[00:00:01] Luke: I had an interesting morning. It's not a real tooth, but I had all my teeth redone last year with a dentist here. And I was eating some healthy M&Ms, the organic Whole Foods version. So there I'm watching TV chewing some M&Ms and all of a sudden one of my molars just goes poof and pops out. So yeah, it's funny. So I went and had that reinstalled this morning.

[00:00:29] Izabella: The joys of not being 25 anymore, right?

[00:00:32] Luke: It's funny. Yeah. There were a number of years that I was really leading a very toxic lifestyle and doing all kinds of drugs and stuff, which probably didn't help. But then when I got my act together, I became a vegetarian for many years and my teeth just literally just fell out of my head at that point.

[00:00:51] Yeah, I didn't know about fat soluble vitamins. I was like, "I'm going to be healthy and be a vegetarian." So yeah, it's been a long, long, hard journey, but here we are. It's incredible that I've been doing this for so many years, and I maybe have alluded to the thyroid talking to various practitioners, doctors and so on, but I've never actually focused on it.

[00:01:14] And so I'm so excited that JJ Virgin introduced us and she's like, "You haven't talked to her about thyroid? Are you nuts? You're missing a huge piece of the puzzle." And then once we started talking, I realized Jarrod here, my producer has thyroid issues. And then you were talking to my wife, Alyson, and we don't know if it's thyroid, but she's definitely at a stage in life where her hormones are doing different things. And I'm sure that's related. So it's become pertinent, and I'm so excited to share your knowledge with everyone.

[00:01:46] Izabella: Thank you so much for having me here, Luke. It's such a joy to be here with you. Thyroid conditions, not a lot of people think about them until they get out of balance. Hashimoto's is the condition I specialize in. Sounds like an exotic Japanese sword fighter, but it's such a common condition affecting as many as one in five women at some point in their lives.

[00:02:07] So it's a very, very common thing that people struggle with, and a lot of times they don't actually know that they have a thyroid condition. It takes on average of 10 years for a person to be diagnosed.

[00:02:21] Luke: Wow. And there's probably a lot of chasing of one's tail, putting out fires, trying to arrive at that as the root cause, I imagine.

[00:02:31] Izabella: There's a lot of, I guess, misdiagnosis that happens. So I can go through a woman's history. If a woman might be a cranky teenager, this can be a thyroid dysfunction because thyroid conditions can make people anxious. Anxiety and obsessive compulsive disorder symptoms are some of the earlier symptoms that can occur.

[00:02:53] Women in their 20s might struggle with irritable bowel syndrome. This is another common symptom of thyroid disease. As many as 20 to 25% of people with IBS actually have hypothyroidism, subclinical hypothyroidism. And then we look at women with fertility issues in their 30s.

[00:03:12] Many times fertility issues, fertility challenges, multiple miscarriages, this is another thyroid symptom. And then when we look at women in their 40s and beyond, oftentimes they're going to be presenting as more of the "classical thyroid patient" when they're putting on extra weight. And perhaps maybe they are losing their hair and they're feeling more fatigued.

[00:03:38] And so this is going to be more of the classical presentation, and women might get finally diagnosed in their 40s or 50s. But when you look back at their history, it's like, no, you've probably had this since you were a teenager. And this is why you struggled with fertility challenges.

[00:03:53] This is why you had digestive issues. This is why you were "depressed" or a hypochondriac or considered to be those things. I've worked with women in their 60s and 70s that were like, "I lost so much of my life because I wasn't diagnosed with a thyroid condition." And they'll look at their old labs and they'll say, "Oh my gosh, this lab actually shows that I was hypothyroid in my 20s and my 30s. And so I'm really grateful that you're having me here to talk about this because it impacts so many men and women around the world.

[00:04:29] Luke: What led you to focus on this particular area? What's your journey? I understand you have somewhat of a pain to purpose story, as many of us do? The healed often become the healers.

[00:04:42] Izabella: Yes, of course, the wounded healer. I was never interested in the thyroid during pharmacy school. I thought it was this boring little organ and there were very boring drugs for it. You just have an underactive thyroid. You take this drug. If you have an overactive thyroid, there is a couple of options for that.

[00:05:02] And really, I wasn't interested until I was already a practicing pharmacist and I was diagnosed myself with a thyroid condition, Hashimoto's hypothyroidism, in my 20s, after almost seven or eight years of some really challenging and debilitating mystery symptoms. So I had chronic fatigue syndrome.

[00:05:25] I had acid reflux, irritable bowel syndrome, carpal tunnel in both arms. I had anxiety and panic attacks, just a really long list of symptoms, and none of them were like life-threatening. So people are like, well, you don't have cancer. You don't have this. Maybe you should just eat less, exercise more.

[00:05:47] Maybe you're sleeping not enough. You're sleeping too much. And I was trying to do all of the things. And then finally I started getting hair loss, which I'm a Leo, so that was just too much handle. I was like, "Okay, something is really, really wrong."

[00:06:01] Luke: Sound the alarms.

[00:06:02] Izabella: And I started seeking out doctors that were perhaps a little bit more willing to do additional testing beyond the basics. I had already been a practicing pharmacist, and when I was in pharmacy school, I thought everybody that got a degree-- whether that was a nursing, pharmacy, or medicine-- all of a sudden they were awarded with this limitless knowledge where you can go to any doctor in the entire world and they knew everything.

[00:06:33] But having been a pharmacist for a few years, I was like, "Huh. They're not all created equally." And so I was found to have Hashimoto's subclinical hypothyroidism and thyroid antibodies. My antibodies were in the 2,000 range. Normal is under 35 according to conventional medicine standards, or really should be under 10 for most people with healthy thyroid function.

[00:06:58] And I was like, "Oh, I have this condition." And being a pharmacist, I was so excited about medications. I was like, "Okay, great. I get to take medications and I'll feel so much better." And that was--

[00:07:09] Luke: Probably get a sweet discount too.

[00:07:11] Izabella: Yeah, yeah, of course. That was the one part of me. And then there was another part of me that was conflicted because I was like, "I thought I was living a healthy lifestyle." Why? I'm exercising. I'm eating non-fat dairy. I'm eating whole grains. I'm doing all the things. I don't smoke. I don't drink, so on and so forth. Why is this happening to me in my 20s?

[00:07:34] I had known that women might have hormonal changes and thyroid issues as they got older, but I was still a baby. I was barely an adult when I was diagnosed. And so I was like, "Is there anything that I did to bring on this condition? Is there anything I can do to feel better? Is there anything I can do to potentially reverse this autoimmune attack against my thyroid gland?" And that's really how I became the thyroid pharmacist.

[00:08:04] The Hashimoto's expert was through becoming, I guess, my own guinea pig. I started doing research and started just looking at patient forums and PubMed research and reading anything I can get my hands on, going to all kinds of various doctors with different levels of skills. Some of them were great, some of them not. And I ended up getting myself into remission and have been sharing my story and have helped countless others do the same since that time. And it's been over a decade.

[00:08:37] Luke: So cool. When you were working as a pharmacist, what did your day-to-day life look at? Were you behind the counter at CVS kind of thing or at a boutique pharmacy and you're just filling prescriptions? I don't know what that career entails other than how I interface with who I believe are pharmacists. I have to fill a prescription.

[00:08:55] Izabella: Sure. So the traditional thing that people think about the pharmacist is like a community pharmacist where you would work behind a counter at a Walgreens or CVS or a mom and pop. So I did that during pharmacy school and undergrad and high school. I worked as a pharmacy technician and then an intern.

[00:09:16] Once I graduated, I got more into consulting. So I used to work as a consultant pharmacist helping advise the families and caregivers of people with various types of disabilities. So I was part of a clinical team, and we would review people's medical records, and I would be typically called in when people had a lot of medication-related side effects and a lot of adverse reactions to medications to help sort out their polypharmacy and potentially make recommendations to their caregivers or their doctors and how to adjust their therapies.

[00:09:55] So it was a little bit more behind the scenes than interacting with the public. But it really taught me a lot because I learned about a lot of the different rare conditions that people had. And there wasn't a standard of care for a lot of my clients, so I was always researching with whether it was like published medical research or going into patient or parent forums to think of ways on how to help my clients. And I really learned about how to advocate for others, which then taught me how to advocate for myself with autoimmunity.

[00:10:32] Luke: All right. That makes sense. I think that's something that's so-- I don't know. There's so many shortcomings in the Western allopathic model, and I shit on it a lot, generally speaking. But as I was saying, I'm writing this book, and one of the things I'm writing about is birth trauma. And I was a little bit aggressive in my first draft, and I sent it to my editor and she's like, "Have you ever thought about the fact that you wouldn't be alive if it wasn't for those interventions?"

[00:11:00] I was like, "Okay, you got me." So as you know, I don't want to throw the baby out with the bath water. And I say, if I fall off the roof and break my neck, don't give me ashwagandha. Please take me to the emergency room. I'm not going to take an ice bath for my whatever condition that it wouldn't fix.

[00:11:17] But that said, it seems to me, as someone who's, thankfully, very rarely used any pharmaceutical medication. And when I have, I got to say, most of the time, at best, it's been a temporary symptom reliever-- not solving the root cause, obviously. But one thing that I'm trying to become more aware of is that many people in the world, especially in this country, when they get to a certain age, is not uncommon for them to be on multitudes of different medication.

[00:11:49] Every once in a while, I'm at a family member's house and you see in the bathroom there's six different prescription bottles on the counter. I'm like, "Oh my God." Not only does each one of them have potential for side effects, and you'll be able to correct me if I'm wrong, but how much study actually goes into how they're interacting, just the biochemical nuclear bomb that could potentially take place within our biology by not really understanding how these molecules are going to interface with one another and create other metabolites that could compound side effects and so on?

[00:12:22] Izabella: Oh my gosh, you're so right. And polypharmacy, the things that I used to see is a person would get prescribed a medication for one condition and then that would cause a side effect. So then they would get another medication for that side effect, and this can go on and on.

[00:12:41] I had a case of one little boy that was deemed to have some behavioral issues, so he was put on really heavy-duty psychotropic medications, really high doses, doses that I had not seen in adults. And then just more and more and more. I think he was on four different psychotropic medications, and he was living in a group home.

[00:13:01] His caregivers started saying, "Wow, we think he might have cerebral palsy or something else because he's falling asleep during meals." He looks like he's going to fall over and so on and so forth. And this young child was brought into our clinic where we were able to see him and I thought he was going to fall over just walking. He looked like he was drunk.

[00:13:29] Cerebral palsy is something that you're born with, so you can't just develop it all of a sudden. This small child was having toxicity from all of these medications. And so it was devastating to see some of the effects of that. A lot of times, the people I was working with were not able to advocate for themselves because of their disabilities, so they were very much relying on the people that were caring for them.

[00:13:57] And it's a tragedy in this country with what happens to our elderly, what happens to children, what happens to a lot of us, a lot of people in the communities that are just given this medication after medication and then they start losing skills.

[00:14:16] With older individuals, giving them medications like Benadryl, it's over the counter. It seems innocent, but that can actually slow their cognitive function. There's a whole list of medications that could increase the risk of falls, that essentially could shortcut them into getting into the hospital or a nursing home because they can lose skills from taking these medications.

[00:14:44] Luke: Yeah. One thing is, it's definitely a great business model. It's like, if I'm someone that provides a service or a product and it creates more problems in its solution, I'm going to make a lot more money. It's like if I were to hire a plumber because I had a leak and they come over here and maybe they stop the leak, but they also break the circuit box in the garage and my electrical goes bad and so on and so on.

[00:15:09] It's unfortunately a downward spiral for so many people, which is one of the reasons that I talk to people like you, to try to hopefully reach people before they get to that point of sometimes no return where they're caught in that cycle and just chasing symptoms and making symptoms worse, and so on.

[00:15:28] So with what you were saying earlier about the insane prevalence of thyroid issues, what do you know historically? Was this something that was going on 200 years ago? Is this a result of our toxic environment, EMF, blue light, air pollution, poisons in our food, unnecessary medications, certain harmful medications when we're born and in childhood?

[00:15:55] It seems to me, and I err on the side of paranoia, admittedly, but it seems to me from the moment we're born, it's like everything in our environment is trying to kill us. And it's kind of a sad way to live, but it's something that I'm aware of. So is this thyroid thing a relatively recent phenomenon, and what could you attribute kind of the main underlying causes?

[00:16:16] Izabella: So thyroid conditions have been around for at least 100 years. We know that. And there's always this controversy in medicine. Is it because we're better at diagnosing? Are we just doing more lab testing? Are doctors better trained at recognizing the signs and symptoms? Are people advocating more for themselves?

[00:16:35] And I think part of that is true, but the rates are definitely increasing. Looking at blood samples that were done and frozen from people 10 to 20 years ago, the rates of thyroid antibodies and abnormal thyroid function was much lower than it is now. Some of the efforts, definitely some of the known toxins can be causing more higher rates of thyroid dysfunction.

[00:17:06] But some of the ironic things are the things that public health officials are trying to do to make us healthier can actually cause thyroid dysfunction. So adding fluoride to our water supply to give us beautiful--

[00:17:19] Luke: I was going to bring that up.

[00:17:20] Izabella: Teeth and and to prevent dental cavities, it can work. It can help with dental decay. But it can also lower children's IQ and cause higher rates of thyroid dysfunction. Iodine deficiency worldwide is the primary reason for hypothyroidism. And so public health officials were like, let's solve that. Let's put iodine in the salt supply. Great. No more hypothyroidism.

[00:17:47] Unfortunately, what happened is that iodine is a narrow therapeutic index nutrient, so they lowered the rates of non autoimmune hypothyroidism, but then the rates of autoimmune hypothyroidism and the rates of Graves' disease skyrocketed. So looking at, let's say, the school children in Eastern Europe before a salt iodization program and after the rates have doubled, tripled, sometimes quadrupled of thyroid antibodies in those children.

[00:18:20] I was exposed to Chernobyl. I grew up on the Ukrainian border in Poland, and that big disaster, the children within that vicinity had higher rates of thyroid cancer, thyroid antibodies and Hashimoto's. And you could look at genetically similar children in other parts of Ukraine and they had much lower rates of those conditions and it's not just Chernobyl.

[00:18:46] There's day-to-day radiation and x-rays and things of that nature that can affect thyroid function. And of course, our food. Gluten sensitivity is one of the biggest triggers that I see for people as far as food goes for food related triggers. And so just our processed food diet. I was doing a little bit of research on-- I don't know. My son got this cute, little panda toy and then we were talking about sloths and pandas and somehow I got down the rabbit hole and I was like, "I wonder if sloths have slow thyroid function."

[00:19:23] And it turns out that yes, they have slow thyroid function. And interestingly, giant panda bears do too. And the reason why they have such slow thyroid function is to adapt to their all-bamboo diet so that they can survive on very few calories. Other things, we know that situations like famine, they can increase the rates of hypothyroidism. And people that are hypothyroid are more likely to survive a famine because they don't need as many calories to stay alive.

[00:20:00] And so I'm like, if we're eating just a bunch of processed foods, I feel like that's sending a message to our bodies that we're in a famine. And then, of course, medications. We know that birth control, certain types have been linked to higher rates of irritable bowel syndrome, including Yasmin and Drospirenone containing birth controls.

[00:20:21] And birth control has also been linked to higher rates of thyroid disorders as has the use of proton pump inhibitors. This can be a big risk factor for both IBS and thyroid dysfunction in my experience.

[00:20:34] Luke: So this is a multifaceted causal situation. I'm always like, "What's the one thing?"

[00:20:40] Izabella: I wish. I know. I'm always like, "What's the one thing? What's the one thing?" But oftentimes it's the perfect storm.

[00:20:46] Luke: Going back to two things, fluoride and iodine, and I'm no expert in chemistry, but are they not counterparts in the periodic table wherein one of them is more problematic if you don't have the other and so on. What's the relationship between those as it pertains to thyroid? If we're our entire life drinking fluoridated water and having a diet that's devoid of iodine, it seems to me just in a simplistic way that that would likely lead to thyroid issues.

[00:21:23] Izabella: So the theory is that fluoride can displace iodine in thyroid hormones. And so potentially that could accumulate in the thyroid gland. That's the working theory with that because they're similar weight as far as atoms go.

[00:21:39] Luke: Got it. And then with iodine in the diet, I've heard murmurs of the Japanese, for example, who have generally great longevity and they're eating tons of seaweed and seafood and things like that, very rich in iodine. You're of Eastern European descent, so going back 300 years, where would your ancestors have gotten adequate iodine?

[00:22:01] Would it be eating fish, seafood, things like that in a similar way? I'm thinking of landlocked people that weren't living in a place like Japan surrounded by ocean. Where would we have gotten adequate amounts of dietary iodine?

[00:22:15] Izabella: Well, so interestingly, so there is the Baltic Sea, so potentially from that. But people always quote the Japanese of their high iodine intake. So Hashimoto was a Japanese doctor, Dr. Hashimoto. And so the Japanese do have higher rates of Hashimoto's compared to other populations.

[00:22:34] Luke: Really?

[00:22:34] Izabella: Mm-hmm.

[00:22:34] Luke: Interesting.

[00:22:36] Izabella: And then there's some genetic variations that make people of various ethnicities better able to tolerate higher iodine intake. And of course, like you said, it depends where your ethnicity is and where you are and your microbiome. There's so many different factors as to how much of a nutrient you might be able to tolerate.

[00:22:58] Generally speaking, people with Hashimoto's or a family history or risk factors for it, doses above 300 micrograms per day can be inflammatory to them. So if you're putting on all of this iodized salt into your foods, then you could potentially have toxic levels of iodine. I have seen, unfortunately, some people who are like, "I'm going to eat seaweed snacks because it's so good for my thyroid."

[00:23:27] I write a lot of content for my website, and there's a lot of people that I guess just want to put content out there without doing adequate research. And they say, "Just eat seaweed if you want a healthy thyroid." And this can be great for some people, but then there's people with those genetic predispositions that this can actually induce a thyroid condition in them.

[00:23:52] I had some people who were bedridden. They were a little bit hypothyroid. So then they decided to take a whole bunch of iodine or seaweed, and then all of a sudden they were bedridden and their TSH, which a healthy person should have a TSH around 1, their TSH went to 90 or 100.

[00:24:12] And part of their protocol was actually, let's get you off of that high iodine and give you dosages-- the amount that you would find in a prenatal vitamin or a multivitamin, that amount is generally safe and helpful for most people, even if they have aggressive or active Hashimoto's.

[00:24:31] So that's going to be under 300 micrograms, is going to be well-tolerated. But there's people that are like, let's mega dose on this nutrient. It's going great. And it's like, that doesn't always work out so well, friends.

[00:24:42] Luke: In the wellness blog sphere and podcast sphere, I think there is a predominant idea that everyone should be taking iodine every day.

[00:24:52] Izabella: The more, the better. Just take all these nutrients. But whether it's a poison or remedy, the term is determined by the dose for a lot of things, especially when it comes to iodine and narrow therapeutic index nutrients and supplements. There's some things that you can just take a whole bunch of and it doesn't matter, but there are things that we have to be cautious about.

[00:25:16] Luke: What about the different types of iodine? I have some kelp capsules. My mineral balancing expert has me taking this one kelp a day. And we didn't do any lab testing other than hair mineral tissue analysis. I can never remember the acronym for that. It's much easier to say that way.

[00:25:39] But he put together a program with some different minerals and stuff, and he's like, "Oh, don't take iodine. Take this kelp." And I thought, oh, that makes more sense. There's going to be an entourage effect. There are other constituents that nature's intelligence has provided versus an isolate.

[00:25:56] And at different times I've used Nascent iodine or Lugol's iodine, different types of iodine, and haven't really tracked it with labs to see whether or not it was helping me or not. But how much difference do you see in terms of the form of iodine that are people getting, whether it's supplemental or dietary?

[00:26:17] Izabella: I will say I'm a bit biased because majority of the people I work with have Hashimoto's or hypothyroidism and thyroid dysfunction. I have some people that I work with that have other conditions like IBS or eczema or other things that are going on. So they're seeking my help for that.

[00:26:36] In the Hashimoto's population, it's like, I don't care where your iodine is coming from, how clean it is, how great it is. It's going to be a dose-related response. In people who don't have a hypothyroid condition and who don't have Hashimoto's, a lot of times they do great with kelp, and they do great with every type of iodine supplement.

[00:26:59] I will say, in some cases, if you are selenium deficient, in my experience, and you take iodine, that can actually make you feel significantly worse and that could sabotage your thyroid function. So I oftentimes recommend that people take those two together or consider taking those. But if you're somebody that's like, "Oh, I'm taking an iodine supplement. Should I be? Should I not be?" Really easy way to check is just check your thyroid antibodies.

[00:27:23] You can check TPO antibodies and TG antibodies, thyroid peroxidase antibodies and thyroglobulin antibodies. And I know people that are doing so great with iodine. And they're like, "This high dose stuff saved my life. This is where it's at." And then I know people that are like, "I just took a little bit and my thyroid antibodies skyrocketed." So look at those thyroid antibodies and that will be your marker to guide you on what's best for your body.

[00:27:50] Luke: In terms of testing for someone that is knowingly having thyroid issues, hyper or hypo, whatever the case may be, or someone that's just like, "Oh, I better look out for this," is there, in your experience, a gold standard type of test? There's the Dutch test for this. They have their names.

[00:28:06] People put together a set of labs that become widely known and able to be read by different practitioners and whatnot. What's your go to in terms of websites or anything you might recommend to people that want to do testing?

[00:28:22] Izabella: I recommend a full thyroid panel. And generally speaking, and I'm really glad that you brought this up, but people will have one test done to screen for thyroid function. It's the TSH test called the thyroid stimulating hormone. And this is a great test if you've had thyroid disease for 10, 20 years, because it'll find that. It'll be elevated when your body isn't making enough thyroid hormone.

[00:28:47] This is a pituitary hormone that is released when the pituitary senses that you need to make more thyroid hormone, stimulates. It's thyroid stimulating hormone to stimulate your body to make more. But the challenge is that this test can be normal for the first 10 years that you have hypothyroidism and Hashimoto's.

[00:29:09] And then you also can have fluctuations of it. So one day it could be high and another day it can be low before it's permanently elevated. And then another thing is that many doctors use old reference ranges or reference ranges that are too lax because thyroid disease is so common. The reference ranges, when they determine reference ranges, they take, let's say, a few thousand people's blood and they say, "What's normal in there?"

[00:29:39] Well, they had hypothyroid people in that group of "normal people," and so the reference ranges were overly lax, where they would say even a TSH as high as eight or 10 was normal when really a healthy person with healthy thyroid function should have a TSH somewhere around 1. I would say, 0.5 and 2 is where I like to see most people. If they're elderly, maybe 2.5.

[00:30:03] So that's not the best test to start with, but a lot of times practitioners start with that. The tests that can be elevated for 10 years before you have a change in that test are thyroid antibodies tests. Thyroid peroxidase antibodies and thyroglobulin antibodies are the two.

[00:30:20] And then looking at your active thyroid hormones, so your free T3 and free T4, this actually tells you how much thyroid hormone you have going on independent of whether or not your pituitary is responding to that or not. And then there's something called reverse T3 where you can essentially have a thyroid condition that's not driven by your thyroid.

[00:30:47] It's usually driven by things like low iron status or stress. And so these are some of the labs that I would recommend doing. A lot of times, for whatever reason, people might have a hard time with their healthcare professionals where their doctors will only want to order TSH. And if the TSH is abnormal they'll order the others, which is ass backwards, right?

[00:31:10] Luke: Right.

[00:31:10] Izabella: So I recommend for people to advocate for themselves and say, "Can you please order this for me? If you don't want to order it, can you note on there why you're declining the test? Can you put that in my medical record?" Most people, I think if you say you have a family history of it, most doctors will do the test for you.

[00:31:30] If that's not an option, then you can also self-order. I partnered with Alta Labs, and they have a thyroid pharmacist panel where you can just self-order it and get the whole full thyroid panel. And a lot of times you can take that and reimburse it to your health insurance so that you--

[00:31:52] Luke: Oh, cool.

[00:31:53] Izabella: I don't know how you feel about this, but as a pharmacist and a patient, I feel like we should all have access to our medical data, and we should be able to order our own lab tests, right?

[00:32:04] Luke: 100%. Yeah.

[00:32:06] Izabella:  I'm passionate about that.

[00:32:07] Luke: Yeah, me too. I'm passionate about all autonomy and all areas of life, especially when you're the one deciding you want to have some blood taken out of your body and have it looked at in a lab to tell you what's in it and what's not. It's a fundamental human right as far as I'm concerned. But that's good to know. So there is a universally recognized diagnostic panel that would just be a full thyroid panel, which would be inclusive of all of those markers. And that's the gold standard.

[00:32:35] Izabella: That's correct. And I will say, as I mentioned, some practitioners may interpret that CSH in an overly lax fashion. So I know when I was first, I have like a lab test that said, your thyroid looks great. And it was 4.5. I was like a sloth. I was sleeping 12 hours a day. I was living in LA wearing two scarves and two sweaters every day.

[00:33:00] Clearly, I was not feeling my best. And so once my TSH was closer to 1, I was like, "This is what it feels like to be human and remember things and not be cold all the time." So that's something that I oftentimes will recommend, is you get a copy of your own labs.

[00:33:20] You look at those numbers. And there's a ton of websites that will talk about functional reference ranges. My website is one of them, but you can just do a quick Google search and say, "What are the functional medicine reference ranges for healthy thyroid function?" Not the thyroid function of a sloth or a hibernating bear.

[00:33:39] Luke: Not the general population. I think that's one of the shortcomings in general about lab work, is what it's being measured against. So I'm going to be 54 this month. I would say I'm definitely over average health of most 54-year-old American males. You know what I mean? So I don't want labs that look good on the average of that. I want the abs of a 20-year-old too.

[00:34:07] Izabella: Same.

[00:34:08] Luke: I want the lab results of a super robust and vital 20-year-old male, not the average population. I think that's a shortcoming that we're facing. Maybe not so much in the functional medicine realm because we're looking for optimal vitality there versus just like, yeah, you're going to be alive for a while. The bare minimum. Or comparing us against people who don't exercise and eat junk food and live a really toxic lifestyle. We don't want that to be the point of measurement.

[00:34:40] Izabella: Yeah. It's a little bit challenging for me to understand, but conventional medicine, essentially, when I was diagnosed, they wouldn't prescribe thyroid hormone until somebody had a TSH above 10 unless they were trying to get pregnant. Because then if somebody was trying to get pregnant, they would try to get their TSH around 2.

[00:35:01] And so they would utilize thyroid medications or thyroid hormones for people. And I'm like, so only women that are pregnant should get thyroid hormones, but not anybody else that is trying to optimize their health? So it's just bonkers to me. I think everybody should be able to have the most vital thyroid function and the most access to that. And just being educated about that.

[00:35:31] Luke: Going back to the root causes a little bit, just to clarify, correct me where I'm wrong, but is the thyroid located right here between your collarbone and your Adam's apple, if you have-- do women have Adam's apples, or are they just less pronounced?

[00:35:46] Izabella: I feel like they do, but people have fact checked me on this.

[00:35:50] Luke: Okay. But basically, between your lower throat and the top of your collarbone, it sits in there, right?

[00:35:56] Izabella: Mm-hmm.

[00:35:56] Luke: One of the things that I've wondered, because this is obviously becoming so prevalent of an issue is how much are we radiating from holding our phones up here all the time and sitting in front of computers, that blue light, the radio frequencies, the EMF? It seems like that skin there is very thin.

[00:36:20] I feel like my thyroid is just right there. It's not way back in my neck. It's right here. And seems to be that it would be very susceptible to things like radiation and blue light. Are you aware of any research on that? You mentioned Chernobyl and getting so many x-rays during our lives. But do you think our device use is having a role?

[00:36:44] Izabella: I haven't seen a ton of research lately about device use. I think in my experience with EMFs, I have seen some people just from a client wise being more sensitive to them, where it was just night and day for them, where if they were exposed to EMFs, how their thyroid was doing. A lot of my clients who had that pattern also happened to have mold toxicity. So I feel like there's a bit of synergy--

[00:37:14] Luke: They often go hand in hand. Yeah.

[00:37:16] Izabella: With those two. So I don't know that I've seen a ton of research behind that, but I've definitely seen it clinically. And especially, I have some people that go gluten free and then their whole life changes and they're perfectly healthy. And then I have some more complex clients where they do need to be a bit more careful.

[00:37:37] So you're like, "I'm paranoid." And I'm like, "Yeah, but they really are after you." So there are people that can just cut out gluten and then go on with their lives and they don't need to do anything else. But then there's other people where we're really looking at peeling back the layers of the onion.

[00:37:52] And so a lot of people with multiple chemical sensitivities, they're going to have EMF issues too and they're probably going to have some degree of mold toxicity. And I feel like it's an additive effect, where your body's just overburdened with all the toxins and chemicals that it's just not properly processing anything.

[00:38:16] One of the things that I do that I came across as an accident was a liver reset. I had clients that just were not getting better. I'd be like, "Go off of this food." And they were like, "Okay, I still feel terrible." And I'd say, "Try this vitamin." And they're like, "Now I can't sleep and I feel terrible."

[00:38:34] And so I was like, "Oh my gosh. What could be going on there?" And I started working them through a detox, not like an intense detox process, but it was, let's clean up your personal care routine. That perfume that you've been putting on your neck, maybe let's take a pause from that for a few weeks.

[00:38:53] All of the makeup that you're wearing, let's take a pause from that because our skin absorbs makeup and that can get into your circulation and bypasses the liver. So it's like you've got higher concentration of that.

[00:39:03] Luke: And no regulation on makeup. You can go buy the most expensive Chanel lipstick and it's full of lead still today. It's crazy.

[00:39:12] Izabella: I got arsenic toxicity from lip gloss.

[00:39:16] Luke: There you go.

[00:39:17] Izabella: I have a test showing my arsenic levels and I was like, "This is why I feel so terrible." I digress. But there are people that are very sensitive and oftentimes they have this liver backlog and we do have to peel back a lot of things from their lifestyle to bring them back into health.

[00:39:36] Part of what I do is I also I'll recommend sauna therapy to help them get rid of some of those toxins. And then I'll support things like amino acids to just help with getting some of the toxins out of their system and various types of herbs to support the liver and just to clear some of that toxic backlog because I guess their cup of toxins become so full that they start reacting to a ton of different things.

[00:40:07] Luke: I've heard, I think, you reference the human body as an aquarium. Have you said that before?

[00:40:13] Izabella: Oh, that's such a great reference, right? It's like, do you medicate the fish or do you clean the aquarium, right?

[00:40:18] Luke: Yeah. And I've had some staunch supporters of terrain theory in general that have pretty much convinced me that much of virology, for example, if not all of it is totally bunk, but that's another conversation. But I think that many of us that go through health challenges are endlessly playing a whack a mole, symptom chasing game when so much of this can be attributed to our environment, our lighting hygiene, our sleep hygiene, our movement hygiene, the water we're drinking.

[00:40:55] I forget, but people are still drinking tap water. And even those of us that drink reverse osmosis or spring water still, I think, don't realize that many of your bottled and canned drinks are just tap water with flavoring in them. So it's really hard to get away from this stuff, but I am of the mind at this point after interviewing so many brilliant people like you that that toxic threshold, the overload, when your body as this big sack of water, essentially, it really is much like a fish tank.

[00:41:26] And we're unaware of the fact that when it just gets to a certain threshold of toxicity, you start to develop all these symptoms. And we might call it a flu or a cold or this or that and ultimately it's just toxic overload combined with probably generational nutrition deficiencies.

[00:41:45] I wasn't breastfed, for example, so maybe I wasn't getting retinol and so on. And so if you're just the average person living today, unless your parents were complete tapped in hippies, chances are you're missing a lot of vital nutrients and minerals, magnesium, and so on. And also being bombarded with all of these energetic toxins and also the things in our food.

[00:42:10] But I'm going to ask you this, based on that theory of more of like the body's entire terrain, how much of it do you think has to do with circadian biology and environmental versus food? And I ask that because over the 25-plus years that I've been really working on my health, food has become, I think the least important for me.

[00:42:33] And what has made the biggest difference is wearing my blue blockers, getting rid of the EMF in my house, getting outside, getting a lot of sun, grounding, working with magnetism, all the Jack Kruse circadian biology stuff has moved the needle more for me than really obsessively orthorexically being concerned about what I eat, provided I'm not eating glyphosate and seed oils.

[00:43:01] There's the main offenders I'm a big fan of avoiding, but I have not really noticed much difference in my health journey, is what I'm saying, regardless of whether I've been paleo or carnivore or vegetarian. As I said, vegetarian, I did actually have a lot of negative consequences of that. But where do you stand on just environment versus diet?

[00:43:21] Izabella: So if you had asked me this question, I guess in 2014, 2015, I thought it was all about diet. I had a personal chef and I was like, "Okay, everything's going to be so great because I have my diet and then I'm taking all of these multivitamins and everything is amazing." And then when my son was born in 2018, I was so tired and he was waking up all kinds of night in the night and I was like, "Oh my gosh. I'm still eating this amazing diet, but I'm so tired. What can I do?"

[00:43:56] And that's when I really got excited about or interested in circadian biology. My first book up here, Hashimoto's Protocol, is very much about how to get Hashimoto's into remission and the adrenal transformation protocol. This really focuses on the circadian rhythm and how to get that into balance.

[00:44:17] For some people, they might find food as medicine is where it's at, and then you see others that have this plateau where they're like, "I'm eating clean, but why do I feel so terrible? I'm off of gluten. I'm off of dairy. What else is going on? I'm eating organic and so on and so forth."

[00:44:35] And yeah, there are things that I wasn't super tapped into. For example, when you wake up in the morning and you look at your phone and you spend all of your days indoors. You don't really go outside. I was living in Colorado at the moment, so I was like, "It's cold outside. I'm not going to go outside. I'll just sit in front of the fireplace."

[00:44:57] Things like that could make you more tired because you get disconnected from the circadian rhythm. So our indoor lights are not going to be as bright as being outside. And we need that brightness to send a message to our brain that, hello, it's time to wake up. Rise and shine.

[00:45:16] The sun is out. This is when you want to produce your cortisol. And when we're in that environment the whole day and then we're looking at screens, we're watching TV or our computer, then we get this message in the evenings that it's not time for sleep. Essentially, we're just like plants with feelings, so we really rely on the sun to give us that message of this is when you make your cortisol.

[00:45:46] And people talk about cortisol is bad. No, too much cortisol is a bad thing, and if you don't have any cortisol, you're going to die. And you need to have just the right amounts of cortisol. Generally, in the morning you want higher levels, and then as the day goes down, you want it to gradually decrease to the point where you have low cortisol in the evenings and then you get tired and then you can sleep.

[00:46:07] Cortisol helps to manage inflammation in our bodies. It has a lot of benefits. And the way that we adjust our cortisol is through the circadian rhythm. And so getting that morning sunshine outside, I know it's easier to do in Texas and California than it is in other places. I know this. I hear you people.

[00:46:27] But this is such a big part of healing. I have been able to help so many people just by aligning their circadian rhythm where anxiety gets better and they sleep at night. I'm the kind of person, if I don't get sleep, I am cranky. And I don't think I'm the only person in the world, right?

[00:46:46] Luke: Yeah, trainwreck. Ask my wife.

[00:46:50] Izabella: Yeah. My husband will tell you, he's like, "Somebody did not get their sleep last night."

[00:46:53] Luke: Yeah, yeah. I've really had to engineer my life in the past few years to really put a lot of emphasis on that. Just non-negotiable no blue light at night in the house. I don't want to torture my wife. So we have incandescent bulbs. Those still have a little bit of UV.

[00:47:10] If I had my way, the house would be totally red from the second the sun goes down. So I wear my glasses at least, but yeah. And just the quality of my sleep and then as a result, the quality of my life, I think it's hard to communicate the idea until someone has actually experienced the changes. Because it's an inconvenience. You have to change the way you operate.

[00:47:36] I have this thing called Iris on my computer, and it turns red when the sun goes down. And it's annoying because sometimes I want to keep working and look at something and I'll be like, I want to turn it off and I'll cheat and turn it off. And then I won't sleep as well.

[00:47:49] And so I find that it's interesting. It's like by exerting, at first, are more narrow parameters in terms of modifying your behavior, I'm talking about just the circadian part of it, it seems restrictive when you're habituating to it, but then the freedom that you get in your vitality, energy, and overall health, to me, the way it's been is like, I can't not do it now because I'm used to feeling really good.

[00:48:18] I have an ice bath in the yard and people think I'm nuts because I'm in there, not exaggerating, four or five times a day, just for a few seconds. I'm not doing five minutes every time, but it's like, anytime I start to feel a little bit funky, I just go jump in the ice bath and I'm a new man.

[00:48:37] 30 seconds later, I get out, I'm like, "Oh, what?" No more stress. My mood's elevated. I got some natural sunlight in my eyes. And it's something that's so simple but does require a little discomfort when you're in the stage of habituating yourself to it, where it just becomes an automatic thing. I don't think most normal people would want to get in 36-degree water a bunch of times every day.

[00:49:02] Izabella: It's funny you mentioned with the red lights. My husband has set up our house so that after dark all the lights get red and all of the neighbors in the house. Like, this was a great way for us to meet all of our neighbors when we moved in there. You guys are that house with the red lights, aren't you?

[00:49:15] Luke: Right, right. Yeah.

[00:49:16] Izabella: But it really does make a difference when you do these little things. And I'd rather be a little bit odd and quirky but feel amazing and have a great brain function and energy and be happy than be what I used to be. It's like if you want the standard American diseases, follow the standard American diet and lifestyle.

[00:49:35] So if you want to be like everybody else that's struggling with their mental health, physical health, with their brain, then this is option a. But if you want to feel great, here's some weird things to do.

[00:49:49] Luke: That's so cool that you got your husband on board or that he got you on board with the total red light thing. It's an adjustment. You know what I mean?

[00:49:56] Izabella: It's fun.

[00:49:56] Luke: Yeah, I personally like it. Did you find when you started going red at night that if you happen to be out, you're at a grocery store, somewhere, and they have normal nighttime bright blue lighting-- or even headlights when you drive at night, I'm like, oh my God. How do people deal with this?" Because I always wear these when I drive at night, you know?

[00:50:18] Izabella: I don't get out much. I have a six-year-old, but yeah, the few times that I've been out at night, it's very odd. And it's so bright everywhere.

[00:50:26] Luke: It's jarring when you're not used to it. That's what I noticed. And I just go, "Wow, this is interesting that I somehow unfortunately acclimated to that level." Not just the blue, that non-native really nasty spectrum of light, but just the brightness is just insane.

[00:50:42] Izabella: Yeah. There's a lot of things. I think when I moved to Texas, I lived in Colorado in Boulder, and there's just a very health-conscious lifestyle there. And coming to Texas, I was very surprised that there were a lot of the things that were just very commonplace in Boulder. For example, all the kids' schools had natural lighting in Boulder and very much outdoor time and just very crunchy.

[00:51:10] And then here, when we came to Texas, there were things they were like, didn't even consider the effect of lighting on kids' development and how well they were able to take naps and didn't even consider that kids should spend time outdoors. So yeah, it's been very eye -opening when you live a certain lifestyle that not everybody is as aware as you are, right?

[00:51:32] Luke: Yeah.

[00:51:33] Izabella: Some things I was like, "Oh, I thought every child care center was like this."

[00:51:36] Luke: Yeah. Speaking of kids and going into behavioral issues, what's the relationship between thyroid dysfunction and OCD and anxiety and things that are more on the behavioral mental health side?

[00:51:52] Izabella: It's such a huge, underappreciated connection. I know there's a ton of research behind it anywhere, obsessive compulsive disorder. This is going to be oftentimes the first thyroid symptom. Anxiety is going to be one of the first thyroid symptoms that people present with, depression. I have had clients who were misdiagnosed with bipolar disorder and schizoaffective disorder.

[00:52:20] Once we got things in balance for them, it was like blood sugar balance and thyroid function, maybe a few little supplements, and they were like, "Oh, I don't have mental health issues anymore. I feel normal again. This was a misdiagnosis, right?" So what's happening within the thyroid gland, the thyroid gland runs our metabolism.

[00:52:46] Really, thyroid hormone impacts every cell in the body. And so when we think of a person who's hypothyroid, they're going to be slower metabolism and slower brain function. So typically we think of somebody with brain fog and they might have depression.

[00:53:04] Depression is actually a well-known thyroid symptom. When you have somebody with an overactive thyroid, it's like a sped-up system. And you can imagine somebody might have insomnia or they might have anxiety. And these are also well-described symptoms. What hasn't been as well described is what's happening when you have this autoimmune process.

[00:53:26] In autoimmunity, and Hashimoto's is responsible for something like 90 to 97% of hypothyroid cases in the developed world, is you have an attack against your thyroid gland and a little bit of thyroid hormone gets dumped into your system whenever you have damage to the thyroid gland.

[00:53:51] And so this can cause a transient hyperthyroidism. And then as your body clears that out, you can become hypothyroid. And so you might have that anxiety and you might have that depression and you might even have mood swings because of that. The OCD connection is really, really interesting.

[00:54:10] There's a huge overlap there and a lot of the things that help hypothyroidism and Hashimoto's actually help OCD as well. For example, myonositol and NAC and berberine are some things that can be very helpful for both conditions. And yeah, it's just incredible. I've seen women who were depressed for such a long time and even suicidal, and then they got sometimes just on the right type of thyroid medication or right dosing and all of a sudden they had a new lease on life. And it's such an important and overlooked cause of mental health issues.

[00:54:46] Luke: It sounds like a vicious cycle when it comes to mental health because so many of the psychiatric medications are loaded with fluoride. And they're giving these medications to young kids because they have behavioral issues. And then you're taking something that's going to trash the thyroid, which is also going to cause its own set of mental health or behavioral issues. It sounds like a real quagmire.

[00:55:13] Izabella: Yeah. Lithium is used for bipolar disorder and it's very toxic to the thyroid gland. So it's one of the things I learned in pharmacy school. If somebody is on lithium, you always need to monitor their thyroid function. And it's like, did you give them lithium because they already had thyroid dysfunction and you worsened it?

[00:55:32] And it's just very, I guess, heartbreaking for a lot of people when they don't get the proper diagnosis and they start believing things about themselves and they start thinking, this is just who I am. I'm just a depressed person. I thought I was just an anxious person and then all of a sudden I had my thyroid antibodies stabilized and my thyroid hormone stabilized and I was like, "Whoa, I'm actually like a very even keel person. Where did this come from?" My heart feels for all the people that don't know this, that it could just be their thyroid and it could just be a few lifestyle changes, a few simple tweaks into their routine.

[00:56:15] Luke: With the lithium being harmful for the thyroid, would that be true also of a lithium orotate, a supplement version of lithium, or is that restricted to a really strong pharmaceutical anti-psychotic type of lithium?

[00:56:32] Izabella: So definitely the pharmaceutical lithium. As far as nutritional lithium, I'm not sure if you've had Dr. James Greenblatt on your show.

[00:56:40] Luke: No, I haven't.

[00:56:41] Izabella: He's got a book about lithium, and I talked to him a great length about this and he recommends monitoring thyroid function with lithium orotates. So I have recommended it for some people with thyroid conditions and it hasn't impacted their thyroid function, but there might be a small percentage of people that may be sensitive to it.

[00:57:03] So I always would recommend monitoring thyroid function, even if you're taking lithium orotate, and potentially considering using it with myoinositol because the mechanism of action that seems to be responsible for lithium toxicity on the thyroid and kidneys potentially is myoinositol depletion. So that would be my two cents on that.

[00:57:26] Luke: Yeah. My ears perked up because I don't take it every day, but I have a couple different brands of lithium orotate. It was supposed to be good for your mood, whatever. I don't know that much about it. I just know it as a mineral. It's one of the minerals that could be essential, I guess, in some dose. So I take it here and there. I don't really notice big change on those days, but I also do and take a lot of things, so it's hard to isolate the results. But yeah, when you said I was like, "Oh shit, I take lithium sometimes."

[00:57:52] Izabella: And you have to think about lithium orotate is one to five milligrams. And so the pharmaceutical, if you were to do blood work on somebody to test their lithium levels and they were on the highest dosage of nutritional lithium, it wouldn't even register at the bottom range of what pharmaceutical lithium would be like. So it's going to be doses that are far, far lower.

[00:58:18] Luke: it Got it. I figured much because before I knew there was lithium orotate, which I think I learned about it from John Gray, I think he's the one that's like, "Oh, it's the best mood supplement ever."

[00:58:27] Izabella: It could be great. Yeah.

[00:58:28] Luke: But I was like, lithium, isn't that what they give to crazy people? Not to be disparaging toward our mentally ill folks because I've struggled with mental health issues. But lithium to me is in a category of really hardcore antipsychotic medications.

[00:58:44] Izabella: And nutritionally, there's some fascinating data about lithium in the water supplies. So they've studied low levels of lithium in our water supplies and they found that communities with low levels of lithium versus no lithium at all, they had lower rates of suicide.

[00:59:03] So I think lithium, in those nutritional amounts, again, is it a poison or remedy depends on that dose. It can be very, very beneficial for mental health. And I think oftentimes it can be life changing for people.

[00:59:20] Luke: You just reminded me, speaking of Colorado, I was born in Denver and my dad's lived in Colorado his whole life. I guess, yeah, his whole life and my whole life. And so I'm a big fan of hot springs. And so anywhere I travel in the world, the first thing I do is try to find a hot spring, if they exist.

[00:59:38] And some of these older boutique mom and pop little hot spring spas, they'll have on the wall the mineral analysis or on their website. They'll have their bragging rights about what their mineral profile is. And many of them will highlight the fact that they're very high in lithium and saying it's more relaxing and you'll be really blissed out.

[01:00:00] And I think there's something to that, soaking in really high lithium content hot water. Some of it's probably placebo because you read the sign, you're like, "Oh, I'm going to be so relaxed." And then you get out and you're relaxed and happy because you believed you were going to be. But I bet there's something to that based on that research of looking at populations that are using high lithium water versus those that aren't.

[01:00:25] Izabella: Yeah, I love just using hot baths in general. So I'm a big proponent of Epsom salt baths. And you are going to get some of that topical absorption of whether that's lithium or magnesium. So I'm a big proponent of all of those types of healing modalities. Personally, every time I've gone into those hot baths, I've done them in Poland and a little bit of Colorado as well. I do feel the effects. I always feel so much better. When I had arsenic toxicity, part of my protocol to clear the toxins from my body was hot springs.

[01:01:01] Luke: I love it. When we moved here, I was disappointed to find that there aren't any hot springs.

[01:01:08] Izabella: There's cold springs.

[01:01:09] Luke: Yeah, there are cold springs, thankfully. And then I found one, I wouldn't say it's a hot spring, but it's a warm, geothermal spring hour or so out of Austin. So I make it out of out there every once in a while, but that's something I miss living in California and Colorado and places like that, where there's just hot springs everywhere. Very therapeutic. What's the relationship between our gut health and thyroid?

[01:01:31] Izabella: This is a pretty big deal. So oftentimes people don't realize, but the gut is going to be key to restoring how you're feeling when you have a thyroid condition. I guess I first came across the connection between gut health and thyroid health when I was on my healing journey and I was trying to research what caused me to have this condition.

[01:01:58] I had IBS a few years before I had the thyroid condition and then I developed acid reflux. And I was like, "Okay, I clearly know that something is off about my gut. I wonder if this contributed to some malabsorption or what's going on within my body. And how is this connected?" Conventional medicine was like, this is your left arm. This is your right arm. We're going to treat it separately.

[01:02:22] But I was like, "No, this all has to be connected." And so Dr. Alessio Fasano has talked about the three-legged stool of autoimmunity. Essentially, he talks about what has to be present in your body for you to have an autoimmune condition.

[01:02:41] And so number one is the genetic predisposition. Number two is going to be some kind of environmental trigger. And so we've covered a lot of environmental triggers. And number three is going to be intestinal permeability or leaky gut. And all three of those factors have to be present for autoimmunity to manifest or that three-legged stool to stand.

[01:03:02] And so I was like, "Huh." I know I've got all of these triggers. I was exposed to Chernobyl. I've got all these things going on, but they wouldn't really be making as much of a relevance if it wasn't for something that was going on with my gut. And so I started really digging into why I might have leaky gut or intestinal permeability.

[01:03:22] And I found that for some people getting off of gluten can be a big game changer. I got off of gluten and dairy and I started feeling a lot better. The acid reflux and the irritable bowel syndrome went away and I was like, "Okay, this is it. I've discovered it. I'm amazing. I'm feeling great."

[01:03:41] But then a little while later, some of my symptoms started coming back. So I was like, "What else could be?" And I started digging deeper. The big focus in functional medicine when I was on my healing journey was immune imbalance. So if you have a thyroid autoimmune condition, then these different cytokines are going to be elevated and these other ones are going to be low.

[01:04:09] And so we could use herbs and different types of things to bring the immune system in balance. And I was like, that sounds interesting. And then there was also Epstein Barr virus as a potential trigger. And I was like, "Yeah, that does sound interesting too. And how did this all play together?"

[01:04:27] And then I came across infections and gut infections and they too can have an impact on our immune system. So I was sort of like, well, who's running the show? Is it my immune system that's running the show? Is it this virus, or is it something else? And I did a lot of comprehensive stool testing. I know, very glamorous and very cool, but it was.

[01:04:50] Luke: It's important. I always say, make poop great again. It's a really important biomarker. And also, just one's regularity is a really important biomarker of your health, right? People don't like to talk about it because it's gross, but it's super important.

[01:05:07] Izabella: Yeah, it's super important. And I think at first it feels really weird to take a stool test because you're taking your poop and you're pooping in a little container and then you're putting it in a package and you're going to the post office and wondering if everybody's judging you because you're carrying a box of poop around.

[01:05:23] But stool analysis, especially functional medicine stool analysis could be very helpful in finding out the root causes of what's driving autoimmunity. In my case, I had a protozoa, which people think of parasites. It's a giant worm. I didn't have giant, crazy worms. I had a one-celled organism called the protozoa named Blastocystis hominis.

[01:05:50] And once I treated that, I felt significantly better. My thyroid markers improved. My food sensitivities resolved. My IBS went away. I also had chronic hives, which I don't think I mentioned. But that protozoa has been tied to, at the time when I was on my healing journey, it was recognized as a trigger for irritable bowel syndrome and chronic hives. I started writing about it and then I started working with clients and I found about 30% of them also had this particular bug.

[01:06:23] Luke: Wow. That's pretty significant.

[01:06:25] Izabella: I was, I talked to my mentor, Dan Kalish at the time. I'm like, "Is it just this common?" And he's like, "No, I think you might be onto something because I don't see it that commonly in my population of various health conditions."

[01:06:39] And so I started talking about it because I would see some people would get normalized thyroid function. Some people's thyroid antibodies would improve. Some people would have a little bit of improvement. Some people would have a complete transformation. But there was always like, "Okay, if I find this and we're going to treat you for it, you're going to feel better."

[01:06:59] It's either going to be a huge improvement or a little improvement, but there's definitely going to be improvement. And then I was excited that a few years later, researchers started writing about this connection. And so now it's been recognized as a trigger for Hashimoto's. And so it can essentially shift the immune system in a way to make more of the cytokines that attack the thyroid gland and so on and so forth.

[01:07:30] So it's my claim to fame. People always think I talk about gluten free diet and all of that and I'm like, "I'm actually the one that talked about blasto being as a potential, very relevant trigger for Hashimoto's. And so this is something that can be incredibly life changing for thyroid disease, chronic hives, and also irritable bowel syndrome.

[01:07:53] So many women and men struggle with this and sometimes it's just one tiny bug. And if you get rid of that tiny bug and then you really shift your microbiome, you can not have those symptoms anymore that you thought were just a part of you.

[01:08:10] Luke: So it sounds like stool testing would be a good, if not sometimes necessary, adjunct to doing a full thyroid panel. While you're at it, just get a good comprehensive overview at any possible culprit.

[01:08:24] Izabella: For me, yeah, that's a non-negotiable. So if I were to work with somebody and they were coming to me for help, I would be like, "Okay Let's do a stool analysis." That's going to be one of the number one things that we're going to recommend for you.

[01:08:39] Luke: Cool. And for those listening, as someone who found it to be kind of awkward and gross the first few times I did it, once you do it a couple of times, it's not that big of a deal.

[01:08:49] Izabella: No big deal.

[01:08:50] Luke: Yeah. It was part of you. First, it was part of something out there that you put in your body and now it's just a different part of you that smells bad.

[01:08:57] Izabella: And they send gloves with most of the kits.

[01:08:59] Luke: Yeah, totally.

[01:09:00] Izabella: So you don't have to touch it.

[01:09:02] Luke: Yeah. It's just you get a little French fry tray, a little wood scooper. Okay. I get a little too silly sometimes. Reel it in there, Luke. All right. I forgot to let people know listening, if you go to lukestorey.com/drwentz, that's D-R-W-E-N-T-Z,  lukestorey.com/drwentz, we're going to link to everything possible that we talked about today. And then we'll also send people to your website, thyroidpharmacist.com, your Instagram, and all those things. We'll put that all in one catch-all show notes.

[01:09:38] Going back to gluten, this has been a bane of my existence because I would say if you put me on a deserted island and I could only have one food for the rest of my life, it would probably be-- well, technically three-- sourdough bread toasted with sea salt and grass-fed butter. Literally, I could eat a massive loaf of that. And so over the years, I don't have-- what's it called when you're really allergic to gluten? Celiac.

[01:10:12] Izabella: Celiac disease.

[01:10:13] Luke: I've been tested for that. I don't have that. People in my family do. I don't seem to have it that hardcore. But as much as I try to apply mind over matter or trick myself into thinking that all the nasty gluten got gobbled up through the fermentation process of properly made sourdough bread-- the old-world heirloom, seeds from Europe, whatever-- I've tried everything. Taking enzymes with it, the whole thing.

[01:10:36] And still, even to this day, as healthy as I am, in many ways, I have a difficult time tolerating the most organic, beautiful fermented bread. So I'll still eat it sometimes, but I'm going to have a little joint pain and probably digestive issues two or three days later, which took me a while to figure that out because I'd eat gluten and the next day I'm like, "I feel fine."

[01:10:57] I'm still regular. Everything's moving. And then two or three days later, the symptoms would set in. I go, "Oh, yeah. I had pizza three nights ago or something." My question is this: how much of the gluten issue do you think is the actual gluten in wheat? And how much of it is the glyphosate that they're spraying on said wheat?

[01:11:17] There's a lot of debate about this. I think they both could be bad for some people, but definitely, anytime I see anyone eating just regular flour products, you know it's loaded with glyphosate. And I'm just sitting there biting my tongue. Don't say anything, don't say anything. But I think that is a massive issue. What's your take on differentiating those?

[01:11:37] Izabella: So there's a lot of reasons why somebody could be reactive to gluten or even wheat. So it could be celiac disease. And so if you have celiac disease, then you're going to be super sensitive to gluten, even tiny amounts of that. Then there's non-celiac gluten sensitivity, which could be a delayed reaction.

[01:11:54] Then there's wheat sensitivity. Then there is nickel sensitivity. So wheat is a high nickel food. And if you're somebody who has a systemic nickel sensitivity, that could be the reason you're reacting. It could be SIBO. If you have SIBO or a different FODMAP reaction, there's components in wheat specifically that could be reactive.

[01:12:19] And then there's the glyphosate question. And so glyphosate can very much be a relevant trigger for people and the reason why a lot of people are gluten sensitive. But not everybody. I'm from Europe, and I have clients in Europe. I've lived in Europe. I've lived in the United States, and everybody that I know that was American says, "Oh, it's the American wheat. It's the American bread."

[01:12:43] And then they're like, "When I go to Europe, I'm totally fine." And so why does that happen? Are they just crazy? So the thing is, there are people in Europe that are also gluten sensitive. There are people in Europe who also have celiac disease. And many countries in Europe, most countries, do not use glyphosate.

[01:13:04] So what's going on? And there's actually a honeymoon period because if you go to Europe and you're gluten sensitive here, the gluten in Europe is going to be a little bit different. And so you're going to have about two weeks worth of time where you can actually tolerate the gluten in Europe if you haven't been sensitized to it.

[01:13:26] That's in my experience. But eventually, unfortunately, your body will catch up and then you'll probably become reactive to the gluten in Europe. I will say, it's interesting, I'm looking at some microbiome shifting and there might be ways to get rid of gluten sensitivity with very big microbiome shifts. So I'm looking into some testing for that these days.

[01:13:46] Luke: Oh. Keep me posted because I would love to be able to eat gluten with impunity.

[01:13:51] Izabella: Right. It would be nice to just not be sensitive to anything. But with thyroid people specifically, there is a protein on gluten that can cross react with a thyroid gland as well. And so it's one of the foods that I generally recommend holding off on long-term. Most people can introduce most foods back, but gluten is one of the things. I figured out how to get dairy back for most people and eggs and a lot of the different reactive foods, but I'm still working on gluten.

[01:14:23] Luke: Yeah. Oftentimes when I have these conversations, I learn more than I want to. And many years ago, I interviewed Dr. William Davis, the author of Wheat Belly, a great guy. And the way he broke down the gluten issue, I went gluten free for quite a while after that, non-negotiable level. He just unequivocally proved to me at least that pesky gluten protein or whatever it is in there is just doing everyone harm, whether they know it or not.

[01:14:54] But yeah, to your point, it is frustrating to see some people seem to be able to eat it with no problem, apparently, and others do. And I want to be one that can eat it. So keep me posted on that.

[01:15:06] Going back to this Dr. Hashimoto character, I hear that word thrown around a lot and I've never really known exactly what it means. Is Hashimoto's thyroiditis what all Hashimoto's is? Is that just the complete term, or is Hashimoto's have different variations?

[01:15:25] Izabella: Okay. So Hashimoto's thyroiditis is basically the most common cause of hypothyroidism. And that has five stages. The first stage is you have the genetic predisposition, but really no markers of it and no symptoms, no thyroid dysfunction. The second stage is where we start having some of that autoimmune infiltration into the thyroid gland.

[01:15:49] The third stage is when people start having a little bit of thyroid dysfunction and still that autoimmune infiltration. And then the fourth stage is overt hypothyroidism. So you can essentially have Hashimoto's thyroiditis and thyroid inflammation and damage to your thyroid gland, but you're not hypothyroid because your body's still compensating.

[01:16:15] And most people are not diagnosed in those early stages, but then you get to that fourth stage and your body no longer compensates because a lot of your thyroid gland is damaged. And so this is overt hypothyroidism is going to be the fourth stage. And some researchers are saying that the fifth stage is progression to other types of autoimmune conditions.

[01:16:35] There's a big connection between one autoimmune condition. If you have one, there's a higher chance of you having additional ones. And there's also something known as Hashimoto's encephalopathy, which is very rare and very scary. It can cause people to have psychosis, catatonia, basically be hospitalized with brain inflammation.

[01:17:03] The big connection is really high Hashimoto's antibodies and potentially there's some cross reactivity between the thyroid antibodies and the brain and people have to get hospitalized and they usually can go on something steroids or having have plasma exchange or immunoglobulins to get that under control. But it's more of a life threatening situation and more urgent. So typically, when people talk about Hashimoto's, they're mostly talking about thyroiditis.

[01:17:34] Luke: Got it. Okay.

[01:17:35] Izabella: I don't know if that's TMI.

[01:17:37] Luke: No, that's perfect. No, I want TMI. We want the details here. This isn't an issue that I've knowingly struggled with, but I know, as you've said, so many people are, especially women. So I'm sure people listening that are struggling with this one, every bit of detail there is to know.

[01:17:54] If hypothyroid, the Hashimoto's plethora of issues here is more of the lethargy and being cold, brain fog, brain function, that kind of thing, it sounds like it's really slowing you down. And then hyperthyroid would be more in the anxiety, too much energy other end of the spectrum. So in hyperthyroid, is that an overactive thyroid?

[01:18:24] Izabella: That's correct. So there's a condition called Graves'. It's an autoimmune--

[01:18:28] Luke: I've heard of that. Okay.

[01:18:30] Izabella: Thyroid condition as well. And so people can have an overactive thyroid from that. And then in some cases, with the early stages of Hashimoto's, there can be an overactive thyroid there too.

[01:18:42] Luke: Which side of the spectrum is more prevalent?

[01:18:46] Izabella: Hypothyroidism. Underactive thyroid is far more prevalent.

[01:18:49] Luke: That's the big one. And why do you suppose that it affects females more than males?

[01:18:57] Izabella: That's such a great question. I thought about this for a long time, and of course there's the hormones at play and there's the personal care products. Women put a lot more of those personal care products on. For me, I think it all comes down to safety. Women are far more in tune into our environment. So we are essentially--

[01:19:19] Luke: Got that right. Thank God someone does.

[01:19:24] Izabella: We have to carry babies. And so we're very much in tune, whether there's a war or a famine, because that is not a great time to reproduce. And so a lot of times I find, I guess, the modern world is set up in a way where many of us don't feel safe, whether that is from over exercising, under eating, over eating, watching really scary-- what do they call that?

[01:19:56] Luke: Horror movies.

[01:19:56] Izabella: A few porn.

[01:19:57] Luke: Oh, yeah.

[01:19:58] Izabella: Watching that kind of stuff.

[01:19:59] Luke: Watching the news is a horror movie.

[01:20:01] Izabella: Exactly. Yeah.

[01:20:03] Luke: These days, especially.

[01:20:04] Izabella: Being tuned into the news, that can really dysregulate a person's nervous system and send the messages that we are unsafe, and this is not a great time to reproduce. So can we please slow down our fertility? Can we please just lay back in our caves? And can we please maybe hold on to our calories more? You think about what hypothyroidism does and essentially it turns humans into hibernating bears.

[01:20:34] So when we become hypothyroid, we don't need as many calories to keep on our weight. So a lot of us complain, I'm having trouble with my excess weight. But our body's like, "Hey girl, I'm trying to help you out. I see that you're in a famine. You're eating salads every day and nothing else. I'm going to help you keep some meat on your bones. I'm going to slow down your hypothyroidism so you could survive this famine."

[01:21:00] And so it's been really interesting. There is a naturopathic doctor that talked about the Irish potato famine and that a lot of the people that survived it were actually hypothyroid because they didn't require as many calories to live. And the reason why women have more thyroid conditions is because we don't feel safe. And we're very tuned into that compared to men and their hormones. Men are just not as turned into those cycles that women are.

[01:21:31] Luke: So it's multifactorial. I just think being a male observing you female as a species, it's just very complex. Biochemically, emotionally, intellectually, there's so much more complexity. And it's unfortunate that our medical system, and I guess there are various reasons for it, but it seems most of your areas of study and research are based on male subjects predominantly.

[01:21:59] And so there's this air of mystery around what makes women tick on so many levels. And I'm grateful for people like you that are helping to unpack this, but I would have probably never made that energetic or psychological connection to women just being more tapped into the safety or lack thereof of the environment, of their life, of that stress that the intuition causes.

[01:22:28] And I laughed when you first mentioned that because I'm so grateful that Alyson here has just incredibly strong intuition. And being a bit more dense in that way, it took some time for me to learn how to honor that in her. I just felt at first like, "God, why is she worried about everything all the time?"

[01:22:46] Everything's cool. And then she'd warned me about something going on in her life, in her home or whatever. And I'm like, "Oh shit, she was right. How did she know that?" It's like she had some premonition or ESP going on. But it helps me to understand my relationships with women that you have such a finer, subtle level of feeling of the environment.

[01:23:11] So it would make sense that if the nervous system is getting signals from wherever, whomever, that you're not safe, that it's going to obviously affect your neurotransmitters and hormones and ultimately thyroid.

[01:23:23] Izabella: Yeah, absolutely. And I feel like more marriages would be happier if more husbands understood that, right?

[01:23:31] Luke: Well, it's a huge asset to our family now at this point, thankfully, because I recognize it and I don't see it just as somebody worrying or nagging, unnecessarily. I've learned to pay attention because it's helped me. I heard somewhere--

[01:23:44] Izabella: A gift?

[01:23:46] Luke: Yeah, it's an absolute gift, and it's just a beautiful part of that synergy of just playing on each other's strengths and picking up where the other might be deficient. I'm sure there are ways in which I'm tapped in that are helpful to her safety. I heard somewhere, and I don't know where this originated, but it was on a meme or something and it really made sense to me. It said something to the effect of, in a male-female relationship, I guess it could be true of any masculine and feminine dynamic relationship, that the man protects the woman physically and the woman protects the man spiritually.

[01:24:20] I've really, really felt into that. And in my relationship, that's definitely true. And a lot of it is due to that heightened intuition and just that sixth sense. And man, any men listening, there's a lot of value in life to be able to have someone that loves you that has those abilities that we might be less-- I'm sure some men are more or less tuned into that, but I feel pretty capable of protecting our physical space in our life and being a provider and all of that.

[01:24:51] But I don't know that I'm tapped into the ethers all the time in a way where I could see trouble coming in the way that she does, or be able to use her discernment to assess someone's character and their level of integrity or safety to be part of our life. It would take me much longer, and has historically, to catch cues until it's too late and there's already a mess that's been created, for example. So yeah.

[01:25:16] Izabella: That's beautiful. I love that.

[01:25:18] Luke: It's cool. I just love people. I love learning about people and what makes us tick and trying to improve the way that I apply that understanding. But I really like the emotional piece there. So you write books and on your website you have a number of different offerings in the educational variety.

[01:25:39] Are you still working clinically with people one-on-one? Could somebody hire you to coach them or guide them directly, or do you have more of a broad stroke and take my online course, read my book and go see a practitioner? Where ae you at in terms of how you serve people at this point with your knowledge?

[01:25:57] Izabella: I would love for people to-- my goal is for people to educate and empower themselves. So I have all the tools on the website for that. I have tons of free articles, how to solve just about every thyroid symptom. I have books, I have online courses, and I have a practitioner database too, so that they're not limited to working with me.

[01:26:18] There's one of me and so many people struggling that I wanted to offer all the different resources for people so they could help themselves. And then if people wanted to work with me too, I do offer that as an option. Just very small handful of people that I take on every year because I have a six-year-old and I've just finished writing a new book, so I have very limited bandwidth. But my team and I do offer that as well.

[01:26:48] Luke: Okay, cool. Tell us about your new book. You mentioned it before, but give us the spiel on it.

[01:26:54] Izabella: So I have a lot of books. I have Hashimoto's Protocol. This is the most popular book that I've written that's helped a lot of people take charge of their health. The Adrenal Transformation Protocol helps people recover their health in about four weeks, and it's really focused on fatigue and then circadian balance.

[01:27:15] And then you and I both have books coming out in a few years around the same time. Mine's going to be on irritable bowel syndrome and yours is going to be on loneliness. And so I'm excited to get more of that into the world and help more people.

[01:27:30] Luke: So it sounds like the way your content works is there are one dovetails into the next. Because I'm assuming adrenal function and issues in that realm are directly correlated with thyroid and so on.

[01:27:44] Izabella: It happened because in order to become really good at helping people with thyroid conditions, I had to learn adrenal issues really well because majority of people that I've worked with have some degree of adrenal dysfunction. And when I used to initially work with people, I would be like, "Okay, just sleep for 12 hours a day for 30 days and then take these hormones and do this."

[01:28:10] And then when I was a new sleep-deprived mom, I was like, "This seemed like really good advice before, but now I've got this beautiful little creature, I don't think I could sleep for 12 hours a day." I can't go to Bali for two weeks by myself. I just can't do all these things.

[01:28:27] And so I really got into more of like that circadian rhythm balancing and it's got additional strategies there. And then through the process, I also found that I really had to help people with their gut health to get their Hashimoto's into remission. And so the last 10 years, everybody's like, you should write a book about IBS. And I'm like, "Yeah, but I'm the thyroid pharmacist. What does that IBS have to do with it? And there's not a book on the market about IBS." So I was like--

[01:28:57] Luke: Really?

[01:28:58] Izabella: With all the functional medicine and all the different causes that I cover, a lot of times they focus on SIBO is the cause, or food sensitivities are the cause, or stress is the cause. And I'm like, "There's more than one cause and here's how to figure out which one's relevant to you." Ad so I ended up writing it. I have some gray hairs from it.

[01:29:19] Luke: I can imagine.

[01:29:21] Izabella: Yeah, yeah. I love writing books. As you know, it's an intense process. It takes a lot of heart and soul, some gray hairs too.

[01:29:30] Luke: I'm always encouraged when someone writes a book and then keeps doing it.

[01:29:35] Izabella: Yeah. Insanity, right?

[01:29:37] Luke: In the process of the first one, I'm like, "People do this all the time?" And then you look at the authors that have multitudes of books. They put one out every couple of years. I know a lot of people rely on ghost writers and editors to varying degrees, which I'm sure makes it easier. And I'm not doing that, so it seems harder. But man, I'm glad to know that you had more in you after doing the first one because it is quite a journey.

[01:30:00] Izabella: Yeah. I don't know. I always said no more after this and then I just turned in my book two days ago, three days ago. And now I'm telling everybody this is the last book that I'm going to write. So we'll see what happens. But it is quite a labor intensive process. I feel like it's almost like having a child, very similar to that.

[01:30:19] Luke: Yeah, yeah.

[01:30:21] Izabella: Yeah. My hope for all of my books is that the right people find them and they can help themselves with them. That will help me grow back my hair. Yeah.

[01:30:34] Luke: Help turn the gray hairs brown again.

[01:30:35] Izabella: Turn the gray in hairs brown again, right?

[01:30:37] Luke: Yeah, totally. So here's my last question for you. Who have been three teachers or teachings in your life that have influenced who you are of any category whatsoever?

[01:30:50] Izabella: Okay. So definitely my mom has influenced me a great deal. She was a physician when I was growing up. And just watching her and seeing her as a healer helped inspire me to do the same. I would say another very important teacher has been my son. We can talk about child development and things that happen to us as children, but seeing that in front of us, just seeing this little creature develop on a daily basis, he has been my greatest teacher, my most challenging teacher sometimes too.

[01:31:37] And then I would say nature out of all things. Just being in nature and watching nature, that has taught me a great deal too, because how nature flows and changes, it has such a huge impact on me as a person. It's been a great healer for me anytime that I've struggled in life. I've spent a lot of time in nature. And without speaking to me, really, it speaks to me.

[01:32:07] Luke: Yeah. Beautiful. I share that. Thanks for the reminder. I spend too much time in this space here. There's a beautiful greenbelt down the road. Have you ever been to the Hamilton Greenbelt in Lakeway? It's right there, and I swear most days I'm like, "I'm definitely going over there today."

[01:32:23] It's a five-minute drive from here. Probably a couple more minutes on a bike, and you could even walk if you were so inclined. And it's just like, oh man. The day just gets away from me. And next thing you know, I'm going to go on walks and go for a swim, jump on the rebound or whatever in the backyard. But in terms of leaving the living area, leaving a neighborhood and actually going into some woods, it was just incredibly restorative.

[01:32:47] Izabella: Yeah, it's so healing. And you can think about you being in that space and another person being there 1,000 years ago or 200 years ago or 200 years from now and whatever problems they had, whatever problems you have, none of that matters. That tree still there. I know it's just all--

[01:33:04] Luke: That's cool.

[01:33:05] Izabella: It's just all so, I guess, long-lasting, and it takes you out of your own head. And then it just allows you to see the world and maybe your problems don't feel so big. Right?

[01:33:19] Luke: Beautiful.