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For the average person, it can take years to get properly diagnosed with a thyroid condition – and in the meantime, the symptoms can look like almost anything. In this episode of Thyroid Pharmacist Healing Conversations, I spoke with Sara Russell, PhD, FNTP, a functional nutritional therapy practitioner who specializes in women’s mental health and perinatal lab interpretation.
We talk about the complicated (and often overlooked) overlap between bipolar symptoms, thyroid dysfunction and thyroid autoimmunity, celiac disease/gluten sensitivity, and postpartum mental health. Sara also shares why people with psychiatric diagnoses often don’t get the medical follow-up they deserve, and what lab markers can help reveal root causes that might otherwise be missed.
With World Bipolar Day coming up on March 30th, this conversation feels especially important. It’s a reminder to cultivate a more thorough understanding about the disease – including how seemingly unrelated factors, like thyroid imbalances, can impact mental health. It’s also a reminder to advocate for ourselves and our loved ones when we know something is wrong, but isn’t being fully addressed by conventional health care.
If you’ve ever wondered, “Is this really my mental health… or is my body waving a giant red flag?” – this episode is for you.
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. I share my own experience of feeling better off gluten… yet more anxious when my blood sugar swings got worse. We 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. We get into 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.
Freebies
- 5 Research-Backed Ways to Choose the Perfect Prenatal (Sara’s free prenatal guide)
Guest Resources / Connect With Sara Russell
- Find more resources on Sara’s Website
- Follow Sara on Instagram and Facebook
- Take the Blood Work in Pregnancy Masterclass: What You Never Learn About Blood Work in Preconception, Pregnancy & Postpartum. Use coupon code: WENTZ100 to receive 10% off.
Supplements We Discussed
- High-quality B-complex – Supports methylation and nervous system resilience; especially relevant when homocysteine is elevated or B vitamin status is low.
- Vitamin B12 + folate – Key for mood, energy, and homocysteine balance; often worth monitoring in people on certain psychiatric medications. Consider Pure Encapsulations B12 Folate.
- Vitamin D – An immune and mood-support nutrient that’s commonly low; especially important in autoimmune patterns and postpartum recovery. Consider Pure Encapsulations Vitamin D 5000.
- Vitamin B6 – Supports neurotransmitter balance and histamine metabolism; may be useful when mood symptoms overlap with histamine issues. Consider Rootcology P5P.
- Retinol (vitamin A) – Plays a role in immune modulation and overall resilience (best used thoughtfully and ideally guided by labs).
- Omega-3 fish oil– Sara shares that the EPA fraction may be particularly supportive for mood stability. Consider Pure Encapsulations EPA/DPA Essentials.
- Vitamin E – Antioxidant support that can help protect fatty acids (including omega-3s) from oxidation; also often low in modern diets. Consider NOW Sun-E 400 for a soy-free option.
- Selenium – Foundational nutrient support commonly discussed in Hashimoto’s care. Consider Rootcology Selenium + Myo-inositol.
- Myo-inositol (and D-chiro-inositol blend) – Often used to support insulin sensitivity and hormone signaling; we also discuss how lithium can deplete inositol pathways. Consider Rootcology Myo-inositol and Pure Encapsulations Inositol Complex.
- Carnitine – Mentioned in the context of medication nutrient depletion; supports cellular energy metabolism. Consider Rootcology Carnitine Blend.
(As always: confirm supplement fit/dosing with your practitioner – especially in pregnancy/postpartum.)
Other Tools and Resources
- Fatigue and Brain Fog Fix in Six: Thyroid & Adrenal Program – A step-by-step program from Dr. Izabella Wentz that can help reduce brain fog, balance blood sugar, balance mood, and restore energy, clarity, and vitality. Learn more and join the program here.
- Full thyroid panel (including antibodies) – TSH, free T4, free T3 + thyroid antibodies (and consider ultrasound when appropriate).
- Celiac testing + follow-up evaluation – Including consideration of biopsy when clinical suspicion remains high despite negative antibodies.
- Homocysteine Testing – A key functional marker tied to B vitamin status and metabolic stress.
- Fasting glucose, fasting insulin, hemoglobin A1C – Core markers for insulin resistance and blood sugar stability.
- Kidney monitoring labs when on lithium – Especially critical during pregnancy due to filtration changes.
- NaPro Technology – Mentioned as a supportive approach for fertility-focused hormone monitoring and progesterone support.
- Research article: Bipolar disorder and antithyroid antibodies – This paper reviews evidence linking bipolar disorder with elevated antithyroid antibodies, suggesting that thyroid autoimmunity may play a role in mood instability even in the absence of overt thyroid dysfunction.
- Research article: Affective psychosis, Hashimoto’s thyroiditis, and brain perfusion abnormalities – This case report describes a patient with Hashimoto’s thyroiditis and affective psychosis who demonstrated abnormal brain perfusion patterns, highlighting a potential autoimmune-related mechanism behind psychiatric symptoms.
- Research article: Rapid cycling bipolar disorder is associated with antithyroid antibodies, instead of thyroid dysfunction – This study found that rapid cycling bipolar disorder is more strongly associated with the presence of antithyroid antibodies than with abnormal thyroid hormone levels, reinforcing the connection between thyroid autoimmunity and mood disorders.
Articles About Thyroid Health, Mental Health, and Postpartum
- Are You Going Crazy Or Is It Just Your Thyroid?
- Root Causes of Depression and Hashimoto’s
- How Myo-inositol Can Improve Hashimoto’s Symptoms
- MTHFR, Hashimoto’s and Nutrients
- Is Gluten the Root Cause of Your Thyroid Condition?
- Could Nutritional Lithium Benefit or Hurt Hashimoto’s?
Get the Full Episode Transcript
Let’s Connect!
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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, is available for order here.
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