Adrenal Transformation Protocol with Dr. Izabella Wentz

This week on The Less Stressed Life Podcast, I interview the delightful Dr. Izabella Wentz, who is a compassionate, innovative, solution-focused, integrative pharmacist dedicated to finding the root causes of chronic health conditions. On this episode, Dr. Wentz shares that adrenal dysfunction is essentially what happens when your body gets overwhelmed by stress and/or inflammation, and you end up in that altered physiological state. She also tells us about her Adrenal Transformation Program.

KEY TAKEAWAYS:

• What is adrenal dysfunction?
• Adrenal dysfunction symptoms
• Examples of different kinds of stress
• Best tests to determine adrenal dysfunction
• Things you can do to support your body
• Prioritizing sleep
• Adrenal receptor sensitivity
• Mitochondrial health
• Benefits of electrolytes for adrenal dysfunction

ABOUT GUEST:
Dr. Izabella Wentz is a compassionate, innovative, solution-focused integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis with Hashimoto's thyroiditis in 2009, following a decade of debilitating symptoms.
As an accomplished author, Dr. Wentz has written several best-selling books, including the New York Times best-seller "Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause," the protocol-based #1 New York Times best-seller "Hashimoto's Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back," and the Wall Street Journal Bestseller "Hashimoto's Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health."
Her latest book, "The Adrenal Transformation Protocol," is set to be released on April 18th, 2023. The book focuses on resetting the body's stress response through targeted safety signals and features a 4-week program that has already helped over 3,500 individuals. The program has an impressive success rate, with over 80% of participants improving their brain fog, fatigue, anxiety, irritability, sleep issues, and libido.

WHERE TO FIND:
Website: https://thyroidpharmacist.com/
Instagram: @izabellawentzpharmd
Facebook: https://www.facebook.com/ThyroidLifestyle/

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Leave a review, submit a questions for the podcast or take one of my quizzes here: https://www.christabiegler.com/links

TRANSCRIPT:

[00:00:00] Christa: Stress is the inflammation that robs us of life, energy, and happiness. Our typical solutions for gut health and hormone balance have let a lot of us down we're overmedicated and underserved at the less stress life. We are a community of health savvy women exploring solutions outside of our traditional western medicine toolbox and training to raise the bar and change our stories.

[00:00:26] Christa: Each week, our hope is that you leave our sessions inspired to learn, grow, and share these stories to raise the bar in your life and home. 

[00:00:44] Christa: All right. Today on the Less Stressed Life, I have Dr. Isabella Wentz who is a compassionate, innovative solution- focused, integrated pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis with Hashimoto Thyroiditis in 2009. Following a decade of debilitating symptoms.

[00:01:02] Christa: As an accomplished author, Dr. Wentz has written several bestselling books, including The New York Times bestseller, Hashimoto Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause. She also wrote Hashimoto's Protocol, a 90- day plan for reversing thyroid symptoms and getting your life back. And the Wall Street Journal bestseller, Hashimoto's Food Pharmacology, Nutrition Protocols and healing recipes to take charge of your thyroid health.

[00:01:24] Christa: Her latest book, the Adrenal Transformation Protocol, was released on April 18th. The book focuses on resetting the body's stress response through targeted safety signals and features of four week program that has already helped over 3,500 individuals. In my next life, I would like to get Guy RA's job, how it's made. So I can't wait to talk about how you had 3,500 people go through the program already.

[00:01:44] Christa: So the program has an impressive success rate with over 80% of participants improving their brain fog, fatigue, anxiety, irritability, sleep issues in libido. So this is such an underrated topic and a topic most people don't get enough support in, but I think that everyone needs to know about. So I'm really excited to jump in today and welcome to the show.

[00:02:05] Dr. Wentz: Thank you so much for having me. It's just such a joy to be here with you. 

[00:02:08] Christa: Yeah. So a few years ago for context, I just think this is interesting and funny. I think it was Previd times, right? Like everything is measured in like, was it before three years ago or more recent than that? I think it was before that I had put out a four week program called this Adrenal Resilience Reset or something like that.

[00:02:26] Christa: And I remember my business manager at the time said, "You know, I think you're a little ahead of the times on this. I think you're a little ahead of like where people, I don't think people know what adrenals are yet. I think people are like still on gut health for the last 10 years." And she was probably right.

[00:02:40] Christa: But I think here at the perfect time. I think there's never been a time where we needed adrenal support more over the last three years. So, getting into this. First of all, I wanted to jump right into like, why do we care about adrenal health? What are the symptoms look like? And then importantly, why is there such a rift in diagnostic terms?

[00:03:00] Christa: But before we do that, I think we better talk about this major. Not a departure, but it might look like it, right? You've got a few books out on thyroid. You're the thyroid pharmacist. So let's talk about what is up with for into adrenals now. 

[00:03:17] Dr. Wentz: Such a good question. My own personal health journey was really focused on getting my Hashimotos into remission and feeling human again. And so when I was diagnosed with Hashimotos in 2009, as a pharmacist, I was excited to get on medications cuz I was like, "Okay, great. This little pill's gonna solve all of my problems." I wish that was the case, right? It certainly was not the case, and it's not the case for most people with Hashimotos, hypothyroidism.

[00:03:43] Dr. Wentz: So I took the medication, I got a little bit better. I slept a little bit less, so I went from sleeping like 12 hours to 11 hours a night. I didn't need to wear two jackets in Southern California, which was a huge improvement. I only needed one, right? But then I still struggled with all of this, like anxiety, brain fog, fatigue, irritability, panic attacks.

[00:04:04] Dr. Wentz: Irritable bowel syndrome, acid reflux, carpal tunnel in both arms. And I mean I was in my twenties, but I felt like my body was breaking itself apart. I was like, "How is my, 75 year old grandmother feeling better than I am?" Like, "How is this possible?" And so I started to really research and look into some of the root causes and some of the lifestyle things that were potentially contributing to symptoms and my condition. One of the biggest things for me was dietary change. So I eliminated gluten from my diet and I was like, "oh my gosh, what happens? Like I don't have acid reflux anymore. I don't have I B S anymore. My carpal tunnel went away within a few weeks after that." And this was a huge, huge for me and my healing journey was figuring out that I was gluten and dairy sensitive and getting off of these foods, but then the other symptoms still remained. So I was like, okay, I have to keep digging. I have to keep digging deeper. And one of the things that was really critical for me to get rid of the anxiety and the panic attacks and the fatigue and unrefreshing sleep was actually addressing the help of my adrenals.

[00:05:09] Dr. Wentz: And I first heard about adrenal fatigue and being a pharmacist, I'm like, let me look this up. And it was like, "Adrenal fatigue doesn't exist. It's not a real disorder." So I was like, "Okay, whoever told me this, you don't know what you're talking about." Like, "This doesn't exist. I read it on Medline or some other kind of website and I kept coming back to it because nothing else I was trying, was really working.

[00:05:32] Dr. Wentz: And finally it was another pharmacist that mentioned it to me and I was like, "Okay, fine. I will look into this voodoo thing that you are talking about and try these voodoo recommendations." And then I did, and holy cow, I got better. And so I've been talking about adrenals for the last decade. 

[00:05:47] Dr. Wentz: So I talk about adrenal dysfunction in my first book, Hashimoto's Root Cause. In my second book, Hashimoto's Protocol. These books have been out for 10 years, five plus years. But my really big, I guess, passion came from getting into adrenal dysfunction as a new mom when I was eight months postpartum and my son wasn't sleeping, and then I was like, "Okay, I definitely know that I have adrenal dysfunction."

[00:06:15] Dr. Wentz: I tested myself and my adrenals were flatlined and I was like, "Okay, but I can't utilize any of the things I used to recommend." I can't recommend hormones which I would've previously recommended for people with adrenal dysfunction or glandulars. And I can't recommend things like sleeping for 10 to 12 hours, cuz hello! I have a young child that is, you know, waking up throughout the night and I need to care for them. And I also was like not willing to give up caffeine. I had like just started drinking coffee for the first time in my adult life and I was like, I need this. This is my lifeline. And so I came across like just this new approach to really feel better and to give myself more energy and more resilience.

[00:06:56] Dr. Wentz: And this is where the Adrenal Transformation Protocol was born. And this is kind of a new, unique path to really giving yourself safety signals and resetting your stress response to get a person out of survival mode into thriving. 

[00:07:10] Christa: So much to unpack here, and I bet when you share your story that so many people feel like they're seen and heard, and often a conversation I will have with people is people can get frustrated that their provider does not know what an adrenal dysfunction is. And I often like to say, "Your provider probably has adrenal dysfunction and doesn't know it yet.", right? Because it's such a common situation. So let's unwrap how people can figure out that they have adrenal dysfunction because our conventional testing is a challenge.

[00:07:45] Christa: So before testing, let's talk about symptoms. And you brought up something I should underline that you got a little bit better on thyroid medication. And the nice thing about talking about thyroid is a lot of people can relate to that, right? They've been able to maybe hang their proverbial hat on a diagnosis there, but they take a medication and maybe they're not getting a whole lot better because there's more things that they can do.

[00:08:05] Christa: So in the adrenal realm, let's first talk about symptoms, things that are dead ringers, and then with adrenals, there's a couple situations, right? Maybe let's unwrap the whole picture of HPA access dysfunction and how cortisol can be up, can be down, et cetera. So however you wanna go about answering this, take it away.

[00:08:23] Dr. Wentz: Great. So, brain fog, fatigue on refreshing sleep, irritability, anxiety, trouble waking up in the morning. You wake up, you don't know who you are, where you are, where you've been or you can actually be jumping out of bed in the morning very anxious. Going about your day when you have the 3:00 PM crash.

[00:08:43] Dr. Wentz: Feeling like in the evenings you get a second wind and you're wired or tired. You might be the person if you stand up too quickly, you feel lightheaded and faint. You might have bright light sensitivity, you might have noise sensitivity, you might have cravings for things like potato chips, right? You eat a whole bag of potato chips and other kind of salty things.

[00:09:03] Dr. Wentz: You could be the person that you need caffeine to really start your day. So you're the person that's like crawling out of bed to your coffee machine because you're just so dependent on it and you're the kind of person maybe depends on wine to get you relaxed in the evenings. So these are kind of the main symptoms, and I would say the overarching things that people say is they feel overwhelmed. They feel like their vitality in life is gone. They might have libido issues, they might have mild depression, they might have joint pains, they might have pain all throughout their bodies, and they just feel like they're living at 10, 20, 30%. 

[00:09:39] Dr. Wentz: And this is kind of usually where people come and seek help is when they're in this adrenal dysfunction pattern. It used to be called adrenal fatigue, and there's a ton of controversy over that term, so we can get into that in a little bit. But I guess the important underlying thing is you don't just get there overnight. It doesn't happen you just wake up one day and all of a sudden you're in adrenal dysfunction. There's a process of what happens and there are various stages. So typically a person will be under a lot of stress and we can unpack what types of stress this can get a person into, but they'll start off with having too much cortisol produced throughout the day.

[00:10:21] Dr. Wentz: And cortisol is our stress hormone. So it kind of helps us survive like a really challenging, stressful, life-threatening situation. But it can be activated by not life-threatening stress, either, like chronic stress. And so a person may start off with having too much cortisol, and this is the person that's doing it all, right?

[00:10:40] Dr. Wentz: So they're waking up early, they're going to school, they're working after school, they're taking care of their family. They're just burning the candle at both ends, right? And everybody's like, "how are you so energetic? How are you doing this? How are you doing this all?"

[00:10:53] Dr. Wentz: And this is kind of an over-functioning state that people can be in because of that stress response. It's like, "I just need to do more.", right? And as time goes on, this stress response is going to change. Your body's going to adapt. Your body's gonna say, "Okay, we can't have so much cortisol being put out at all times."

[00:11:13] Dr. Wentz: Cortisol, when it's in excess amounts, can be very catabolic on the body, which means it can break the body down. And so as time goes on, the cortisol secretion will change and alter, and people may end up with altered cortisol patterns that no longer align with a circadian rhythm. 

[00:11:31] Dr. Wentz: So they'll have not enough cortisol in the morning where they have a hard time waking up and they might have more cortisol in the evenings where they have a hard time falling asleep. Healthy circadian cortisol release should start with high cortisol in the morning, and that gradually goes down as the day goes on. And then, they could have what I call the cortisol roller coaster where they maybe have high cortisol in the morning and then that drops, and then they have anxiety fatigue that picks up and then they can't sleep at night.

[00:11:59] Dr. Wentz: Or the one pattern that I've seen a lot of, and this is very common in people with chronic fatigue syndrome, fibromyalgia, hypothyroidism, is this crashed cortisol pattern or flat line cortisol pattern where you secrete very little cortisol in the morning and all throughout your day. So this is the person that's exhausted all day.

[00:12:21] Dr. Wentz: They're tired at night too. And this is the person that goes to bed tired and wakes up tired. And this is the person that tries to like exercise because people say exercise will make 'them feel better, and then they feel worse. They'll be like, "Oh, people tell me community is so important. So I try to spend time with friends and then I feel worse.", right? And then they're like, okay. And everybody said fasting should make me feel better. They try to fast and that makes them feel worse. And these are some of the names for people within this community could be spoonies or autoimmune warriors, or chronic fatigue warriors, hypothyroid warriors .

[00:12:54] Dr. Wentz: What my frustration is that a lot of people are ignored when they're in this low cortisol state because if you look at mainstream media, they talk about how cortisol is bad and high cortisol is bad, and the truth is we need cortisol, we need just the right amounts of it, and ideally secreted most of it towards the morning.

[00:13:14] Dr. Wentz: Early in the middle of the night is when the cortisol production starts to increase. Nice wake up from cortisol somewhere between seven and 8:00 AM and really these people with that low cortisol pattern, they're very much ignored by mainstream medical providers, unfortunately.

[00:13:33] Christa: Yeah, we don't have very good diagnostic criteria.

[00:13:35] Christa: But before we get into diagnostic criteria, I wanna go back and talk about some of the things you brought up here. Which, first of all, what's going on in the adrenals once that cortisol is getting flatlined? You spoke about it just a little bit, but essentially what's actually happening there? And then can you also talk a little bit about mechanism of action?

[00:13:54] Christa: You brought up that you had carpal tunnel, some people have joint pain, and that was a question I got from someone that wanted to know. Talk to us about how is joint pain associated with adrenal? So can you draw those lines a little bit? 

[00:14:07] Dr. Wentz: Sure. So some of the patterns and how does it actually happen?

[00:14:11] Dr. Wentz: And I think there's a lot of controversy about low cortisol and where does it come from? And when Dr. James Wilson and naturopath first coined the term adrenal fatigue, he thought it was like the adrenal glands had a mild version of Addison's and they were quote unquote, actually "fatigued and unable to produce cortisol".

[00:14:32] Dr. Wentz: To Addison's disease is a rare life-threatening autoimmune condition where it'll manifest when 90% of the adrenal glands are destroyed. And this is something that's very much recognized by conventional medicine. If you have this condition, John F. Kennedy was one famous example, then you will need lifelong, medication to provide the things your body can no longer make.

[00:14:54] Dr. Wentz: Well with adrenal fatigue, adrenal dysfunction, Dr. James Wilson kind of popularized that term and people were going to their endocrinologist and saying like, "Hey, I have adrenal issues." And adrenal fatigue sounds a little bit like adrenal insufficiency which is another name for Addison's.

[00:15:10] Dr. Wentz: And so these individuals would be tested for Addison's disease and the endocrinologist would be like, "You don't have Addison's disease. What's going on?" And now we understand that the mechanism that Dr. James Wilson had theorized isn't necessarily accurate. It could be for some people.

[00:15:26] Dr. Wentz: Sure. There might be people out there who have Addison's disease and maybe only 80% of their adrenal glands have been affected. So they might have that mild version of Addison's that maybe they haven't been diagnosed yet and they're producing very little cortisol. But for most people with this adrenal dysfunction and this cluster of symptoms, what's actually happening?

[00:15:47] Dr. Wentz: It's a breakdown of the feedback loop between the brain and the adrenal glands. So the more accurate term, if somebody wants to be like nerdy and Google it or look it up on PubMed, is Hypothalamic Pituitary Adrenal access dysfunction. And essentially what it is, is the body or the brain senses so much stress and provides this feedback to our adrenals to secrete cortisol where an after a certain period of time, the receptors are going to become desensitized to all that messaging, right? 

[00:16:22] Dr. Wentz: And so a person will end up not releasing as much cortisol, even though the brain keeps sensing stress and really the root cause is this stress sensing, stress perception. And so this is what we need to work on to get the person back into thriving.

[00:16:39] Christa: So one of the biggest challenges I see in practice is when people don't recognize the stress in life, and I want to maybe insert here if we can talk about what are maybe things that are stressors on the body that we don't think of as stressors on the body. Some of the ones that I have seen that have caused this flatlined cortisol pattern have been I V F treatments, fertility treatments, death of a loved one. 

[00:17:08] Christa: And we kind of know that would be stressful, but we don't realize how maybe long-term it is. You brought up, I think also over exercising and undereating to some extent, right? because we talked about that. What are some other ones that are kind of a little bit less expected stressors that maybe we don't think of.

[00:17:25] Christa: I mean, I think this is always the challenge of how do you help somewhat acknowledge that there's a stressor? I mean, and I've been a person like this as well, right? It was my fast talking was like lots of cortisol over and over when I didn't even get a chance to breathe through my nose when I was back to back appointments all day. So what are some things that we don't always think of as stressors? 

[00:17:45] Dr. Wentz: Sure. So there's always those obvious things like you're annoying boss or your toxic work culture. I think a lot of people can really put the finger on these triggers and these stressors, but a lot of the people that I've talked to or worked with over the years, they're like, "Well, my life isn't stressful. There's nothing stressful about my life." But then you dig in a little bit deeper, and then it might be a past history of trauma, so something that happened in your life as a child, as a young adult that could have left an impact on you and left a mark on how your body responds to and perceives stress.

[00:18:19] Dr. Wentz: Looking at some of the research around H P A access dysfunction ACEs, so adverse childhood events. So anything that happened throughout your childhood that maybe was traumatic, like abuse, death of a loved one, parental divorce, all of these things can actually shift the H P A access. And so people can end up with this cortisol pattern because of something that happened so, so long ago.

[00:18:45] Dr. Wentz: I call this unprocessed trauma. So this is something that just sticks, stays within you, and just really impacts how you perceive the world today. So you're looking at the world without the right hint with it. So you're looking at this. The world with perhaps some dark tinted glasses and you're the person that's like, "Why this person looked at me funny?" and that your perception is always like the negative, right? And you're always perceiving the world a little bit different than what it actually is, and you don't think people have the best intentions. 

[00:19:16] Dr. Wentz: So this is one particular thing that I feel like psychologists really make like they've done a lot of research and they really talk about this, but there's also physiological stressors. So these are things like over exercising and undereating. If you're somebody that is trying to lose a little bit of weight, you typically might hear that you should exercise less or exercise more and eat less. And that can actually send your body a stress signal. 

[00:19:44] Dr. Wentz: When I think about cave women and what we've evolved from in our ancient genes. If you, for a prolonged period of time weren't eating enough calories, you were eating foods that were inflammatory to you, you were constantly on the run on a treadmill. As a cave woman, usually perhaps after a prolonged period of this, you might receive the message that there was either a famine or some kind of a danger or threat, and typically the best way to survive a famine is by having a metabolism that's a little bit slower, right? How do bears survive a harsh winter?

[00:20:20] Dr. Wentz: They hibernate. So they go into this altered state where they're storing more fat. And this is what happens when we slow down our metabolism. I did a little bit of a deep dive into kind of the thyroid parameters of bears, hibernating bears, and turns out they tend to have more of like reverse T3, right?

[00:20:37] Dr. Wentz: And so this is what happens when we're under a lot of stress is our body will send out these chemical messengers to essentially slow down our metabolism. One of them is reverse T3. This can actually be increased by excess cortisol production where this will bind up our thyroid receptors and slow down our metabolism because active thyroid can't get in.

[00:20:57] Dr. Wentz: So this is a very real pattern that I talk to women with thyroid issues about, like, "This is what happens when you over-exercise and you don't get enough food into your system. This can be a huge stressor. Things like overwork are other triggers. And then there are things that are maybe not as obvious to us, and these could be exposure to toxic mold.

[00:21:23] Dr. Wentz: This could be exposure to pathogens. So if you have gut pathogens, these are causing inflammation within your gut and then this is gonna cause you to constantly release more cortisol. Inflammation is a really powerful signal to the body that we need more cortisol. So cortisol is an anti-inflammatory, right?

[00:21:46] Dr. Wentz: I'm a pharmacologist, so I'm always like, I'm pharmacology, but hydrocortisone and steroids, these are drugs that are used to suppress inflammation in the body. And so whenever there is already inflammation, our internal resources are gonna say we need more cortisol. So anything really that could be contributing to inflammation. 

[00:22:05] Dr. Wentz: There's obvious things that are like, "Oh, you're not eating the right kind of diet. You're eating too many omega 6 of, not enough omega 3s, but there's also hidden infections and triggers. And I think you and I get really excited about those. Maybe not everybody else does, but these are very real drivers of that adrenal dysfunction where people will say, "Oh, it's not really adrenal dysfunction, it's toxic mold.", or "It's not adrenal dysfunction, it's mitochondrial issues." or "It's trauma."

[00:22:33] Dr. Wentz: I'm like, "It's kind of all of the above." Adrenal dysfunction is essentially what happens when your body gets overwhelmed by stress and or inflammation, and you end up in that altered physiological state. 

[00:22:45] Christa: Yeah, you're not gonna have the option to just address one. You now have to address all. Whether fortunately or unfortunately, right? At least you can see it which is good. 

[00:22:54] Christa: I just realized when you were talking about cortisol being anti-inflammatory, do we think that flatlined cortisol would be a reason for some of this, like fibromyalgia type symptoms and joint pain stuff? I don't know if we ever got to that. Is it kind of a, "we're not sure why we're having that physical manifestation, but here's a possibility."

[00:23:15] Dr. Wentz: Absolutely. Looking at some of the studies with fibromyalgia, we do tend to see more of that low cortisol pattern in HPA access dysfunction. I was just sharing on social media the other day when I was a young pharmacist and I was in my, this is many years ago, but 20 years ago now. How am I still 22, right?

[00:23:35] Dr. Wentz: But it was a lecture I had about fibromyalgia and chronic fatigue syndrome where I learned about it, but the professor said, "We're not really sure if it exists or if it's something that is in people's heads." Like, I have scientific evidence that it's a real condition. And I remember going to pharmaceutical conference where I talked to a pharmaceutical rep who was really advocating and kind of bringing awareness campaign about fibromyalgia.

[00:24:01] Dr. Wentz: And I'm much wiser now, but I remember saying like, "Do you think this is a real condition because I learned that it's not real?", and the pharmaceutical rep was like, "It's absolutely real. " This is something that people are affected by and they need to be recognized.

[00:24:15] Dr. Wentz: And not coincidentally, that same company ended up producing a drug for fibromyalgia that was FDA approved. So, kind of all that to say is a lot of these conditions, they really don't get the attention and the recognition that they deserve from a medical standpoint, unless there's a drug that's approved for them.

[00:24:35] Dr. Wentz: And it's very sad for me to hear from people who are like, my doctor said, "This is all in my head, or this is not real." And so on and so forth. But the pain, this is a real, real manifestation of when you have flat- lined cortisol curves. You don't have enough of your natural anti-inflammatory cortisol, so yet the inflammation in the body is going to go unchecked, so people will end up with things like thyroiditis as well and other types of breakdown in their body that doesn't get fixed.

[00:25:07] Dr. Wentz: Our body is constantly going through a breakdown and repair process, and cortisol helps to keep that balance in check and helps to manage the naturally occurring inflammation, right?

[00:25:18] Christa: So moving on to testing. You were talking about Addison's being a downshift of approximately 90% of adrenal function. And I often tell people, your doctor is not going to find an adrenal function unless you are almost dead because cortisol is essential for life. And so briefly, I'm curious about diagnosing, adrenal or Addison's and what medication people go on? And then because everyone feels better when we have testing validation. Let's get into what our options are for functional testing to address HPA access dysfunction. 

[00:25:50] Dr. Wentz: So yeah, typically I will say people will go to their doctor and they will get asked to get tested for adrenal issues. And the doctors will typically test them for Addisons, right? And usually they'll say, "Okay, I tested you and you don't have Addisons. It's gonna be like a blood test." And you know, people will kind of come back to square one and then I'll be back to educate them and I'll say, "Okay. Well, we really need to focus on more of the I guess functional medicine, integrative testing, and typically things like the adrenal saliva test, as well as the DUTCH urine test."

[00:26:29] Dr. Wentz: These might be what can really show this altered circadian cortisol pattern, which is what we're looking for when we're talking about adrenal dysfunction versus Addison's disease. And a lot of times these tests are gonna be out of pocket and you have to work with a functional practitioner or an integrative practitioner, somebody that has like ability to order those tests for you.

[00:26:52] Dr. Wentz: And they're not gonna be covered by most insurance companies, unfortunately. So it might be few hundred dollars before people have access to these tests. So the point where this has been such a big challenge for people. You ask how do, I have so many people that going through my programs, it's people within my own community where I will open up group programs for individuals to come and join me for a four to six week challenge where we go through just based on our symptoms.

[00:27:21] Dr. Wentz: And I've tested so many people for adrenal dysfunction that I can just talk to them and say, "I can draw your cortisol pattern just based on what you're telling me, how you're feeling throughout the day."

[00:27:33] Dr. Wentz: So I will say if you can get the testing, you can absolutely work with your doctor to order a Z R T cortisol pattern, or you can work on the DUTCH test, get that test done.

[00:27:47] Dr. Wentz: You can self-order them online, like RUPA gives you these opportunities to self-order. But really I'm at this point where I will just ll say, "If you have these symptoms, you might as well just assume that you have some degree of adrenal dysfunction and you can try utilizing a four week protocol to see if you feel better."

[00:28:08] Dr. Wentz: I don't know if you've had this Christa, but you'll work with a client and you 'll say, "Here's a test to order." And then a few weeks later they'll order the test and then the test will sit at their house for a few months and then like, they send the test results and then, you know, it takes four to six weeks to get them back.

[00:28:24] Dr. Wentz: And you're like, "It's been six months and I could kind of tell by your symptoms that you could probably benefit from some adrenal support." So I'm sort of at this point right now where I love tests. I love to do them on myself. I actually have, I had a dog with Addison's, so I did, you know, all the conventional tests with him, as well as all of like every functional medicine test I could, even with my dogs.

[00:28:48] Dr. Wentz: And every client that comes to me, I will recommend tests if I'm working with them one-on-one. But at the same time, if there's so many people that need this help and the symptoms are so telling that you probably have adrenal dysfunction, where at this point I'm like, " If you're hearing this or you're resonating with this, look into doing some of the protocols."

[00:29:09] Christa: Right. I would agree with that. So we've got the salivary cortisol pattern. You can get urinary or salivary from DUTCH. But then, correct me if I'm wrong, but what I was running into was falsely looking good cortisol because cortisol can be secreted by abdominal adiposity.

[00:29:27] Christa: How awful! And so if you have anything going on around your waist, it was possible that you were getting a false. So no test is perfect. This is now, you know, I like the H T M A now, right? And I like the H T M A, cuz there's also issues there for different reasons. But generally, I'm able to get a more subclinical picture of thyroid or adrenal dysfunction.

[00:29:47] Christa: But again, that's not a very straightforward thing either and I don't think that's a very good DIY Test cuz it's not quite straightforward. I mean, there are options for DIY in it with certain coursework, but it's kind of tricky. And so I would just say on the same note of DUTCH test. So you can split out the cortisol test and maybe it's a couple hundred dollars, but then for a little bit more you can get all the hormones and then before you know it, you know, it's more like a, "Well, you gotta make sure you're doing it with your cycle." And it's wonderful, but you just need to feel better and there's so many things you could do to feel better in the short term. 

[00:30:18] Christa: I always think you are not going to go wrong loving on your H P A access. It is not a problem to try to improve the sense of safety in your brain and nourishing your body appropriately to support your adrenals. So I would just like put big underlines under everything you just said there.

[00:30:37] Christa: Okay, so big picture. Conventional testing- not super awesome, pretty much nonexistent. Functional testing- some options for sure. But like with all testing, there are some drawbacks, right? Just from a time perspective, et cetera. So, symptoms speak loudly and symptoms that you're not gonna hurt to do things.

[00:31:00] Christa: So let's get into a little bit about the protocol overall. Actually, back to my guy Raz, how it's made thing. I know you said you've had 3,500 people utilize, I think it's, yeah, four weeks. You've had them go through the protocol and have results. And so you kind of already talked about this a little bit, but I'm just so curious over what time period this was?

[00:31:22] Christa: How did you have 3,500 come in? How did you measure some of that stuff? Because I'd just love to know the mechanics up behind the scenes. 

[00:31:28] Dr. Wentz: Sure. Yeah. And so my background is in outcomes research, so that's what I did when I worked in public health. So it's a lot of fun for me. I've taught a lot of healthcare professionals over the years, both in conventional and functional medicine how to utilize this, where I've worked in population, health and outcomes research, and really figuring out what are some of the biggest needle movers that can help 80% of people feel better.

[00:31:53] Dr. Wentz: Initially I was a new mom in 2018 and you know, kids are our best teachers. And I was like, I did so many different things to help myself heal as a new mom that I'm like, "Okay, I need to share this with people." And initially what I'll do is I'll start with a small pilot group of people, maybe about a hundred people. And then they'll have access to like a consultation with me and they'll have access to this group program that I'll build where we'll have a health coach and a nutritionist and a customer service team. And we write it all out beforehand. So we produce the contents and the person will be part of like a group program.

[00:32:36] Dr. Wentz: The first one I did was Hashimoto Self-Management Program, and I based it on the diabetes self-management model that I learned about when I was working in public health. And I was teaching clinics on how to set those up. But essentially we'll do this for, a program where we'll have a week of onboarding, four weeks of being live, and then the last week would be kind of an offboarding process.

[00:32:59] Dr. Wentz: And so I will ask every person going into the program to share their symptoms. And to do a little bit of an intake to rate their symptoms. Initially, it's just that small group so it's very manageable and then we'll go through the program. We'll have Q and A's we'll. We'll kind of dial things in as we need to.

[00:33:18] Dr. Wentz: And if we have enough success with the pilot group, then we'll go back and we always have what we call a retro meeting with our team, and we'll go through everybody's feedback. And we'll say this person thought that this recommendation was completely useless and undoable. One feedback we always got was like, you told people to go outside and get some sunshine first thing in the morning, but there were people that live in Alaska that can't do this. What else can we recommend? 

[00:33:48] Dr. Wentz: And just taking back this feedback that we got from the community and saying like, "Okay. That's kind of person actually-" what were their patterns and why did they not get better? Or what is our sweet spot? What are the specific symptoms that we expect to get better with this program?

[00:34:03] Dr. Wentz: And so we'll do this and then we'll release it to a bigger group. So the program has been launched seven times since 2020 and the first launch, believe it or not, the pilot group was actually in March of 2020. And I was like, "Oh my gosh, is this program gonna work? Is it not gonna work?" and remarkably still, people had so much less anxiety.

[00:34:23] Dr. Wentz: Our stats are more than 80% of people will have less brain fog, less anxiety, less fatigue, better libido. We're looking at about 76% of people will have less pain as they go through the program, and so it's been released seven times and somewhere around 2021. I was like, "you know what? I think I need to put this out into the world in a bigger way." Because this is a really unique approach to getting the body into that safety zone without using hormones. And I love hormones. I love all of the treatment modalities out there. Don't get me wrong, there's nothing with utilizing them if they're utilized by the right person and the right dose, then they're working with a practitioner, but not everybody can do hormones.

[00:35:08] Dr. Wentz: Like some people take D H E A and it over converts to estrogen and it makes estrogen dominance work . And so that's kind of how I've done it. And it's been something that I'm very proud of and I'm very excited to have all of the success stories that have come out of the program.

[00:35:23] Dr. Wentz: Typically, I'll do like a Q & A session every week, and it's interesting because I can predict the type of questions that are gonna happen. So the first week it's always everybody's anxious and overwhelmed. By the third week, they're like, I am running up and down my stairs. I have so much energy, I have my libidos coming back, my spark is coming back.

[00:35:43] Dr. Wentz: And it's been really, it's just been a beautiful journey to witness. People really coming into themselves and having that vitality again. 

[00:35:51] Christa: Oh, that's so fun to hear about. Okay, so I have some questions. You talked about sending safety signals to the brain, right? Because this is really a brain thyroid loop, so to speak a little bit. 

[00:36:04] Christa: So talk a little bit about opportunities for sending that signal. We talked about the things that kind of signal to the brain danger zone, and I think there's always more to dig into there. And I think if you're struggling with this, one thing I wanna say about the positives, I talked about some cons around testing, but some of the positives on testing, and I bet you've experienced this a lot as well, is that sometimes you have high performing women.

[00:36:26] Christa: Maybe I, or maybe not. I was also talking about myself in this example. I think that they feel okay, but their testing comes back that their adrenals are not in good shape and it's like, "Well ,that's funny." Cuz I just had interviewed another health practitioner who said really similarly the same thing at the other day.

[00:36:42] Christa: I have seen this with clients that sometimes you think you feel kind of okay, but the test can say maybe you actually need to like, Dial it down for a moment. So that was a positive I wanted to mention, but back to safety signals. So digging into what's not sending safety signals, there's a lot of options. But talk about some ways that people can send positive safety signals to their brain, or what do you mean by that?

[00:37:04] Dr. Wentz: Sure. So there's always gonna be this teeter-totter of like, we live in the world, real world, and there's always stress, right? One of the best things you can do to overcome stress is get more sleep. And like I used to recommend getting 10 to 12 hours of sleep for 30 days straight. If you can do that, have this beautiful reset that's gonna allow your body an opportunity to heal. And we always have to be like, okay, what is realistic for me in this lifetime in this day? And there's a lot of various safety signals we can pull on whatever is accessible to us what's relevant for us.

[00:37:37] Dr. Wentz: Not everybody can get lots of sleep. I know new moms. I really appreciate new moms haven't been one for the last few years. That's not realistic. But there are things that just about everybody can do and that's gonna be getting more protein into your diet. When we're in a stressed out state, our body's in a catabolic process, so that means the body's breaking itself down for fuel.

[00:38:00] Dr. Wentz: And so getting more protein is gonna give us some of those amino acids so we can build ourselves back up. And that way the body is gonna be a little bit shifted more towards that balance, that safety, if you increase your protein intake, generally, increase your fat intake of good fats compared to what the standard American diet might be.

[00:38:20] Dr. Wentz: And we're eating for blood sugar balance. One of the really big danger signals to the body is if we have blood sugar swings. If we go hypoglycemic from too much of a response from eating foods that are maybe too high on carbs for us, then our body has to step in and create more cortisol, create more glucose, and we utilize this via cortisol.

[00:38:45] Dr. Wentz: And so this is a huge, huge thing. I've had people going through the program. That have said, "Oh my gosh, I thought I had anxiety. I thought I had panic attacks. It turned out I just needed more protein and fat and I just needed to balance my blood sugar." This is a huge safety signal that most of us can utilize.

[00:39:02] Dr. Wentz: Another safety signal that a lot of people can do is utilizing nutrients. So B Vitamins, Vitamin C, electrolytes. These are gonna be pretty straightforward for people to take. They're safe for most people. They're not gonna be something that can be problematic for most people, and most people will feel better when they utilize them.

[00:39:25] Dr. Wentz: I've had a few people who have said, oh my gosh, I thought I was hydrating. It turned out that I was just missing electrolytes and a lot of the pain in my body went away just from utilizing electrolytes. And then, probably my favorite way to send safety signals is through Epsom salt baths. So magnesium is a component of epsoms getting magnesium into your body through that topical route.

[00:39:49] Dr. Wentz: There is some evidence that suggests it can be helpful for supporting our healthy D H E A production, which is our anti-aging hormone, and it can also really give us that beautiful magnesium that's important for so many of our pathways in the body, whether that is through managing our pain, through helping us sleep better at night, to having less anxiety.

[00:40:13] Dr. Wentz: I will have people going through the program and I'll say, " Just do this little thing if you're having trouble sleeping, if you're anxious.", and they'll do it. Epsom Salt Bath, and it helps to put them at ease, helps to relax them. They get outta the bath, they can sleep better. I have done some testing with Aura Rings with myself and some of the people who have had them, and they'll find that they can get into deeper sleep if they utilize the epsom salt bath. So that means their body is restoring itself more and fixing itself more.

[00:40:43] Dr. Wentz: This is another just powerful way of giving yourself a little bit of T L C to kind of neutralize the effects of that chronic stress response and to kind of be like, "Okay. This is gonna give you an opportunity to actually feel good." Because we're replenishing some of the things that get really burned through when you're super stressed. 

[00:41:02] Christa: I recommend epsom salt baths a lot, but I have a lot of people who cannot or will not, don't have a bath, don't fit in the bath. It's not comfortable. What would you offer for them? 

[00:41:14] Dr. Wentz: That was one of the feedback points too throughout my program participants. And I was like, "who doesn't love a bath?" But I get it.

[00:41:20] Christa: Half the people.

[00:41:21] Dr. Wentz: Yeah. 

[00:41:21] Christa: They're either gonna love the recommendation or they hate it. 

[00:41:24] Dr. Wentz: Yeah. So you can use a foot soak if that is something that you're interested in.

[00:41:29] Dr. Wentz: So getting like just a little basin, a salad bowl, if you will, put some warm water in it and a little bit of maybe half a cup to a cup of epsom salt, and you can get magnesium that way. And then there's also some companies that make topical magnesium. There's spray topical magnesium, and then there's certain lotions as well.

[00:41:49] Dr. Wentz: Now, I tend to recommend if you could put them at the bottom of your feet, that might be helpful. If you are somebody that, for me personally, some of them can be very irritating if I shave my legs. So if you're thinking about putting them on your legs, Make sure you, you didn't just shave cuz that could be a little bit, cause a little bit of burning.

[00:42:07] Christa: Yeah. Do you have anything else to say about the burning from different ones? I have found brands affect it. I think putting on the bottom of your feet that's really thick is always like the best first thing. And then to try, I think I like a different, like lotion one a little bit better for this reason, but it is kind of a frustrating symptom, unfortunately.

[00:42:24] Dr. Wentz: Yeah. You can just grow out your leg hair. Yeah. 

[00:42:28] Christa: Oh yeah. Maybe. Maybe I'm already covering that. I don't know. Okay. So we talked a little bit. Those are some really practical things. I think some other things people might give feedback about is when people have adrenal dysfunction, sometimes they would consider themselves a light sleeper, right? They would wake up several times through the night. So my feedback is always do whatever you can to make it work, right? And that might mean taking some sleep aids, right? I would rather people sleep than not sleep. Like the benefit is much superior. 

[00:42:59] Christa: There's just a lot of different things we can trial, and people know this, right? Because I don't know what the stats are, but something like 40% of Americans don't sleep well right now, right? 

[00:43:06] Dr. Wentz: So I have kind of the fundamental protocols in my book where I really focus on the things like four week plan to get 80% of people's sleeping better, feeling better, more energy, and then I have some advanced protocols that focus on if you have issues with sleep, here's what you can do. Like when I was in my '20's and I thought anybody could just go to sleep, right? I was like, you just have to prioritize it. That's all. And so yes, I've learned a little bit since then. 

[00:43:32] Dr. Wentz: But you know, if you're a woman in perimenopause, for example, or menopause, one of the reasons you might have issues with sleeping is because you don't have enough progesterone. And so utilizing a topical progesterone, ideally working with a practitioner at bedtime, that may help you sleep a little bit better. If you're drinking your caffeine too late in the day. And if you're a slow metabolizer of caffeine, perhaps pushing it back a little bit earlier in the day, I'm not gonna take away your caffeine during the four weeks, don't worry.

[00:44:00] Dr. Wentz: But you know, maybe instead of doing it at 5:00 or 6:00 PM have your last cup before 3:00 PM and see if that makes a difference in how light you're sleeping. If you're somebody that's waking up at 3:00 AM throughout the night. Eating for blood sugar balance can help. You can also utilize something like Myo-inositol that can help your blood sugar get balanced more naturally.

[00:44:21] Dr. Wentz: If you're somebody that wakes up because you maybe didn't have enough calories throughout the day, consider a Chromium supplement that can help people with sleeping through the night if you're waking up frequently throughout the night. This could be an ammonia issue, so consider like an ornithine supplement.

[00:44:35] Dr. Wentz: And I've worked with enough people and sleep issues where I can really help you dial things in based on whatever pattern that you're presenting with. Cuz like you said, sleep, if you can prioritize it, if you can do it, it can be the most healing thing for you. 

[00:44:52] Christa: For sure. You talked a little bit about receptor sensitivity being burdened. You've given some really specifics to different nutrients, et cetera. Is there anything else you wanna say about the nitty gritty of adrenal receptor sensitivity?

[00:45:07] Dr. Wentz: So with respect to adrenal receptor sensitivity, like I said, there's a lot of different pathways and theories on how this condition develops, and that receptor sensitivity can be one of them.

[00:45:17] Dr. Wentz: We know this is a pathway that can be very much impacted when we, any kind of hormonal pathways. When we have too much of a hormone, then the receptors are gonna get desensitized. That's how our feedback loop works. The way that we really reestablish that sensitivity is we try to have a bit of a, kind of a reset, right?

[00:45:39] Dr. Wentz: And so we try to minimize the stress signals and we try to optimize some of the safety signals. I used to work with utilizing low doses of pregnenolone and D H E A throughout the day to help with that receptor rebalancing and rebalancing that pathway.

[00:45:57] Dr. Wentz: But I've actually found that mitochondrial support tends to work more effectively and quicker, and it's much more available to most people too. So this is one of the things that's a little bit different about my current protocols to what I used to do 10 years ago is really focusing on that mitochondrial health.

[00:46:18] Dr. Wentz: We know that our mitochondria help with producing our pregnenalone, and part of healing might be helping the mitochondria feel safe and giving them a lot of the nutrients that they need to do their job. 

[00:46:30] Christa: Yeah. I don't know if we can go wrong there either supporting our mitochondria. We all need of those and we are not getting more of them as we age, we get a decline. So that makes tons of sense. I always think if the intervention could do more than one thing, we're off to a good start, right? 

[00:46:46] Dr. Wentz: I really love utilizing things like that. When you train in functional medicine, you learn about all these beautiful supplements and things and if you're not mindful of it, you could be like taking 45 a day, right? And nobody really wants to do that. It's expensive and it's like a full-time job. 

[00:47:03] Dr. Wentz: And so I've really tried to pair it down to people where I can say, if we utilize electrolytes, these can be very helpful for so many symptoms across the board. If we utilize something like L-carnitine, this can help you have more blood sugar balance. This can help your mitochondria produce more ATP. This can help clear out some of that ammonia from the body that causes a lot of brain fog. And I just have six core supplements that I recommend throughout the program. Throughout the four week plan. 

[00:47:34] Christa: Yeah. So I think you've covered this in one way or the other, but I think I wanna kind of start to, or finish up and wrap up a little bit with this question as well as like things people can do today and where people can find you.

[00:47:46] Christa: But you're coming from an adrenal or a thyroid space where you always talked about adrenals, and I think this is almost said in your own story. How would you answer, do you think, when people are dealing with refractory thyroid, things that probably adrenals are involved or at play, and people should consider adrenals as well.

[00:48:06] Dr. Wentz: It's like the adrenals and the thyroid, there's a beautiful feedback loop there as well. And so a person who maybe is hypothyroid, they're gonna have less, a slower clearance of cortisol out of their body. This is like a protective mechanism that the body will say, "Oh, you don't have enough thyroid hormone on board. Let's keep your cortisol around a little bit longer to give you some of that energy.", right? 

[00:48:31] Dr. Wentz: The cortisol energy isn't the most beautiful and calm energy, so people will typically feel very edgy with it. But at least it's something, right? And so people will go to their doctors and they'll get diagnosed with hypothyroidism and they'll be put on thyroids, which sometimes that's absolutely what they need to get their thyroid hormone in balanced.

[00:48:51] Dr. Wentz: But then what happens with that cortisol that had been hanging out a little bit longer to kind of keep us in balance, the cortisol clearance will normalize once the thyroid function normalizes, which means it increases, which means that more cortisol is broken down quicker out of the body, and that can actually uncover that low cortisol pattern, if that makes sense.

[00:49:18] Dr. Wentz: So that pattern was kind of there already. You probably have some stress response that put you there, but the slowing down of your thyroid was kind of masking it. And so this is a really common pattern that I'll see with people who will say, "I was feeling better when I started on thyroid meds, and then within a few weeks I just crashed.

[00:49:40] Dr. Wentz: I felt more tired, like what happened? "And for many people, you know, this could be absolutely this adrenal situation. I would say, like I did an analysis of about 148 labs and about 62% of people presented with that low cortisol pattern with symptomatic thyroid patients. 

[00:50:00] Christa: Yeah, makes a lot of sense.

[00:50:02] Christa: Okay, so people always wanna know, what can I do today? I know you gave lots of tangible things. Feel free to reuse one. What's your top one or two things you would want people to know to start supporting their adrenals today? 

[00:50:13] Dr. Wentz: So definitely looking at the A, B, C. It's in the body and helping you shift out of that. Your body is constantly under stress and then really focusing on pleasurable activities. So we didn't talk much about this, but getting into sort of that healing state. It's really focusing on doing things that you love. A lot of times I find people are exhausted, not because they're doing too many things, but because they're not doing enough of the things that really bring them joy and energy.

[00:50:45] Dr. Wentz: And so this is probably one of the hardest things for people that are like, I've got so many things to do and I have a side hustle and I'm a high achiever. But it's such an important thing. It's such an important way to shift out of like," I'm surviving. I'm constantly late. I'm going to the next thing." To like, "I'm taking just some time today to have a little bit of pleasure in my life."

[00:51:08] Christa: Yeah, I love that. That was a good quotable, right? It's not that you're not doing enough things, you're too many things, but you're not doing enough of the things that you really enjoy. 

[00:51:16] Christa: So where can people find you online? 

[00:51:19] Dr. Wentz: So my website is Thyroid Pharmacist and I have the ABC's of Adrenal Guide at thyroidpharmacist.com/abc and then I also have a Instagram is Isabella Wentz, PharmD, and then I also have Facebook at Thyroid Pharmacist, Dr. Isabella Wentz. 

[00:51:36] Christa: Perfect. Thanks so much for coming on today. 

[00:51:39] Dr. Wentz: Thank you so much for having me. 

[00:51:40] Christa: I already wrote down some questions for part two when you feel like doing more interviews. We'll go back and cover thyroid a little bit deeper.

[00:51:47] Dr. Wentz: Ooh, that'll be fun. 

[00:51:48] Christa: Yeah.

[00:51:48] Christa: Sharing and reviewing this podcast is the best way to help us succeed with our mission. To help integrate the best of East and West and empower you to raise the bar on your health story. Just go to review this podcast.com/lessstressedlife. That's review this podcast.com/lessstressedlife, and you'll be taken directly to a page where you can insert your review and hit post.