Episode #184: Adrenal Transformation Protocol with Dr. Izabella Wentz, PharmD, FASCP

Welcome to Better Health Guy Blogcasts Empowering your better health and now here's Scott, your Better Health Guy. The content of this show is for informational purposes only and is not intended to diagnose, treat or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or or his information to facilitate self treatment. As always, please discuss any potential health related decisions with your own personal medical authority.

Hello everyone and welcome to episode number 184 of the Better Health Guy Blogcast series. Today's guest is Dr. Isabella Wentz and the topic of the show is the adrenal transformation protocol. Dr. Isabella Wentz is a compassionate, innovative, solution focused, integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis with Hashimoto's thyroiditis in 2009 following a decade of debilitating symptoms. As an accomplished author, she's written several best selling books including the New York Times bestseller Hashimoto's Lifestyle interventions for finding and treating the root cause. The protocol based number one New York Times bestseller Hashimoto's Protocol a 90 day plan for reversing thyroid symptoms and getting your life back and the Wall Street Journal bestseller Hashimoto's Food Nutrition protocols and healing recipes to take charge of your thyroid health. Her latest book, Adrenal Transformation Protocol focuses on resetting the body's stress response through targeted safety signals and features a four week program that has already helped over 3,500 individuals. The program has an impressive success rate with over 80% of participants in improving their brain fog, fatigue, anxiety, irritability, sleep issues and libido. And now my interview with Dr. Isabella Wentz. I am very excited today to have the thyroid pharmacist, Dr. Isabella Wentz on the show to talk about the adrenals and her transformative approach outlined in her latest book, Adrenal Transformation Protocol. Thanks so much for being here Dr. Wentz.

Thank you so much for having me Scott. It's such a delight to be here with you.

Talk to us about the personal path that led you to making the thyroid and the adrenals the focus of your work. Did you have your own health journey that was the catalyst for the work that you do today?

I did so during pharmacy school. I was never really interested in the thyroid gland. I was taught that essentially if you have hypothyroidism you just need to take a pill and that people will get better with taking thyroid hormone. I was also taught that these conditions tend to happen in women who are older, so maybe women who are menopause age. And I personally started having health issues during my first year in undergraduate studies where I just went from a bright eyed and bushy tailed person to all of a sudden being so exhausted that I went to take a nap for a, to study after class one day. I had an exam the following morning at 7am and I took a nap in the afternoon and I woke up at like 8am the next day. So and you know, of course I didn't get a chance to study, right? And I run to my exam and I'm crying tears and I got there and I was like, I overslept. And they're like, well it happens. You were probably up late studying and I'm like, but I wasn't, I took a nap last, you know, in the afternoon the day before. And this kind of fatigue never really left me. And for many years I just kind of learned to adjust my life. I was like, okay, I know I need to study so I can't, you know, I can't participate in, in life basically, right? I have to just focus on my studies. And as time went on, I became a pharmacist. And by that point I actually had a lot of symptoms. I had started new onset anxiety and panic attacks and hair loss and carpal tunnel, just a long list of symptom. But I also had a bit of more knowledge than I did as a student. And so then I realized that not all doctors are created equally. And I was like, oh, so I've been going to the doctor every year complaining about these symptoms and really wasn't getting any answers. So I sought out some additional doctors and finally learned that I had Hashimoto's thyroiditis, which is an autoimmune thyroid condition that results in the thyroid gland getting destroyed so it can't produce its own thyroid hormone. And many of the symptoms just really, really fit for what I had been going through for the, you know, for the previous decade. And part of me was excited to finally have an answer. And I was like, yes, I get on thyroid meds, right? That's going to be great. But of course I was also sad because I was like, how did I develop this condition in my 20s when most women are supposed to get that when they're quote unquote older? And, and is there anything from a lifestyle standpoint that I can do to prevent this condition from getting more aggressive or potentially reverse the condition? And so I got on the medications and they helped a little bit, but not all the way. And so this is how I became a Hashimoto's expert slash human guinea pig. Was really trying to take back my own health and figuring out, you know, kind of the onions of an autoimmune thyroid disease and what are the layers of that onion that we need to peel to figure out what was triggering it. And initially I thought it would be, like, one thing. And I was like, oh, I heard about going gluten free. I went gluten free. That really, really helped. But then, like, my irritable bowel syndrome, my acid reflux went away. But then I still continued to have the anxiety and the morning fatigue, fatigue throughout the day, unrefreshing sleep. And somebody mentioned the word adrenal fatigue to me. I was like, well, let me look it up in my, like, you know, websites that I look things up on as a pharmacist. And it said, I don't know if it was Mayo Clinic or Medline. It said, adrenal fatigue doesn't exist. And I was like, oh, okay, it doesn't exist. So kind of went back on my, you know, searching for answers, and eventually came back to it after, like, the 15th person mentioned adrenal fatigue to me. And I did the testing. Sure enough, I had low cortisol throughout the day, and I tried the recommendations, and I actually got better. And I was like, oh, so there's this thing that doesn't exist. And I'm doing what they recommend, you know, what these voodoo doctors say to do. And the voodoo things actually helped. And I've been talking about, you know, all the different ways to overcome thyroid issues in the last decade. And I have a really special place for adrenal dysfunction in my heart. This is something that I've helped a majority of my people with thyroid issues with. And five years ago, my own kind of methods for helping people recover from adrenal dysfunction were really put to the test when I was a new mom. And I couldn't utilize some of the recommended, you know, integrative recommendations, like taking hormones or sleeping a lot or quitting coffee. And so I had to come up with a new pathway to rebalance that stress response sometimes known as adrenal dysfunction.

Yeah, it's amazing how many of these conditions that are so very real are really invalidated. And my personal health journey has been chronic Lyme disease and mold illness. And it's kind of fortunately, it's getting a little better. But years ago, when I was really dealing with those, those were also, you know, all imaginary, all in your head didn't exist, weren't real. You mentioned the adrenal fatigue. So for years, adrenal exhaustion or adrenal fatigue are discussed as contributors to dis ease. And yet, as you pointed out, some people argue that they're not real conditions. So is adrenal, quote, fatigue a real condition? And how important is optimizing the adrenals to support optimized health?

I think there's a lot of controversy about this term adrenal fatigue. There is something known as adrenal insufficiency and Addison's disease, which is, you know, a conventionally recognized condition where usually it's an autoimmune condition as well, where 90% of the adrenal glands will be under attack. And by the time 90, they're 90% damaged, they're no longer able to make their own cortisol. And so this is a situation where some, typically people need to get on medications. They have very severe symptoms, oftentimes landing them in, you know, like emergency rooms, intensive care units, people like, can't get out of bed and they can't walk. Very, very serious kind of symptoms. And I think the confusion stems from the. The naturopathic doctor that first coined the term adrenal fatigue had noticed this pattern in people where they had a cluster of symptoms that were a little bit related to what a person with low cortisol might present with. They tended to be a bit more mild. Although still, if you've had adrenal dysfunction, it is very much something that can interfere with your ability to thrive. So you might have that fatigue. You might have the brain fog, mild depression, unrefreshing sleep, disconnected, being disconnected from the circadian rhythm, difficulty with bright lights and salt cravings. And if you get up too quickly, you might feel faint. And so for the people that are experiencing it, it's very, very real. It is very much a real response of what the body does when it's under stress. And I don't mean just you have an annoying boss that yells at you. It's oftentimes it's inflammatory stress. So your body is overwhelmed by potentially it's something like traumatic psychological stress. Maybe you're burning the bridge at both ends. Maybe you're not eating enough calories. Oftentimes it's also things like chronic mold exposure or an infection in your gut that's causing a lot of inflammation. For many people, it's. It's a combination of all of these things that kind of come together and really overwhelm that stress response. So it is A real thing. It is a real physiological response. I don't think the term. The original hypothesis of Dr. Wilson, he thought that adrenal. That this like cluster of symptoms was a mild version of Addison's and that the adrenal glands were damaged and unable to produce hormones. What we now understand is that this is not necessarily the right mechanism of action. The mechanism of action is that because of all this stress, the. Our adrenals start to compensate, and rather than producing lots of cortisol all day, which is what they normally do under acute stress, they will start suppressing some of that cortisol production. And the scientific term of this is hypothalamic pituitary adrenal axis dysfunction. And this is. People will say, does adrenal. Adrenal fatigue doesn't exist. And I'm like, well, first of all, look at the people who have these very real symptoms. And also look at the research where if you look up hypothalamic pituitary adrenal axis dysfunction, this is it, right? And I personally don't care what people call it. Some people have called it burnout, some people have called it adrenal fatigue, some people just call it fatigue. My preferred term is hypothalamic pituitary adrenal axis dysfunction. It's not necessarily fun to say, so I've settled on the term adrenal dysfunction. But it is a very real phenomenon. It is not necessarily a diagnosable disease by conventional medicine standards.

So when we look at hypothalamic pituitary adrenal, Some people add thyroid to that at the end as well. So this HPA or HPAT axis dysfunction, essentially, are the solutions then more aimed at supporting the adrenals and supporting the thyroid? Or are some of the interventions things that are more upstream, looking to support the hypothalamus, the pituitary? Where do the interventions kind of fit in the conversation?

You know, you can do interventions at any point of that pathway, right? And so some practitioners will say, this person has this presentation and their cortisol output all day is low. And so they would utilize hydrocortisone as a medication to try to raise up and mimic the natural body's production of cortisol throughout the day. They might utilize something like pregnenolone and DHEA to kind of mimic that production. Pregnenolone turns into. It's the mother hormone that turns into a whole host of different symptoms. So you could absolutely do it that way. You can also approach it from the other direction, where you look at okay, what is the root cause? And why are people stuck in this chronic stress response? And it's to address stress, right? So figuring out what's driving that HPA axis dysfunction. And a lot of times it is because we're constantly getting those stress messages. Right.

I've seen some people that previously talked about adrenal dysfunction kind of shifting away from that, where now they're more focused on mitochondrial dysfunction, that production of ATP, the energy currency of the body, that also obviously has an effect on the adrenals. And so I'm wondering, is there a connection between what we may have thought of as adrenal dysfunction and what we now might think of as mitochondrial dysfunction? What's the overlap between those two conditions or terms?

Well, one of the interesting things is that the mitochondria are actually the production side of pregnenolone, which is our mother hormone. And I. I mean, in my experience, the protocols I was using for adrenals in the past were very much based on supporting that. That kind of towards the end of the line spectrum where utilizing hormones to kind of mimic that pathway. And I was also working on some lifestyle changes to really lower the stress. But what I found in my work is that supporting mitochondrial function can be extremely helpful for balancing adrenals as well and for resolving the brain fog and resolving the fatigue throughout my. You might notice the title of my book is Adrenal Transformation Protocol, and that stands for ATP. Right.

So beautiful.

So, yes, if you're a nerd, you get it. Right. But it is. I feel like it's both oftentimes where you do need to do some support for the adrenals, and you do need to focus on mitochondria. And there's a whole other bunch of different systems that might be broken that we need to address to really recover from those symptoms, such as blood sugar issues and some. Some gut permeability. And I've try to, you know, I really look at results and how do I get people results so they feel better when some of the other things I used to recommend I would be like, do all this. Do all these testing and quit caffeine and do this. And people were like, bye, not talking to you again. Right. So really what I found is when you focus on, you know, utilizing some of the adrenal strategies in conjunction with mitochondrial strategies and some of the other safety signals that I talk about in my book, then you can really get really fantastic results. Like, you know, 92% of people have less brain fog through using these strategies. And the. The kind of old school approach that I used to use, it might take three months to two years for people to see these results. Where with this approach it's like four weeks where most people see results and some people do see them within like the few days or the first, second week of doing the lifestyle changes and utilizing some of the interventions.

Yeah, I loved how holistic your approach is and looking at so many different areas where we can remove stress from the body, remove these danger signals, create safety signals, as you term it in the book. Let's come back to. You just mentioned testing. So how important is testing when it comes to exploring potentially adrenal dysfunction dysregulation? Do we need to do that? If we do do that, do you prefer the salivary adrenal profile profiles or maybe something like the Dutch test which is using dried urine. Do you think it's critical to test or can we work primarily with symptoms and then kind of empirically introduce some of these things that you talk about in your protocol?

So I personally love functional medicine testing and I would test my. I've tested myself like every other month for the last 10 years with various cool, innovative tests. Anybody that I've worked with, I'm always recommending tests. The challenge has been for me with educating people kind of in books and online in. I'll be like, you need to look into adrenal dysfunction. And so they'll go to their endocrinologist and they'll be like, I want to have my adrenals tested. And they'll be tested for Addison's, which they don't have. And then, then it'll be like, no, you have to go to an integrative doctor and do something like a saliva profile or the Dutch test. And so maybe they'll find somebody eventually and then they'll pay out of pocket for the test. And then the test sits on their shelf for like three months. Maybe they finally send it in and it's like four weeks later they get the results. And I'm like, but we can make such a big difference in four weeks if we just focus on lifestyle. So for me, I personally would love if every single person that had a million dollars and did all this, all this tests, I really love the ZRT adrenal saliva profile and the Dutch profile. Both of those are fantastic. I will say for the average person, I have an. You can, I could teach you how to interpret an adrenal saliva test in 20 minutes to understand your results and what to do the Dutch test. I feel like I've Spent like seven years learning it, and I'm still learning new things about it every other week. So it's one of those nuances where definitely you want to be working with a practitioner that's knowledgeable on how to interpret those tests as well. And all of these things can really be barriers for people to get the care that they need. Right. And my kind of, my thought process has been that a lot of times we can figure out that we're in this stressed out state, this adrenal dysfunction state, just by looking at our symptoms. And we can do so much to resolve those symptoms in four weeks, in the time that it would take us to do a test and get the test results back. That I'm like, you can do a four week protocol and if you still have the symptoms at the end of the protocol, which majority of the people who do the work, they don't, then by all means invest in the testing. Right. And make sure you find a practitioner that can work with you. And there are these protocols, like utilizing hydrocortisone and pregnenolone and dhea, all of these hormonal therapies that may be something to utilize if some of the solid mitochondrial support and lifestyle changes haven't helped.

I think it's interesting, particularly in the chronic infection community, chronic Lyme community, when people hear hydrocortisone, a lot of times they're like, oh my gosh, that's a steroid and that's going to suppress my immune system and my infections are going to get worse. But when you're using it correctly at low dose for purposes of supporting the adrenals, that is not the case. And so I think sometimes one of the biggest needle movers for people is introduction for some period of time of hydrocortisone and can be tremendously helpful when we think about stress as items that are stressing the adrenals. But we know we also could not survive without stress. So what are some of the stressors that are more likely impacting the adrenals in a negative way as compared to being more hormetic or healthy. Stressors. And then is that dynamic, meaning something that might stress me when I have adrenal dysregulation might later be something that the body can in a more healthy way manage and respond to. Talk to us about some of those things that are stressors to the adrenals.

Absolutely. So I think we all can be. It's pretty easy to recognize psychological stress, right? So we have a toxic workplace, maybe difficult family situation, and that might be one Source of stress that people, I think a lot of people are acutely aware of if they're in that stressful situation. I had a person review one of my books and they said I didn't need to do anything. That she said, I just quit my job and got out of town, away from my toxic boss and I healed. And I'm like, yeah, absolutely. If you can identify the source of the stress that, that those rocks that are weighing you down, then you can absolutely heal. I wish it was that simple. For most people it's not. But there's also traumatic stress. So anytime you might have aces, adverse childhood events are things that have happened to us as children, even young adults, even in our recent lives that might be traumatic and that may stay with us. Some of the more well known things might be post traumatic stress disorder or somebody that survived a mass shooting at, at a school. And now every time they pass a school they get palpitations, they get a cold sweat, they have a hard time walking into a school. And you can see how, how this, this is connected. Right. But there might be other kind of micro stressors that we maybe have had that can still shift our HPA access to more of over responsive state or where we're kind of, we're seeing the world through different colored glasses where we're looking around and we feel like everybody's a threat to us rather than this person could be a future friend or this person's neutral. And so these are, these are some stressors that I will say a lot of people may not be aware of where they have had some sort of trauma in their lives that's not, that's not been processed. And I talk about ways to process this trauma if that's relevant for people. Then there are things like our lifestyle. So we're watching news a lot and it's all doom and gloom, right. That sends our body a signal that we're not safe. Right. Even though the, the situation may be hundreds and thousands of miles away, we're still feeling it like it's, it's within happening to our bodies. If we're tuned into that, then there might be things like over exercising and under eating, eating foods that are inflammatory to us, not getting enough sleep, whether that is self induced or because of something like sleep apnea or insomnia, burning the bridge at both ends, overworking, not having that time to rest. These can all be drivers of that inflammation and that stress for our bodies. Then there are things from our, One of the big ones is just blood sugar. So if we're eating too many, too much sugar or too many carbohydrates, not enough protein and fat. That can actually be a stressor for the body. So every time we eat too much high carb foods, that could set us up on a blood sugar roller coaster where we get a spike in our blood sugar and then we might get a crash when we might become hypoglycemic. And then cortisol gets released to produce more glucose through the liver. And so that can be a stressor for many people. And then there are also like inflammatory sources of stress. So in people that I've worked with, it might be like an H. Pylori infection that's in their gut that's causing stress. It might be a protozoal infection. It could be something like a toxic exposure like mold or Lyme. It could be a nutrient deficiency. A lot of times people, it's interesting because people will say adrenal fatigue doesn't exist. It's actually mitochondrial issue, it doesn't exist. It's actually ptsd, it doesn't exist. It's actually trauma, it doesn't exist. It's actually fill in the blank, whatever specialty it is. But the truth of the matter is, anything that's overwhelming for your system is going to send you in that stress response. And I get this common question a lot. What about positive stress? What about exercising and high intensity exercise? Right. What about fasting, cold plunges and all of these wonderful things that can really help us build resilience and spending time in community. And in my experience, the people that I've worked with, it depends on what level of adrenal dysfunction you have. If you're in that flatlined cortisol state, you're going to hear fasting is good for you. You fast and you feel awful, you're going to hear that exercise is good. You do exercise, you have to recover for three days. Everybody's like, built community, socialize, spend time with friends. And you spend time with friends and you're like, why did I do that? Now I have to take two weeks off from talking to people and hold plunges. All of these things when you just have this high degree of stress and inflammation, your body can't produce the right kind of stress response to it, where your body will just become overwhelmed. One of the big symptoms of adrenal dysfunction is feeling overwhelmed all the time. And so normal things like cleaning the house or taking the dog for a walk or tasks of daily living can be overwhelming. So some of these health trends that I can do today that I enjoy doing today, and that people who have a kind of a stable adrenal function can do and benefit from people with that low cortisol curve that can potentially make them feel worse. And these are the people that come to me. They're like, I'm doing this. I'm doing all the things, but why do I feel so awful? Right.

So in the book, you talk about inflammation, circadian rhythm, balance or imbalance, nutrition, psychological stress as kind of areas where we can get some of these danger signals. I like that you just explained to us that something that could be stressing to the adrenals when we're in more of an adrenally exhausted state might be hormetic at some point in the future. It might be a stress that actually then results in a positive response or almost kind of like going to the gym and having a positive response. Another thing that came to mind was I've heard somebody say that if you take your three fingers and you put them here on your neck, that if you feel a heartbeat, that that's a sign you probably have adrenal dysregulation in our modern society, that it's just unfortunately so incredibly common. Right.

I was, like, trying to think through my medical training, and I was like, I think everybody. Ah, I get it, I get it. That's a really good one.

You have said in the book that when the danger signals outweigh the safety signals, that the body goes into survival mode. You just talked about some of these danger signals. We're going to talk about some of the safety signals. So we want to remove as many danger signals as possible. We want to introduce or increase safety signals so that the body can shift out of survival mode. You are very well known for your work in the thyroid realm. Having yourself, as you mentioned, having Hashimoto's, what's the connection between the adrenals and the thyroid? And should we support the adrenals before we attempt to support the thyroid? Does the order matter?

Oh, my gosh, that's such a good question. When I first started working with clients, I would test them for adrenal dysfunction, and most of them had it, right? They had some degree of it. About 62% of the labs I analyzed ended up with that low cortisol pattern. But it's interesting because there's an. There's a. Definitely a feedback loop between our hormones in our body. Right. And so with the adrenal hormones, with cortisol and thyroid hormone, there's a few different things that can happen when we have a lot of stress in our lives. And typically, people who might have high cortisol, they might produce more of something known as reverse T3, which is a inactive thyroid hormone that can set up in our thyroid receptors. And you can have a perfectly healthy thyroid producing just the right amounts of hormones. But if you produce reverse T3 and too much of it, that's going to sit in those receptors and you can actually have, quote, unquote, thyroid symptoms, even though you don't have a thyroid disorder per se. And so I've had a small population that have come to me that doesn't have thyroid issues. It's like they have adrenal issues, right? And that's the cause behind their weight gain and their fatigue. And some of them have actually been put on thyroid medications, which. Which is not indicated, which can actually be a dangerous situation to be on thyroid meds when you don't have a thyroid condition. And so in that case, you absolutely need to focus on the adrenals. Right. Typically that person will have, generally they won't have thyroid antibodies. They might have a normal thyroid ultrasound. They will have a lot of the symptoms. If you test their reverse T3, that might be elevated, and sometimes the TSH might be as high as like, a 3 that I would see from these patterns. And typically adrenal support is going to be what is needed to, to get them in balance so that they don't have so much of that reverse T3. And then the other pattern. And this is the majority of my clients being the thyroid pharmacist, most people that come to me, they, like, already know they have a thyroid diagnosis, right? And so they would have Hashimoto's and they would find out that they have Hashimoto's and they would get on thyroid medications. And many of them, like myself, were like, oh, great, I'm going to have something that's helpful. And so they get on thyroid medications and initially they feel better, but after some time, usually a few weeks, they're like, I feel worse. Why is my energy, like, plummeted? Like, what is going on? And the interesting thing is that thyroid hormone can, when we don't have enough of it, then our breakdown of cortisol can slow down. And this is kind of an adaptive response of the body, that hypothyroidism will result in our cortisol metabolism being slower. And when people get on thyroid medications, this can mean that they can unmask a low cortisol state. Because when you get on thyroid medication, your cortisol Clearance normalizes, which means that it's probably going to increase from what it was. So even though your cortisol maybe was kind of in the low to normal range or the normal to high range, all of a sudden, once that clearance starts to normalize, you might find yourself with low cortisol. And I think it just goes to show, a lot of times when I've worked with people, I will ask them the question, what happened before you got sick? Right. And there's always something like, I've had a really stressful situation in my life, right? And typically a person gets this really big stressor that may cause them to essentially get into this adrenal dysfunctional state after some time. It might take one year, it might take five, sometimes 10 years, where their cortisol will become flatlined if they let this go on long enough. And so this is. This is an interesting pattern that I've seen with quite a few people with Hashimoto's, where all of a sudden you get on thyroid meds and all of a sudden your adrenals, that your adrenal issues start to manifest. And do you treat the thyroid or the adrenals first? In Addison's disease, you always want to treat the adrenals first because you can have an Addisonian crisis when you take thyroid hormone in people with. With Hashimoto's and adrenal dysfunction, I feel like you should do the both simultaneously. Right. Especially if you're experiencing. Not everybody will have crashed cortisol once they start on thyroid hormone. But generally the people that have come to me are not the ones that are feeling amazing on thyroid hormone. Right. And so if you're somebody that starts on thyroid hormone and you're like, I'm just not feeling amazing, like, what. What is going on? And there's a good chance it's your adrenals that need to be addressed.

So it sounds like we really want to look at things more holistically, this HPAT axis, if you will, that if we're thinking about supporting the thyroid, that it would be at least wise to have some understanding of that person's adrenal status and potentially then make sure the adrenals are getting supported as well. You mentioned that in some cases people start thyroid medication, they do better for a while and they get worse. I did a fun podcast a while ago with Dr. Eric Balcavic and Dr. Kelly Halderman on their book called the Thyroid Debacle, where they go into that detail and much more as well. So people can refer back to that how often do you find people need pharmaceutical tools like Cortef, like Florinef, the hydrocortisone to support their adrenals versus being able to adequately support the adrenals with natural approaches, or as you refer to them in the book, the ABCs, the adaptogens, the B vitamins, and vitamin C.

In my experience with having about 3,500 people going through the Adrenal Transformation Protocol, when it was a program offered to my community, community, we would have about an 80% success rate within the four weeks of people feeling significantly better. We. What I do is I typically have the very specific protocol that breaks it down, makes it really easy for people to follow, and they do that for four weeks, and then I give them some advanced tools and strategies during the fifth week, which, which I've placed in the back of the book that go over, like, if you're still struggling with energy levels and fatigue, and if you're a woman and you're menstruating, then maybe we should look into testing your ferritin levels. Perhaps you have low iron and that could be the reason for your fatigue. Right. And so I give them a lot of tools and resources to look into what might be driving, what might be additional reasons why they might be out of balance. And certainly that may be a time to revisit doing adrenaline saliva testing or doing some Dutch testing and working with a practitioner. But in, in my experience, when, when people do the work, we do have such a high success rate of, of almost 80% across a lot of the different symptoms and 92% for, like, brain fog. And then I believe it's like 79 for depression. But it's, it's remarkable because I, I, you know, when I initially trained on adrenals, it was like, you can use the hormones and those can get people imbalanced within three months to two years. Or you can utilize. If you, the more you can focus on lifestyle and kind of rebalance the stress response, then you can get results quicker and kind of bounce back quicker. So for some people, I think, like, if, obviously if they have Addison's, then they need the hormones. And for other people, it might be one step on their healing journey to utilize the lifestyle. They might need to take additional steps.

I mean, it is pretty remarkable, to use your word, that any protocol could improve symptoms in 80% of people in four weeks. So congratulations on that because it is. I don't know many other protocols that are that amazingly successful. When might you look to some of the hormones like DHEA or pregnenolone to support the adrenals. What are the pros and cons of more direct hormone replacement versus some of the other things we've talked about. And in someone with low DHEA, for example, does supporting the adrenals with your ABCs and some of the other things we're going to talk about without DHEA supplementation exogenously, does that lead to an increase in the production of DHEA over time?

Yeah, absolutely. So when I have worked with people in utilizing hormones for them, I would do this based on a cortisol test. So either a saliva cortisol test or I would the Dutch test. And I would get a really good idea of what their cortisol output was for the day, what their DHEA was like, what their curve looked like. And then I would develop a very specific protocol for them based on, okay, if you have low cortisol in the morning, we would use this many drops of pregnenolone, depending on where your DHEA was, we would use this many drops of DHEA and we would kind of do that on a circadian fashion. So doing it three times a day generally. And then I would also have, okay, let's say you, you struggle with low morning cortisol. I could give you some licorice drops to raise your cortisol levels there. If you have too much cortisol at night, we can utilize something like phosphatidylserine within a short time period, as long as your overall cortisol wasn't low, to help bring down some of that high cortisol to allow you to fall back and sleep at night. And we can utilize this for these patterns for three months, sometimes up to two years, to really do it that way. I personally have had some situations myself where I had a practitioner give me a really high dose of pregnenolone, which probably 20 times of the dose that I would give people. And that caused me to have water retention and a lot of pain in my body because that can over convert to aldosterone, which is, can cause water retention. We have too much of it and I don't want people doing it by themselves. And I want them to work with a very knowledgeable practitioner and use a very accurate cortisol test, either the Dutch test or the ZRT test. And then there I feel like there's a time in place for that. The challenges that I have had with clients is in some cases, if women are estrogen dominant, DHEA can over convert to estrogen. Right. Men as well, unfortunately, it like we wish that it would just raise the right thing that is missing. But sometimes if you're pathways are kind of like geared to producing more of one thing then utilizing just that, that hormone can actually it can over convert to something else. And then women who have had estrogen sensitive cancer because there are family history of that, like I wouldn't want to use DHEA with them. Sometimes with the pregnenolone you you weren't hope that it would convert to cortisol, but maybe it might convert to that aldosterone. And then there are things like some women may over convert DHEA to something that causes acne and chin hair and that's never fun. So those are kind of some of the challenges that I have had with utilizing those. And some of my clients in other countries, they can't readily order those kinds of supplements because they might be prescription, right? Definitely. If you're an Olympic athlete, you probably can't use them because they are going to be on the list of things not to use. But there are modalities utilizing for example some of the adaptogenic herbs, reishi. This can help raise your DHEA levels naturally. And so that can be very helpful as well as getting really good sleep, sleep can help you raise your DHEA levels and really aligning with the circadian rhythm that could laser raise your cortisol levels naturally. Stepping outside first thing in the morning. So I feel like I always, I almost owe it to people to like give them a really solid lifestyle plan before we start messing with hormones. I'm a pharmacist, I love drugs, I love hormones. I think there's a time and place for everything. But at the same time I'm like if there are lifestyle things that can do that without side effects and they're fun and pleasurable like spending time outside in nature. Most people feel better with this and that can actually help rebalance your. That can help you get aligned with cortisol really well with your cortisol curve throughout the day.

When we look at some of the sex hormones like estrogen, testosterone, some people talk about this concept of the pregnenolone steal where pregnenolone is shunted to create cortisol. Not enough then remains to support sex hormone production. The whole concept of pregnenolone steel I know is debated. So I'm wondering do you resonate with it and does supporting the adrenals then lead to balancing of estrogen and testosterone without more direct hormone replacement support?

I'm still debating internally the pregnenolone steal, whether that is accurate or not. I can't see inside of the, the body what's actually happening. But the theory is that essentially when you are in that stressed out state, that your body will prioritize making cortisol from pregnenolone, our mother hormone, rather than making our sex hormones like progesterone and estrogen. And I will say that clinically, I don't know what's going on on the, on the, on the back end. But clinically, people do tend to have lower progesterone when they are in that adrenal dysfunction state, and that can contribute to hormonal imbalances. When we think about what our adrenals produce, they actually do produce DHEA and they actually do produce sex hormones. And so this can be very relevant for women in perimenopause and menopause, where if we properly support their adrenal glands, then perhaps their hormone function may improve. I know I have seen it clinically where we would just focus on, on those strategies. But there's also other tools, like, I mean, if you are post menopause or in perimenopause, you may actually need to utilize some of the downstream hormones, such as progesterone, because your ovaries maybe aren't producing as much and your adrenals can't compensate enough. So I think there is definitely in younger women, I would say under perimenopause age and younger men, this is going to be more relevant, but with, it's not going to replace the women's hormones that are post menopause. Right. Or, and even in perimenopause, it's, you still need to really work on your adrenals. You need to really focus on your adrenals at that time. But you may also need to support your sex hormones too.

You alluded to caffeine earlier in the conversation maybe not being something that has to be completely eliminated in your new adrenal transformation protocol. So talk to us about that. Should we still attempt to limit it later in the day to avoid impacting our sleep? Potentially, I personally try to avoid caffeine after noon. Is reliance on caffeine a cause of adrenal dysfunction or dysregulation or a symptom of that condition?

So I used to think that it was primarily a cause, and I think in some cases it definitely can be. If you're drinking too much caffeine, that could interfere with your sleep at night. Right. So you're not going to be getting refreshing sleep. You're going to be blocking your tiredness receptors and you're going to be waking up all throughout the night. And if you're drinking caffeine too early in the morning, that can potentially suppress your, your body's natural cortisol production. Because your body is always, it's like a feedback mechanism, right? So if you already have enough cortisol, your body's like, we're good, we don't need to make our own. So that can be potentially, potentially it can be an issue. And I used to tell people, okay, you have to quit caffeine for like 30 days to heal your adrenals. And I will say people were not very happy with me. So as you can imagine. And then, you know, some of my clients where I was like, oh, you're waking up a lot at night and you're tired throughout the day, you're anxious. I think I know what's going on. I think it's because of the caffeine. Let you know you're drinking six cups of coffee a day. Let's cut that down to zero. And they would be like, okay, I'm not drinking any caffeine, I'm like on decaf now, but I'm still waking up at night and I'm still tired and I'm still anxious and now I've like lost my will to live, right? So some people, I feel like when you are in this adrenal dysfunction state, that coffee dependency is very, very real because your coffee is mimicking what your cortisol would normally do where it raises your cortisol in the morning to those, to the levels of like a healthy human. And then another kind of tangent is sometimes some people will require like wine or something in the evenings to actually bring down their cortisol because they may be disaligned with the circadian rhythm. And so that could be a whole pattern where I used to think it was like you're addicted to wine or I used to think it was like, you know, your, your problems are caused by your wine and coffee addiction. Now I'm like, ah, you have adrenal dysfunction and that's causing you to self medicate with these things. And so with what I do now is I really focus on aligning with the circadian rhythm, some of the light therapy and I help people build energy in their bodies before I mention anything about caffeine because we really want to help you feel good and less dependent on caffeine before I say anything about quitting it. So generally the first few weeks of the program, people are allowed to do whatever with caffeine, whatever they want to. I will provide gentle nudges. So, like, maybe you could move your caffeine a little incy bit later in the morning. Like if you're crawling to your coffee machine from bed, like, maybe give it, like step outside and have a smoothie first. That's going to support healthy cortisol levels and then do your caffeine and see how you do. Right. And then you're drinking caffeine later in the evenings. Perhaps that's interfering with your sleep. Maybe we can kind of bring it a little bit earlier. I know, I know when I was like in my 20s or 30s, I could drink caffeine anytime and I would be able to sleep. Now that I'm 40, it's like if I drink it at 2:59, I'm okay. If I drink it at 301, I will not sleep for like that whole entire night. And so sometimes it's just drinking that window of, of caffeine to let your, your body align with the circadian rhythm a bit better. And then I'll recommend like a reduction. When people are ready and we do it 25% at a time, we might do some dandelion to help support our liver just to kind of ease off of it gently. But yes, you do not have to quit coffee entirely or caffeine to heal your adrenals for the most in most cases.

So that's good news for people listening that we're about to stop listening to our conversation, that she's not requiring you to stop your coffee in order to heal your adrenals in the different stages of adrenal dysfunction. In the book, you talk about how it starts with a high cortisol stage, then there's a dysregulated cortisol stage and eventually a low cortisol stage. When we see an inverted pattern where we have high cortisol at night and low cortisol in the morning, what does that tell you? I've heard some practitioners suggest that that could be an indication of parasites. What do you think of as causes for an inverted cortisol pattern and how do you address that?

So this is kind of the night owl pattern. So you are somebody that is going to be more. And I have, I have heard the various, various things. Like if you have parasites, you might have high cortisol in the morning and that causes you to jump out of bed. And I've also heard reverse of if you have low cortisol in the morning, that could be a parasite situation. So I'm not, I'm not fully sure. I haven't correlated the GI map tests with the adrenal test. But that, that's going to be an interesting study. So I might, I might actually do that. Than thank you for that idea. But my kind of impression is that it's people that are not aligned with the circadian rhythm and so they could actually be what I call. There's a really interesting study I deep dive I did on it where they're more aligned with like the moon rather than being aligned with the sun. And they do tend to have more symptoms around the full moon where they have harder time sleeping, which can also be a parasite thing. Right. Because parasites tend to be more active when we have more serotonin, which, which happens around the full moon rather than melatonin. So I think it could all be connected. But the general process of how I restore that is really focusing on the light therapy throughout the day. So first thing in the morning we focus on bright lights and bright light exposure. And then after sunset we really try to limit our exposure to artificial lighting. And that can help to realign that naturally. Part of my protocol, I also have Sarcomyces boulardi, which is a natural anti protozoa and anti anti kind of fungal and anti anti a lot of things. So it's a beneficial yeast that helps to raise our secretory IGA levels and that can help overcome some parasitic infections naturally, including Blastocystis hominis, which is one of the more common ones I've seen in Hashimoto's. And so that, that does help people sleep better at night. And potentially it could be because of the whole parasite connection. It this is something that I'm very interested about because as you might know, a lot of the tests for parasites, they're not, they're not super accurate. I used to do a biohealth lab test and I think I had about 30% of people with Hashimoto's testing positive for Blastocystis hominis. And now I use the GI map, which I love, but I don't think it's more than 10 to 15% of positive testing. I'll get on that.

My favorite test for parasites is Para Wellness Research here in Colorado with Dr. Rafael D'. Angelo. And I think he finds a very high percentage of parasites, but he himself is looking at stool and urine under the microscope. And so that's been tremendously helpful. But I agree with you. It's hard to do that kind of a correlation study when the likely incidence of parasites is significantly higher than how often we're able to find them with these labs. Can high cholesterol be a sign of adrenal dysfunction? And could elevated cholesterol be an intelligent adaptation of the body to create more raw materials for the production of adrenal and other sex hormones and maybe then even kind of tie back into that concept of the protein pregnenolone steel that we talked about earlier?

So, absolutely, cholesterol is the precursor for pregnenolone. And in my experience, I will find people. And it's widely known that people who have low thyroid hormone will have high cholesterol. And sometimes just giving them more thyroid hormone can help normalize their cholesterol levels. And I think the same holds true when the body senses that we need more cortisol. It's kind of like, oh, we're under stress, therefore we need more pregnenolone to make cortisol. And so I think that could be a very intelligent adaptation where the body will say, let's. Let's bring up the production of this, right? And typically, when you look at a person with high cholesterol, a lot of times they're not ones that are, say they're. They're not saying they're not stressed, right?

How much do tools that support calming the body, working with the vagus nerve, working with the limbic system, meditating, working with the autonomic nervous system. How often do these types of practices support recovery of the adrenals? How does the parasympathetic nervous system tie in with the adrenals? And how important is feeling safe in the world to optimize adrenal function?

This is kind of the. The pinnacle of. Of my work is my theory is that people have adrenal dysfunction and thyroid issues because they don't feel safe in the world or safe in their bodies. And to restore that balance, I. We talk a lot about nutrition, right? And so we're eating really good foods that are healthy for us. We talk about lifestyle changes like getting plenty of rest. And there's also a big mind body component, so things like being kind to yourself and also rewiring your stress response, right? So when we're always on that edge, we shift into our sympathetic system. And so we're more in that fight or flight. We're more in that, like, really edgy. I'm just about to jump out of my seat. I'm so nervous. I'm ready to jump on this person. And that we spend time, obviously we have to spend time in that system. And also our parasympathetic rest and digest system. Most people spend time in both. Sometimes it can get out of balance where you spend too much time in that edgy system. And so we don't have enough time to heal our bodies, to do the repair work, to properly rest, to properly digest, and so really can. There's so many things I love about nutrition and supplements, but a lot of times some of these things might be more mind, body and therapy modalities. I, whether that's limbic retraining, I personally love emdr. That helps you really rewire your, your thought patterns. I love neurofeedback that can help shift you into a more positive state. Some people love meditation, some people love breath work. There's a beautiful wide variety of these healing modalities for the biohackers. They might like neurofeedback if you're, if you're really into yoga and living a Zen life, you might like chanting and breath work and meditation. But I feel like that's a really critical component of that healing journey and really rewiring your brain and helping to reconnect that, that sensing of stress, that brain and what our hormones are doing right and to, to get more in balance. I, I feel like that's, that's a really underappreciated part of healing.

Totally agree. And fortunately for those of us that are also biohackers, there's more and more devices coming around that also work with frequencies and vibration and other cool things to be very chill and relaxed. So it's a good time to, to bring some of these tools in. You talk about four primary stressors impacting the adrenals, inflammation, circadian rhythm imbalance, nutritional imbalance, and psychological stress. In the inflammation discussion, you talk about food sensitivities, leaky gut dysbiosis, sibo parasites, viruses like Epstein Barr virus, which is so common. You talk about yeast, you talk about environmental toxicity such as mold exposure. What portion of your adrenal dysfunction clients have vector borne infections or mold illness would you speculate?

It would be challenging for me to speculate that without doing advanced testing with them. I would say, hmm, I would have to do a little bit more research with that. I know that we have people who have mold exposure that have gone through the program and a lot of, a lot of my understanding of Lyme and we have had people with Lyme disease as well people. I kind of feel like when I started working with thyroid issues, I was like, these are the things I need to focus on. And then I was like, oh wait. But sometimes Hashimoto's can be triggered by mold. And then I had to learn about mold. And then, you know, Hashimoto's can be triggered by Lyme. And I'm like, then I have to learn about Lyme and all of these different kind of triggers. And so we'll have a variety of individuals with chronic Epstein Barr virus and Lyme disease. In my experience, kind of the adrenal support can work very. I've kind of designed the program to be helpful for those individuals as well. So typically, if you are mold exposed, you're going to be more likely to have issues with Epstein Barr virus reactivation and you're not going to be able to properly control the Lyme disease. Right. And so one of the things that I utilize is Sarcomyces boulardi, which is that beneficial yeast that you're living in a super moldy house. That won't do the trick, but that can help to carry out some of the mold out of your body and boost your resilience. It does support secretory IGA levels in the gut, which can help us overcome parasites naturally, which can help us clear out some mold and Candida. Then with Epstein Barr virus, part of controlling it is actually supporting your adrenals. So I do have high dose vitamin C and adaptogens. Those things can be very, very helpful. In my experience, people with mold exposure also tend to have carnitine deficiencies. When I've looked at, you know, organics acids tests, that's going to be a really big thing. And I was like, wait, carnitine? And that can cause. And it's been studied in thyroid fatigue and brain fog. And so I utilize carnitine as part of the program as well, which I feel like is one of the reasons why 92% of people actually say they have less brain fog after four weeks. So I've, my mind makes all these connections and I've like, you know, when I drew out the program initially I was like, what are the, what are the patterns and things I want to address knowing that people with Hashimoto's, which has been my primary target population within the first few launches of the adrenal program. And, and then we kind of expanded it because people were like bringing their friends without Hashimoto's into it. But the, I've basically, I've designed it to go wide into helping people, whether they have mold exposure or Epstein Barr virus or Lyme, because I feel like a part of what you need to do when you have those conditions is support your adrenals anyway, and I've tried to add some extras to be able to target a few of these things.

Yeah, I wasn't going to ask this question, but you mentioned that EBV is often more of an issue when there is adrenal dysregulation. That leads me to wonder. In people that are dealing with long Covid or chronic Covid, where we know EBV activation is so incredibly common, what portion of the long Covid population would you suggest might also be tied to adrenal dysfunction?

I've been studying long Covid for some time, and it's interesting because it seems like a lot of the things that we see in functional medicine tend to be present in long Covid, whether that's mold exposure or that EBV reactivation. I think I. I read one paper where it was like 60 to 80% of people, something crazy like that. And so, yeah, I. And I mean, the symptoms, they fall into that adrenal dysfunction, adrenal fatigue state. So I feel like anytime you have viruses that you cannot keep suppressed, that's going to be likely that you have some degree of adrenal dysfunction.

I don't.

I don't know if I could say the word Covid on a podcast or anything like that, but we have had a few people that have been helped with these protocols.

You talk about the importance of sleep or circadian rhythm. How common is it for you to see low blood sugar while sleeping leading to an increase in cortisol, which then is really an attempt to raise the blood sugar, and then that cortisol burst, essentially impacting restorative sleep? And should those with adrenal dysfunction consider a continuous glucose monitor so that we can explore the patterns of their blood sugar while they're sleeping?

Oh, my gosh. It's so interesting because I. I find that there's a few different patterns of sleep issues. The one with cortisol, the one with blood sugar issues. It tends to be that around between 2 and 3am you will wake up wired and hungry, and it'll be like, why? What is going on? And typically for those people, when we first start working with them, I'll say, like, keep a banana by your bed so that you can go back to sleep because your body is actually hungry and you need something, and that banana is going to help you fall asleep. But then we focus on eating for blood sugar balance. And so we add more protein, we add more fat, we eliminate, we minimize some of the carbohydrates. We'll utilize things like the carnitine which can help people with, with utilizing fatty acids for fuel and also myo inositol to help with balancing blood sugar. But I love continuous glucose monitors. I think they can be incredibly helpful because some people might find random things that can set off blood sugar spikes for them or that might cause them to be hypoglycemic. I being like a health enthusiast biohacker, I was like, let me, you know, when I first got a cgm, I'm like, let's see what happens when I do this. Let's see what happens when I did that. Turns out if I drink wine then I'll wake up, I'll have multiple bouts of hypoglycemia throughout the night. Right. It's, I feel like that's most people but they don't realize it unless they see it on a CGM and people think that I'm having wine, it's going to help me sleep better. And it's like, yeah, but you're think so because it's going to help you fall asleep initially but then you might go hypoglycemic. So it's everybody that I know that has utilized one, it's been game changing for them. It's not a requirement to do as part of the program but it can be incredibly helpful for people to really dial things in for themselves.

Yeah, I think we're both definitely a bit on the nerdy side that we both get excited about about CGMs. What, what are the most common nutrient deficiencies you find in those with adrenal issues?

So definitely B vitamins and vitamin C and magnesium and electrolytes. These, this is like a really great place to start a solid protocol where if you can get on some B vitamins you're going to have a little bit more energy. You get on vitamin C, your immune system is going to be working better, you get on magnesium and all of a sudden your hormones are working better. You're going to sleep better at night, you're going to be less anxious and then electrolytes. A lot of people have been telling me I thought I was hydrating properly and turned out I needed more electrolytes. And cramping in their body can improve, energy levels can improve and really that I feel like those are my four non negotiables for most people because a lot of these things really get burned throughout the stress response. Right.

And you talk in the book about from a nutritional macronutrient perspective that oftentimes we need to have more fats, more proteins, less carbs So I think that's another, another piece of the conversation around the adrenals. You talk about a number of interventions in your adrenal transformation protocol that your trial participants found most impactful. Can you tell us a few of those?

So definitely blood sugar balance is going to be really game changing for people where we focus on a paleo like diet where we eliminate gluten, dairy and soy, which are common inflammatory foods. Generally, people with this stressed out state and adrenal dysfunction, they're not going to have enough digestive juice on board. So they may be low in hydrochloric acid and they're going to have a harder time digesting various proteins. Typically, the most challenging proteins to digest are going to be gluten, dairy and soy. And so we eliminate those because they can cause some inflammation. And we also get rid of grains just because they can be associated with some blood sugar issues. And we people. I feel like I don't have to preach to the choir, but protein intake is so, so important for healing the body. When our body is in that stressed out state, it's breaking itself down to fuel the stress response. And so we need to work on. The stress response is a catabolic process and we need to work on building the body back up. And the proteins are broken down into amino acids, which are our building blocks. So eating more protein can be very healing for us, for our hormones, for our bodies. And I typically might recommend eating as much as, as maybe a bodybuilder might eat for some people, even where they. When you think about it, you're like, you are kind of like a bodybuilder when you are in this adrenal dysfunction state because all of the things that you're doing are putting so much stress, your body's under so much stress that you need more protein to help you recover. And so this is a big, big part of what people do throughout the program. And it's incredible because some people are like, I thought I was an anxious person, I thought I had anxiety issues. It turns out that I just needed to eat more protein and balance my blood sugar. Right.

How are the adrenals related to dysautonomia or pots? Postural orthostatic tachycardia syndrome. Do you find that supporting the adrenals can address or help to address the symptoms of dysautonomia and pots?

I feel like they're branches on the same tree with similar root causes. And definitely POTS can be a presentation of adrenal dysfunction where somebody stands up and they get lightheaded and they might have palpitations. And so I feel like doing a lot of the interventions in the program can also be helpful for POTS electrolytes. Very helpful for both conditions. So I do find that people can be benefited from this. I know there's some controversy from POTS is more of a medical diagnosis these days where people will say, you were misdiag. You didn't actually have adrenal dysfunction, you had pots. Right. But I feel like POTS can definitely be a feature of adrenal dysfunction, and a lot of the strategies can be helpful for it as as can utilizing benfotiamine, which is a type of thiamine, my preferred version of it. And that can be helpful for POTS and sometimes for that fatigue that is unresolved in the low blood pressure.

Yeah, big fan of thiamine here as well. Did a podcast with Dr. Chandler Mars. We talked about the different forms like benfotiamine, but also ttfd, which is another form that can be very helpful as well. In the adrenal transformation protocol or the ATP, as you mentioned it, you talk about the different steps, Replenish, re, energize, revitalize, rebuilding, resilience, and then reassessing and moving forward. In our last several minutes together, just going to touch on some of these so people get a sense for what we can do in these different areas. So in replenish, you talk about using nutrition to send safety signals to the body. So how are nutrient density lowering inflammation with our diet balancing blood sugar? How are those keys to sending safety signals to the body, to replenishing the system, and then building on that might high histamine foods in someone with something like mast cell activation syndrome, might those actually be more danger signals?

So much to unpack here. So my kind of theory is that whenever we put ourselves in a situation that our ancient genesis would recognize as a threat, like a war or a famine, that can send us into that adrenal dysfunction state. So, for example, if you are skipping your meals and not eating enough calories, if you're eating foods that are inflammatory to you, if you are nutrient depleted, that's going to be sending a message to your body that you're in a famine. Right. And so what do we do when we're in a. Like, what helps us survive a famine? I came across Dr. Erica Pearson was telling a story about people who survived the Irish potato famine, that the survivors tended to have higher rates of hypothyroidism. And so hypothyroidism, and whether that comes from a Hashimoto's presentation or an adrenal presentation that produces more reverse T3. This can actually be beneficial to survival if we're in a famine because, holy cow, our metabolism slows down and we don't need as many calories to survive and whatnot. And we're more tired and so we're hiding out in our caves until the famine passes. Did a deep dive on the thyroid patterns of hibernating bears. And typically bears that are hibernating seem to have some thyroid alterations that I'm like, oh, maybe it's kind of like a human hibernation process that happens when we're in a famine. Right. And so in our modern days, we're a lot like exercise more, eat less, and we're eating processed foods that don't look like anything close to what we were eating many, many thousands of years ago. So really for me, in my experience is when you let your body know that food is plentiful and you nourish your body properly, you can start feeling a lot better and you can start shifting out of that that state. I know I've had some clients where they were restricting their calories. They were doing a lot of exercise in an effort to lose weight. And then I would look at their cortisol patterns and I'd be like, you have low cortisol all day. I actually think you should start, stop exercising as much as you're doing. Just maybe do some gentle yoga. And I think you need to eat more calories and let your body know that food is plentiful. And they were like, no, not doing it. Like, you know, I'm so scared. And then within, within the course of the month, they'd be able to like, I lost weight. And we actually have about 80% of people do lose weight in the program. And we do not restrict calories. We do not talk about doing more exercise. We're really focusing on nourishing you and giving you lots and lots of really good nutrient dense food and supplements and letting your body know that food is plentiful so it doesn't have to hold on to, to all the weight.

It is funny because years ago, I think so many of us were into the kind of like, oh, you need to eat low fat. And then we realized that's not healthy. I know my morning power shake. My mom asked me one day, well, how many calories are in that? And I said, probably 2,000. And her jaw dropped. And I'm like, but it's 2,000. Really, really good safety Signal calories. Right. So do you find that those that have animal protein in their diet respond better to the program than vegans or vegetarians? And then what's the role of retinol in supporting adrenal function?

Yeah, so one of the things I've noticed in people with hypothyroidism is typically people tend to have worse outcomes if they are on a vegan or vegetarian diet. And I think partially that could be because some of the proteins they utilize are more difficult to digest. Right. Some people are like pizzatarians, like they're not healthy vegans or vegetarians. So that of course could play a role. But I also think the role of carnitine, one of the richest sources, is in, in beef and red meat. I feel like carnitine can be a really, really big game changer for people. And that's one of the ingredients that I feel like you can't really get enough of on a plant based diet. And sometimes you do need to supplement, even if you are eating red meat. And that can be helpful for carrying out ammonia out of the body. That can produce some of the brain fog and fatigue. And then vitamin A. So we have vitamin A from carrots. Right. And so, and then we have retinol. And some people, they can eat carrots and their body converts it to whatever vitamin A we need. And other people like myself, I have a gene variation where I can't do that. And so I actually need to get retinol either from a supplement form or from animal foods. My body can't use carrots as well. Right. As much as I love them. And so for, for a lot of individuals this is very, very relevant. Vitamin A is one of the nutrients that's needed to turn cholesterol into pregnenolone as well. So I feel like for some people this could be relevant. I, of course there's controversy about getting overdosed with vitamin A toxicity. We all have such unique genes and bodies. But I will say from a general standpoint, a lot of people tend to do better if they do introduce some meat into their diets. Especially anecdotally, red meat tends to be very helpful for a lot of people. I do try to meet people where they're at and I know there are religious and ethical reasons where people may feel a certain dietary preference is going to be important to them. And in, in that case, if you're a vegan, make sure you're getting B12 and checking your iron levels and potentially consider carnitine. Look into doing retinol. Right. Maybe if you're a biohacker and a vegan, then maybe, you know, do some gene testing for yourself to see where you might need to dial things in. But I think it. I'm not going to say it's never possible, but I feel like it might be. Might take a little bit more work for people.

Let's talk a little bit about adaptogens. Are these essentially modulators of the adrenals? Do we need to be concerned about using adaptogens if we're already in a high cortisol state? I know. I'm a fan of ashwagandha and Holy Basil. What are a few of your favorites? And then what are your thoughts on adrenal glandulars?

I love adaptogens. I always say adaptogens make everybody around us less annoying, right? So they give us a little bit more resilience and ability to handle stress so we could be exposed to the same exact amount of stress. But adaptogens just help us deal with it better. And there are a variety of different ones. Most of them, with the exception of licorice, which is considered an adaptogen, but it shouldn't be. Most of them will work whether you have high cortisol or low cortisol, to kind of balance it so that you have a healthier cortisol pattern. So I love utilizing them for that. Licorice in particular, if you have high cortisol and if you have high blood pressure, I don't recommend it. So I would recommend it for people with low blood pressure and low cortisol. And some of my favorites. I mean, it's like picking a favorite child, right? It really. It really just depends on what people are going through. If you are somebody that is looking for more support in the hormone and libido department, maybe some maca or Shatavari, if you're struggling with anxiety, maybe some rhodiola. Ashwagandha can help with that. I guess if I had to pick. I love Holy Basil because people can drink that as a tea. And that's really nice to introduce. And it's very, very gentle for most people. Reishi is another one that I like to utilize. It's nice to have that maybe sometime in the evening, and it can give you a little bit more energy without, like, keeping you awake at night. But a lot of. A lot of the ones I like to use, like rhodiola and reishi, they also have some mitochondrial benefits as well. So I have a list of various ones that I'm like, I have for the average person, I would recommend doing like an ABC blend that has adaptogens, B vitamins and vitamin C. So you just take one thing. If you're somebody that sensitive or particular, you're a nursing mom or, you know, maybe you just have specific conditions, then you may wish to just choose one adaptogen at a time.

And I think we weren't going to talk about this, but I think you actually have formulated some products that people can access through your website as well, correct?

I, Yes, I have adrenal support by Rootcology and this is a nice blend. It does contain licorice. So it's for more of the people with low cortisol and it has ashwagandha and it has a few other adaptogens mixed in with some B vitamins and vitamin C. So that's, that's an option for some people. Others, they may wish just to take one, but there's there, it's, it's a beautiful world of adaptogens. And I will say this, they're not gonna give you a perfect life. So you also have to do the other work. I know some people were like, oh, I'm just gonna burn the bridge at both ends and keep taking adaptogens. And so that's, that's not my intention for people. So adrenal glandulars can be helpful for some individuals and they work to raise your cortisol levels. Right. So if you don't have enough adrenal hormones, you can take a glandular. Now the, the challenge with it in some of. I've worked with a lot of people and then I have a lot of, of readers that will write to me too, providing their feedback on some of my books and programs or just their experiences in the world. So have this beautiful community and I have a lot of, I guess, data and information. So I have seen some people where they will take adrenal supplements that are derived from the whole adrenal gland and they might actually get some adrenaline in the mix and that does not feel good. So they will say, I took an adrenal glandular supplement and oh my goodness, I thought I needed to go to the emergency room because I was having like a panic attack. And so I always, you know, caution about that. So you want to make sure that they're not from the whole gland extracts. Be very mindful of where you're getting your extracts from. And the other thing that has happened in some of my clients and this can also happen even with low dose hydrocortisone or some of the things is you, they can actually cause pituitary suppression where your body, you take them, and especially if you take them in the evenings, it kind of can suppress that feedback loop from your body where your body, like, doesn't make its own, so you kind of become dependent on it.

It.

And that those are some of the challenges that I have seen with them. I, as a pharmacist, I'm always like, what are, what are the risks? And I always want to be mindful about that. For some people, they can work really well. I definitely recommend working with a practitioner that's really well versed in using them and being mindful of your dosing. Right. Because if you're overdosing yourself, that could lead to that pituitary suppression.

Yeah. And my understanding with some of the glandulars, too, is maybe there's something to be used earlier and for a shorter period of time where the adaptogens we can use for a much longer period of time. Would you say that that's a reasonable thought as well?

Yes, absolutely. And, you know, to your point, I would want to make sure that you are testing your adrenals before using the glandulars, because if you have too much cortisol, then you wouldn't want to use the glandulars. Whereas the adaptogens and the lifestyle changes, most of them, with some of the exceptions like the licorice or too much salt, they're going to be safe for most people, whether they have high cortisol or low cortisol.

So the next piece you talk about in the book, Re Energize, consists of hydration, mitochondrial support, the circadian rhythm reset. You suggest adding electrolytes or sea salt to water. Another tool you discuss in the book is Soleil, which I have used in the past and prepared a little bit of a process, but that can be fun as well. Talk to us about Soleil and why it might be helpful in supporting the adrenals. And are there times when more salt may not be ideal?

So people with that low cortisol pattern, they tend to crave salt. Our adrenals also produce aldosterone would help, which helps to keep our fluid in our bodies. And when we're salt deficient, we can become dehydrated. And cravings of salt are actually one of the symptoms, like, as I call it, the I just ate a whole bag of chips syndrome. Right. And generally we want to get more sea salt into our diet. That can be balancing. People with adrenal dysfunction with that low cortisol pattern, they tend to have low Blood pressure, low blood sugar, or they tend to go hypoglycemic, not all day. Low blood sugar. And then they might have low cortisol. And so sometimes utilizing extra sea salt throughout the day. And whether that's in a drink like the Soleil, or adding it to your food or adding it to a smoothie, this can be a great way to actually provide some feedback to your body. I typically like to do it first thing in the morning to you. It's. It's like this beautiful feedback system. So if you help to increase your blood pressure, then your cortisol will increase and then help to increase your blood glucose, then your cortisol will increase. And if you help to increase your cortisol with bright light exposure, it's like this beautiful feedback loop system is like time to be awake and have energy.

In the revitalized portion of the book, you talk about positive thought patterns, pleasurable activities, creating. Just because you talk about ways to increase oxytocin. So how can we increase oxytocin? And is there a potential place for supplemental oxytocin, such as in a nasal spray?

Oh my gosh, I love nasal oxytocin. It's so much fun. I think that can be a really cool tool for social anxiety and connecting with people and going to crowds and big parties. Some people do utilize that and typically you would get a prescription from your doctor for that. There might be some websites out there selling it. I'm not sure that I would endorse it, but. But in general, you can also raise your oxytocin levels naturally. So things like physical touch, these can be incredibly helpful, whether that's being with a loved one, making love, hugging somebody, petting a cat or a dog. I've also, when I was doing a deep dive into some of the research, I found a shocking percentage of men in the UK actually have teddy bears that they, that they travel with to hotels. And there's like this whole thing about like getting those teddy bears that were left in hotels back to their owners. But even a stuffed animal can bring some comfort to people. Some, some people, they're more on the biohacking and you might do something like a weighted blanket. All of these can be helpful for raising oxytocin. Anything that warms up your body can be helpful too. So sitting in a sauna or taking a hot bath, certain essential oils, lavender and Clary sage, those are some options to raise your oxytocin. And definitely something for everybody. Like, you don't have to have a partner to, to Benefit your oxytocin. It's like it'd be great if you had a pet, but you don't even need a pet. You can get a stuffed animal or a teddy bear. Right.

I had Dr. Jill Carnahan on the podcast and in her book she talks about coloring. You also talk about coloring as a way to, to really balance the nervous system. So maybe we'll have our coloring sessions with our teddy bears or something along those lines. In rebuilding resilience, you talk about movement, breath, healthy coping strategies, letting go of heaviness and reclaiming your space. You also talk about catabolic versus anabolic exercise and what types of exercise are more ideal for those with adrenal dysregulation. So talk to us about maybe a couple of the more ideal types of exercise. And can the wrong exercise make our adrenal problems worse?

Yeah, so typically what I've seen in, in people with like that low cortisol pattern is they might feel worse when they're doing some more aerobic exercise. So like running or step aerobics, if you will, or it's some of the more high intensity things. And you generally have to be in a healthier state to benefit from those exercises. And so the more of what you may want to focus on to balance that is going to be more anabolic exercises and stress reducing exercises. So things like yoga, tai chi, walking, being in nature, these are some very gentle things that a lot of people can tolerate. And then things like Pilates or weightlifting, these can help you. Part of what's happening with this adrenal dysfunction state, a lot of it is people feel, feel a lot of the mental symptoms like anxiety and the brain fog. But also there's like muscle fatigue and there's some muscle wasting that can happen and when, and this makes sense because when we're in that catabolic process, the body's breaking itself down for fuel. And so part of recovering from the stress state is shifting back into that anabolic state. Being more of a bodybuilder. Right. And DHEA is actually an anabolic hormone that's made by our adrenals. When that can become depleted, we may not be able to put on muscle as easily. We may have some of that muscle wasting. So part of building that back up and those DHEA levels and those healthy hormones and, and lifting weights and doing things that help you build your body back up. So think like Arnold, you know, like more body, more weightlifting.

You then have a fantastic review chapter in the book that puts everything together in example protocols you then move in to reassess and move forward. So what does the protocol look like for most people longer term? Does it end? Are there some aspects of the protocol that should be indefinite? It might the duration depend on whether or not some of the root causes have also been addressed, such as maybe a mold exposure or chronic infections. Talk to us about longer term what this ATP process looks like.

A lot of times people will find that they love a lot of the daily habits and they want to continue with them. Part of what I focus on is adding pleasurable activities to your day. I feel like everybody should continue that for like the rest of their lives. Right? Find your joie de vivre and keep it in there with you for as long as you possibly can. Some of the supplements are going to be generally every three months to two years is what I would recommend utilizing them for. The, a lot of, some of the deeper work that I talk about. So maybe overcoming trauma and getting like, addressing the things that weigh you down and setting boundaries, this might be a lifelong thing that people may need to do. If you have a lot of trauma in your life, it's not going to be one magic session that's going to help you with that. So that might be more of a long term plan for people. The blood sugar balance. I feel like once people start eating more of the protein and they figure out how to nourish themselves naturally and sustainably, a lot of times for people, the habit, it sticks with them. Some of them do introduce other foods back. I will say with Hashimoto's that I haven't figured out how to get gluten back into people's diets. I have been working with getting eggs back and grains back and a lot of different things. Once we address some of the gut issues and some of the nutritional deficiencies. So some people may need to stay off certain foods long term, whether that's dairy or gluten or soy or grains. But generally people find that they, they do stick with this kind of diet for, for the most part to feel their best. And I mean honestly, the, the healing journey, for some people it can stop at four weeks and they're like they've reached all of their goals. For other people, it might be one step of their journey. So if they're still, I think mold is a great example. If you're still living in a moldy house, you know, the adrenal transformation protocol will give you some energy back, it'll give you some, some clarity. Taking away some of that brain fog, it'll Give you a bit more strength to perhaps work on figuring out your next steps. I do have a section about testing. Right. So. And I do have a section about if you're still struggling with this symptom. Here's some potential root causes, here's some tests to consider. Here are some protocols that may help blood pressure issues. People with a lot of time is to go through the program and they may resolve, but sometimes they might need benfotiamine. 600 milligrams of that or so can restore healthy blood pressure levels. Right. And I have some more advanced protocols for people. If they have high prolactin that causes them to be anxious and causes hormonal issues, they might benefit from B6 or P5P.

Pantethine or vitamin B5 is commonly discussed for adrenal support. Which B vitamins do you find are more important when it comes to the adrenals? Is it more pantethine or do we really need a broader spectrum of B vitamins?

I think panthen is the one that's most widely studied and it's important to consider. I do have that as part of my ABC blend. If people don't choose to utilize a blend, I would recommend doing like a B complex that contains pantherine. And you want a lot more that's. That's within a typical B vitamin. Right. So really support the adrenal glands. I generally for the four weeks I will have people on a B complex or kind of a blend of B vitamins if they still have symptoms after the four weeks. Talking about like B12 testing, because sometimes that can be low and that could cause fatigue. That's going to be a blood test. I'm talking about potentially, you know, testing for MTHFR and incorporating some folate. Some people with or dream recall or pyro urea, they may benefit from something like P5P and then the, the thiamine if you have a lot of fatigue. So I. And then myo inositol is another. It used to be considered a B vitamin, but we found out that our body can make it and this can be incredibly helpful for anxiety. Blood sugar issues can help normalize thyroid function in some early stages of Hashimoto's as well.

I love that you mentioned KPU or cryptopyroluria in the book as well. That was something I learned about originally from Dr. Dietrich Klinghardt, who's been my primary mental mentor. And he and I actually wrote an article on that condition. And it is something that can be very important for people to look at you talked about ammonia earlier as being created in the body and creating issues with sleep, potentially contributing then to adrenal issues in those with high ammonia. Do you find that the vast majority of that is being driven by infections in the gut or genetics or eating too much protein? How do you approach that elevated ammonia scenario?

So in my experience it could be the CBS gene mutation, it could be protein issues. So trouble digesting protein, whether that's because you're eating too much or you have low hydrochloric acid. It could be from an H. Pylori infection. So H. Pylori is a really potent producer of ammonia. Right. And other types of gut infections can play a role in that as well, including some parasitic infections. It is something that is. And people who are constipated. Right. That they're going to be producing more ammonia as well. It is something that I feel like it might need a multifaceted approach. If you are somebody that has this issue. But typically the symptoms are going to be brain fog fatigue, muscle wasting and frequent night wakings. That's actually like a sign of it. The protocol is tailored to ammonia toxicity and so I use magnesium citrate as part of the protocol. It does help restore magnesium levels. It also tends to promote bowel movements, which is generally helpful for most people with hypothyroidism. Some people who tend to be more with the diarrhea type, they may wish to use like a magnesium glycinate. But you do want to make sure that you are B6 sufficient. Otherwise that can over convert to glutamate. And so magnesium citrate, Sarcomyces boulardi, minimizes the infections. We utilize some smoothies to help with breaking down protein a bit easier. And then carnitine actually helps to carry ammonia out of the body. Ammonia is like a really intense mitochondrial toxin as well. For people who don't get better with this, I might also recommend something like ornithine, which helps to clear ammonia out of the body. So that's, that's kind of like the advanced section. But I didn't want to put people on like 75 supplements in the, in the four weeks. So I just, and have have them do a bunch of testing. I just wanted them to have a plan based on symptoms on what they could do.

No, that's excellent. And one of the things I loved in the book is you give so many different examples including brands of specific supplements and nutraceuticals, some that you, you formulated, but also others like pure encapsulations and things like that. That's really helpful as a resource. The last topic that I wanted to touch on before our final question is you talk about copper toxicity as a potential stressor on the body, wondering how commonly you see copper toxicity as compared to copper deficiency and how often you find iron toxicity playing a role when it comes to adrenal dysregulation.

So I have, I have a personal bias on copper and iron, so I will just put that out there. I have one of the Wilson's genes, so I tend to be a copper accumulator. And in my experience that tends to be maybe it's kind of attract what you, what you have. Right. So I do tend to think it, it can be more common in people with, who present with symptoms like anxiety. Right. So in that adrenal dysfunction and in people with Hashimoto's who tend to have low levels of zinc and alkaline phosphatase. So typically copper and zinc balance themselves out and typically low alkaline phosphatase can be a marker of low zinc status. And this is more common in people with hypothyroidism. And so I do feel like copper toxicity is actually a more relevant issue than copper deficiency in people with hypothyroidism. Specifically in the general population it might be different. But for me, I'm never recommending that people just take copper when they have a thyroid issue. If generally I might recommend that they take a zinc issue, a zinc supplement if their alkaline phosphatase is low. And typically in my experience, most people have, have low levels of that alkaline phosphatase. The iron situation in most of the people that I've worked with, they tend to be low in ferritin. Most of the hypothyroid individuals, and I will say most of the people I work with are women. Probably 90% of the people I've worked with tend to be women. Thyroid issues are more common in women and HPA axis dysfunction is more common and things that are also more common in women. Women are, you know, menstruation and childbirth. Right. And so these are ways that we can lose blood. And so I predominantly will see people with low ferritin levels. I will say my husband had hemochromatosis. And so for, for the people that have, like I'm never telling people to supplement with iron, right. I'm always saying make sure you test your level. So don't just supplement with copper and don't just supplement with iron. You can do a test like ferritin and see where your levels are at. Generally, iron toxicity tends to be more common in, in men and, or women who are no longer menstruating or people with some of the genetic variations like the type 3 different types of hemocratosis or type 4 hemochromatosis, which is, is the theraportin gene deficiency. So I, I try not to make it so complicated in the book, I promise you guys. But it, there's, there's a lot of thought that goes into why I say test this and don't test that, right?

And it's kind of ironic. My last podcast was with Dr. Christy Sutton. It's called the Iron Curse. She had been had iron deficient anemia as I recall, but her husband also had hemochromatosis. And so that's a whole nother complex, complex area, the whole iron dysregulation. My last question is the same for every guest and that is what are some of the key things you do on a daily basis in support of your own health?

Well, I will usually drink an adrenal kickstart drink. So that has about a half a cup of or quarter of a cup of orange juice. And then I'll put protein powder, vanilla flavored hydrolyzed beef protein powder. I'll add some coconut milk and then some electrolytes to that. And I usually like to start my day that way. I try to spend as much time as I can in nature, so I am huge on hiking, going to the beach, going for walks, even just going outside first thing in the morning and just getting some sunshine in my eyes. This is a big part of what I do. I get a lot of oxytocin because I have a wonderful husband and a five year old that I get to hug all the time. He still lets me me hug him and kiss him and cuddle with him. So those are probably the most important things that I do for my own health other than taking an Epsom salt bath every single day too.

Wow. Excellent. Yeah, I love those too. I don't do every single day, but you raised the bar for sure. The adrenal kickstart recipe that she mentioned is in the book. So definitely recommend getting a copy of the book. This has been such a great conversation. So informative. You are a wealth of knowledge. I've known of your work work for several years. This is the first time we've had the opportunity to connect one on one. It was such a gift and a blessing for me and so I just want to thank you so much, Dr. Wentz. For putting this amazing book together, the Adrenal Transformation Protocol, and for doing all of the work that you do. You are amazing.

Oh my gosh. Thank you so much, Scott. I really appreciate you having me on. I really appreciate all the work that you're doing and helping raise awareness on all of these things that people may not realize can be changed and improved.

To learn more about Today's guest, visit ThyroidPharmacist.com that's ThyroidPharmacist.com ThyroidPharmacist.com thanks for listening to today's episode. If you're enjoying the show, please leave a positive rating or review as doing so will help the show reach a broader audience. To follow me on Facebook, Instagram, Twitter or TikTok, you can find me there as Better HealthGuide. If you'd like to support the show, please visit betterhealthguy.com donate to be added to my newsletter, visit betterhealthguy.com newsletters this and other shows can be found on YouTube, Apple Podcasts, Google Podcasts, Stitcher, and Spotify.

Thanks for listening to this Better Health Guy blogcast with Scott, your Better Health Guy. To check out if you additional shows and learn more about Scott's personal journey to better health, please visit betterhealthguy.com.