Bipolar or Thyroid? The Misdiagnosis Costing Women Their Health With Sara Russell

In this episode of Thyroid Pharmacist Healing Conversations, Dr. Izabella Wentz speaks with Sara Russell, PhD, FNTP, a functional nutritional therapy practitioner specializing in women’s mental health and perinatal lab interpretation. Together, they explore the often-missed connections between bipolar symptoms, thyroid dysfunction and autoimmunity, gluten-related disorders (including serum-negative celiac), medication side effects, and postpartum mental health risks.

They also discuss why many patients aren’t properly monitored when prescribed medications like lithium, how blood sugar instability can amplify anxiety and immune activation, and what key labs can help uncover root causes – especially during preconception, pregnancy, and postpartum, when “normal” reference ranges can shift dramatically.

What you’ll learn in this episode:
✅Why bipolar symptoms can sometimes point to an underlying thyroid issue. Sara explains how hypo- and hyperthyroidism can mimic depression, mania, anxiety, and even psychosis – and why skipping a full thyroid panel (including antibodies) can lead to years of misdiagnosis or mistreatment.
✅The overlooked triad: thyroid autoimmunity, gluten-related disorders, and psychiatric symptoms. We discuss how celiac disease (including serum-negative celiac) can fly under the radar, how gluten exposure has been linked to neuropsychiatric symptoms in some cases, and why “negative antibodies” don’t always mean “not celiac.”
✅How the “gluten-free junk food” trap can backfire – especially for mood and antibodies. Dr. Wentz shares her own experience of feeling better off gluten… yet more anxious when her blood sugar swings got worse. We’ll unpack why blood sugar balance can be a game-changer for calm, stable energy, and better immune resilience.
✅Why lithium requires closer monitoring than many patients receive. Why lithium requires thyroid and kidney monitoring (and why it often doesn’t happen), the “prescribing cascade,” and how one missed lab can snowball into multiple medications and side effects.
✅The postpartum “gray zone”: bipolar vs postpartum thyroiditis vs autoimmune shifts. Sara shares why postpartum psychosis risk skyrockets in people with bipolar disorder, and why postpartum thyroid changes can muddy the clinical picture – making screening and lab literacy critical in pregnancy and postpartum.
✅Preconception + pregnancy labs aren’t “one-size-fits-all.” Sara explains how pregnancy changes kidney filtration, thyroid physiology, and reference ranges for many markers, and why interpreting labs by trimester (and postpartum) can prevent unnecessary panic and missed issues.

Tune in to learn how to advocate for the right labs, the right monitoring, and the right root-cause approach, especially when mental health symptoms may actually be driven by thyroid, immune, or metabolic imbalances.

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🔗For the full list of resources and products mentioned in this episode, and to get the full episode transcript, see complete show notes here: https://thyroidpharmacist.com/articles/podcast/