Addressing

the Root Causes

of Hashimotos
Izabella Wentz, PharmD, FASCP

Objectives
1.Recognize the top cause of hypothyroidism
2.Recognize the top root causes of
Hashimotos
3.Recognize the good, bad and ugly drugs in
Hashimotos
4.Recognize the most helpful nutritional
interventions for people with Hashimotos
5.Recognize top functional medicine and
complementary treatments for Hashimotos
2

MyStory/Disclosures
ReceivedDoctorofPharmacydegreefrom
MidwesternUniversityCollegeofPharmacyin
2006
DiagnosedwithHashimotosthyroiditisin
2009
AuthorofNYTbestsellingpatientguide
HashimotosThyroiditis:Lifestyle
InterventionsforFindingandTreatingthe
RootCause
Authorofwebsite:thyroidpharmacist.com
CofounderoftheHashimotosInstitute
PractitionerTrainingProgram
TrusteeforThyroidChange
HashimotosAwarenessBoardMember
PaidAdvisortoPureEncapsulations
PaidspeakerforDesignsforHealth
3

WhatWeAreTaught
AboutThyroidConditions

Hashimotos:
PrimaryReasonForHypothyroidism

WhatItFeelsLikeToHaveHashimotos

StagesofHashimotos
1:Geneticpredisposition

2:Immunecellinfiltrationintothyroidgland

3:Subclinicalhypothyroidism

4:Overthypothyroidism

5:Progressiontootherautoimmunedisorders

ProperDiagnosis
InrecentyearstheNationalAcademyof
ClinicalBiochemistsindicatedthat95%of
individualswithoutthyroiddiseasehave
TSHconcentrationsbelow2.5IU/L,anda
newnormalreferencerangewasdefinedby
theAmericanCollegeofClinical
Endocrinologiststobebetween
0.3 3.0IU/ml
Source:2012ClinicalPracticeGuidelinesfor
HypothyroidisminAdults:Availableat
http://aace.metapress.com/content/b67v7mk73g3233n
2/fulltext.pdf

1.TSH
2.TPOAntibodies
3.ThyroglobulinAntibodies
4.FreeT4
5.FreeT3
6.(ThyroidUltrasound)
8

TraditionalApproach

OldSchoolNaturalApproach

10

Root Cause Approach

11

DogmasAreDangerous.
YouShouldNeverBeaMartyrToaSole
HealingPhilosophy.
IHaveFoundThatAPatientCentered
IntegrativeApproachIsTheKindest
AndMostEffectiveApproachTo
Healing.Dr.IzabellaWentz

Hashimoto'sBeyondNutrition

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ThePerfectStormOfAutoimmunity

AlessioFasanoet.al.
1.Geneticpredisposition
2.Exposuretoantigen(trigger)
3.Intestinalpermeability

13

RootCauses
Toxins
Intestinal
Permeability
Food
Sensitivities

Nutrient
Depletions

Chronic
Infections
Poor
Stress
Response
14

Toxins
Excess
Iodine

Fluoride
Petrochemical
plants
Radiation
Medications

15

Triggering/ExacerbatingMedications
Substance
Iodine
Fluoride
Amiodorone
Lithium
Interferon
Somemonoclonalantibodies
Botox
Accutane

16

AutoimmunityandInfectionMOA
Molecularmimicry
immunesystembeginstoattackourownthyroidgland
becauseweareinfectedwithapathogenicorganism(likea
bacteria,parasiteorvirus),thatlookssimilarto
componentsofthethyroidgland.
outsideofthethyroid

Bystandereffect
thethyroidisinfectedwithapathogen(usuallyvirus),the
immunesystemstartstoattackthevirusshome
insidethethyroid

Intestinalpermeability
Gutinfections
17

Infections:MostResearch

HPylori

EpsteinBarr

Yersinia
entercolitica

Lymedisease
(Borellia and
others)
16cross
reactive
proteins

Reductionin
antibodies

Onset

19cross
reactive
proteins

Remission

Reactivation

Remission

SIBO

50%of
hypothyroid
subj (n=100)

18

RootCauseApproach Part1:
StrengtheningtheBody
LabTesting
TurningYourBodys
RegenerationSetting
On
Medications
LiverSupport
OptimizingDiet&
Macronutrients
Optimizing
Micronutrients
Hashimoto'sBeyondNutrition

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RootCauseApproachPart2:
Identifyingandaddressingthetriggers
Antibodiesand
Nodules
AdrenalTriggers
DentalTriggers
ChronicInfections
GutHealing
Deeptoxins,next
steps,stayingin
remission
Hashimoto'sBeyondNutrition

20

Lessons Learned From Being a

Human Guinea Pig, Spending All of
My Free Time on PubMed and
Supporting Two Hundred Thousand
People with Hashimotos
21

May 2015: Surveyed 2232 of my

readers with Hashimotos
My Analysis

Hashimoto'sBeyondNutrition

22

FoodSurveySays
(Originalresearchpublicationpending)
Intervention

Feltbetter

FeltWorse

Reduced
Antibodies

FoodSensitivity

62%

4.20%

43%

AIP

75%

4%

38%

Soyfree

63%

1.20%

34%

Gluten free

88%

0.73%

33%

Grainfree

81%

0.74%

28%

Paleo

81%

3.20%

27%

LowFODMAPs

39%

0%

27%

Hashimoto'sBeyondNutrition

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FoodSurvey,cont.
(Originalresearchpublicationpending)
Intervention

Feltbetter

FeltWorse

Reduced
Antibodies

Vegan

30%

28.00%

23%

Low GI

76%

2.30%

22%

Dairy free

79%

1.50%

20%

Egg Free

47%

3%

19%

Nightshade free

48%

2%

14%

Red Meat
Avoidance

40%

14%

8%

Wentz,I.Resultsofsurveyof2232peoplewithHashimoto's.YourThyroidPharmacist
Website. http://www.thyroidpharmacist.com/blog/top10takeawaysfrom2232peoplewith
hashimotos.AccessedJune26,2015.

Hashimoto'sBeyondNutrition

24

HashimotosPatients+GFDiet
(n=2232)
FeltBetteronGlutenFreeDiet:88%(n=1793)
Sawanimprovementindigestivesymptomson
GFdiet:85.9%(n=1634)
ConfirmedCeliacdisease:3.5%(n=2226)
FeltBetteronSynthroid:43%(n=843)
FeltBetterArmour 58.9%(n=729)
TopBenefits
Energy(67%)
Mood(60%)
Weight(52%)
25

HighlyReactiveFoods(IgG)
(preliminaryresearch)
100% Cottagecheese,brewersyeast
90% cola,safflower,whey,bakersyeast
80% casein,bluecheese, chicken,cowmilk,
goatmilk,rosemary,yogurt
70% corn,cheddar,Swiss,licorice,
mushroom,sugarcane
60%pineapple,pintobean,ginger,oregano,
oyster,whitepotato,sesame,walnut
Hashimoto'sBeyondNutrition

26

MostCommonNutrientDeficiencies
Selenium

Ferritin

www.thyroidpharmacist.com/labs

27

StressIsAtTheRootCauseOf
MostChronicConditions

AnecdotalEvidence
Blastocystishominis
HPylori
ReactivatedEBV
SIBO
OtherParasites
Yeast
DentalInfections
29

CommonFactorsofSuccess
Positive,candoattitude
Supportive
spouse/partner/network
Celebratelittlesuccesses
Notafraidtodreambig
Stressreliefhobbies
Willingtoinvestinthemselves
Dontstoplivingjustbecause
theyhaveHashimotos
Willingtoaskforhelpfrom
others
Willingtosurrendertheirneedto
controlthesituation
Willingtorestwhentheyneedto
rest
Hashimoto'sBeyondNutrition

30

PredictorsofPoorOutcomes

Attachedtoadogma
Notwillingtoinvestinthemselves
Gurushoppers
Perfectionismandunrealisticexpectations
Notgoodenough
Caughtupinbeingsick
Paralysisbyanalysis
Peoplewhoaresociallyisolatedanddonthavea
supportnetwork
Hashimoto'sBeyondNutrition

31

MedicationManagement
RightMedication

RightDose

AretheyconvertingT4toT3?

Aretheyonthecorrectdose?

FreeT3

TSH

FreeT4

FreeT3

Symptoms

FreeT4
Symptoms

Isacombomedicationrequired?
Isahypoallergenicoptionneeded?
FeltBetteronSynthroid:43%(n=843)
FeltBetterArmour 58.9%(n=729)

Goldilockshormone

32

DucksInARow

1. Diagnosis
2. StressStrategies
3. MedicationManagement
4. FoodPharmacology/Nutrition
5. LiverSupport
6. Advancedadrenals
7. Gut(includingoralhealth)
8. AdvancedDetox
9. Triggers

Top Hashimotos Food Myths

34

LowCarb
Myth:Iwentlowcarbandfeeltired,sothelow
carbdietmustbebadforpeoplewiththyroid
issues
Hack:Feelingtiredafterstartinglowcarbdiet
likelyduetopoordigestionofproteins.
Trystartingyourdaywithagreensmoothie,
increasingyourveggieintakeandtakingprotein
digestiveenzymeBetaine withPepsin
Somepeoplebenefitgreatlyfromketosis!
Hashimoto'sBeyondNutrition

35

Almonds
Myth:Almondsarehealthy,Icaneatthem
everyday
Unfortunatelymanypeoplecanbesensitiveto
almonds.
Almondsareoneofthetopreactivefoodsfor
peoplewithHashimotos.Ifyoudontreactto
themnow,rotatethem.

Hashimoto'sBeyondNutrition

36

RawDairy
Myth:RawdairyisperfectlyOKforHashimoto
PerhapsifyoudrankityourwholelifeIfyouare
alreadysensitizedtothedairyproteincaseinor
wheyfromdrinkingconventionalmilk,youll
likelyreacttotheproteinsinrawcowsmilkas
well.
Goatsmilkishighlycrossreactive.Youmaybe
abletotoleratecamelmilk.Itsdifferentenough
andmayhelptohealadairysensitivity.
Hashimoto'sBeyondNutrition

37

Goiterogens
Myth:GoiterogensneedtobeavoidedinHashimotos
Thosepoorbrassicavegetables!Goitrogenisareallyold
wordmeanttodescribesomethingthatcausesagoiter.Its
averydeceivingword,andcanmeandifferentthingsfor
differentsubstances.Inrelationtobrassicas(cabbage,
Brusselssprouts,broccoli,cauliflower)thismeansthey
blockiodineabsorption.Thiswasanissueintheoldendays
Theyareperfectlyhealthy,helpusdetoxandexcellentfor
Hashimotos
MostcasesofHashimotosarenotduetoiodinedeficiency
Ontheotherhand,ifyouareiodinedeficient,youmaywantto
steamtheveggiesorfermentthem.Thiswillbreakdownthe
glucosinolates(theiodineblocking)

Hashimoto'sBeyondNutrition

38

Seaweed/Iodine
Myth:EveryonewithHashimotosshouldeat
lotsofseaweedforiodine
Hashimotosisnotnecessarilyaconditionof
lowiodineintake.Itsmoreofaconditionof
pooriodineprocessing,soexcesscanactually
inflamethesystemevenmoreso.Avoidsuper
highdoses

Hashimoto'sBeyondNutrition

39

IodineControversy

Hashimoto'sBeyondNutrition

40

Iodine
Intervention

Felt Better

FeltWorse

NoChange

TotalNumber

HighDose
Iodine

25.28%

28.37%

46.25%

356

Iodine
restriction

31.7%

7.17%

61.13%

265

41

SeleniumfromBrazilNuts
Myth:IneedtoeatmyBrazilnutstoget
Selenium
SeleniumcontentinBrazilnutsisvariable.
Also,manypeoplemaybesensitivetothem!
Supplementof200mcgseleniummethionine
hasbeenclinicallytestedtoshowareduction
inthyroidantibodies

Hashimoto'sBeyondNutrition

42

SELENIUM

Hashimoto'sBeyondNutrition

43

DietWillHealAll
Myth:IfIjusttakeoutmorefoods,Iwillbe
healed
Whilesomepeoplehavehadgreatsuccesson
restrictivedietsliketheAIPdiet,(Imabigfan
myself),ifapersonhasbeenonacleandietx
3monthsandnotseeingresultsorgetting
stuck,youwillneedtotestforgutinfections&
otherrootcausesASAP,asyouruntheriskof
themlosingmorefoods.
Hashimoto'sBeyondNutrition

44

MoreonOptimizingNutrition

www.hackinghashimotos.com/webinar

45

HashimotosBeyondNutrition
46

Dietusuallywillheal/help
Hashimotosisacombinationof
Foodsensitivities(gluten,dairy,soy most
common,otherstoo)
Nutrientdeficiencies(nutrientdense,veggies,
adequateprotein)(processedfoodshurt)
AdrenalIssues(lowcarb,lowsugar,highfat)
GutImbalance(fermentedfoods)
Toxins(lowinmercuryfish,nottoomuchiodine)

Hashimoto'sBeyondNutrition

47

Dietwillsometimeshelp
Nutrientdeficiencies
Butoftensupplementsareneededduetopoor
digestion(notenoughnutrientsinfood)
Sometimesmayneeddigestiveenzymes
Sometimesnutrientdeficienciescausedbyinfections,
mayneedprotocolstoclear
Sometimesnutrientdeficienciescausedbytoxins,
mayneedprotocolstoclear

MultipleFoodSensitivities
Maybetriggeredbyinfection
Hashimoto'sBeyondNutrition

48

Dietusuallywontheal
Chronicinfectionsthatcantrigger
autoimmunediseasemayrequire
treatments,herbs,sometimeseven
antibiotics,antifungals,antiviralsetc.
Toxicitymayrequireavoidance,supplements,
medicationsandadvancedtreatments
Emotions/stressinyourlife

Hashimoto'sBeyondNutrition

49

WhentoMoveOn
IfyouvebeenonaGFdietfor3months,and
stillnotinremission
Ifyouarelosingmoreandmorefoods
Whenyouveplateauedwithdiet

Hashimoto'sBeyondNutrition

50

NutritionalNonResponders
51

NutritionProtocolNonResponders
PeoplewhocontinuetohaveHashimotos
symptomsandantibodieseatingthecleanest
dietpresentwiththefollowingrootcauses:
Toxicity 95%hadmoderatetohighresults
ontoxicityscale
Advancedadrenalfatigue(catabolic)93%
Infections78%
Hashimoto'sBeyondNutrition

52

2015AdrenalTestResults
AllTestedinQuarter(n=14)

Stage3Breakdown(n=13)

Fall2015401HTestResults

WhatIDoWithClients

55

TwoProngedApproach
Vulnerabilities

Triggers

Food

Infections

Nutrients

Adrenals

Stress

Toxins

Hashimoto'sBeyondNutrition

56

90DayStatsfromProgram
Herearetheresultsfrompreviousnonresponders:
97%improvedtheirknowledgeofHashimotos
81%sawanimprovement/resolutionindepression
80%sawareductioninstomachpain
75%sawareductioninjointpain
74%sawanimprovementinfatigue
73%sawareductioninTSH
71%improvedtheiracidreflux
65%sawanimprovementinsymptomsaftertheliver
cleanse(Module4)
Hashimoto'sBeyondNutrition

57

StatsContd

62.5%improvedbrainfog
62%improvedweight
61%reducedtheirirritability
56%reducedtheirTPOantibodies
54%reducedtheirpalpitations
52%sawanimprovementmorningfatigue
50%reducednightsweats
45%reducedhairloss
45%sawimprovementininsomnia
44%sawareductioninTGAntibodies
Hashimoto'sBeyondNutrition

58

RootCauseAssessment

RootCauseTesting

59

MySecretWeapon?
StartwithLiverCleanse!
65%ofHashimotos
Hackerssawan
improvementin
symptomsaftertheliver
cleanse(Module4)

Hashimoto'sBeyondNutrition

60

AChristmasStory
Michelle,45
Multiplechemicalsensitivity
Arthritis
ElevatedTSH
Heartpalpitations
ElevatedTPO
IcannowwalkpastaYankeecandlestoreatthe
mallandnotholdmybreath!
Hashimoto'sBeyondNutrition

61

2WeekLiverCleanseOverview
GF/DF/SF/Clean
GreenSmoothie
Breakfast(peaprotein)
Saladsforlunch
Meat+Crucifersfor
Dinner
Lemonwater,green
juice,cilantrojuice

Paleo Cleanse(DFH)
Homocysteine Factors
(PE)(2/day)
AminoDTox (DFH)
(6/day)
NAC900mg(PE)(2/day)
MagnesiumCitrate
150mg(PE)(12HS)

62

Cheryl,31:FullProgram
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Hashimotos
IBS
PCOS
BrainFog
Celiacdisease
Overweight
Eczema,psoriasis,asthma
Depression
Anxiety
Fatigue
alopeciaareata
Sleepingfor14hours
Sleepapnea
Prematureovarianfailure
Migraines,headaches

Hashimoto'sBeyondNutrition

63

Who Are You Really Feeding?

64

Blastocystis hominis &Hashimotos

65

Blastocystis hominis
Protozoa(trophozoite andcystform)
Consideredtobeacommensalorganismby
mostdoctors,despitestudiessuggesting
otherwise
ConnectedtoIBS,chronicurticaria (hives)
Resolutionaftertreatment

Cancauseleakygut
Multiplestrainsexist
66

Symptoms

Multiplefoodsensitivities
Fatigue
Hives
IBS
Pain
Notallmayhaveallofthese,somemaybe
asymptomatic!

67

Whoareyoufeeding?
DietforBlasto
DietalonewillNOTeradicatethispathogen.Itcan
eatanything(evenprobioticbacteriainourgut
havebeensuggestedasafood!)
Somepatientsareabletomanagesymptomswith
anextensiveexclusiondiet,whichmayinclude
exclusionofrefinedsugar,wheat,dairyproducts,
rice,corn,carbonateddrinks,tea,coffee,alcohol,
andfruit.
68

Treatmentconcerns
Resistanttostandardantibioticsused
(metronidazole)
TheissuewiththeBlasto isthatitcanchange
statetoacystform,whereitisnotpenetrable
tothemedications,soyouneedtomakesure
yougetitintherightlifecyclestage.

69

Blasto HerbalProtocol
60dayprotocol,coverstwolifecycles,with
threeherbstopreventresistance
Artemesia:2threetimesperday
Candibactin BR:2threetimesperday
OilofOregano:2threetimesperday

Lipasecontainingdigestiveenzyme(Digestive
enzymesultra)
SBoulardii:2threetimesperday(upto8per
day)
70

BlastoMedications
Alinia 1000mgtwicedayx3days,repeatintwo
weeks,thenonceagaintwoweekslater.
Alternateoptionsare:Alinia 500mgtwicedailyx30
days,orAlinia 1000mgtwiceperdayx2weeks,but
Alinia willkilloflotsofgoodfloraandyoumayhave
extremedieoffsymptoms(beingexhausted,body
pains,moodchanges)
Nystatin shouldbetakenwithAlinia orafter
treatmentfor13monthstoaddressthefungal
overgrowth,Nystatin 500,000units:twocapsules
threetimesperdayx3090days
71

For Elusive Root Causes

72

LDN
LowDoseNaltrexone
FDAapprovedmedicationusedforopioidwithdrawalata
doseof50mgperday
IncreasesTregulatorycytokinesandmodulatesTGFB,
leadingtoareductionofTh17,thepromoterof
autoimmunity.
Helpfulformanysymptoms
Ratesoflabsin1000+rangedownto100s

StartingdoseforHT1.5mg
1.54.5mgperdayareusuallyrecommended

Compoundingpharmacist
Survey:38.2%better/4.56%worse/57.3%nochange
(n=241)
73

Connectwithme
www.thyroidpharmacist.com/labs togeta
listingofmyfavoritefunctionalmedicinelab
testsforuncoveringrootcauses&nutrient
depletionswebinar
www.hackinghashimotos.com/webinar
BookSigning
Panel
74

ResourcesIProvide
HashimotosThyroiditis:LifestyleInterventions
forFindingandTreatingtheRootCauseBook
www.thyroidpharmacist.com/book

HackingHashimotosProgram
www.hackinghashimotos.com Code:NTA2016

RootCauseRecipePortal
www.rootcauserecipes.com

HashimotosInstitutePractitionerTraining
www.hashimotosinstitute.com
75