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The Melanie Avalon Biohacking Podcast Episode #206 - Izabella Wentz

Izabella Wentz, PharmD, FASCP, is an internationally acclaimed thyroid specialist and a licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009. She is the author of three books on Hashimoto’s: Hashimoto’s Thyroiditis Lifestyle Interventions for Finding and Treating the Root Cause, Hashimoto’s Food Pharmacology, and Hashimoto’s Protocol, which became a #1 New York Times bestseller. Dr. Wentz currently lives in Los Angeles with her husband, Michael, and their son, Dimitry.



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The Melanie Avalon Biohacking Podcast Episode #38 - Connie Zack
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Adrenal Transformation Protocol: A 4-Week Plan to Release Stress Symptoms and Go from Surviving to Thriving

izabella's personal story

the Knowledge of pharmacists

does adrenal fatigue exist?

addison's disease

adrenal dysfunction

the confusion in diagnosis

cortisol testing types and effectiveness

cortisol from fat cells

Epinephrine and norepinephrine

the role of cortisol in inflammation

circadian Chronotypes with delayed morning cortisol spike

light exposure and restful sleep

stages of dysfunction

izabella's protocol creation

where to start

blood sugar balance

can fasting be inappropriate?

inositol deficiency

irritability: Is this a cause or an effect?

using supplements effectively


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How Myo-inositol Can Improve Hashimoto’s Symptoms

movement for healing



Melanie Avalon: Hi, friends. Welcome back to the show. I am so incredibly excited about the conversation that I am about to have. And you know, it's with a guest that I really, really love because I'm recording a little bit of video for the introduction, because you guys know I'm not a huge fan of video. But I have been following this woman's work for years, years, years, years, especially because have hypothyroidism, not Hashimoto's, but just when you have hypothyroidism, you go in all the rabbit holes of all the tangents and do all the research, and a legend in that sphere is Izabella Wentz, who I am here with today. She is a pharmacist and a New York Times bestseller. I originally got into her work for her original books, which include Hashimoto's Thyroiditis and Hashimoto's Protocol. And she has a new book out, which is fan-tastic. When I heard about it and saw the subject, I was just so, so excited because I think it's something that people-- well, a lot of people struggle with, for one. And two, there is so much controversy surrounding this topic, as in people think maybe it doesn't even exist. So, does it exist? I don't know. [giggles] We're going to talk about that in today's episode. Her new book is called Adrenal Transformation Protocol, and it deals with the topic of "adrenal fatigue." So, I have so many notes, so many questions. The book was absolutely fantastic and fabulous. Izabella, thank you so much for being here.

Izabella Wentz: Thank you so much for having me, Melanie. It's an honor to be here with you. 

Melanie Avalon: I am going to turn off my video in a little bit. But before I do, could you just tell listeners a little bit about your personal story, and what led you to writing this book specifically, today? 

Izabella Wentz: So, I was diagnosed with Hashimoto's in my 20s. When I was probably 25 years old, I kept going to doctors and wondering, why I was having irritable bowel syndrome, brain fog, fatigue, carpal tunnel in both arms, tons of allergies. Really the thing that got to me was that I started losing hair. And so, I had been going to doctors pretty much every year since I was 18, when I started to have chronic fatigue and I was like, "Well, what's going on with me?" I was going through undergrad, I went through pharmacy school, didn't really get a lot of answers. Finally, I pushed for testing and I learned that I had Hashimoto's thyroiditis in my 20s. And at that point, I was like, "Okay, so what can I do about it?" 

I had already graduated from pharmacy school and was a practicing pharmacist at the time. Of course, I was excited to get on medications, because what pharmacist isn't. But the medications, they helped me a little bit. I was like, "Oh, these thyroid medications I learned about in pharmacy school like that, this is the answer." When you have a thyroid condition, you take a thyroid medication and I was like, "Wait a minute, but I'm still losing my hair. I'm still having brain fog and fatigue." I need a little bit less sleep. I'm going from 12 hours of sleep to 11 hours of sleep, but I'm still having acid reflux, and carpal tunnel, and just all of these symptoms. And I was like, "Is there anything I can do beyond taking medications or in addition to or whatnot?" And then I started to really research some of the root causes of Hashimoto's, and autoimmune disease, and some of the symptoms that I was dealing with, and that's how I became a Hashimoto's expert/human guinea pig was just really trying to get myself to feel halfway human in my 20s. 

I fortunately was able to get myself into remission after a few years, and then I released my first book, Hashimoto's: the Root Cause, 10 years ago. And this really documented my journey from having full blown Hashimoto's with a ton of symptoms to getting myself into remission and feeling amazing. I had energy again. My hair came back and I was like, "Wow, people need to know this." I'm a pharmacist, but here I am talking about other things that you could do beyond medications. At the same time, I thought I was the right person to get that message out, because I'm like, "I was trained in medications and people need to know beyond meds." Part of what I did to heal myself was changing my diet around and going gluten free. Dairy free was such a big breakthrough for me for acid reflux, and IBS, and carpal tunnel. But then I still struggled with the brain fog, and the fatigue, and unrefreshing sleep, and anxiety, and the panic attacks. And then I was like, "Okay." Asking questions, going to different practitioners. And I kept hearing the term adrenal fatigue. Being like a skeptical pharmacist, I'm looking it up and I go online and it says, adrenal fatigue doesn't exist. It's like a made-up disorder. You don't have adrenal fatigue. So, I was like, "Okay, I don't have this." Obviously, I'm not going to be fooled, like, whatever these people are saying, and then just tried other things. I'm putting coconut oil on my thyroid gland. Maybe that'll help. It didn't. Spoiler alert. 

Finally, I got into, "Okay, somebody mentioned adrenal fatigue again." I'm just going to look into it. I'm going to try the things. I've tried everything else at that point. And sure enough, I had done the test, and I had adrenal dysfunction and low levels of cortisol production throughout the day. And holy cow, the treatments that I used for this actually worked and I was like, "Oh, so this thing that people said didn't exist, actually, you can test for it." I had the test results, and then I did what the test results said to do, and I actually got better. I haven't had a panic attack in over 10 years. I don't have anxiety anymore. It turns out that I'm a pretty laid-back person, not a really high-strung person. I have refreshing sleep. I have energy even when I wake up in the morning, which was such a rare thing for me to be waking up with energy. 

Then some of this shifted over the last decade. I've been talking about it, I've been helping people with it, and I had my set of protocols that really focused on either using hormones or really intensive lifestyle changes like sleep for 10 to 12 hours a night for 30 days. And then I found myself, five years ago, in an another bout of adrenal "fatigue," where I was a new mom and I was like, "Oh, my gosh, I can't take hormones and I can't sleep for 12 hours a night because I have this little person that I have to care for every two hours to three hours all night." And so, I came across a new way to rebalance the stress response that is known as Adrenal fatigue and to actually get people to thrive in a few weeks. 

Melanie Avalon: That is so incredible and I'm making a list in my head, so many things I want touch on. It really shows your-- You're glowing, your hair looks amazing. [giggles] So, clearly, everything that you're doing is working. Okay, wow. So, so many questions for you. So, I actually have a question, first, just about your career, something that stuck with me. I think it was my mom who told me this forever ago, but it was one of those little things she said in passing when I was probably younger. It just really stuck with me, and it was about how [giggles] when it comes to knowing things about conventional medicine, pharmacists are the ones that know, not to say that conventional doctors don't know things. I think a lot of us don't really appreciate how much pharmacists probably know about medications. I'm just really interested in-- The schooling that goes into that and your experience as a pharmacist, how do you think it informed your perspective of medicine and health, especially when it comes to comparing it or putting it up against the functional medical world? 

Izabella Wentz: So, such a great question. Most pharmacists go through a four-year program for undergraduate studies. So, this would be something similar to a premed program, usually biology, chemistry, physics, all those fun things. And then there's a four-year graduate program, a doctorate degree in pharmacy, which is what I went through. It's a lot of medications. It's a lot of chemistry. It's a lot of pharmacology. Here's what a disease might look like and here are the treatment options. I will say, I was taught about other treatment options, but it was very much light, like, a few percent of the conversation would be spent on lifestyle. My professor sure did try, but a lot of it was focused on like, these are the medications that you would utilize. So, as you can imagine, for four years, just studying medications and then optimized medication use, there are advanced certifications for that as well. So, I'm trained in medication therapy management. So, this is how to choose the right kind of medication for the right person. 

There are a lot of nuances that go into medications and precision medicine. It's like so many different options for one condition, and how do you choose the best option for that individual based on the other medications that they're taking, their risk factors. There's also pharmacogenomics that looks at their genetic profile to figure out what might be the optimal medication for that person. So, yeah, it's interesting because a lot of the pharmacists that work in the community, their primary job-- I think what most people know pharmacists as is you bring in your prescription, and they fill it in the back of the pharmacy, and they bring your medications. But the schooling that goes into it really prepares you to be on the front lines of, "Hey, this is a person that's got all these chronic health conditions, and everything is going on with this person's life, and they have a ton of medications that they're taking. How do you create the most safe and effective plan for them?" And so, that was really my training. 

After pharmacy school, I tried working in the community, and I enjoyed it. Part of me enjoyed it, but at the other part, I was like, "Wait, I want to use some of this other knowledge that I learned." And so, I started working more in a consulting role for people with really complicated health conditions. So, typically, the individuals I would help advise usually had numerous disabilities, rare genetic disorders, sometimes mental health issues, sometimes a few chronic health conditions. I would be looking into whole body assessment and looking at all of their health conditions, and medications, and how to really create a plan for them, oftentimes, when there wasn't a clear defined guideline. And so, I guess, my training is a little bit unique because for the clients that I worked with rare disorders, I had to learn so much. I had to always be on top of the latest research. Sometimes, it was forums of parents who had children with these disorders to try to find out what was actually working for these individuals who maybe didn't have a lot of answers from a conventional medical standpoint. 

This is what I ended up using for my own health to try to figure out how to get myself better. 

Melanie Avalon: I'm so fascinated by it. I was thinking more about why I'm so fascinated by it, because I don't think any of the authors or people that I've interviewed have that background specifically. I think what's so interesting about it is, rather than conventional doctors, where the focus is usually like one specialty, I'm assuming with the pharmacology, it requires you to have knowledge. Like you just said, over such a broad spectrum of, I mean, the entire health spectrum, essentially. So, that's really fascinating to me. Wait, so did you put coconut oil on your thyroid, like, on your skin? 

Izabella Wentz: Yes. My skin looked beautiful, but it didn't heal my thyroid.

Melanie Avalon: Well, [giggles] that's amazing. I also, by the way, with my thyroid, stuff that I went through, the hair loss was happening, and the panic that comes with that is very-- or at least for me, was very intense. I was like, "I have to fix this. I have to do all the things." So, I definitely empathize there. Okay, so coming back though to the topic of today, which is the "adrenal fatigue." So, I mentioned it. You mentioned it. There's this concept that it doesn't exist. So, why? What is going on there? Does it exist? What is Addison's, for example? 

Izabella Wentz: That's such a great question. So, going back to the history of it all, I've been trying to sort of the myths, and there's a lot going on in, I guess, natural medicine that may not be 100% accurate or even helpful like coconut oil over your thyroid gland. Some things just work, and some things don't work. And so, I always try to figure out how it started and where theory came from and the history of it. And so, I think it's helpful to talk about the history of adrenal fatigue. About 25 years ago, a naturopathic doctor named James Wilson wrote a book by that title, because he noticed this pattern in some of his patients where they really weren't getting a diagnosis or much help from their conventionally trained doctors, where it was really like, this person is tired. They have brain fog. They have morning fatigue. They have anxiety. They might have a mild version of depression. They have trouble falling asleep. They're wired, but tired. When they get up too quickly, they feel lightheaded. They have salt cravings and light sensitivity. He termed this kind of syndrome or this presentation as Adrenal Fatigue. His initial theory was that this was related to Addison's disease. 

Now, Addison's disease is a condition where our adrenal glands, which produce our cortisol, which is our main stress hormone, among other things, cannot physically they're unable to produce adequate amounts of cortisol to get us through the day. Addison's disease, it's usually an autoimmune condition where the immune system starts to attack the adrenal glands. This will manifest that low cortisol pattern will be seen when 90% of the adrenal glands have been destroyed. And then the adrenal glands, physically, they cannot produce any cortisol. And a person will have symptoms similar to those of adrenal fatigue, but far more intense, where they might bedridden, they cannot walk, right? This is usually a situation where a person might go to intensive care, they might be hospitalized for this situation. This generally requires hormonal support once they get this diagnosis. And so, Dr. Wilson, his theory was that could adrenal fatigue kind of be the early stages of Addison's? Maybe only 60% of your adrenal glands are destroyed, something to that effect. So, he thought people with adrenal fatigue could not produce their own cortisol. 

Now, more research has been done since that time, and I can't say that maybe there isn't or there aren't some people who maybe have a mild version of Addison's or the early stages of Addison's that present that way. But we now understand that "adrenal fatigue," and I would say the more accurate term that I tend to use is adrenal dysfunction. This is essentially the way that the body responds to stress. So, when we've been stressed out for a long time, our body will shift into this state known as adrenal dysfunction. The scientific term is hypothalamic-pituitary-adrenal axis dysfunction. This happens over time because initially, when we're stressed, the body gets the message to produce more cortisol. As that goes on for too long and we still keep having stress exposure and perception of stress, the body will eventually compensate. Some of the cortisol receptors can become saturated, desensitized. And essentially, what can happen with time is that the body still senses stress, and so our brain will send a message to the adrenal glands to produce stress hormones, but then the adrenal glands don't respond properly, and there seems to be this communication breakdown along the hypothalamic-pituitary-adrenal axis where it's like, "Yes, I'm stressed, and yes, I need to make cortisol, but my adrenal glands are not doing it." And usually, it's because you've been in a chronic stress state. 

So, people are like, "Oh, adrenal fatigue doesn't exist." And I'm like, "Okay, why don't you do a PubMed search for hypothalamic-pituitary-axis dysfunction?" Because that's actually what it is. So, that's the scientific term for it. I believe that the I guess, skepticism around it comes from the term adrenal fatigue sounding a lot like adrenal insufficiency, which is another name for Addison's. People would go to their doctors after reading something online or maybe working with their naturopaths, and they'd go to an endocrinologist and say, "Can you test my adrenals?" The endocrinologist would do the test for Addison's and they would say, "You do not have Addison's disease." I've been talking about it a lot and I'm like, "This is like a nomenclature thing," where it's really the naming of it that got people confused and the initial theory about what the mechanism of action was behind this.

Melanie Avalon: So, basically, when people think adrenal fatigue, they think that adrenals literally cannot produce cortisol, but really, they're just not. [laughs] They're just choosing not to or they're not hearing. Are they not hearing the message or are they hearing the message and choosing not to? 

Izabella Wentz: I think it could be one or a bit of both of these. I think the key is that they're physically going to be healthy, but they're not producing cortisol at the right times in the right amounts. Some of theories behind that would be the receptor desensitization, so that cortisol receptors maybe pick up the messages and they don't send it forward. But it is something that is very, very common to the point where a lot of the symptoms are so common that they get brushed off. You can actually test for adrenal dysfunction through some integrative tests as well. 

Melanie Avalon: So, when they're testing for adrenal dysfunction, what do they test specifically? 

Izabella Wentz: Some of the tests that I find the most helpful are going to be things like the adrenal saliva test, and this is cortisol. You can test your cortisol secretion throughout the day. Generally, we want to have a healthy cortisol response first thing in the morning, and then you should have a gradual decline of cortisol production throughout the day, so that in the evenings, you can rest and sleep. The cortisol levels can be tested throughout the saliva. And then there's also a DUTCH profile test that looks at your cortisol levels and your cortisol metabolites in your urine. So, this is another test that we can do. These tests, they're not going to be approved by your insurance and the endocrinologist may not be utilizing them. So, generally, if you're going to an integrative practitioner or a functional medicine practitioner, this is a person that may be able to order those tests for you or you can self-order them online. 

Melanie Avalon: You spoke in the book about hurdles you experienced with your program with testing, and changes in labs, and things like that. In general, though, do you find both the saliva and the urine? Are they accurate portrayals of the whole-body status of cortisol or do you think one is more accurate than the other? 

Izabella Wentz: Yeah. I've had a lot of issues with testing in the last decade. So, normally, I try to educate people about doing, "Do you have adrenal dysfunction? This might be a part of what's going on with your body if you have these symptoms." And then they'd go to their endocrinologist and get tested for Addison, the doc would be like, "You don't have this." So, then it would be like, "Okay, well, you actually have to go to an integrative practitioner and then they would do the test." Sometimes, they wouldn't do the test. Sometimes, the test would just be sitting at their houses for a few months before they did them. But the tests that I have found to be accurate are going to be, both the cortisol saliva tests, such as the ZRT lab. It doesn't matter which lab company does it. I have worked with a whole host of different labs. I used to use a company called Bio Health in the past where I could look at a person's symptoms and I could draw their cortisol curve, and the test results I would get would match perfectly. 

Then after some time, they redefined their reference ranges. And so, I would be talking to people who were tired all day and then I'd get their results back, because the reference ranges were adjusted and the person would come back with "normal cortisol secretion" throughout the day. So, I ended up having to go back and use the old reference ranges and that's what a lot of integrative practitioners were doing. This company has since closed, but typically I found ZRT lab can be the most accurate for that as far as saliva testing. Some of the things that can be tricky if people have a lot of fat in their bodies that can actually secrete cortisol, so that can throw off those results. And then of course, if people drink caffeine, that can throw off the results as well if people have issues with producing enough saliva. So, some people with Sjogren's or other conditions of dry mouth might have an issue with that. 

I really love the DUTCH test, because it looks at urinary metabolites, so that gives us a little bit more information. So, it looks at how the body processes the cortisol as well. It has a few additional markers. The tricky thing about the DUTCH test and I will say this, so appreciate what they do, but the tests are so challenging to understand and read that it took me like three years to five years to master that test, where the cortisol saliva test, I can just give it to a person. Most people without any kind of medical training or background can understand how to read that test, whereas the DUTCH test, it's a little bit nuanced to understand the results.

Melanie Avalon: Something I will mention for listeners, and I'm sure we'll touch on this, but you wrote your book and you have your program, which does not even require testing. People can read it and self-diagnose based on symptoms and do the protocol without necessarily testing. So, that's making everything so accessible. So, thank you for that. Two things you mentioned. One, you've been mentioning the cortisol receptors in the body as well as what you were just saying about the fat cells releasing cortisol. So, where all in the body are receptors for cortisol. And the second question is, does it matter where the cortisol is coming from as far as how we feel from it, so cortisol being produced by the adrenals versus cortisol from fat cells? 

Izabella Wentz: It's such a great question. One of the places where we have a high concentration of cortisol receptors is in our belly. So, people who tend to have more belly fat, this can be a cortisol response. I do think it matters, because is it coming from a person having too much weight or is it coming from stress. Both things are stress per se, but the approach might be a little bit different. 

Melanie Avalon: Got you. Okay, that makes sense. Okay, still on the cortisol front. How does it compare to epinephrine and norepinephrine? Because I think for all of those, we think like stress hormones. What's the difference between them? 

Izabella Wentz: So, our epinephrine and norepinephrine, these are also secreted during a stress response. Cortisol is typically something that is secreted in a circadian fashion when we're healthy. People typically hear about cortisol being high, this might be a problem. That's the mainstream medical approach it's like, "Your cortisol is too high. You're going to be having trouble." But cortisol, we really do need it for optimal function. We can have issues with it being too high or too low. And so, typically, we do want more cortisol secreted in the morning, and that to follow a circadian fashion where the cortisol levels decline throughout the day. Whereas there are things like adrenaline dominance and other kinds of things that may occur when somebody has a dysregulated stress response. For the common patterns that I've really focused on are going to be those cortisol responses when a person isn't producing enough cortisol, so that they're not properly managing the inflammation in the body, they're not producing enough energy throughout the day, and they're having perhaps too much cortisol in the evenings when they're not sleeping at night. 

So, there's a lot of different hormones that are produced by the adrenal glands. There are a lot of hormones that are produced in response to stress. I feel like cortisol is probably the most relevant one for a lot of us, and this is a great place for people to really start and dial in a lot of the things that we do to help normalize cortisol levels are also going to help normalize with that whole stress response. So, even people with some of the adrenaline dominance symptoms, balancing cortisol, but in my book it's all going to help. 

Melanie Avalon: So, you just mentioned the role of inflammation. That's something else I've always been a little bit confused about, because I've read cortisols, both, I've read it's anti-inflammatory and that it's inflammatory. So, when you say managing inflammation, what is the role of cortisol inflammation? 

Izabella Wentz: Yeah, that's such a great question, because when we typically hear about cortisol, when we have too much of it can be inflammatory, it can cause breakdown of tissues in our body and that can be inflammatory. When we don't have enough of it, it can be a problem where our inflammation goes unchecked. So, cortisol is naturally has anti-inflammatory benefits, and it is something that our body releases when it senses stress, when it senses inflammation. So, what I've seen in my experience is people that have low levels of cortisol, this may be a pattern that occurs before they start getting some sort of a chronic inflammatory condition, such as thyroiditis or colitis, where their inflammation goes unchecked and the body ends up in this breaking itself down mode and doesn't spend enough time in managing inflammation and repairing.

Melanie Avalon: I've been so confused about that for so long, because I knew that cortisol, like you said, has anti-inflammatory properties, but then we so associate it with chronic inflammation and inflammation. So, that is interesting. Okay, so this curve. You talk in your book about what a normal, and you mentioned it just now, what a normal cortisol curve, circadian curve looks like for a given person, and then how there's these three stages where things start going awry. One thing I'm really interested about with that curve. Do you have thoughts on circadian chronotypes? And so, people who are morning people versus evening people and them having a delayed cortisol spike-- I was going down the rabbit hole of trying to find all the studies I could find on this. What are your thoughts on that and does that come into play with if somebody is more susceptible to adrenal dysfunction? 

Izabella Wentz: So, I've gone through some of those rabbit holes as well. So, I used to think that I was that person where I would have trouble waking up in the morning, and then you might have this night owl person that has trouble falling asleep at night. These individuals are also tend to be more sensitive to light and dark. So, they're going to be the ones that are going to be more likely to have seasonal effective depression, and they're going to be potentially the people that have a harder time around the full moon, and they might have a harder time sleeping around the full moon. And so, I've gone through this deep dive on that. One of the interesting studies that I came across is that a lot of this can be reset by getting really in alignment with circadian rhythms. So, how do we do that? We can go camping for two weeks in nature. And then we have this natural exposure to light and dark. 

Part of why I think we have a lot of these chronotypes is because of the wonders of modern technology where we have these beautiful lights in our homes, and we have wonderful television shows, and we have phones that let us connect with the entire world and computers. And so, we lose the signal of when is it daytime and when is it nighttime, because the lights inside of our house are not as bright as outside lights, but they still give us more light than complete darkness could. And so, if we spend enough time indoors and we don't get early morning sunshine and if we have the lights on after dark, some people tend to be more sensitive than others, then we can get really disconnected from that circadian rhythm and that circadian cortisol production. So, I can't say I've worked with every single person who identifies as a night owl, and I can't say that I've worked with every single person that's a late riser, but I have say that I've worked with enough people where we focus on rebalancing their circadian rhythm, where they're like, "Oh, no, I now have energy in the morning and I could sleep at night now. I thought I was a night owl." So, I'm never going to speak in absolutes, but I think maybe it's a myth from, what I've seen and what we can do with just proper light exposure. 

Melanie Avalon: So, for you you said normally, you felt like you're more of a night person. Did you ever actually feel like a morning person [laughs] when you healed your adrenals? 

Izabella Wentz: I never felt like a morning person until I healed my adrenals. So, I used to be up until like 02:00 AM to 03:00 AM, 04:00 AM trying to get things done. I would wake up with brain fog, kind of confused. I was like, "Where am I? Who am I? Why am I here? Why is it so bright?" and all of that. And then I started really working with circadian rhythm work and realigning with that. And it's like, morning time, I wake up with energy and nighttime, I get tired. In our house, we do red lights after sunset. We're very intense like that. I don't know, I've worked with over 3,500 people that have gone through my Adrenal Transformation Protocol. And a big part of what we do is we really focus on realigning with the circadian rhythm. Around 89% of people have less fatigue and around 80% of people sleep better at night and they're able to fall asleep and stay asleep. I don't know, I feel like this is something that you can definitely rebalance when you just get enough light exposure and you get really refreshing restful sleep at night, and really manage your stress too, because stress can make us all kinds of crazy.

Melanie Avalon: Yeah. No, so, think-- Okay. Well, first of all, I'm like the same as you. So, I do all the red lights and the blue light blocking glasses and all the things. I think where I've landed presently is that, because I just intuitively feel like a night person. But on top of that though, I also used to really struggle with sleep and felt like I needed way more sleep and then I didn't feel rested and I had insomnia. So, now I've really addressed all of that with everything I've been doing health wise and light exposure and circadian rhythm and all the things. I still go to bed late and wake up late. I'm just actually like sleeping well [laughs] not having insomnia. So, I feel like I'm like halfway in between.

Izabella Wentz: Why do you consider it late? 

Melanie Avalon: Oh, goodness. [laughs] Like you mentioned like 03:00 AM or 04:00 AM. 

Izabella Wentz: I will say some people do find that they're more productive and they may prefer that lifestyle. Let's say, there's a lot going on throughout the day. But just having that, I know a lot of creative people may feel that's when they can get a lot of things done and have that open time to create. But I think the key is, you don't have to be that way. If you wanted to be a morning person, you could be.

Melanie Avalon: I want too so bad. Yeah, it's like a whole thing. I'll lament to my mom. I'm like, "Mom, I want to be a morning person." But she also identifies as like a night owl and so she's like, "Melanie, you were born this way." [laughs] She's like, "As long as you can do your lifestyle this way, just keep on going." So, I'm always on the fence where I'm like, "I want to be a morning person, I want to work on this, but maybe not." [chuckles] I don't know. It's a whole thing. So, I'm very motivated hearing what you just said, that you've worked with so many patients and have seen this ability for people. So, I'm inspired. [giggles] Maybe I'll work on it some more. Okay, so, well, speaking of those stages, to define them for listeners, did you come up with the three stages in the book based on all of the work that you've done with your patients or people that you've worked with?

Izabella Wentz: As far as the different patterns of adrenal dysfunction? 

Melanie Avalon: Yes, like the Stage 1 and then the roller coaster stage, and then the Stage 3. 

Izabella Wentz: I did not come up with that. I cannot take credit for that. This is just traditional functional medicine training. There is a lot of different LOP companies and some of them have tons of different stages of adrenal dysfunction that you can present with. The most common patterns I've seen are the ones that I talked about where a person can either have too much cortisol produced throughout the day. And so, this is a person that wakes up edgy and wired, and that goes on the entire day, and they have trouble falling asleep at night. And this is considered Stage 1. This may be a place where people start off. Then Stage 2 is when a person might have normal levels of cortisol secreted throughout the day, but they're just not produced at the right times. So, they might have low cortisol in the morning, and then high cortisol in the evening. This is that typical night owl pattern where that person has a hard time getting up in the morning. 

Honestly, that was me for the longest time. I don't ever remember being a morning person until I really started working with this Adrenal Transformation Protocol. This person has a hard time. You're like the night owl. You're the life or the party. Everybody's ready to go home and you're ready to dance. And so, this is a presentation that can occur. Another presentation might be where a person is on a blood sugar roller coaster, where they start off with low energy in the morning, and then they might have more energy as the day goes on, and then they drop, and then they have usually anxiety or mood swings, and then they have a harder time falling asleep at night, where they're on an emotional roller coaster. They're like every day at 3 o' clock, I feel anxious, or every day at 3 o' clock, I feel tired. It might be something that a person may say. 

Then probably the most common stage that I've seen in people is going to be low cortisol production throughout the day, where a person will have very low amounts of cortisol released in the morning, low amounts all throughout the day, and low amounts in the evenings. These are typically people that I see with hypothyroidism. About 62% of people fall in that category. And then people with chronic fatigue syndrome and people with fibromyalgia typically fall in that category as well, where they wake up tired. They're tired like at 1 o' clock 00 or they're tired at 3 o' clock. They go to bed tired and then they have unrefreshing sleep. And then some of these individuals may get that second wind in the evening which is like, "Oh, great, so I'm tired all day tired."  

Melanie Avalon: Because you mentioned different types of people in those different stages, do most people progress through those stages or do some people just live in one stage? 

Izabella Wentz: That's an interesting question. So, what I've been taught is that the stages are progressive. When my experience in testing people over the years, if you do nothing about your lifestyle, the stages can progress and get worse. For some people, it might take a year. Some people, it might take months. For other people, it might take 10 years, but they generally are thought to be progressive. If you really work on your health, you can get back into that healthy cortisol pattern. You can be working on your health and be very healthy. But just not knowing the type of things to reset that can basically mean that a person could get stuck in that progressive cortisol dysfunction pattern.

Melanie Avalon: Awesome. Well, speaking of things to reset that, so your protocol is honestly, it's breathtaking. What I love about it is I think when a lot of people think of health issues, oftentimes, it's siloed in a specific approach as in its[?] diet. Like, it's a diet solution or it's a mindset solution or it's a supplement solution, but there's a breadth to your work and it's whole body. So, it encompasses the diet aspect of it, the lifestyle, the sleep, the mindset. I really love the parts of the book about the mindset issue or aspect of it all. So many questions. One, coming up with your protocol. Because you talk in the book about and you mentioned it on this podcast as well, how historically your protocol dealt more with the supplement side, or you talk about how you originally worked more with testing and endogenous hormone. Were you using exogenous hormone supplementation in your protocol initially, or was that never a thing for you? 

Izabella Wentz: Yeah. So, initially, I was doing a lot of testing, and then when I started working with clients 10 plus years ago, I was utilizing pregnenolone alone and DHEA in a circadian fashion to reset that cortisol production where they'd get a little bit more of it in the morning. Pregnenolone is a precursor to cortisol, and all of these other hormones and to try to reset their production. And this worked well for some people, not for everybody. So, some people may utilize DHEA, and it can over convert to estrogen, and converse an estrogen dominance. Other women may over convert it to something that causes chin hair and acne, never fun. And then some women with a family history of breast cancer or other kind of estrogen receptive cancers, they may not want to use hormones at all, because it's like they're trying to keep that in balance and minimize those risk factors. And so, that worked well for some people that I worked with. It can work. It worked well for me the first time I got out of adrenal fatigue.

When I started to educate people more online and through programs, I got a bit nervous about people just dosing themselves on hormones, because you can really mess things up with pregnenolone. The first practitioner that I went to gave me such a high dose of pregnenolone that I ended up really fluid retained and had a lot of pain in my body. It was a pretty scary situation. And so, you really have to be working with a practitioner that's knowledgeable, because there's so many factors that can impact the dosing, not just weight. [giggles] And so, then I was like, "Well, how do I help people get out of this? What are some additional things they can do?" And then I got onto like, "Oh, we can do heavy duty lifestyle things." I got into like, "Okay, you could sleep for 10 hours to 12 hours a night, and then you could quit caffeine, and just really focus on decommitting and destressing your life." That worked well for some people that were able to do it. 

Of course, I had the clients that were like, "I quit the coffee and 60% of my joy is gone, but I still have all symptoms." And so, my protocols have just evolved with me over the last decade to try to figure out-- I'm always thinking about what's the simplest solution that gets the best results and what my pharmacist training is always like, "What's the safest thing?" rather than doing hormones. And then what's like, the most achievable thing? My training is also in compliance or patient adherence. So, it's hard for me to tell people like, to heal your adrenals, you're going to have to quit coffee and sleep for 10 hours to 12 hours a night. It's like, some of my clients will be like, "I'm out. Not doing--   

Melanie Avalon: [laughs] Bye. Oh, man. Okay, more questions about that one. Just really quick tiny question. Pregnenolone. Did I say that right? 

Izabella Wentz: Pregnenolone.

Melanie Avalon: Pregnenolone. Okay, I knew I was saying that wrong. Okay, I as well way in the past had a doctor suggest that I take it, but I read about how it could become different things, so I was on the fence. What all can it become? 

Izabella Wentz: It is known as our mother hormone, and it is produced from cholesterol, and it can convert into all kinds of hormones in our bodies. Including that cortisol, it could convert to progesterone, it can convert to DHEA, it can convert to testosterone. I have a chart. I wish maybe we can do a screenshot of it for your audience. But it's something that can convert to a whole bunch of different things, and it's a precursor. So, when you take it externally, the theory was that your body didn't have enough pregnenolone to create some of these other hormones that the conversion will just happen. So, let's say you were low on progesterone. Then you could just supplement with pregnenolone, and that would correct the progesterone deficiency. 

Sometimes this happens, but sometimes the dial switch may be still turned. So, you might be low in progesterone, but rather than pregnenolone going down the progesterone pathway, it may get converted to DHEA and then over converted to estrogen. So, it'd be nice if you could just be like, "Okay, turn into this hormone, turn into this hormone." But that doesn't always happen. And so, then some professionals may be like, "Okay, well, let's use progesterone or let's use this specific hormone."

Melanie Avalon: Okay, that's really interesting. So, it's like, if you had a kid that didn't have food and you gave them money, you got to just hope that they go buy food, but they might go buy like a toy or drugs.

Izabella Wentz: [laughs] Or, candy, right? 

Melanie Avalon: Or, candy. Yeah, exactly. [laughs] Okay. Wow, that is so interesting. So, when you did land on the current manifestation of your plan, is one thing most important like, diet, sleep, lifestyle, mindset, or is it really all of them? I know you mentioned that different things work for different people. How did you approach that as far as actually making the protocol and what's most important and the order people go in and all of that? 

Izabella Wentz: When I created this protocol initially for myself, I was a sleep deprived mom. One of the fastest ways to get into adrenal dysfunction is through sleep deprivation. So, if you are deprived of sleep and if you can get less of sleep, that would be the fastest way to help yourself and get out. I also know, but this wasn't realistic for me, so then I had to focus on other things. I have 14 different safety signals throughout the book that focus on meeting you where you're at. So, maybe this isn't necessarily accessible to you right now at the moment, but maybe you can choose some of the protocols and strategies. For a lot of people, what's very accessible is balancing their blood sugar. This is actually where we start with. For majority of the people, when I released the Adrenal Transformation Protocol as a program to my community in 2020, we focused on, "Okay, the first week, we're going to get ramped up, we're going to get educated and get ready and to do the program, and then we would start with the diet piece."

So, making sure that you're eating for blood sugar balance, generally that means more protein and fats than the average person. We're limiting some of the carbohydrates. So, to really get your body into that blood sugar balance state, for many people, this alone just really can help with things like anxiety and waking up in the middle of the night, people that tend to wake up between 03:00 AM are so are going to be the ones that are going to have blood sugar issues at night. Then I focus on getting off of some of the inflammatory foods. People might have all kinds of different foods that they react to depending on what's going on with their microbiome. Generally speaking, if you're in that stress stage, you're going to have low amounts of stomach acid, and so protein that are more difficult to digest, such as gluten, dairy, and soy are going to be the foods that I have people get off of, just because they're the most common inflammatory foods for most people. 

Then I also have them get off of grains just because of the blood sugar issue. So, this is a really solid place to start is focusing on your nutrition and making sure that you're really nourished and that you are getting really good nutrients from your food and you're getting your macronutrients. We try to eat as neutrally dense as possible as well to help send some of those safety signals. This is a solid, solid foundation. We're working on some of the mindset things and setting intentions throughout that process, just because it's like making a plan makes everything so much easier. And then we'll start adding in some of the supplements and then going a little bit deeper into some of the mindset and resilience work. Once our body is happy and cool and not inflamed, it's much easier for some of the mindset and resilience work. So, we're not going to be as triggered, for example, if we're well fed and blood sugar balanced as we would be had we tried to just do some of the personal growth things that can be sometimes triggering if we're not properly balancing.

Melanie Avalon: I loved the trigger section of your book. Before talking about that, quick question about the blood sugar concept. So, I think this might be a little bit of a controversial question, but when it comes to the blood sugar balancing, and especially people with low blood sugar, so part of your protocol does include, at certain points, a little bit of fruit juice if people have low blood sugar? I think people in the keto world might be like, "What? You should not have that for low blood sugar, like, you need to keto it out" and address it that way. So, how did you come to dealing with that issue, specifically people with low blood sugar actually using a carbohydrate to bring it back up versus going on a perpetual low carb diet?

Izabella Wentz: In my experience and working with people, I've tried a lot of protocols with different people where initially I'd be like, "Oh, my gosh, this person's feeling worse before they feel better." That's always where I have a person maybe they go keto and they're not properly digesting fats or protein, and then they feel so much worse. Maybe they go through a situation where they're trying to do more exercise, which is generally good for them, but then they feel worse after it. And so, everything that I put into the program is focused on how do we make you feel better, rather than having you do fasting. And then we know that's really good for us, but the first few days we feel miserable. So, again, I'm trying to think of what is the most likely to result in people utilizing this strategy, because there's always more than one way to heal. There's just so many different pathways to healing. I can't say one is wrong and another one is the right path to go. But I will say, for a lot of the people that I've worked with, having a little bit of orange juice and you add some protein powder and you could add some coconut milk and electrolytes, blend it up in a smoothie, having that first thing in the morning really helps you wake up. The electrolytes help your cortisol levels increase naturally. It provides a beautiful feedback to the body, because people with morning fatigue and low morning cortisol also tend to have low blood pressure in the mornings and they also tend to have low blood sugar in the mornings. It's like, they're very disoriented.

In my experience as a pharmacist, it's like one of the fastest ways to get people out of that low blood sugar state was through juice. Give them some OJ, right? I do it though combining with the protein and fat, so you don't get that blood sugar crash afterwards. This really can restore people's energy levels and get their circadian rhythm back on track. And then they can tolerate more things like fasting, and then they can do better with the keto diet, because sometimes you introduce the keto diet and people are like, "I can't wake up. I'm waking up all throughout the night or I'm doing this." And I'm like, "Okay, what can we do to get a person to feel better?" Because sometimes you only have one chance to help a person as a practitioner or whatnot, before they're like, "I don't trust this person anymore. I did what they thought and I feel worse," right? 

Melanie Avalon: Yeah. I really love hearing that, especially because I think-- That was something I really did appreciate about the book was what you just touched on the nuance with the diet. Because a lot of people are like, all keto or they're like all high-carb, low-fat, and it's nice to see that people are at different places, and that there might actually be a sort of blend that can work for people. Do you work often with people with continuous glucose monitors? 

Izabella Wentz: I love continuous glucose monitors. I think they could provide so much feedback to our bodies. The beautiful thing too is it might differ for person. So, I know I was talking to one of my girlfriends that was like, "Rice, I cannot eat rice." And another person's like, "I do just fine with rice, but grapes are the thing that really sets me off." So, it's really, really helpful. I don't require for people to use a CGM throughout the process. It is something that can be super, super helpful to figure out exactly how your body's responding to the foods that you're eating. 

Melanie Avalon: Do you wear CGM often? 

Izabella Wentz: Yes, but it gets me in trouble because being somebody that loves to experiment, I'll be like, "What happens if I drink Rozay today, all day." For most people, it would keep them on track. For me, it keeps me off track, if that makes sense because I just love experimenting. I'm like, "What would happen if I did this?"

Melanie Avalon: That's so funny. "Oh, well, got to drink all the wine. [laughs] Got to see what happens." 

Izabella Wentz: In the name of science, right?   

Melanie Avalon: That's funny. No, I love that. Just to clarify about mentioning the fasting, do you think most people with adrenal dysfunction? I'm also the host of the Intermittent Fasting podcast, I have a lot of listeners that do fasting. Do some people have adrenal dysfunction and at the beginning be okay with fasting or do you feel like most people need to heal a little bit first? How do you feel about the spectrum of fasting as far as it being appropriate for people? 

Izabella Wentz: So, for myself, like, today, I can intermittently fast and I oftentimes do. I feel great with it. When I was not sleeping well at night or when I was going through a very stressful time, this was not a thing, so that actually made me feel worse. I feel like people really need to listen to their bodies, where if you're skipping breakfast because you're trying to do intermittent fasting and then you're finding yourself gaining weight or waking up throughout the night, probably not the right dose of medicine for you at this time. If you're exercising and you feel worse after the exercise that you're doing and you feel like you have to recover for a few days, probably not the right dose for you and really tuning into your body and seeing how you feel. Typically, the women that I start working with, they're the individuals that are skipping breakfast and they're carrying a bit extra weight and they're waking up in the middle of the night and they have trouble falling asleep. So, a lot of times what I'll say is like, "Keep a banana by your bedside, so that when you wake up, you can fall back asleep easier just going on that banana, and let's actually get more calories throughout the day into your system." We're going to do smoothies that are easy to digest and try to move your caloric intake. 

Initially, it might be like, you wake up in the morning and you eat right away and then you're going to have a snack before bedtime. And then over time, we can shrink that window once we really focus on balancing your blood sugar, because there are things, for example, if you have an inositol deficiency, which a lot of women with anxiety and thyroid issues seem to have some kind of a functional inositol deficiency. If you have a carnitine deficiency, that can prevent you from fasting properly and being able to get into ketosis really well. So, I just really try to meet people where they're at, if that makes sense. My goal is for people to understand their bodies and understand the symptoms that their bodies are communicating to them. So, I guess, it's a long-winded answer. I think it can work really, really well for some people. It has worked really well for me. If you are feeling worse with it, I wouldn't recommend doing it. I would actually recommend eating on a schedule to set yourself up with getting more calories in during the daylight hours. Some of the women, I'll say, eat every two hours to three hours within the first month as we're really focusing on. I'm not just doing diet, I'm also doing supplements, I'm doing some of the light exposure. Some of the mindset work to really bring it all together, so that you could be more metabolically flexible, as time goes on.

Melanie Avalon: I love that so much. I think it's so unique for different people, even because I've gone down the rabbit hole looking at the studies on fasting and cortisol levels and things like that. I've seen studies showing completely different things. Like, I've seen them showing that it helps with normalizing stress related hormones and endocrine hormones, and then I've seen that it exacerbates issues. So, I just feel like it's so, so unique. Oh, the banana thing. It reminds me of-- because we were talking before the call about Dave Asprey, and I've been following his work for so long, like decade. I remember when I first heard him talking about having honey in the middle of the night and I was like, "Whoa." [laughs] That seems like the antithesis of what he'd been talking about. But I think it just as far as the low carb approach to things. But I just think it speaks to how-- I mean, it's like theme of this episode, not getting wedded to these one mentalities and approaches, especially if they're not working for you. So, that is fabulous to hear.

Okay, going back to the triggers thing. Well, first of all, listeners, so there's so much in this book as far as when it does come to the mindset aspect and how to make interventions in your life for positive mindsets, and pleasurable activities, and all of these things that you can do. I love the triggering section, I love the boundary section. I'm super curious, so with the triggering specifically, because you talked about in your personal story about how-- like one of the moments when you realized that you were falling back into the health issues and adrenal dysfunction was when your mom called and you were annoyed that she called. So, being annoyed or irritable or triggered by things, is that the cause or effect of adrenal issues? 

Izabella Wentz: It can be both. So, it's always, for me, a rule of thumb. It's like, if you look around the room and you're like, "This person's annoying. This person's annoying. My dog, if you breathe any louder, I'm going to put you out back for the rest of the day." So, it's like, some people, yes, could be annoying and triggering and just like energy vampires to be around, but also, if you have very little energy to interact with others, if you're very easily overwhelmed even by day to day activities, everything feels like a marathon to you, it's probably not necessarily them. It's probably you and you need to work on your resilience a bit, because unless your mom is like a super awful person that calls you 35 times a day and yells at you, probably you shouldn't be annoyed when your mom calls to say hello, right?

Melanie Avalon: Yeah. No, it's so funny. It's me. I'm the problem. Another question also related to that. The concept of boundaries. I love talking about boundaries. I think they're so important. I think one of the biggest, for me personally, as far as my own health issues and energy and life has been reframing boundaries as something-- Well, first of all, I think people see boundaries and they think that they're like a negative thing. That's being rude to people or shutting people out or being selfish. They think it's being selfish. What I've come to learn is that in order to have energy and thrive and protect yourself, you have to have boundaries. That's the way. And doing that for yourself is how you can most help other people. So, what have you found when it comes to people having boundaries and people with adrenal issues? 

Izabella Wentz: I found that a lack of boundaries can cause us to burn ourselves out. And so, if we're the person that somebody's like, "Oh, you need to do--? Can you do this favor for me, or can you do this with me?" You're trying to be nice and you don't have proper boundaries, you're going to keep pushing yourself past the point where you should be. And so, really a big, big step for people is starting to say no to a lot of things and really creating the space for themselves to heal. Maybe for some people, that does involve decommitting from the things that they're doing. One thing that I've been very mindful of is, sometimes our boundaries may not be compatible with another person's needs. Sometimes a person might need something from us, and we have boundaries where we're just not able to do that. And sometimes that can feel very challenging and difficult and it may impact relationships, especially if this person's used to you picking them up every single day and taking them shopping for a six-hour shopping spree and all of a sudden, you're like, "Hey, I've got no money. I've got no time. I got to set some boundaries that can certainly change and shift dynamics." 

Melanie Avalon: Have you found with the people that you've worked with? Because there's all these different options of stress creation in the body. We're talking about this thesis that we're overwhelmed with all these chronic stressors and our body needs to feel safe. And it can't feel safe if it's not physically nourished, if it doesn't feel safe mentally. Are we also unique in that aspect? What I mean by that is, are some people's bodies, they just don't get as stressed by lack of nutrition, whereas some people do. And then on the flip side, with the mindset and the boundaries. Some people, their bodies just don't get as stressed by stuff like that and other people do. How unique is it by interpreting the stressors? 

Izabella Wentz: Yeah. It's not necessarily, if you're an extrovert like going to seven parties. 

Melanie Avalon: Yes, that's a question. [laughs] 

Izabella Wentz: That's great. That might be your jam. You're like, "I feel so happy I got to go to seven different parties." If you're an introvert and you hear like, "Oh, I should be spending time in community and that's completely draining for you." Then of course, there's differences in personality. Some people get super nervous doing public speaking, for example. For me, that doesn't stress me out. I know I'm going to mess up things, I know I'm going to forget things, I might make funny faces. It just doesn't really bother me. Like, I can publicly speak all day and that really doesn't bother me. But if I had to clean my house for every single day, that would be overwhelming for me.

Melanie Avalon: Having your son, what was some of the big takeaways you learned for how to tackle that when it comes to all of the newfound stressors that come along with that? That's a huge question, I know. And people get the book because [laughs] you put a lot of stuff in the book. But maybe just a few things, because you just mentioned, not liking cleaning, for example.

Izabella Wentz: Yes. Laundry, all the piles of laundry, it's never ending. When you have one little person and they have so much laundry, it's like, "How do you do it all?" This little person comes with so many things. It's like, you've got the crib and the bass in it and all the things. So, for me personally, all the clutter was overwhelming from all of the baby things everywhere. And so, one of the things that helped me a lot was just becoming more of a minimalist with things to create a little bit more space for my son and his things, if that makes sense. Because it's like, my life was already pretty full before I had him, and then I had him, and it was like, "There's baby stuff everywhere on top of all of my stuff." So, just reevaluating what I really needed in my life. It turned out I didn't need 50 pairs of shoes that don't fit anymore, and dresses that I wore in college, and whatnot to really just creating that space and becoming more of a minimalist. We have all of our clothes in the same closet now, so that we don't have to go to 27 different places to put away laundry. [laughs]  

Melanie Avalon: That's smart. There's a really, really nice section in the book where you talk about getting more time. Like, people think they don't have time. You mention a lot of things people can try to tackle that, especially little things like auto paying bills. It's like the little things that really add up and you don't realize. So, I love the practicality there. You've mentioned a lot of supplements throughout the interview. And in the book, you have and in your program, you have six core supplements. I think people get very overwhelmed by the supplement world. How did you decide which to have in your six core supplements? How did you come to that decision? 

Izabella Wentz: I got to a point where a lot of people working with functional medicine practitioners, it was like they got put on 25 different supplements. And that can be overwhelming and stressful in itself, trying to remember all of these things you have to take and swallowing the pills, so on and so forth, and you're like, "What is working? What's not working?" And so, I wanted to find supplements that I knew could produce really powerful results for me in general. If a supplement is going to work, you should see some benefits within three days to five days for something. And for a lot of the supplements that I've chose, that's what they do. They help people feeling better within a few short days, sometimes a few short weeks. And then I also wanted to choose supplements that were multipurpose. So, for example, carnitine is one of the supplements that I chose. I think it's the primary reason why 92% of people will have less brain fog when they program is because of carnitine. 

Now, carnitine can help with getting rid of ammonia in our bodies. Ammonia can cause brain fog. It's something that's produced when we don't digest our foods properly, when we have certain stress related infections like H. pylori. So, carnitine clears out ammonia. It also helps to support a healthy muscle function. So, a lot of times, people, when they go through this adrenal dysfunction, their body gets stuck in a breaking itself down mode and they might have some muscle deterioration and muscle wasting, carnitine builds back muscle. Carnitine has been studied for resolving fatigue. So, it is very effective for that. It helps with carrying fatty acids into the mitochondria, so that you can produce more ATP and energy. It also helps you to fast better. So, if you're somebody that cannot fast, carnitine deficiency could be at the root. Other benefits, it can help because it strengthens the muscles in your small intestine. It can actually help with having healthier bowel movements. And so, every supplement that I've chosen, I'm like, "This has so many different benefits." Like, I could choose this to do this or I could choose this supplement, and it does five to seven different things in your body. 

Melanie Avalon: I definitely need to look more into this carnitine fasting connection to supplement it. Is it taken with meals or on an empty stomach? 

Izabella Wentz: Some people might find that they can take it with food. Generally, most supplements, I recommend taking with food in case. Some people might get an upset stomach if they take it on an empty stomach. 

Melanie Avalon: Okay, got you. Because you have your supplement line Rootcology, do you have a carnitine? You do, right? 

Izabella Wentz: I do. The one that I like to use has acetyl-L-carnitine, and that's blended with L-carnitine. Acetyl-L-carnitine is helpful for our brain, and then the L-carnitine is helpful for our body. They both work for both areas, but I wanted to combine both of them. So, acetyl-L-carnitine help with memory. It's considered a nootropic. I utilize a blend of those. I have found to work really, really well in the individuals that have utilized it. There's other companies on the market that make it though too so.

Melanie Avalon: Well, that is awesome. And for listeners, so you can actually get 10% off Izabella's Rootcology line with the coupon code, MELANIEAVALON. So, thank you so much for that, because I know that especially after this interview and reading the book, they're probably going to want to stock up on all the things. So, for all the six supplements that you have, you have versions of all of them, correct, in your line? 

Izabella Wentz: Yes. The Rootcology line has all of them, and then I have some alternatives in the back of the book as well. So, different kind of brands that you could utilize too. 

Melanie Avalon: Okay, so that's the carnitine. I would love to hear more about the myo-inositol. Do you know Cynthia Thurlow by chance? 

Izabella Wentz: Yes. Uh-huh.

Melanie Avalon: Okay. She was my cohost of the Intermittent Fasting podcast, actually up until this week that we're recording, but she actually recently released a myo-inositol as well, so I've been hearing all about it. So, it was exciting to read your book and learn even more about it, like, briefly, what does it do? Why is it so great? 

Izabella Wentz: So, myo-inositol used to be considered a B vitamin. Generally, vitamins are things we can't produce on our own, but because our body does produce it naturally, it was declassified. But it is something that seems to be low in people with conditions like PCOS, with blood sugar issues, with diabetes, with obsessive-compulsive disorder, as well as in people with thyroid issues. So, I started really working with it a few years ago after a study came out that, in women with subclinical hypothyroidism, taking myo-inositol could normalize their thyroid function in some cases completely. And when it's combined with selenium, their thyroid condition like Hashimoto's with antibodies and an elevated CSH, which indicates low thyroid function. Just taking those two nutrients together can get some people into remission, so their antibodies can go in the normal range and their thyroid function can normalize. I'm like, "Wow, I wish I knew about this when I was first diagnosed."

This research wasn't out yet, but this is something that I've been utilizing for people, and it does help with supporting thyroid function to the point where I'll say, if you're on thyroid meds and if you're starting myo-inositol, be sure that you monitor that thyroid function with your doctor because in some cases, some people may need to lower their dosage of thyroid meds and even come off of their medications once they address that myo-inositol issue. 

Then it's so helpful for blood sugar issues. I oftentimes will recommend it in the bedtime, so that people can sleep better throughout the night. It may be helpful for balancing reactive hypoglycemia. Interestingly, it's also used in obsessive-compulsive disorder. I have about 700 mg that I'll recommend for the Adrenal Transformation Protocol, but some people may wish to use dosages that are a bit higher. And so, I have it in powder form for conditions like OCD or PCOS. I always say like, you may wish to use it with caution with hypoglycemia, just see how you do with it first. But it is incredible. It's been studied for diabetes, for PCOS. And in my experience, people feel more calm with it, they sleep better, and their blood sugar issues improve significantly. 

Melanie Avalon: Well. I've definitely been hearing, like I said, a lot about it from Cynthia. I wonder, in that study, did they compare just myo-inositol and just selenium or did they just compare the combination? 

Izabella Wentz: There are a few different studies, and I can share a link to my blog about the various studies that have been done. There are studies done on just selenium by itself and studies done on just myo-inositol by itself for thyroid function. They both have benefits. But when they're used synergistically in a dose of 600 mg of myo-inositol and 83 micrograms of selenium, there seems to be this synergistic effect where you will get more benefits than utilizing either one alone. 

Melanie Avalon: Wow. Do you have a product that is that combination or do you have them a la carte? 

Izabella Wentz: I do have a selenium and myo-inositol, and it's called Drumroll Selenium and myo-inositol. 

Melanie Avalon: Yes, awesome. [laughs] So, for listeners, that's awesome. Okay, so remember, coupon code, MELANIEAVALON to get 10% off that for Rootcology. I love also that you talk about Saccharomyces boulardii, which is a beneficial yeast. So, have you found with that, because the probiotic world is very overwhelming? You found that patients in particular react well to that one in comparison to bacterial probiotic strains?

Izabella Wentz: So, this one is probiotic yeast. One of the magical things that it does is it helps to raise our secretory IgA levels, which are depleted when we're under a lot of stress. So, secretory IgA, it's an immunoglobulin secreted in our gut that helps to protect our gut barrier from invading pathogens. It helps us be more tolerant of various foods. Typically, if a person has low secretory IgA, they might be the person that might go out with a group of people for sushi, and they're the only one that gets sick after. And so, raising secretory IgA levels can actually help us with preventing food related illness, preventing food sensitivities. Also, it can help us with clearing out certain infections. So, some of the like, where does adrenal dysfunction come from? A lot of it becoming from an inflammatory process in the body, such as a gut infection. 

The more common one I've seen in people with Hashimoto's is Blastocystis hominis. It's a protozoan parasite. There's also H. pylori, which is a stress related infection that can be tied to thyroid issues, acid reflux, even stomach cancer. And Saccharomyces boulardii, just helps our body become more resilient. So, if you're taking other kind of herbs or medications to clear out infections, it can help them work better. And for some infections, just using that by itself can help clear things out. It can also help rebalance the gut flora. If you have too much Candida in your system, if you have too much mold in your system, it can be helpful for clearing out some of the ammonia that can cause brain fog. It's one of those great probiotics that can also be used with people who have SIBO. Because a lot of probiotics, unfortunately-- If you have SIBO or if you have histamine issues, you may not be able tolerate them, but boulardii is one of the ones that most people do well with unless they're immune compromised. 

Melanie Avalon: Was it difficult for you to source that? Was there a lot of options when it came to choosing your source for it? 

Izabella Wentz: I had used ones that were needed to be kept in the fridge before, and I used to recommend those to my clients. But for me, I'm always like, "How do you make it easy for people? Like, compliance and adherence?" And so, when you keep a probiotic in the fridge, sometimes it's like you forget to take it. And so, I wanted one. It's also something that I love utilizing for travel. So, you could just put it in your travel bag and you're going on an exotic beach vacation in a foreign country, you probably need to support your secretory IgA. It has also been studied for preventing food borne illness. So, I wanted one that was heat stable. So, that's the one that I have by Rootcology. So, you do not need to keep it in the fridge. You can put it in your travel bag, and you could take it on vacation with you, and you can put it in your pill organizer, so that you remember to take it versus like, "Oh, it's in the fridge and I forgot to take it again."

Melanie Avalon: Well, for listeners, we'll put links to all of this in the show notes. And yes, again, coupon code, MELANIEAVALON for 10% off. So, one very last quick thing, because I want to be really respectful of your time. On the movement side of things, because you mentioned movement. You mentioned in the book, this concept in-- Like, animals, when they experience a stressful situation, they shake off those stress hormones, which I find fascinating. So, this concept of movement, is it good for dealing with stress or can it be too much? I know we're running out of time and there's a lot here with like, anabolic versus catabolic exercise. But in general, how do you suggest that people approach movement and they can get all the details in your book?

Izabella Wentz: Movement can be incredibly healing. Generally speaking, if you are somebody that is in that catabolic process, your body's breaking itself down. Doing things like aerobic exercise or high intensity exercise might be too much for you at this time. So, you may need to really get more into a balanced state where you're doing exercise that's more relaxing. So, yoga or tai chi, perhaps doing some walking or hiking in nature. And doing some muscle like weightlifting exercises, that can help you build more muscle, so you become more in that anabolic state. The kind of rule of thumb that I give to people is, if you're feeling worse after you do your exercise, and everybody's like, "Do exercise. It'll give you more energy." And you're like, "I did exercise, and I had to sleep for three days straight." Probably not the dose of medicine right for you at this time. And so, you may wish to either reduce the amount of time you're doing that exercise, the intensity, or even the type of exercise. 

So, a lot of the women that I've worked with the chronic fatigue and adrenal dysfunction and hypothyroidism, they're like, "I'm trying to lose weight. And so, I'm going on these long power walks or running to try to lose weight." And then I'll say, "Actually, based on your adrenal symptoms, I would recommend that you pull back from that for 30 days and see what happens." And they're like, "Oh, my gosh, no, I don't want to gain weight." And then it ends up happening that you can actually get into a healthier metabolic state, because sometimes it's like if you're sleep deprived, if you're feeling stressed in your life, you have too much stress and you tip that scale, exercise can be too much for our system. It could send more of a danger signal. So, for me, it's all about what's the balance. And so, if you're not sleeping at night, and you're not eating well enough, you're not eating for blood sugar balance, you're eating a lot of inflammatory foods, and then certain types of exercise can be just too much and too inflammatory. And then your body gets this message, it's like, "Oh, no, we're in a famine because we're not eating enough, and we must be chased by a bear because we keep running on a treadmill." We're keeping watch late at night because we're not sleeping.

So, obviously, we must be in a war. Let's shift into this adrenal dysfunction conservation state. 

So, again, it depends on where you are in that state. So, generally speaking, socializing is really great for us, being able to fast is going to be really great for us, and doing exercise is going to be great for us. But it's like, you've got to figure out your medicine and is this the right time for it and what's the dose, right?

Melanie Avalon: Seems to be theme of everything. Just really quick. Just speaking of balance and uniqueness, you have a very extensive overview of adaptogens in the book, and I know people have a lot of questions about that. So, friends, get the book. Get Adrenal Transformation Protocol to learn all about those. But are adaptogens something where it's also very unique to the individual? Like, do they have to find the adaptogen that works for them, or do you find that some adaptogens tend to work for everybody? 

Izabella Wentz: Generally speaking, if you're somebody that's sensitive to supplements-- I've worked with so many people that I have enough people that are like, "I'm just sensitive to everything," or they might have certain life situations, like, maybe they're nursing moms, or they might have estrogen dominance or other kinds of things going on. It's like, maybe you just start with one adaptogen, and see how you do with it before you add anything else. There's ones that are a little bit more gentle, like holy basil, and that can be used for tea. Rhodiola and rosea is generally pretty gentle as well. If you're somebody with high blood pressure, I wouldn't recommend that you utilize licorice. If you are somebody that needs more support in the libido department, maybe it's doing some maca and shatavari. Those might be helpful things for you. 

Then for the average person, if you are looking for an adaptogenic blend, you can actually utilize a few of them together, and they can work in synergy with one another, and then you don't have to take a whole bunch of them. I'm not a person that's very sensitive to supplements, so I do really well with a blend of various adaptogens, where I'll have some ashwagandha there, and some ginseng, and then I'll do a little bit of holy basil in addition, and I do well with that. But again, it depends on your unique makeup, so not everybody can do a whole bunch of adaptogens at once. 

Melanie Avalon: Well, thank you so much, Izabella. I've been looking forward to this for so long. Like I said, I've been following your work for so many years, and I just think what you're doing is so incredible, so life changing for so many people. The last question that I ask every single guest on this show, and it's appropriate for our conversation, but it's just because I realize more and more each day how important mindset really is. So, what is something that you're grateful for? 

Izabella Wentz: I'm grateful for my family and for having the opportunity to connect with so many brilliant people like yourself. I'm grateful for being able to take my journey and some of my pains that I have gone through and to have created something to help others heal. 

Melanie Avalon: Thank you so much. I am so grateful for you, and I really appreciate the science and the nuance and the intelligence that you bring. You've worked with so many people. So, clearly, there's a reason that this is all working. And then you just have a really, it's so wonderful to meet you because you just have such a beautiful vibrant spirit. Hopefully, we can meet in real life. We were talking before the call about how you live in Austin along with everybody else, so I got to come visit. But this has been so amazing. How can people best get your work, follow your work, and get your book? 

Izabella Wentz: Thank you so much for having me. It's been such a delight to meet another kindred spirit, and hopefully, we'll get to hang out in Austin soon. For anybody that's looking to help themselves heal, my website is thyroidpharmacist.com, and I have a new book called Adrenal Transformation Protocol. It's a four-week plan to release stress symptoms and go from surviving to thriving. I also have three books about reversing Hashimoto's, including a dietary book that has recipes. So, if you have thyroid issues or Hashimoto's, please come. I would love to help you on your healing journey. 

Melanie Avalon: Awesome. Well, we will put links to all of that in the show notes. Thank you so, so much, and enjoy the rest of your day, and hopefully, we can talk again in the future. 

Izabella Wentz: Likewise. Looking forward to it. 

Melanie Avalon: Bye. 

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