Interview with Dr. Izabella Wentz, Integrative Pharmacist and Thyroid Expert

Dr. Thais Aliabadi and Mary Alice Haney sit down with Dr. Izabella Wentz—known to many as the Thyroid Pharmacist—to untangle the confusion around Hashimoto’s, hypothyroidism, adrenal dysfunction, and the gut’s role in autoimmune thyroid disorders. Her story is a familiar one: years of symptoms dismissed by clinicians, a slow path to diagnosis, and then a focused search for root causes that changed everything. Below we present the conversation in a clear question and answer format so you can use it as a practical roadmap to test, troubleshoot, and begin to feel better.

Table of Contents

• About our guest
• Interview (question and answer)
• Treating the whole person: nutrition, nutrients, and testing targets
• Food, gluten, and blood sugar
• Adrenal function and stress
• Gut health and its central role
• Root causes and triggers
• Special life stages: pregnancy, puberty, and perimenopause
• How we evaluate progress: lab targets and remission
• How to advocate for better thyroid care
• Quick implementation checklist
• Practical FAQs
• Final notes we want to leave you with
• Resources mentioned
• Where to find Dr. Wentz
• Further reading and next steps

About our guest

Dr. Izabella Wentz is a pharmacist turned integrative thyroid specialist. After a decade of debilitating, unexplained symptoms, she was diagnosed with Hashimoto’s in her 20s. She used clinical research, nutritional strategies, and investigative testing to get herself into remission, then distilled what she learned into books, protocols, and an online resource hub that now helps hundreds of thousands of people.

Interview (question and answer)

We heard your journey to diagnosis took a long time. What happened, and why did you decide to focus on thyroid health?

Her experience mirrors so many we meet. Despite being in her 20s, she was exhausted, losing hair, waking up after 12 hours of sleep still tired, and experiencing palpitations, acid reflux, carpal tunnel, and cold intolerance. Clinicians told her the symptoms were psychological or just aging. The diagnosis of Hashimoto’s changed everything. Instead of accepting the old medical attitude that “there’s nothing we can do” until the thyroid burns out, she started digging into research and patient communities to find interventions that would prevent thyroid damage and restore quality of life. That search led her to adopt a root-cause approach—testing, nutrition, stress management, gut repair, and targeted supplementation—and to share those tools via books and teaching.

How do Hashimoto’s and hypothyroidism differ? Aren’t they the same thing?

They are related but not the same. Hypothyroidism is the clinical state of not having enough thyroid hormone in the body. Hashimoto’s is an autoimmune process in which the immune system attacks the thyroid gland, commonly leading to hypothyroidism over time. Hashimoto’s can be present for many years—often a decade or more—before standard screening reveals reduced thyroid function. Because symptoms often begin early and are nonspecific, diagnosis is frequently delayed.

What symptoms should prompt testing for thyroid dysfunction or Hashimoto’s?

The symptom list is broad because thyroid hormones affect nearly every cell. Key red flags include:

• Hair loss (notably loss of the outer third of the eyebrow)
• Persistent fatigue or brain fog
• Cold intolerance and low body temperature
• Palpitations or anxiety
• Digestive symptoms such as reflux, IBS, constipation, or diarrhea
• Unexplained weight changes (gain or loss)
• Fertility issues and recurrent miscarriages
• Unexplained pain, including carpal tunnel

When these symptoms cluster or persist, especially in younger women, it’s worth asking for a full thyroid evaluation.

Which lab tests should we request if we suspect Hashimoto’s or thyroid disease?

We should never rely on a single lab. Ask for a complete thyroid panel that includes:

• TSH (thyroid-stimulating hormone)
• Free T4 and Free T3 (the active thyroid hormones)
• Thyroid antibodies: TPO (thyroid peroxidase) and TG (thyroglobulin)
• When relevant, tests for Graves disease antibodies (TBII/TSI)

Why antibodies matter: TPO and TG antibodies can be elevated for many years before TSH moves outside the “normal” range. If antibodies are present, the immune system is attacking the thyroid even when routine screening appears normal.

If a physician says our labs are “normal,” but we still feel awful, what should we do next?

We need to read the numbers and reference ranges carefully. Many labs report overly wide TSH ranges because the original reference populations included people with subclinical thyroid disease. In practice, a healthy TSH commonly sits between 0.5 and 2. If TSH falls below 0.5 or rises above 2, that’s a sign worth investigating. Also, confirm whether antibody testing was done—missing antibodies is a common reason people are told everything is normal.

How are thyroid conditions managed medically, and why do some people still feel unwell on medication?

For underactive thyroid, standard treatment is replacement hormone—levothyroxine (T4), being the most prescribed. Levothyroxine often helps many people, but some do not fully convert T4 into active T3 due to genetic variations, nutrient deficiencies, or other biochemical blocks. For those patients, options include adding T3 (liothyronine), using compounded combination T4/T3, or using natural desiccated thyroid, which contains both hormones.

Medication absorption is another major factor. Thyroid meds can interact with a wide range of foods and supplements. Coffee, calcium, iron, and even timing can impair absorption. For some patients, a gelcap formulation can improve absorption and allow closer-to-normal daily routines.

Treating the whole person: nutrition, nutrients, and testing targets

Which nutrient tests should be on the non-negotiable list for people with thyroid disease?

We recommend testing and optimizing three labs regularly:

• Ferritin (iron storage): Target 90–110 ng/mL for resolving many symptoms like brain fog, hair loss, and fatigue.
• Vitamin D: Aim for 60–80 ng/mL to support immune balance and reduce autoimmune activity.
• Vitamin B12: Labs often report 300 ng/L as “normal,” but neurological symptoms can appear at that level; we prefer levels around 700 pg/mL for optimal neurological health.

Addressing these deficiencies often explains why some people continue to feel unwell despite appropriate thyroid replacement.

Which supplements can make a meaningful difference?

Dr. Wentz highlights three powerful, accessible supplements that many people can try safely at home:

• Selenium: Can help lower thyroid antibody levels and support thyroid function.
• Thiamine (vitamin B1): Has shown quick improvements in fatigue for some people with Hashimoto’s.
• Magnesium: Supports sleep, nerve function, and overall metabolic balance.

Give any new supplement or dietary change at least 90 days to judge its impact, while monitoring labs and symptoms. Some improvements (like reduced reflux or better energy) can appear in days to weeks, but full effects often take 3 months.

Food, gluten, and blood sugar

Does going gluten-free help Hashimoto’s?

From clinical observation and patient reports, a large majority—roughly 88% of people with thyroid disorders—feel better on a gluten-free diet. Part of this is because celiac disease is more common among people with autoimmune conditions. Another explanation is molecular mimicry: proteins in gluten can resemble thyroid tissue, provoking immune cross-reaction in susceptible individuals. The research is mixed, but the practical approach is simple: if you have symptoms or test positive for celiac or antibody markers, try a gluten-free trial and evaluate symptoms over 90 days.

What other dietary shifts help?

Focus on blood sugar balance. This means fewer processed carbs and sugars, more high-quality protein, healthy fats, and fiber-rich vegetables. Balanced blood sugar stabilizes energy, reduces anxiety and inflammation, improves sleep, and often results in lower thyroid antibody levels. Start with three practical moves:

• Remove or reduce gluten as a test.
• Eat meals that combine protein, fat, and fiber to prevent blood sugar spikes.
• Adopt daily stress-reduction practices (sleep, movement, breathing) that support metabolic resilience.

How long should someone commit to a diet trial?

Give a well-implemented diet trial for 90 days. Some benefits appear sooner, but the 90-day window allows physiologic changes—immune modulation, microbiome shifts, and symptom trends—to stabilize so you can make an evidence-based decision.

Adrenal function and stress

What is “adrenal fatigue,” and is it a real medical problem?

“Adrenal fatigue” is controversial terminology. Many mainstream clinicians reject the phrase, but the phenomenon of hypothalamic-pituitary-adrenal (HPA) axis dysfunction is real. What we see clinically is a communication breakdown between the brain and stress-response glands, producing an abnormal cortisol pattern. Instead of normal high morning cortisol that tapers through the day, patients may have:

• Low morning cortisol with high evening cortisol (a flipped curve) leading to morning fatigue and nighttime insomnia
• Low cortisol throughout the day, producing persistent sluggishness
• Excessive cortisol produces irritability, anxiety, and poor sleep

Root causes include chronic psychosocial stress, past trauma, sleep disorders (including sleep apnea), blood sugar dysregulation, chronic inflammation, infections, and toxin exposure. Addressing these upstream drivers improves the HPA axis over time.

Should we test cortisol? Which tests are useful?

Functional tests can map cortisol patterns. Popular options include:

• Salivary cortisol panels (multiple samples across the day)
• Dutch urine test (measures cortisol metabolites over 24 hours)

These tests are often ordered by integrative practitioners. However, in many situations, you do not need tests to act: improving sleep, reducing stress, balancing blood sugar, and addressing chronic inflammation can help cortisol patterns normalize.

What practical stress-reduction measures consistently help?

For most people, we recommend:

• Prioritizing sleep and treating sleep disorders
• Daily practices that induce relaxation—meditation, prayer, breathwork, yoga, or tactile relaxation like massage
• Stable meal timing and balanced macronutrients
• Addressing unresolved emotional trauma with therapy when necessary

Small, consistent habits add up. Finding one reliable daily ritual that calms the nervous system has outsized benefits.

Gut health and its central role

How is gut health related to thyroid autoimmunity?

We can think of autoimmunity as a three-legged stool: a genetic predisposition, a trigger event, and intestinal permeability or leaky gut. If all three are present, autoimmunity is more likely to manifest and persist.

Gut cells and thyroid cells share the same fetal origin, and a dysfunctional gut often precedes or accompanies autoimmune thyroid disease. Common gut-related culprits include H. pylori and parasites like Blastocystis hominis. Gut infections and food sensitivities can both drive leaky gut, allowing undigested proteins and microbes to encounter the immune system and provoke or maintain an autoimmune response.

How do we identify gut issues that matter?

Pay attention to symptoms: reflux, bloating, gas, diarrhea, constipation, and abdominal pain. For deeper investigation, functional stool tests—GI-MAP, Gut Zoomer, or comprehensive digestive panels—can reveal infections, dysbiosis, enzyme deficiencies, and markers of inflammation. These tests require collecting and sending a stool sample.

What can someone do right away to start healing the gut?

Begin with supportive measures that are safe and evidence-based:

• Bone broth to supply collagen and support the mucosal lining
• L-glutamine and zinc carnosine to support epithelial repair
• Butyrate or prebiotic fibers that nourish colonocytes
• Sacrifying simple steps: remove obvious inflammatory foods (like gluten, if reactive) and stabilize blood sugar

If symptoms persist or a functional test identifies an infection, targeted antimicrobial or antiparasitic therapies—under practitioner guidance—may be required.

Which probiotics are best for people with thyroid conditions?

There is no one-size-fits-all. Dr. Wentz recommends starting with Saccharomyces boulardii, a beneficial yeast that boosts gut immune response, helps clear pathogenic yeast, and reduces food sensitivities without permanently colonizing the gut. Lactobacillus strains, spore-based probiotics, and higher colony-forming unit formulations may be useful depending on symptoms.

Important practical points:

• Check storage instructions—some strains require refrigeration; others are shelf-stable.
• Therapeutic doses often exceed typical drugstore products.
• When symptoms are severe, it may be appropriate to use multiple probiotic formulations together, but start low and go slow to avoid transient worsening like gas, bloating, diarrhea, or joint pains.

Root causes and triggers

What are the most common root causes of Hashimoto’s you see?

We categorize common drivers into five groups:

1. Food sensitivities—especially gluten, dairy, and soy 
2. Impaired stress response and HPA axis dysfunction
3. Inadequate detoxification or toxin exposures, such as mold
4. Gut infections—Helicobacter pylori and Blastocystis hominis are frequent offenders
5. Nutrient deficiencies that impair hormone synthesis and immune regulation

Less common but notable triggers include excessive iodine intake and exposures like breast implant illness. Each person’s mix of drivers will differ, so individualized detective work matters.

Special life stages: pregnancy, puberty, and perimenopause

How do life stages affect thyroid health, and what should we watch for?

Puberty, pregnancy, depression” target=”_blank”>postpartum, and perimenopause are times of increased vulnerability when thyroid problems are often diagnosed or flare. In pregnancy and postpartum, changes in immune function and sleep deprivation can reveal or worsen thyroid issues. Symptoms to watch for in the postpartum period include depression, anxiety, excessive fatigue, hair loss, and low milk supply. Postpartum thyroiditis can be reversible and often responds well to the same lifestyle and nutritional strategies that help Hashimoto’s.

How we evaluate progress: lab targets and remission

What does “remission” mean with Hashimoto’s?

Scientifically, remission is usually defined by antibody levels: TPO and TG antibodies below 100. Clinically, we consider remission when symptoms have resolved. Both matter. Low antibodies without symptom relief are not true remission in our view. The goal is symptom-free living plus biochemical evidence of reduced immune attack.

How long should we wait to judge whether a protocol is working?

Give a well-implemented intervention about 90 days to assess meaningful change. Some improvements occur sooner. For example, alleviating a food trigger might stop reflux within days, while antibody reductions and gut microbiome shifts may take several months.

How to advocate for better thyroid care

If we want our doctors to listen and act smarter, what should we say and ask for?

Bring specific data and questions. Ask for a full thyroid panel, including free T3 and T4 and thyroid antibodies. Point out persistent symptoms and request evaluation of nutritional labs like ferritin, vitamin D, and B12. Use language that resonates with conventional clinicians—terms like “HPA axis dysfunction” and “burnout” can bridge the gap when discussing stress-related biology. If the first clinician is dismissive, persist. We are our best advocates.

Are conventional doctors becoming more open to integrative strategies?

Yes. Awareness has improved over the last decade as patients speak up and share outcomes. Some endocrinology circles are now discussing combined T4/T3 treatment, and more attention is being paid to root causes. Our work is to democratize information so every patient walks into any clinic with baseline knowledge to guide a collaborative approach.

Quick implementation checklist

For anyone suspecting a thyroid issue or living with Hashimoto’s, start with this practical plan:

1. Request a full thyroid panel: TSH, Free T4, Free T3, TPO, and TG antibodies.
2. Order ferritin, vitamin D, and B12 labs and optimize them to target ranges (ferritin 90–110, vitamin D 60–80, B12 ~700).
3. Try a 90-day gluten-free trial and stabilize blood sugar with balanced meals.
4. Address sleep hygiene and add a daily stress-reduction ritual.
5. Consider a gut-healing starter pack: bone broth, L-glutamine, zinc carnosine, and Saccharomyces boulardii.
6. Work with a clinician for advanced testing (stool panels, salivary or DUTCH cortisol testing) if symptoms persist.

Practical FAQs

How do we know if our thyroid antibodies are clinically important?

Antibody levels matter. Values above laboratory references indicate an autoimmune attack; clinically, lowering antibodies below 100 is a meaningful goal. Equally important is symptom improvement. Low antibodies with ongoing symptoms suggest other drivers remain unaddressed.

Can thyroid medication be taken with coffee?

Most thyroid medications are best taken with plain water and without coffee for at least 30 minutes to an hour. Coffee can interfere with absorption. Some gelcap formulations are better tolerated with coffee, based on limited studies, but discuss formulation and timing with your clinician.

Is every hypothyroid patient autoimmune?

Not every case, but many are autoimmune. Hashimoto’s is the most common cause of hypothyroidism in the Western world. Testing for TPO and TG antibodies helps determine if an autoimmune process is present.

How should we interpret “normal” lab ranges?

Lab reference ranges are statistical and do not always reflect optimal health. For thyroid function, a TSH between 0.5 and 2 is often a better indicator of optimal function. Always pair lab interpretation with symptoms and consider specialist input.

How quickly will supplements work?

Some supplements can produce noticeable benefits in days to weeks—thiamine improves fatigue, for example. For full therapeutic effect and lab changes, allow 90 days and track symptoms and relevant labs.

Are stool tests necessary?

Not always, but they can be game-changers when digestive symptoms are present or when autoimmune drivers remain unclear. Tests like GI-MAP and Gut Zoomer reveal infections, dysbiosis, and enzyme deficiencies that may be fueling autoimmunity.

Final notes we want to leave you with

Thyroid conditions can be confusing because symptoms span many systems. That makes listening to our bodies essential. Persistent symptoms are real signals, not psychological flaws. Testing beyond a single TSH, addressing nutrient deficiencies, prioritizing gut health, managing stress, and trying targeted lifestyle changes create the best chance for remission and restored energy.

To keep learning, Dr. Wentz offers deep-dive resources including a 90-day protocol, dietary guidance with recipes, and an adrenal-focused plan. Her work is a practical bridge between research and everyday steps people can take now.

Resources mentioned

• ThyroidPharmacist.com (comprehensive articles, lab targets, and guides)
• Tests to consider: full thyroid panel, ferritin, vitamin D, B12, GI-MAP/Gut Zoomer, salivary cortisol, DUTCH test
• Common supportive supplements: selenium, thiamine, magnesium, zinc carnosine, L-glutamine, Saccharomyces boulardii

Where to find Dr. Wentz

Search “Thyroid Pharmacist” or visit thyroidpharmacist.com for books, programs, and guides that walk through testing, dosing ranges, and step-by-step protocols.

Further reading and next steps

If you suspect thyroid dysfunction, our recommended next steps are simple and practical: order the right labs, prioritize blood sugar and sleep, correct nutrient deficiencies, and begin a 90-day trial of dietary and supportive measures. If symptoms persist or your labs are abnormal, partner with a clinician who will listen, run targeted tests, and treat both hormones and root causes.

We leave this conversation with one clear message: symptoms are messages. Listen, test, and take thoughtful action. You do not have to accept feeling unwell as normal.

This article was created from the video Demystifying Hashimoto’s, Hypothyroidism & Adrenal Fatigue w/ Dr. Izabella Wentz | SHE MD for Dr. Thais Aliabadi’s website.