LISTEN TO THE PODCAST – Also available on Spotify and Apple Podcasts
In this episode of the Thyroid Pharmacist Healing Conversations podcast, I interview Dr. Eric Balcavage, a leading functional medicine practitioner and co-author of The Thyroid Debacle, about a radically different way of looking at thyroid disease: through the lens of adaptive physiology rather than “broken” thyroid glands. We explore how the body’s cell danger response and mitochondrial stress can drive thyroid symptoms, even when your TSH and T4 look “normal” on paper.
Dr. Balcavage explains why so many people wind up in what he calls “thyroid purgatory” – that frustrating place where you’ve been diagnosed, put on medication, maybe even had your dose “optimized,” yet you still feel exhausted, foggy, inflamed, and stuck. Instead of chasing the perfect T3 dose or obsessing over pushing labs into narrow “optimal” ranges, he teaches us to ask a different question: What is the body adapting to, and how can we change that environment?
If you’ve ever wondered why more thyroid hormone, more labs, or more supplements haven’t solved your symptoms, this conversation offers a deeply validating and hopeful new framework.
What you’ll learn in this episode:
- Why your thyroid may not be “broken” – it may be adapting. Dr. Balcavage explains how the cell danger response and mitochondrial stress can trigger a deliberate, protective downshift in thyroid hormone conversion, so you feel hypothyroid even though the body is trying to survive famine, infection, toxins, or emotional trauma. This shift reframes thyroid disease from “self-attack” to an intelligent (but uncomfortable) survival strategy.
- How over-focusing on lab optimization can keep you stuck in thyroid purgatory. We talk about the pitfalls of both conventional endocrinology (TSH-only, medication-for-life) and “green allopathy” (using different hormones or supplements solely to normalize labs), and why endlessly chasing the “perfect” T3, reverse T3, or TSH often misses the real driver: ongoing cell stress and inflammation that the body is still responding to.
- Why more T3 isn’t always better, and when it may backfire. Dr. Balcavage breaks down the main reasons T4-to-T3 conversion goes down (inflammation, stress, excess T4, and genetics), and why simply adding more T3 can increase oxidative stress, suppress natural hormone production, and even blunt immune surveillance in some people. Instead, he encourages us to ask why T3 is low and address the underlying triggers first.
- The hidden role of mindset, relationships, and finances in thyroid recovery. We explore how chronic fear, resentment, unresolved relationship stress, and money worries wind up the limbic system, keep the body in fight-or-flight, and shut down gut, reproductive, and thyroid physiology. Dr. Balcavage shares real-life stories of clients whose symptoms improved dramatically when they shifted how they viewed their circumstances – even before changing labs or supplements.
- How Dr. Balcavage’s “fitness factors” create a roadmap back to homeostasis. Instead of only looking at gut or hormones, he evaluates 18 “fitness factors” – including sleep, breathing, emotional fitness, relationship health, habitual routines, metabolic fitness, and more – to identify the biggest stressors keeping the body in an allostatic (stressed) state. Addressing these systematically allows thyroid physiology to normalize, sometimes even allowing for dose reductions or gland recovery.
- Why TSH “optimal ranges,” ferritin goals, and vitamin D obsession can be misleading. In the rapid-fire section, we dig into hot topics like whether TSH above 2 is always bad, if low ferritin always means iron deficiency, why 25-OH vitamin D isn’t the whole story, and whether Hashimoto’s can exist without antibodies. You’ll learn why labs should be interpreted in context, not forced into narrow ranges at any cost.
I’ve got a new book coming out!
Thyroid patients often have other symptoms in the body, including gut issues. Through my thyroid healing journey, I’ve learned so much about healing the gut that I decided to write a book about it! My new book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, is a comprehensive guide that reveals how irritable bowel syndrome is often a catch-all diagnosis that overlooks treatable root causes. It offers a step-by-step approach to help readers understand what’s really driving gut symptoms, and how to create a personalized plan to restore gut health and overall wellness. The book is available for preorder here and will be released on March 17, 2026!
Guest Resources / Connect with Dr. Eric Balcavage
- The Thyroid Debacle – Dr. Balcavage’s book (co-authored with Dr. Kelly Halderman) that explains thyroid physiology through the lens of the cell danger response and adaptive physiology, and introduces his fitness factors framework.
- Thyroid Answers Podcast – Dr. Balcavage’s podcast, where he interviews experts and educates listeners on complex thyroid cases, lab interpretation, and adaptive thyroid physiology. Listen to my episode with Dr. Balcavage!
- Work with Dr. Balcavage – Learn more about his Strategic Thyroid Solutions approach, view services, and apply for a discovery call.
- Follow Dr. Balcavage on Instagram, Facebook, and YouTube
Supplements We Discussed
- Vitamin D – Discussed as a powerful immune and calcium-regulating hormone that can be over-supplemented if we only look at 25-OH levels and ignore 1,25 vitamin D, calcium balance, and inflammation. Consider Pure Encapsulations Vitamin D3.
- Magnesium – Highlighted as a critical cofactor for vitamin D metabolism and binding proteins, as well as overall cellular and mitochondrial function. Consider Rootcology Magnesium Citrate Powder.
- Iron – Covered in the context of ferritin, anemia of chronic inflammation, and why low ferritin does not always equal simple iron deficiency or a straightforward need for supplementation. Consider Pure Encapsulations Optiferrin-C.
- Vitamin A – Mentioned as an important partner to vitamin D in immune regulation and cellular signaling, and something to consider when supplementing high-dose vitamin D.
Other Tools and Resources
- Cell Danger Response paper by Dr. Robert Naviaux – The scientific paper that first helped Dr. Balcavage see that many “dysfunctions” are adaptive responses to cellular threat.
- GLP-1 medications – Discussed as an example of the conventional model (pharmacologic GLP-1 agonists) versus asking why the gut isn’t producing adequate GLP-1 in the first place. Consider Rootcology Berberine as a supplement that can help with blood sugar balance.
- Cyrex Lymphocyte Map / Immuno Typing Test (Lymph Map) – An advanced immune panel that maps patterns like Th1, Th2, Th17, CD8, and NK cells to help identify immune drivers and patterns behind autoimmunity and thyroiditis.
- Cyrex Biome Burden panel – A newer test that evaluates immune reactivity to various fungal, bacterial, and mold-related antigens to help direct deeper root-cause work.
- Map Method, EMDR, neurofeedback – Therapeutic tools Dr. Balcavage often recommends to help reprocess trauma, calm the limbic system, and shift the body out of chronic fight-or-flight.
- Map Method – A trauma-informed somatic approach that helps reprocess stored emotional stress and restore nervous system regulation.
- EMDR (Eye Movement Desensitization and Reprocessing) – A well-researched therapy that uses bilateral stimulation to help the brain reprocess trauma and reduce chronic fight-or-flight responses.
- Neurofeedback – A non-invasive brain-training tool that helps the brain learn self-regulation, supporting calmer stress responses and emotional balance.
- HeartMath – A simple, accessible tool for training heart rate variability and improving stress resilience through breathing and coherence practices.
- Apollo Neuro wearable – A wrist or ankle device that uses vibration patterns to help calm the nervous system and support better sleep and emotional regulation.
Books and Articles About Thyroid Health and Adaptive Physiology
- IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome by Dr. Izabella Wentz. Addressing gut health can be key to addressing autoimmune thyroid disease. This comprehensive guide dives deep into how irritable bowel syndrome is often a catch-all diagnosis that overlooks treatable root causes. It offers a step-by-step approach to help readers understand what’s really driving gut symptoms, and how to create a personalized plan to restore gut health and overall wellness. The book is available for preorder now and will be released on March 17th, 2026!
- Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause by Dr. Izabella Wentz – My book outlining the root-cause model for Hashimoto’s and practical strategies to reduce thyroid antibodies and support healing.
- The Benefits of Vitamin D for Your Thyroid
- Studies on Magnesium and Thyroid Health
- How Balancing Iron Levels Can Help Your Thyroid
- Top 10 Thyroid Tests and How to Interpret Them
- How To Get Accurate Lab Tests When Taking Thyroid Medications
- Why Women Have More Thyroid Disorders: The Izabella Wentz Safety Theory
- 14 Safety Signals for Adrenal Healing
- How to Shrink Thyroid Nodules
- Is Hashimoto’s a Surgical Disease?
- Lasers for Thyroid Tissue Regeneration
Get the Full Episode Transcript
Let’s Connect!
- Follow me on Instagram: @izabellawentzpharmd
- Get my FREE weekly thyroid & gut health newsletter: Sign up here
- Subscribe & Review: If you loved this episode, please leave a review on Apple Podcasts or rate it on Spotify!
Got questions? Drop them in the comments! 🙂
About Our Host
Dr. Izabella Wentz
Dr. Izabella 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 of Hashimoto’s thyroiditis in 2009, following a decade of debilitating symptoms.
Dr. Izabella Wentz has written several best-selling books, including the New York Times bestseller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, the protocol-based #1 New York Times bestseller Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back, the Wall Street Journal bestseller Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, and Adrenal Transformation Protocol. Her latest book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, will be released on March 17, 2026, and is available for pre-order here.
Thyroid Pharmacist Blog
Instagram
Facebook
TikTok
Rootcology
About Our Guest
Dr. Eric Balcavage is a leading functional medicine practitioner with over 25 years of experience specializing in thyroid and chronic health conditions. As the founder of Dr. Eric (formerly Rejuvagen), he’s revolutionizing thyroid care through his innovative Strategic Thyroid Solution approach. A Doctor of Chiropractic from Palmer College and certified functional medicine practitioner, Dr. Eric hosts the Thyroid Answers Podcast, co-authored The Thyroid Debacle, and is known for his groundbreaking work in interpreting thyroid physiology through adaptive cellular physiology rather than conventional dysfunction models. This allows his clients to recover their thyroid health, not just manage their disorder.
Leave a Reply