Podcast Summary: Call It What It Is Episode: Call It Fatigue, Medical Guesswork, and a Diagnosis No One Saw Coming
Release Date: August 14, 2025
Host: Camilla Ludington
Guest: Dr. Isabella Wentz, Pharmacist and Thyroid Health Expert

Introduction

In this enlightening episode of "Call It What It Is," host Camilla Ludington delves deep into the complexities of Hashimoto's hypothyroidism with renowned pharmacist and functional medicine expert, Dr. Isabella Wentz. Drawing from her personal battle with the condition and extensive research, Dr. Wentz provides listeners with a comprehensive understanding of Hashimoto's, its symptoms, diagnosis, and management.

Understanding Hashimoto's Hypothyroidism

Dr. Wentz shares her personal journey with Hashimoto's, highlighting the often-misunderstood nature of the disease.

• Personal Diagnosis and Journey
  "I was diagnosed myself with Hashimoto's in 2009 after about a decade of some really confusing and debilitating symptoms," [04:24] shares Dr. Wentz. Her experience led her to become a leading voice in thyroid health, emphasizing the importance of self-advocacy in managing the condition.

• Common Symptoms and Misdiagnosis
  Dr. Wentz outlines the diverse range of symptoms associated with Hashimoto's, many of which are easily mistaken for other ailments.
  "Unrelenting fatigue was the most damaging symptom because it took so much of my life away in my 20s," [05:12] she explains. Other symptoms include panic attacks, anxiety, carpal tunnel syndrome, brain fog, and hair loss, often leading patients to consult multiple specialists without finding answers.

Prevalence and Heredity

• Commonality in Women
  "Hashimoto sounds like an exotic Japanese sword fighter, but it's a very, very common condition affecting one in five women at some point in their lives," [06:50] states Dr. Wentz. She discusses how hormonal changes during pregnancy, puberty, and perimenopause are peak times for diagnosis, suggesting a link between hormonal fluctuations and autoimmune susceptibility.

• Genetic and Environmental Factors
  Addressing hereditary aspects, Dr. Wentz notes,
  "It's both hereditary, but it's also environmental," [07:27]. While genetics play a role, environmental factors significantly influence disease manifestation, making it crucial for children of affected parents to be monitored for early signs.

Impact on Fertility and Pregnancy

Dr. Wentz emphasizes the profound effects Hashimoto's can have on reproductive health.

• Fertility Challenges
  "Having not enough thyroid hormone on board... can lead to trouble with getting pregnant and miscarriages," [09:08] she explains. Additionally, elevated thyroid antibodies may interfere with fertility and implantation, further complicating pregnancy outcomes.

• Pregnancy Management
  Proper thyroid function is vital during pregnancy for the baby's development.
  "Babies... depend on mom's circulating thyroid hormone. And that helps with brain development," [09:08]. Thus, dosage adjustments of thyroid medication during pregnancy are often necessary to ensure optimal health for both mother and child.

Diagnosing Hashimoto's

Proper diagnosis is critical for effective management.

• Comprehensive Thyroid Testing
  Dr. Wentz advises,
  "Ask for a panel, a full thyroid panel... you also want to ask for thyroid antibodies," [11:07]. Key tests include Thyroid Stimulating Hormone (TSH), T3, T4, and antibodies like Thyroid Peroxidase (TPO) and Thyroglobulin (TG).

• Interpreting Lab Results
  Many patients may have normal TSH levels yet still experience symptoms.
  "Most of my clients feel best with the TSH between 0.5 and 2... anything above, I would say 2.5 is going to be suspect," [12:30]. She highlights that elevated thyroid antibodies can be present even when standard thyroid hormone levels appear normal, necessitating a more thorough evaluation.

Treatment and Medication Options

Managing Hashimoto's often requires a multifaceted approach.

• Medication Types
  Dr. Wentz discusses various thyroid medications:
  "Levothyroxine is the same as T4... you can take T3 directly. There's a medication known as Cytomel or Leothy..." [14:10]. Some patients benefit from natural desiccated thyroid medications or compounded versions tailored to their specific needs.

• Addressing Conversion Issues
  "In some cases, a person might be taking levothyroxine and their body just doesn't convert enough of it to that T3," [14:10]. Supporting liver function and addressing nutrient deficiencies can enhance hormone conversion and overall thyroid health.

Lifestyle and Dietary Interventions

Beyond medication, lifestyle changes play a pivotal role in managing Hashimoto's.

• Dietary Adjustments
  Dr. Wentz recommends eliminating potential triggers like gluten, dairy, and soy:
  "About 80% of the people I've worked with feel better dairy-free... soy-free," [19:27]. She also emphasizes blood sugar balance, advocating for a diet rich in protein, healthy fats, and controlled carbohydrates to mitigate blood sugar swings that can exacerbate thyroid antibody activity.

• Managing Stress and Gut Health
  "We might use thiamine for energy production, we might use some adaptogens like Ashwagandha to help them calm down their stress response," [26:39]. Addressing stress and supporting gut health are crucial for reducing autoimmune activity and promoting overall well-being.

Natural Remission and Recovery

Hope for remission exists, especially in early stages.

• Early Intervention Success
  "In the early stages... you can absolutely take on lifestyle changes... and absolutely get into remission," [28:30]. Nutrients like selenium and myo-inositol can synergistically lower thyroid antibodies, potentially reversing the condition without medication.

• Advanced Stages Management
  While remission is challenging in later stages, lifestyle changes can still significantly improve quality of life.
  "You can absolutely reduce your thyroid antibodies, but you're still going to need to be on some kind of thyroid hormone," [28:30].

Additional Health Connections

Dr. Wentz explores other health factors linked to Hashimoto's.

• Breast Implants and UTIs
  "Breast implant illness can be a potential factor for various types of autoimmune disorders," [20:45]. Additionally, recurrent urinary tract infections and antibiotic treatments can disrupt the gut microbiome, further impacting thyroid health:
  "About 50% of people mentioned that before the onset of Hashimoto's, they struggled with urinary tract infections," [21:58].

• Impact of Medications
  "In recent years, large scale studies have confirmed that birth control pills can potentially lead to thyroid dysfunction," [33:07]. This highlights the need for careful consideration of medications in thyroid health management.

Advocating for Your Health

The episode concludes with empowering advice for listeners navigating Hashimoto's.

• Self-Advocacy
  "Often, we have to advocate for our own health," [37:16]. Dr. Wentz encourages patients to seek comprehensive testing and personalized treatment plans, especially when standard medical approaches fall short.

• Hope and Transformation
  "You can absolutely live symptom-free... It just takes a little bit of time," [35:27]. Many individuals, regardless of age, have successfully managed their Hashimoto's through dedicated lifestyle changes and appropriate medical interventions.

Conclusion

This episode serves as a crucial resource for anyone affected by Hashimoto's hypothyroidism. Through Dr. Isabella Wentz's expertise and personal experiences, listeners gain valuable insights into understanding, diagnosing, and managing this autoimmune condition. The discussion underscores the importance of comprehensive testing, personalized treatment plans, and proactive health management in achieving remission and improving quality of life.

Key Takeaways:

• Hashimoto's is a common autoimmune thyroid condition, especially in women.
• Comprehensive thyroid testing, including antibodies, is essential for accurate diagnosis.
• Treatment may involve various medications and significant lifestyle and dietary changes.
• Early intervention can lead to natural remission, while advanced stages require ongoing medical management.
• Self-advocacy and personalized healthcare are paramount in managing Hashimoto's effectively.

Notable Quotes:

• "Unrelenting fatigue was the most damaging symptom because it took so much of my life away in my 20s." — Dr. Isabella Wentz [05:12]
• "Hashimoto sounds like an exotic Japanese sword fighter, but it's a very, very common condition affecting one in five women at some point in their lives." — Dr. Isabella Wentz [06:50]
• "Most of my clients feel best with the TSH between 0.5 and 2... anything above, I would say 2.5 is going to be suspect." — Dr. Isabella Wentz [12:30]
• "In the early stages... you can absolutely take on lifestyle changes... and absolutely get into remission." — Dr. Isabella Wentz [28:30]
• "You can absolutely live symptom-free... It just takes a little bit of time." — Dr. Isabella Wentz [35:27]

This summary is intended to provide a comprehensive overview of the podcast episode for those who have not listened to it. For more detailed information and personal anecdotes, listening to the full episode is recommended.