throughout the day, maybe 10 minutes, maybe 15 minutes, maybe 30 minutes, that’s going to allow your body to respond to that morning light and produce your own cortisol naturally. So, this can be really, really game changing. And I know not everybody, I’m from Chicago and I’ve lived in Europe, I’ve lived in places when it’s not always like, sunny outside, so it doesn’t have to be sunny. Like, just going outside can be really, really helpful.

And now people are going to say, like, “Yeah, but it’s like, the weather is awful, it’s raining.” I get it. I lived in Amsterdam. So, in that situation, it’s not free but doing like, a light therapy box first thing in the morning can be a game changer for your energy levels. And that can help you sleep better at night as well because that morning light exposure sets you up to have that healthy cortisol curve. It lets your body know, “Hey, it’s daytime, time to be awake and have lots of energy.” And it also gives you an opportunity to have a little bit more time to wind down throughout the day where your body is going to be like, “Okay, we’ve kind of released all the cortisol we wanted to, and so the evening time is when we can wind down and get some rest.”

Cynthia Thurlow: I love that suggestion and it’s interesting when you were saying that one of the exercises you do with your patients and clients is to have them divide and make a list of what brings them joy and what does not. One of the first things I thought of before you mentioned that was connection to nature in the morning, that there’s something very joyful that I experience getting sunlight exposure on my retina, suppressing melatonin, and telling my body it’s time to get moving and as an added bonus, as you mentioned as well when we wake up in the morning, that’s the time to be thinking about sleep at night, because actually getting that light exposure on your retinas in the morning can set you up for better sleep quality at night as well. I think that’s certainly something I wanted to reemphasize

 Dr. Wentz, it’s been such a pleasure. I could talk to you forever. Can you please let listeners know how to connect with you, how to purchase your new book, and how to connect with you on social media?

Izabella Wentz: Absolutely. Thank you so much for having me. My website is thyroidpharmacist.com. I’m also on Facebook under Thyroid Pharmacist Dr. Izabella Wentz and then people can find me on Instagram under @izabellawentzpharmd. I do have a guide if you go to thyroidpharmacist.com/ABC, and that’s the ABCs of adrenal support that goes into a little bit more detail on some of the adaptogens, the B vitamins, vitamin C, and some easy-to-do lifestyle changes that you can start incorporating right away. My book is available on Amazon and Barnes & Noble wherever fine books are sold, and it’s called the Adrenal Transformation Protocol.

Cynthia Thurlow: Thank you so much. It’s been such a pleasure.

Izabella Wentz: Thank you so much. I really appreciate it.

Cynthia Thurlow: If you love this podcast episode, please leave a rating and review, subscribe, and tell a friend.