Thyroid Trouble or Cognitive Decline? How to Tell the Difference

Introduction to the Reversing Alzheimer's Summit 0:00

Hello and welcome to a very special episode of the Reversing Alzheimer's Summit. I'm one of your co-host, James Maskell, and throughout this week we have amazing content talking about the leading lights and reversing cognitive decline and all the different aspects of it. And I'm really excited to have one to be in person today and to have a good friend of mine, the thyroid pharmacist Doctor Isabella Wentz, in the studio. Great to be with you. So great to be here with you, James. Well, I know you can contribute so much to this because one of your talks actually, in the functional forum that I've been doing for ten years is actually by far the number one talk of all time.

And that was really about how, thyroid can show up in brain related issues and mental health. And so I thought we could just start there because ultimately, you know, in this summit, what we're really looking to do is to help everyone understand the different things that can contribute to cognitive decline and Alzheimer's, the drive, the things that can drive it forward. And in that, one of the key areas that we see is, is hormonal and trophic factors. And ultimately I would put thyroid in that in that area.

So why don't we just start there? And I'd love to just sort of catch the audience up on the connection between the thyroid and the brain and, and the mechanism by which people might get symptoms in, in, in that area. Sure. So there's a very interesting connection between one thyroid function

Thyroid Function and Brain Symptoms 1:24

and two thyroid autoimmunity, as it relates to brain function. So we know if somebody has an overactive thyroid, which is hypothyroidism, they're generally going to be more anxious. They might have panic attacks, might have a lot of irritability. On the other hand, we have hypothyroidism where they have an underactive thyroid. And this is oftentimes going to be a reason why somebody might have an overall slowing down of the function in their body, including their brain. So a person might present with symptoms like depression and brain fog where they're very, very forgetful.

They're walking into rooms and they don't quite remember why they're there. They're having trouble with word finding. And, you know, this is something that wise psychiatrist might be aware of, that when a person has depression, you need to check their thyroid function. And in some cases, getting them on thyroid hormones can reverse that depression in some cases. Number one. So levothyroxine is the number one prescribed thyroid hormone. And this is something that many people utilize really really well and can resolve all of their symptoms, including that brain fog, fatigue and depression.

But in other cases this levothyroxine which works as a prodrug, which means it has to be turned into the more active version of the hormone, doesn't quite convert properly in the body. And many people get on thyroid hormone medications and they continue to struggle with depression. They continue to struggle with brain fog. And in some cases, all they might need is utilizing a different type of thyroid hormone that's also available as a prescription medication known as T3. This is the more biologically active thyroid hormone.

You can find it in medications like cider mill, lever fire firing, and even natural desiccated thyroid extracts, for example. Armor. Thyroid is one of the brand names. Unfortunately, this is not something that's commonly used, but every now and then I'll see a psychiatrist that'll say, hey, I have a person with depression. I'm going to actually put them on T3 and as many as one, you know, 30% of those patients might respond where their depression will be significantly improved sometimes, oftentimes even better than with utilizing traditional antidepressants.

So this is kind of like a big, big I guess, spectrum of how thyroid disease can impact the brain function just relating to thyroid hormones. The other component that I don't, I feel like not a lot of people talk about is thyroid autoimmunity. So whenever people have an underactive thyroid or an overactive thyroid, nine out of ten times this is because they have an autoimmune response in their bodies. That means their immune system is attacking a part of their thyroid physiology, and this can lead to additional symptoms.

So traditionally when we study thyroid disorders, we would have a picture of a woman that's cut in half and half of her is hypothyroid. The other part of her is underactive thyroid. And she looks different, like one side is anxious. One side's depressed. Now with autoimmune thyroid disease, this can be a mixed presentation where you might have a person with anxiety and with depression. They might have panic attacks, insomnia, irritability, all kinds of symptoms. Actually, the very first symptoms that are recognized in people with thyroid autoimmunity are oftentimes anxiety.

Obsessive compulsive disorder also falls on that spectrum is included in that anxiety conversation. I've personally seen people who were misdiagnosed with bipolar disorder cognitive decline. I've seen people who are misdiagnosed with psychotic features. There's also something known as Hashimoto's and Sep Allopathy, which is a very, very serious disorder that may present as psychosis, dementia, really a lot of brain inflammation. People can become catatonic from that, and that can be related to those elevated thyroid antibodies.

And they can be not just attacking the thyroid, but also attacking parts of the brain. Yeah, I'm so glad you shared that. And it's interesting, some of the symptoms that you shared there, because it's like something's going off, something's going slightly wrong with the physiology.

Thyroid Autoimmunity and Psychiatric Effects 6:00

And in some people it shows up as this sort of, cluster of symptoms. In some people it shows up as this. But ultimately what's happening is there's like a function that is being lost, you know, in the journey. And, a lot of the things that you mentioned would be some of the things that you might see ahead of cognitive decline. And so it seems like understanding what's happening in the physiology is, is the first, most important thing. Right? Yeah, absolutely. The other kind of challenging thing is, I have to say, when I was first diagnosed with hypothyroidism and Hashimoto's, my TSH was at a level of 4.5, and I was extremely brain fogged and I was like a walking sloth or barely walking sloth, exhausted all of the time.

And my doctor told me that TSH level was normal and that I didn't need to be on thyroid hormone. Now, most healthy people with appropriate thyroid function their TSH, they would do best with the THC right around one. And when we look at some of the lab tests that are done these days, especially in older adults, a lot of times the reference range is overly generous or overly lax, where a doctor might see an underactive thyroid on the lab result of potentially an older adult, and not really treat it because the person is quote unquote, just older.

And so I think this is a really important consideration for anybody struggling with depression, any kind of brain fog to really look at, not just what the reference ranges are for proper thyroid function by conventional medicine standards, but also looking at the reference ranges from an optimal standpoint. Yeah. You know, as I've spent time with Doctor Burke and seeing her go through her journey to work with people with cognitive decline, it's amazing to see that one. You know, in some cases, it is quite a simple fix, right?

You get the understanding of what's happening in the physiology. And this person was just short of thyroid, you know, hormones. And you you know, give those hormones and a lot of symptoms clear up. But I think one of the other things that you're speaking to here is just about the the doctors can, you know, armed with that information, it's all about like, pattern recognition, right? So in the data you can see is this a thyroid, hormone issue or is this an anti, you know, an autoimmune condition.

And so it seems like there's, there's some subtlety there to, to identify when you help people with this, how do you is your, is your focus to sort of empower them to learn about themselves and do it from home? Or how do you recommend that people go about getting the information about themselves? And what's the most critical that you, steps that you recommend for people? So my best practices and I'm trained in public health, and all of the research there showed that people tend to have the best outcomes when they're working with a knowledgeable practitioner, and when they themselves are empowered and knowledgeable about their condition.

Optimal Thyroid Testing and Treatment 9:00

So you're going to get much better outcomes when you have these two things together. I do love, love, love educating people on how to take charge of their own health when they have thyroid conditions. And part of what I teach them about is that when they have a thyroid condition, it's not just thyroid hormones that need to be addressed, but there's a lot of other things that need to fall into place. For example, there are consequences of this thyroid ism. So if you've been hypothyroid for a long time, that's going to affect other parts of your body.

For example, you might develop Sibo, small intestinal bacterial overgrowth, and you might need to correct that because that's going to be propagating symptoms, nutrient deficiencies. There's also reasons that perhaps lead you to have a thyroid condition. Maybe it was some kind of a chronic infection. Maybe it was a nutrient deficiency, a food reaction, some toxins that were in your system. And so I really like to empower people on how to address those things, from food sensitivities to nutrient deficiencies, to looking at their stress response, to their ability to detox.

Many of these things people can do in their very own homes, some of the things they do need to do with a practitioner that knows what they're doing. Yeah, but definitely the best outcomes are going to come from the people that are both self trained and self-aware and self empowered, and those working simultaneously with with practitioners that know what they're doing. Wonderful. Well, I'm super grateful that we'll be able to, you know, provide support for everyone who's listening and watching to this, to, you know, to understand what's happening on that end.

Let me just ask you this. So you mentioned thyroid and that sort of in the context of hormones outside of the thyroid hormone itself. If you look at the sort of broader hormonal regulation system in the body, what are some other things that you've seen that can contribute to a lack of brain function? In, in that realm. So definitely perimenopause and any kind of hormonal changes in women can contribute to impact can impact brain function. So anything like lack of focus can be caused by, for example, not having enough progesterone, not having enough progesterone on board to things like mood disorders from the hormonal imbalances.

So I feel like this is a very much underappreciated that we're not talking about that women in menopause are more likely to have nuance, had psychotic disorders, women and perimenopause, women and perimenopause are more likely to have new onset psychiatric disorders, whether that's depression, psychosis, higher rates of suicidality. And this is I feel like a topic that should get a lot more attention. The other component that I really focus on is that stress response, as well as the adrenal hormones such as cortisol.

This cortisol dysregulation is a pattern I very, very commonly see in people

Hormonal Imbalances, Stress, and Adrenal Health 12:00

who are anxious, depressed, irritable and deal with brain fog. And a lot of times, you know, you have to address not just one hormone, but you do have to address quite a few different hormones to get a person to be sharp and back on their game again. While speaking of sharp and back on the game, look, I know that this is very powerful for you and I know you know how much work it took initially to get back to a state of health. Obviously, what we're trying to do here is to help anyone understand what the root causes of that condition might be to try and either prevent or reverse the Alzheimer's or the cognitive decline that they're experiencing from your experience of, like living with or starting having symptoms from, a particular condition and now living healthily, right, to keep it at bay.

What are some of the key things that you feel are the most critical for maintaining healthy function? For for me, really, it started with figuring out which foods were triggering, and gluten and dairy were the two biggest foods for me, as well as 80 to 88% of the people that I've worked with. And I've done some outcomes surveys with them. 80% of people feel better dairy free and 88% of people feel better gluten free. Utilizing digestive enzymes. This doesn't sound like it would be make a lot of sense, but many times I have seen people when they use betaine with pepsin, their protein digestion improves.

They're able to take in more amino acids that produced neurotransmitters better, so they're able to extract those amino acids out of their proteins. And a lot of times their mood improves pain, improves their energy levels, and brain function can improve. Looking at various nutrient deficiencies, methylation is very, very helpful for depression. For, a lot of brain function. So getting that optimized is going to be critical. Generally speaking, I would utilize things like methyl folate, tri methyl glycine, riboflavin, perhaps some P5P for that to help support brain health.

And then also interestingly, anything that supports the mitochondria, anything that helps to clear out ammonia out of the body could be a really, really big game changer for a lot of my clients. For fatigue, one of the biggest things that's helped to turn that around, and I mean like physical fatigue and mental fatigue, is Bento timing. Around 600mg of that can really bring back so much more brain function for people. And generally speaking, it's going to be in 3 to 5 days where I have had people on disability for cognitive decline and chronic fatigue, and they're able to come out of that with like, this one nutrient and maybe doing a few other lifestyle changes.

The other really powerful brain changing nutrient that I like to utilize is carnitine, and I like to utilize carnitine in the combination of l-carnitine with acetyl l-carnitine. L-carnitine is for the body. So it's really helpful for muscle wasting. If you are somebody that's been mold exposed and you have really weak muscles, this is going to help to bring that back on board. It's going to help you physically feel a lot better. It also clears ammonia out of the body, which is a toxic byproduct from protein digestion from some of our pathogenic bacteria that can really produce a lot of brain fog.

Yeah. And that acetyl l-carnitine is really great for that brain function. And just utilizing these two together synergistically,

Diet, Nutrients, and Mitochondrial Support 16:00

I see a really big response in people with like, their brain awakening and they're able to have like their body becomes strong again. I know one of the things that you've, you've done over the last decade is use your journey, to inform other people on the same journey and not just through, like communicating outwards right through the books and so forth. You've written about fiber, but also taking people through a journey and and seeing how they do. And I think that's really exciting because it's no longer just like your experience, but the experience of all these people.

So when you throw out 80% and 88%, this is over a number of people and, lots of people over lots of years who have done a very specific process in that journey. What have you seen outside of just the gluten and area that are the other things that you've seen that have really moved the needle for the kind of transformation that we're talking about here? Oh my gosh. So I've taken thousands and thousands of people through like very specific protocols. So one of them is the adrenal transformation protocol that helps to resolve fatigue and brain fog in the course of four weeks.

And we do this through focusing on pleasurable activities. I feel like people really resonate with that. Sometimes people are fatigued and brain fogged and unfocused, not because they're doing too much, but because they're not doing enough of the right things in their lives. That can be like lifestyle changes, that can be really, really great for for getting some of those neurotransmitters going again. We really focus on blood sugar balance. So we're generally adding more protein and fats to people's diets, cleaning cleaning up their diets.

So they're not eating as many carbs. They're not having those carb crashes. We're focusing on the circadian rhythm. So we're really trying to get people getting that morning sunshine or some kind of light therapy if they don't live somewhere warm, really focusing on getting quality, quality, restorative sleep at night. I love to utilize Epsom salts baths for that as well as magnesium. I find that the I haven't seen in a research on this, but I have seen people's data on whatever tracking things that they use, that their deep sleep and restorative sleep and REM sleep improves when they're utilizing plenty of like magnesium at bedtime.

And so they just wake up, they sleep better, and they wake up far more refreshed, and their body is able to regenerate. Part of the adrenal transformation protocol is we really focus on shifting them from that catabolic state, where their body is breaking itself down into more of an anabolic state, where they're really building themselves back up so that any kind of muscle wasting, brain fog, all of those things that really, you know, when we're under a lot of stress in our body, stuck in that stress response, it's like my body's breaking itself down to fuel that stress instead of shifting into that rest and digest process.

I love neurofeedback, eMDR, like really focusing on trauma work and processing that to help to get people back into more of a parasympathetic state. If they tend to be more in that sympathetic overdrive when their body is just, you know, cannibalizing itself, breaking itself down. Yeah. Well, that's that's really interesting. And I think a lot of people will benefit from, from those ideas. One of the things I wanted to ask you about is I know in hormonal balance and thyroid as well, and also in cognitive decline a lot.

One of the topics that we're talking about, you know, throughout this summit, is the presence of chemical toxins and how those affect hormonal balance or otherwise. When you're communicating to your, you know, your the people who are coming through your programs, what are some of the ways that you see that people can take action? I know that there's some part of it where you go to see a doctor and you see what's actually going on, but like, what are some of the ways that they can participate and where are some of these toxins hiding in the environment that are sort of low hanging fruit to make a big impact?

Yeah. So I've taken thousands of people through my research and it's like, basically we focus on supporting your liver and getting rid of the low toxic hanging fruit. I started working with clients over ten years ago, and some of them I was doing a lot of functional medicine testing and recommending various protocols. They just really weren't getting better and they were spending a lot of money. Yeah. And I was like, can we do for you?

Detoxification and Environmental Toxins 20:30

Couple of them happen to have multiple chemical sensitivities. So I randomly thought, why not put them on liver support. And with utilizing liver support within two weeks, a lot of their symptoms vanished. And I was like, wow, this is this is really crazy. This is something that's very, very interesting. And so what I teach people about is let's clean up your personal routine, the things that you're putting on your skin every day and turn into this. This is very much absorbed in your body and creating a toxic log.

A lot of personal care items. I know I personally had arsenic toxicity from lipstick out of all things. It was like a lip gloss, and a lot of times the cosmetic industry is not regulated. And so you're putting something on these mucous membranes, you're absorbing that into your system. A lot of the women I work with, I'm like, okay, let's focus on doing a personal care routine cleanup. Maybe we're going to not just just not wear personal care items for a few weeks and take them down that road. We're removing plastics from microwaves.

You know, if you're microwaving your food in plastic, then you're you're eating those microplastics, right? We're focusing on cleaning up the water supply. We know that fluoride has been correlated to thyroid disorders as well as a reduced IQ. It can absolutely impact cognitive function. So I'm a big proponent of utilizing fluoride filters to get that minimized to what you're exposed to. I'm a big proponent of utilizing air purifiers, so we know that mold can be an equal opportunity destroyer. This can lead to various autoimmune issues that can lead to cognitive decline.

And part of that is cleaning up your air space and figuring out if perhaps you might have mold overgrowth in your home. There are some simple test kits that people can purchase and set that up around their home. Just as a screening, just just as a beginning standpoint. Or they can even work with remediate or some practitioners to come in and test their home. The other thing that I like to utilize is sauna or sweat therapy. 30 minutes a day, four days a week. This is going to help to clear out so many of those toxins out of your system.

Really, really big game changer. I do love to use like herbs and supplements, just not to force the toxins out, but to gently support those detox pathways. For example. And Acetylcysteine is fantastic for detoxification. It was one of the things that, you know, they kind of wanted to take off the market and make it into a drug, but thankfully it's still available as a supplement. It can be very, very helpful. Then there are herbs like milk thistle, various amino acids that can help us with our detoxification, liver and gallbladder support, magnesium.

I love to utilize these to really help people process the toxic backlog. And sometimes, you know, you might know which specific toxin it is and you might do very specific protocols for that particular toxin and so on and so forth. But it's always best to start with like a broad spectrum in my experience, because a lot of these herbs and just supporting your own detox pathways, you know, you can get it out through your liver, you can poop it out, you can sweat it out. And there's much less work for the functional doctor to do, right?

Yeah, but it's interesting you you mentioned that. And I wonder, like you mentioned, a sauna, a sauna, a pop part of a Polish culture, or is it just more Scandinavian? That's a good question. I know the Russian culture has a lot more of that hot therapy. Yeah. So it's interesting to see, you know, how those kind of cultural norms, come along and see. I guess one of the things that I just maybe would like to just just touch on is, you know, what you're dealing with, with the patients that you work and the people that follow you.

And what we're talking about here with cognitive decline, one of the tricky things is that it could have so many different root causes, right. And that ultimately you could be experiencing some of these symptoms and it could be 20 different reasons why it's happening. And I just love to get your insight. You know, when you speak to patients who are sort of in this stage of unknowing, you know, what you what how you how you think about what is the what is the quickest and most efficient, affordable way to identify what's going on and also then to do something about it.

Well, like, I mean, you're just inspiring me with everything that you're doing. I have like an old school assessment that I would take people through, and it was 600 questions to really figure out what might be their main drivers or main root causes. Right breast implant illness, for example, is a very is potentially a very important cause of autoimmunity and inflammation.

Root-Cause Assessment and Practical Protocols 25:30

If you don't have breast implants, that's probably not your report. That's right. But there's a lot of different things that we can do. And just simply asking people what their symptoms might be and getting a little bit of their history to try to predict what are the things we might want to do next as far as which are the lab tests we should invest in, right? Yeah, because it's like doing so much lab testing. I love it. It's so much data. Yes. But I've also had some people, like I tell them to test their adrenals.

And a year later, the tests are still sitting on their shelf and they're still having those same symptoms. So I do love assessments and lab testing. I also have very specific protocols where I've compiled the data on the people that I've worked with, and I've been like, okay, I see about 30% of them have this protozoa that causes a lot of gut inflammation and has some cross-reactivity with the thyroid. When we treat the protozoa, that person can get into remission. So I'm like, okay, that's that's an interesting data point.

And then I see some people have Candida and some people have this and some people have that. And I kind of look at what's something that we can use. That's low risk that would help all of these things. And so I'll, I'll come up with something. For example, in this case it's sarcoma is baladi. It's a beneficial yeast that helps to clear out protozoa raises immune secretory IGA. So people gut immune system is stronger. It's able to overcome various infections. It helps to bind up some mold toxins.

So it helps with that. And I've created protocols for people where my goal is always to help. About 80% of people feel 80% better where they can go through a guided liver protocol. That's two weeks of lifestyle changes and two weeks of supplements. And then we go through a four week adrenal protocol similar again here. The lifestyle changes to really dial in on that brain fog and fatigue, irritability. And then we have like, gut protocol to really dial that in where my Michael, you know, having worked in public health is I, I'm, I love outcomes research and I love looking at the data and being like okay what's the biggest needle mover?

What's the biggest game changer. And we can I feel like we can use that in conjunction with functional medicine testing and in conjunction with all of the fancy things, but sometimes it's like, you know, some people get off of gluten and a lot of a lot of them and a lot of the symptoms just vanish. So it's like, why not like start there before we go into like this really deep level diagnostic. Beautiful. Well, Isabella, thank you so much for being part of this. I really think your wisdom is going to help so many people.

And part of what I'm excited about is that you know, as people are empowered and start to participate and start to learn about their body and, you know, do different things and experience it. And so also then have so much wisdom in the community between the practitioners that we're working with at junior, but also like the programs that you've developed, I think right now, there's a better chance for everyone to live a long and healthy life, free of chronic disease, free of cognitive decline, free of Alzheimer's, free of dementia.

And thank you for all your pioneering work and being part of the community. Thank you so much for having me, and thank you for starting these conversations, for building the communities that you've built and from empowering practitioners and patients so that we could all live healthier. Thank you. This has been part of the Hormonal and Trophic Education Day as part of the Reversing Alzheimer's Summit. We got loads more good stuff for you, but check out Doctor Isabella Wentz. All of the content that she puts out.

She has a great podcast and you can find out more about her everywhere. Thank you.