Call It Fatigue, Medical Guesswork, and a Diagnosis No One Saw Coming

Summary

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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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].

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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.

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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.

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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.

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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]

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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.

Transcript

[Camilla Ludington]

This is an I Heart podcast. Hey, can we talk about Plan B for a second? What exactly is it? Okay, Plan B is emergency contraception you take after unprotected sex. Think of it as backup birth control. It works by temporarily delaying ovulation to help prevent pregnancy before it starts.

[Dr. Isabella Wentz]

And it's available right off the shelf.

[Camilla Ludington]

Yep. It's at all major retailers in all 50 US states. No prescription ID or age requirement.

[Dr. Isabella Wentz]

Ah. Together we've got this.

[Camilla Ludington]

Follow Plan B on insta at Plan B one step Use as directed iheart.

[Ryan Seacrest]

Presents the Big three Playoffs this Sunday. The remaining four teams battle to make the championship in the most physical, fierce and competitive basketball league in the world. The action starts with the Big three Monster Energy Celebrity Game. Then Dwight Howard and his Ellie Riot take on Montrez Harrell and Dr. J Chicago triplets. The finale will see popular Miami 305 with stars MVP Michael Beasley and Lance Stevenson take on Nancy Lieberman's Dallas who will make it to the Big Three championship. The no holds barred action starts Sunday at 3pm Eastern, 12 Pacific only on CBS.

[Jessica Capshaw]

This summer, Disney is going retro with all your Disney and Hulu throwback faves. Hit endless rewind on Disney with the Princess diaries, the Lizzie McGuire Movie and Freaky Friday. Then with Hulu Throw It Back with Gilmore Girls, One Tree Hill and Full House. All these and more now totally streaming with Hulu on Disney with a bundle subscription available with bundle plans starting at $10.99 a month terms app. Visit disneyplus.com hulu for details.

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[Camilla Ludington]

Call it what It Is with Jessica Capshaw and Camille Ludington an iHeartRadio podcast hello, hello, hello, Call it crew and welcome to another episode of Call it what It Is. I, Camilla Ludington. I'm flying solo for this episode today and before I tell you guys about our amazing special guest that I'm really excited that we have on today, I want to talk a little bit about last week's episode. So obviously I revealed that I had Hashimoto's hypothyroidism. And I have to say, you guys, the feedback from all of you has just been really incredible and has felt so supportive. And I've been reading so many of your comments and I'm overwhelmed, honestly, by how many of us in this call it community also have thyroid diseases or you've had your thyroid removed and you're experiencing very similar symptoms. And I asked you guys for any questions you had to send them our way and you guys absolutely followed through. One person I kept seeing come up online was Dr. Isabella Wentz. Now she is a pharmacist and a functional medicine expert who became a leading voice in thyroid health after her own diagnosis of Hashimoto's Hypothyroid ITIs in 2009. So many of you have read one of her books. It just kept coming up and it was called the Hashimoto's Protocol. And I'm very happy to welcome her onto the podcast. Dr. Wads, welcome to call it what it is.

[Dr. Isabella Wentz]

Thank you so much for having me, Camille. It's such a pleasure to be here with you.

[Camilla Ludington]

Can you tell us a little bit about your journey?

[Dr. Isabella Wentz]

Sure. So, in full disclosure, I was never interested in the thyroid gland during my own training. It wasn't until I was diagnosed myself with Hashimoto's in 2009, after about a decade of some really confusing and debilitating symptoms, is when I decided that I was going to figure out how to get myself better and then I was going to help others do the same. So I became a Hashimoto's expert by ways of being a bit of a human guinea pig and being my own experiment.

[Camilla Ludington]

I think it's amazing to have a doctor and talk to somebody that actually understands the experience because it's. It is very confusing. What are some of the symptoms? I'm interested. That you were feeling for a long time that you felt could have been something else, but then ended up being Hashimoto's.

[Dr. Isabella Wentz]

I would say unrelenting fatigue. Yeah. Where I was just chronically exhausted. And everybody would say, you need to sleep more, you need to sleep less, you need to exercise more. Have you tried this? You know, you're just getting older. And I would say that was the most damaging symptom because it took so much of my life away in my 20s. Then there were symptoms like panic attacks and anxiety, which were not really part of my personality. And they sort of came out of nowhere. And, you know, of course people were would say, oh, well, everybody's anxious. You're in graduate school or you're working. This is hard. This is big girl stuff. Of course you're going to be anxious. And then there were symptoms like carpal tunnel syndrome and brain fog and hair loss, where I would go to see different experts and they would say, oh, the hair loss, this isn't related to this, or this isn't related to that. So I would go to see somebody like a specialist for pain for my carpal tunnel syndrome, and then somebody to help me with acid reflux. And it was just very confusing because the symptoms were all over the place.

[Camilla Ludington]

It affects so much, and that's what I'm learning. It affects so much of your body. And so it does feel like these symptoms are sort of all over the place. I'm going to jump into all the questions so that we can get through as much as possible because this, you know, we had such a huge response from. From people. So I think people were very shocked. Can you let us know again how common this is and why you believe it's more common in women? That question came up a lot.

[Dr. Isabella Wentz]

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. Typically, pregnancy, puberty and perimenopause are going to be the peak three times when women are diagnosed. There is a school of thought that believes that hormonal changes, you know, all of our hormones, talk to one another, can be one of the primary reasons why women may be more susceptible.

[Camilla Ludington]

Wow, okay. Is it something that is hereditary and genetic? So I have a daughter. Is she more likely to develop something like this because I have it?

[Dr. Isabella Wentz]

It's an interesting condition because it's both hereditary, but it's also environmental. And so you can have identical twins if a condition was purely genetic. Both. If one twin had the condition, the other one would as well. That's not necessarily the case with Hashimoto's, so. So if my twin had it, then I would have a greater chance of having it, but not 100% chance. So we know there's a big environmental factor. We do know that children are going to be at greater risk if parents who have the condition. Interesting. Studies have shown that the dad having Hashimoto, there's going to be a much more higher likelihood that the CH children will as well. With moms, it can be hit or miss. I do think it's an important thing to monitor and be aware because a lot of times Hashimoto can start for 5, 10, 15 years before we get a proper diagnosis. And sometimes that can show up in children in different ways than it could show up in adults. For example, children might have growth issues. Teenagers might be extra, extra moody. We might have young women in their 20s and Hashimoto might show up as irritable bowel syndrome. Then we might have women in their 30s and Hashimoto. Hashimoto's might show up as trouble trying to conceive or multiple miscarriages. And unfortunately, a lot of times this diagnosis is missed, which is so amazing that you're raising awareness about this and you've gotten your own diagnosis.

[Camilla Ludington]

So I want to touch on something that you just mentioned there, because we did have a lot of questions about this. People were wondering, do women with Hashimoto's need to take extra precautions when they're pregnant or breastfeeding? And can it affect your fertility?

[Dr. Isabella Wentz]

Yes, it could absolutely impact your fertility. So having not enough, not enough thyroid hormone on board, which is going to be an advanced stage of Hashimoto's, can lead to trouble with getting pregnant. It can lead to miscarriages. It can also lead to developmental delays in the offspring. Having hypothyroidism can lead to trouble with breastfeeding. So you may not make enough breast milk, can lead to postpartum depression. And then there's also the hypothyroidism piece, which a lot of, I think endocrinologists and doctors may talk about. But there's also the autoimmune piece, where a lot of functional medicine practitioners tend to focus on that, the autoimmunity. When you have the elevated thyroid antibodies that can actually interfere with fertility and implantation as well, that can impact our ability to carry a baby to term. And that can also be associated with issues like postpartum psychosis, postpartum health issues. So it is extra important to make sure I, I would advocate for every woman trying to get pregnant to test for thyroid antibodies and to test her thyroid function to make sure that was dialed in, because you're gonna, you're gonna feel so much better, you're gonna have a greater chance of getting pregnant, and your babies are going to be much healthier. And if you're already on thyroid meds, you also need to adjust your dosage when you first get pregnant. Generally speaking, people are going to need more thyroid hormone to ensure that the baby gets enough right, because babies, and when they're still developing right, have thyroid glands. So they depend on mom's circulating thyroid hormone. And that helps with brain development. And so many other important parts Of. Of the baby's growth.

[Camilla Ludington]

How do they test for it? Like, what do they need to specifically ask their doctors for when they're going for their labs? What. What do they need to be doing?

[Dr. Isabella Wentz]

So I would ask for a panel, a full thyroid panel. Generally, if you were to go into an office and say, I want my thyroid tested, test would be done, which is very helpful for advanced cases of thyroid dysfunction. But it can actually be normal in the first five to 10 years. And so you also want to ask for thyroid antibodies. The two most commonly associated with Hashimoto's are going to be thyroid peroxidase antibodies and thyroglobulin antibodies. TPO and TG is how I. I have people just write that and then look at the thyroid hormones. In rare cases, somebody might have normal thyroid levels of tsh, and they might have. They might not have thyroid antibodies, but there might be a communication breakdown between their pituitary gland that secretes TSH and between the actual thyroid hormones that are present. And so T3 and T4 hormones are also what people want to look at. And I would say that would be a minimum for me for every woman in the childbearing ages. Anybody with weird symptoms like anxiety or fatigue or pain or even irritable bowel syndrome. Wow.

[Camilla Ludington]

Okay.

[Dr. Isabella Wentz]

Now, I was seeing a lot online.

[Camilla Ludington]

People talking about, my TSH level looks normal, but I'm still feeling awful. Why is that?

[Dr. Isabella Wentz]

Most of my clients feel best with the TSH between 0.5 and 2. And really, anything above, I would say 2.5 is going to be suspect. Where I've seen dozens of lab tests that people have brought to me, and their doctors will say, your TSH is 5 or TSH is 6 or 7 or 8. That's normal. We don't need to do anything. Where, personally, I felt like a sloth when I had a TSH of 4.5, I was wearing two jackets in the middle of and a scarf and just all over the place. And so this is going to be another important reconsideration. And then, of course, there's the autoimmune component. So you can have a normal tsh, but if you have really high thyroid antibodies, these antibodies can be leading to a whole host of different symptoms, such as anxiety, such as fatigue, just an overall feeling of unwell. And then, of course, we have to look at the thyroid hormones sometimes that TSH might be high, it might be normal, it might be low. But we also want to take a look at what's actually happening. Do we have enough of Those thyroid hormones to bide thyroid receptors.

[Camilla Ludington]

So now is that a different kind of medication? Because when I got diagnosed, I got put on levothyroxine. If your TSH is now normal, but you're noticing in your panel that other things are not, is there an additional medicine that then you should be taking or prescription you should be taking or supplement?

[Dr. Isabella Wentz]

For sure, Definitely. If you have a TSH that's normal, but you're still not feeling your best, I would Look Thyroid Hormones. T4 is one of the main active thyroid hormones, and levothyroxine is the same as T4. Now we also have T3 that gets converted from T4, and T3 is the more physiologically active hormone. Generally Speaking, when your T3 levels are dialed in, you're going to have beautiful hair, lots of energy, your metabolism is going to be working really well for you, your brain's going to be working for you really well. And on paper, the T4 to T3 conversion happens really, really nicely. Right. However, in the human body, in some cases, a person might be taking levothyroxine and their body just doesn't convert enough of it to that T3 and so end up having a lot of thyroid symptoms even though they're on thyroid medicine. And so this is where other types of thyroid hormones can come in, in prescription formats. So you can take T3 directly. There's a medication known as Cytomel or Leothy that could be added to the T4. Some patients might benefit from using a natural desiccated thyroid medication like armor thyroid, and this is derived from animal thyroid glands and has some T4 and some T3 in it. Or patients might wish to get compounded versions of T4 and T3 and just the right ratios for them. And then of course, I always like to look at what are the underlying reasons why somebody might not making. Might be making that conversion. So why, why are you getting all this T4 but your body's not making enough T3 from it? And a lot of times it has to do with low iron status, it has to do with, with stress. It can also be an issue when your liver is overburdened or you have nutrient deficiencies. So we can do a lot of different. We can do a lot of different things to optimize those pathways. But for some people, it's easier just to take a T3 containing medication directly.

[Camilla Ludington]

Okay, thank you so much for that, because I know a lot of people are still not feeling great on their medication.

[Dr. Isabella Wentz]

Foreign.

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[Jessica Capshaw]

This summer, Disney is going retro with all your Disney and Hulu throwback faves. Hit endless rewind on Disney with the Princess diaries, the Lizzie McGuire Movie and Freaky Friday. Then with Hulu Throw It Back with Gilmore Girls, One Tree Hill and Full House. All these and more now totally streaming with Hulu on Disney plus with a bundle subscription available with bundle plans starting at $10.99 a month. Terms apply. Visit disneyplus.com hulu for details.

[Ryan Seacrest]

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[Dr. Isabella Wentz]

Ugh. Come on.

[Camilla Ludington]

Why is this taking so long? This thing is ancient.

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[Dr. Isabella Wentz]

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[Camilla Ludington]

There's a lot of talk online and this is where it got confusing for me. Should we be avoiding gluten and dairy?

[Dr. Isabella Wentz]

For me, from a practicality standpoint, I tell people why don't you try a gluten free diet for three weeks if you improve. And some people are like I'm never, this is never going to work. And then all of a sudden they're like holy cow, so many things improved. I have so much less inflammation. And your body will tell you the other reactive foods are going to be dairy and soy. So about 80% of the people that I've worked with feel better dairy free. About 78% of the people feel better soy free. The other major dietary change I recommend is blood sugar balance. So generally speaking, maybe not in la, but western diet we want to eat more protein and carbohydrates, potentially more of a more healthy fats versus being very, very dependent on carbohydrates. So getting on like a very blood sugar balanced diet can be very, very helpful for people because the blood sugar swings actually really can impact Hashimoto's antibodies.

[Camilla Ludington]

Okay, I love.

[Dr. Isabella Wentz]

Okay, that's great.

[Camilla Ludington]

That was actually my next question, so that's perfect. Okay. Is there a link between breast implants and Hashimoto's?

[Dr. Isabella Wentz]

Breast implant illness can be a potential factor for various types of autoimmune disorders in some women have observed that their health started really declining once they had breast implants put in. Right. I have had some clients and definitely there are clients that never had breast implants and still had Hashimoto's. Right. But getting them, their breast implants removed would be has been a really big game changer for them as far as their inflammatory markers and feeling their best. I've had clients that were eating the cleanest diets and trying to do everything perfectly well on thyroid medications and still not thriving. And then they would connect with a breast implant surgeon and in some cases they might have leaky breast implants or perhaps some, some growths around them that could potentially what can happen is that they can essentially stimulate the immune system and upregulate it. So you end up attacking whatever pathogens are perhaps growing as thyroid gland that may cross react.

[Camilla Ludington]

Okay, what about a link between UTIs and Hashimoto's?

[Dr. Isabella Wentz]

That's a very interesting link. So typically UTIs can be caused by E. Coli and Klebsiella. I did a bit of an outcome survey with some of my Followers and clients to see if there was a connection there. And about 50% of people mentioned that before the onset of Hashimoto's, they struggled with urinary tract infections. Now the UTI themselves or all of the antibiotic treatment that follows, and that really challenges the gut microbiome, which helps us absorb all of our thyroid nutrients. But there's definitely a connection there.

[Camilla Ludington]

Wow, that's fascinating. Okay, so I think one thing that's been asked a lot is, so someone was saying, someone wanted to know their 14 year old just got diagnosed and her TSH was 91, mine was 97.5. And 18 months ago I had normal labs, I guess.

[Dr. Isabella Wentz]

And.

[Camilla Ludington]

Is there. Does that mean that I had no Hashimoto's before that, or could it have been like, lying dormant?

[Dr. Isabella Wentz]

Yeah, absolutely. So there are different stages to Hashimoto's. Five have been described. The first stage is essentially just the genetic predisposition. So for all intents and purposes, you don't have thyroid antibodies. There's no attack against your thyroid gland, and your thyroid function is normal. The second stage of Hashimoto's is when you start having an attack against your thyroid gland. Typically, this is going to present with elevated thyroid antibodies. So high levels of those TPO and TG antibodies. But your TSH might still be perfectly normal and your thyroid hormone levels might still be perfectly normal. Then the stage three, but you might still be symptomatic just because of those thyroid antibodies. Stage three of Hashimoto's is when you start seeing a little bit of a gradual rise in TSH where you might have a TSH of up to 10. And then stage four is when your TSH goes really high above that 8 or 10 mark, your T4, T3 may get impacted. Stage four is when most people actually get diagnosed. But everything else starting stage two could have been going on for 5, 10, 15 years. So it could have been marinating in the background where your thyroid could have been under attack, but it was still compensating. By stage four, you've damaged the immune system, has damaged enough of the thyroid gland where your body is no longer able to compensate. It's just essentially shouting, please, more thyroid hormone and not more of that TSH signal. And then stage five is progression to other autoimmune conditions. I'm a big proponent of getting an early diagnosis. So can we figure out when you're in stage two, that you have thyroid antibodies and we can work on reducing those thyroid antibodies so you don't progress to overt hypothyroidism and we prevent 5, 10, 15 years of getting the runaround, going to psychiatrists, going to pain doctors, going to all these different places because you have no idea what's going on. And nobody can figure out why you know, why you're sick, why you're struggling.

[Camilla Ludington]

Am I more likely because the sort of mine ended up being very severe right when I got diagnosed, Am I now in a situation where one auto, this autoimmune disease can go on now to lead to another? Am I more susceptible to that?

[Dr. Isabella Wentz]

If you have one autoimmune condition, you're going to be at greater risk for additional autoimmune conditions.

[Camilla Ludington]

If someone is, you know, has a 91 like this lady is saying that her daughter has, or like a 97.5 like I have, how quickly are we able to feel better?

[Dr. Isabella Wentz]

Generally speaking, you can get feel significantly better in about 90 days or so with a really elevated TSH. It might take you a few months of starting thyroid meds and then following up, retesting your levels. You don't want to go on like a super mega dose right away and want to figure out exactly how much your body needs and that may take a few months to really titrate up to that target dose for you. And starting the lifestyle changes and lifestyle interventions, people could feel better within few weeks, few days, depending on if they, if they do the right type of intervention. I typically walk people through a 90 day protocol and they do start feeling better within the first week or so.

[Camilla Ludington]

What does that protocol look like? Can you break it down for us?

[Dr. Isabella Wentz]

Focus. We focus a lot on nutrition. So getting through a blood sugar balanced diet, we might cut out gluten, dairy and soy for a period of 30 to 90 days to make sure those are not an issue for that person. And then we really start focusing on supporting some of the body's own pathways. So for example, a lot of times people have a hard time with conversion of thyroid hormones. So I have them support their liver function to help to process various hormones, various toxins in our environment. And this can help them feel better in about two weeks. Then we really focus on their stress response. We might use thiamine for energy production, we might use some, we might use some adaptogens like Ashwagandha to help them calm down their stress response. And we'll do that for about a period of four weeks and then we'll really dial in some gut health. I typically work that a little bit longer. A lot of times the there are triggers that bring on the autoimmune condition. Sometimes they are related to having chronic stress in your life, Sometimes they're related to a toxic exposure, and sometimes they're related to a gut infection. And so we're just trying to dial those things in and cover all of our bases to get a person into feeling better and into that remission state so that they're thyroid antibodies aren't continually destroying their thyroid gland.

[Camilla Ludington]

Some people online are talking about how they've been able to put their Hashimoto's into remission naturally without taking any medication. Is that, I guess my question is, like, is that real? Like, can you really do that?

[Dr. Isabella Wentz]

Definitely. In the early stages. Okay. Diagnosed in stage two of Hashimoto's and you don't have any damage to your thyroid gland, then you can absolutely take on lifestyle changes. Selenium and myo inositol in the very early stages. When used together, they seem to have a synergistic approach where the thyroid antibodies can lower and normalize. And even like very, I guess I would say, small disruptions in thyroid function can be normalized. And so the very early stages, you can utilize something like that for two to three months and you can absolutely get into remission. Now, if you're in stage stage four of Hashimoto's and you've had 90 of your thyroid gland damaged, you can absolutely still do all the lifestyle interventions. They're going to make you feel a lot better, they're going to reduce your thyroid antibodies, but you're still going to need to be on some kind of thyroid hormone because, you know, we can't necessarily grow back a thyroid in this day and age. There are some innovative companies that are trying to figure out a way to do so, but we're not there yet. Right. Maybe in a. In five years. But at this point, we do have to take thyroid hormones when we are in those advanced stages.

[Camilla Ludington]

Okay, so that would be me. A lot of people are asking, can your thyroid affect your sex drive?

[Dr. Isabella Wentz]

Absolutely. Both for men and for women. So thyroid hormones can impact our testosterone levels. Interestingly, I will say women typically complain about hair loss, on fatigue and weight gain, and men will come in because of sex drive issues. Right. Or they can't grow a beard. So just thyroid hormones themselves can absolutely impact our libido and sex drive.

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[Camilla Ludington]

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[Dr. Isabella Wentz]

Shut up.

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[Dr. Isabella Wentz]

You got it dude.

[Camilla Ludington]

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[Ryan Seacrest]

Terms Apply hey, it's Ryan Seacrest for Albertsons and Safeway. Now through August 26th. It's back to deals time where you can enjoy storewide deals and earn four times points. Look for in store tags to earn on eligible items from Kettle, Haagen, Dazs, M M's Ritz Chips Ahoy Arrowhead, All Poppy Charman and Red Bull. Then clip the offer in the app for automatic event long savings. Shop in store or online for easy drive up and go pickup or delivery subject to availability restrictions. Apply. Visit Albertsons or Safeway.com for more details.

[Dr. Isabella Wentz]

Ah, come on.

[Camilla Ludington]

Why is this taking so long? This thing is ancient.

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[Dr. Isabella Wentz]

Whoa, this thing moves.

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[Camilla Ludington]

Can birth control mess with your thyroid?

[Dr. Isabella Wentz]

That's a really interesting question I, when I first started researching Hashimoto's, I thought about that question and I, it made sense to me that the birth control could do that. I wasn't 100% sure, but I looked at all the different pathways with altering gut microbiome with, with, for, with changing different hormones, as well as the impact on various vitamins and nutrients, and it made a lot of sense to me. In recent years, large scale studies have actually come out and confirmed this, that yes, getting on birth control pills can potentially lead to thyroid dysfunction. So this is, this is something I've suspected, but just recent, very recently the research has confirmed.

[Camilla Ludington]

Okay. Somebody else has asked, what age should you get regular blood checks or general health checks? We have a lot of young listeners.

[Dr. Isabella Wentz]

Gosh, I would say at 18, I have a son. And as much as he hates blood work, we try to do it on an annual basis. We put some numbing cream on his arm. He plays a little bit of Minecraft. And I do think it is important to be proactive with our health and especially if you have a family history and if you've got anything weird going on. Right. So yeah, a teenager that's moody or maybe she doesn't have her period or she's losing her hair or gaining weight or losing too much weight. Let's get some blood work for her and it takes a few, few minutes. You know, I'm, I'm, I'm needle phobic and I do it.

[Camilla Ludington]

So yeah.

[Dr. Isabella Wentz]

Important.

[Camilla Ludington]

Okay. And can you, could you be. I have, my daughter's 8 years old. Could you be 8 years old and this, this be something that happens to you or is that very rare?

[Dr. Isabella Wentz]

It's can happen in children. It tends to be more common around puberty.

[Camilla Ludington]

Interesting. Okay, that's, that's great for everyone to look out for. If people are a stage four like me, is there hope? Because sometimes there's a lot of doom and gloom when I've been on TikTok and it gets so overwhelming. It. Have you seen women, men with, you know, 97.5, maybe even in the hundred, something extreme, be able to feel normal again? Have you and, and have their levels return to normal?

[Dr. Isabella Wentz]

Oh, absolutely. I see it all the time. So it is some work that you have to put in. So you have to probably dial in a few things. If your thyroid has been dysfunctioning for a while, you might have to, you might be nutrient depleted. So you would want to address nutrient deficiencies. B12, ferritin, vitamin D are some of the ones that come up. In addition to Doing, you know, the thyroid hormones. Typically, I would say we might need to adjust a few different things to get you back on track, but. Absolutely. And I've had women who are in their 70s and 80s, and by following some of these lifestyle changes, sometimes it's as simple as starting on one nutrient. You know, depending on what's going on within their bodies, they can be completely transformed in three, five, seven days. Sometimes. Sometimes it does take longer if they've got more going on. But one example that I'm always excited to share is thiamine. Women with thyroid fatigue and low blood pressure. Some of them, when we would give them around 600 milligrams of thiamine, they'd have a resolution of their fatigue in, like, three to five days. I've had women.

[Camilla Ludington]

Wow.

[Dr. Isabella Wentz]

For 20 years. And with the addition of thiamine, even though they had been on thyroid meds and tried some other things, they were able to get a complete remission of their fatigue, and they started to feel human again. So definitely you can get there. I'm so glad that you were diagnosed, and I'm so glad that you took charge of your own health and ordered your own labs, because sometimes we have to. Right. Yeah. Ourselves. And now you're doing, you know, now you're doing the research and figuring out what things you. You need to dial in. I think a lot of us do have to advocate for our own health.

[Camilla Ludington]

Yeah.

[Dr. Isabella Wentz]

Doctors, you know, that everybody's a little bit different. So one person might be super well versed in something, and another person might just be very much by the book where they learned that thyroid disorders are no big deal. And you just need to give this one medication. And if somebody has ongoing symptoms, they're probably just making it up. And I'm not kidding. That's. That's what some people have learned.

[Camilla Ludington]

No, I'm seeing that a lot online. A lot of frustration. A lot of people not feeling that, like they're being heard because their labs are TSH is coming back, back normal. And it's overwhelming.

[Dr. Isabella Wentz]

It's. It can be very challenging. Can be very overwhelming. One of the challenges I've seen is that some people simply do better on natural desiccated thyroid. They dent they tend to have, for whatever reason, their unique biochemistry responds much better to that. Some of the synthetic medications and the natural desiccated thyroid hormones, they contain T4, T3, and perhaps small amounts of T1 and T2 that may play some physiological action. And unfortunately, these medications are commonly underutilized. Many practitioners don't know how to work with them. And recently the FDA has asked for them to be removed off the market. So there's a lot of challenges. We need to advocate for ourselves.

[Camilla Ludington]

Okay. Can we still enjoy alcohol?

[Dr. Isabella Wentz]

So I've had alcohol, I've had mojitos, and I've had margaritas and all kinds of things. And this is definitely something that you can enjoy in moderation.

[Camilla Ludington]

Okay.

[Dr. Isabella Wentz]

On your healing journey, I would commit 30, 60, 90 days and just. Just try to focus on eating a clean diet. Blood, we know wine, as much as we love it, it can cause a lot of blood sugar swings, Right?

[Camilla Ludington]

Yeah.

[Dr. Isabella Wentz]

Blood sugar swings, hypoglycemia, or even too much blood sugar can really impact those thyroid antibodies and increase the aggressiveness of the attack on the thyroid gland. And so I say, generally in my protocols, I'll have people go for at least two weeks off of alcohol. That doesn't mean you'll never be able to have alcohol again. You know, you can. In many cases, you can introduce a lot of the foods and dairy and all the things back into your. Into your body, but.

[Camilla Ludington]

Okay.

[Dr. Isabella Wentz]

Some of the things initially gives you an opportunity to recognize what your individual triggers might be like. I had no idea that my. I had irritable bowel syndrome, carpal tunnel syndrome, horrific bloating, despite all the Pilates classes I went to and reflux. And within three days of going gluten and dairy free, all that was gone.

[Camilla Ludington]

And you don't. Yeah.

[Dr. Isabella Wentz]

That different things are triggering you. Gluten and dairy are being some of the more common ones. For some people, it's alcohol. I have random strange foods like pineapple. That's a trigger, but it's a. It's a matter of figuring out, like, what's kind of messing with your immune system, what's messing with your blood sugar. Right. And how to dial that in.

[Camilla Ludington]

Before you go, I want to just reiterate because I want you just to repeat one last time. For anyone listening to this is thinking, wait a second, I have anxiety, I'm tired, my hair spinning, or any combination or one of these and wants to go to their doctor. Let's. I would love for you to just repeat one last time what they need to be asking for. To find out if there is a thyroid issue in play.

[Dr. Isabella Wentz]

To find out if you have a thyroid issue in play, you definitely want to ask your doctor for a TSH test that's going to see if your pituitary is responding to your thyroid hormone levels. You're going to want to ask them to check for T3 and T4 hormones. And you definitely want to ask for thyroid antibodies. The two most important ones are going to be thyroid peroxidase antibodies and thyroglobulin antibodies. You can ask for TPO and TG antibodies. They'll know what you're talking about. Oftentimes, these antibodies can be elevated for 5, 10, 15 years before we see a change in TSH.

[Camilla Ludington]

This is so informative. Thank you so much. I was equally comforted and horrified by how common this is. And. And thank you. And I would love to have you back on the show again. I'm sure we're going to get more questions from the listeners. Thank you so much for being here. I feel more educated. I had so many of these questions myself. I think it is so confusing when you're reading everything and you sort of don't know what you should be doing. And it's a. It's an overwhelming diagnosis when you get it. But I think that you've really made sense of so much of this, and it's just so encouraging. So thank you for being here and educating all of us.

[Dr. Isabella Wentz]

Thank you so much for raising awareness about this topic. I know it's probably not something that was on your radar until you were personally diagnosed, but know that you're making a big difference. Just, I know that you will heal and you're going to find ways to get yourself feeling better. It's absolutely possible. I think sometimes there's a lot of doom and gloom online because people come there to complain. But I think it's also important for us to share stories of healing.

[Camilla Ludington]

Yes. Yes.

[Dr. Isabella Wentz]

I'm an example of that. And I have a lot of friends and colleagues and clients who are also examples of people that have taken charge of their health and healed themselves. They don't have any more symptoms. They're thriving. They're living their best lives. I would love to have you on my show, Thyroid Pharmacist Healing Conversations.

[Camilla Ludington]

I would love that you can share.

[Dr. Isabella Wentz]

Your healing journey and we can inspire other people to take charge of their own health. It's the. There's so many solutions out there. You can absolutely live symptom free. If you got caught in the early stages, you can definitely get the condition into remission in most cases. And then there's also ways to dial in your thyroid hormones. Even if you got caught in the later stages. It just takes a little. It can take a little bit of time. And. And it does take advocating for yourself.

[Camilla Ludington]

Amazing. Thank you so much. I will happily go on your podcast anytime. All Right, guys, I'm so happy that we got to talk to her and pick her brain and ask her all the questions. Honestly, sometimes I was just thinking this as I was talking to her sometimes when I realized that I was so severe. You know, she's talking about TSH levels that are way lower than mine. And then I'm like, with my almost a hundred. But I know that there are listeners out there that are also, you know, you guys are in the stage four like I am. And, and I think that this brings a lot of comfort and a lot of hope. And for any of us listening to this and just thinking, like, you know, I'm really tired all the time. Maybe it's not just me. Maybe it's not just me being a mom and all those things that we just discussed. Really advocate for yourself. Go get tested. Because to have an answer like this, even though it's, you know, intimidating, is just so helpful. Please send us any more questions that you have. I will continue to have her on the show. I'm going to continue to take you guys on this journey with me. I think it's so important. And for now, I will call it the end of the episode.

[Dr. Isabella Wentz]

Foreign.

[Camilla Ludington]

Hey, can we talk about plan.

[Dr. Isabella Wentz]

B for a second?

[Camilla Ludington]

What exactly is it? Okay, Plan B is emergency contraception you take after unprotected sex. Think of it as backup birth control. It works by temporarily delaying ovulation to help prevent pregnancy before it starts.

[Dr. Isabella Wentz]

And it's available right off the shelf.

[Camilla Ludington]

Yep. It's at all major retailers in all 50 US states. No prescription ID or age requirement.

[Dr. Isabella Wentz]

Ah. Together we've got this.

[Camilla Ludington]

Follow plan B on insta at Plan B. One step Use as directed.

[Ryan Seacrest]

Iheart presents the Big three playoffs this Sunday. The remaining four teams battle to make the championship in the most physical, fierce and competitive basketball league in the world. The action starts with the big three monster energy celebrity game. Then Dwight Howard and his LA Rock Ryan take on Montrez Harrell and Dr. J Chicago triplets. The finale will see popular Miami 305 with stars MVP Michael Beasley and Lance Stevenson take on Nancy Lieberman's Dallas Power who will make it to the big three championship. The no holds barred action starts Sunday at 3pm Eastern, 12 Pacific only on CBS.

Hey, it's Ryan Seacrest for Albertsons and Safeway. Now through August 26th, it's back to deals time where you can enjoy storewide deals and earn four times points. Look for in store tags to earn on eligible items from Califia Farms, Pillsbury Crescent, Yoplait General Mills, Prego, Bertoli, Heinz and Kraft. Then clip the offer in the app for automatic event long savings. Shop in store or online for easy drive up and go pickup or delivery subject to availability restrictions apply. Visit Albertsons or Safeway.com for more details.

[Dr. Isabella Wentz]

For years everyone thought Verizon had the best network because they did.

[Ryan Seacrest]

But now the best mobile network in.

[Dr. Isabella Wentz]

The US is T Mobile.

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[Dr. Isabella Wentz]

5G with more towers and their signal reaches further than ever. So you can text an insta talk and say, you won't believe where I am.

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T Mobile has the best mobile Network.

[Dr. Isabella Wentz]

In the US based on analysis by Ookla of speed test intelligence data 1H.

[Ryan Seacrest]

2025C T mobile.com network this is an iHeart podcast.