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If you’ve been told your thyroid labs are “normal” yet you still feel exhausted, foggy, puffy, anxious, or like your body is moving through wet cement – you are not alone. I’ve been there, and I’ve seen it in thousands of people with Hashimoto’s and hypothyroidism.
In this episode of the Thyroid Pharmacist Healing Conversations podcast, I interviewed Dr. Sam Shay, a functional medicine expert (and comedian!) who helps women use personalized, data-driven strategies to improve energy, brain health, and resilience. Dr. Sam shares the story that shaped his thyroid work: a woman with classic hypothyroid symptoms and a visible goiter was told she was “fine” because her TSH was normal… and was offered antidepressants instead of deeper thyroid (and root-cause) testing.
Together, we explore the critical lab tests that help uncover what’s really driving symptoms – including nutrients, gut health, stress hormones, estrogen balance, genetics, and (a big one that’s often missed) mitochondrial function.
What you’ll learn in this episode:
- Why a “normal” TSH can be misleading – and what a full thyroid panel reveals. Dr. Sam explains how people can have significant thyroid symptoms and autoimmunity even when their TSH is in a “normal” range. He outlines the additional labs that provide a more complete picture of thyroid function, hormone conversion, and immune activity so care is not based on a single number.
- How gut permeability and gluten can trigger thyroid antibodies (and why it’s a “two-for-one” problem). Intestinal permeability (“leaky gut”) can allow food particles or microbial byproducts into the bloodstream, prompting antibodies that may cross-react with thyroid tissue. Gluten is a key factor because it can both increase gut permeability and contribute to immune cross-reactivity.
- Why chronic stress can suppress thyroid function: Dr. Sam breaks down how HPA axis dysfunction shifts the body into a survival state, which can reduce thyroid activity and slow long-term healing. He also explains how ongoing stress can worsen gut health, creating interconnected challenges.
- The role of mitochondria in thyroid-related symptoms. Dr. Sam describes mitochondria as the place where thyroid hormones are activated to produce energy. When mitochondrial function is impaired, individuals may experience symptoms of hypothyroidism even when standard thyroid labs appear normal.
- Key symptoms that may point to mitochondrial dysfunction. The discussion highlights patterns such as persistent fatigue, low exercise tolerance, muscle weakness, brain fog, blood sugar instability, and migraines. Dr. Sam also explains how environmental factors like mold and toxins can significantly impact mitochondrial function.
- How personalized testing can help identify root causes more effectively. Instead of relying on generalized approaches, Dr. Sam explains how targeted lab testing and genetic insights can guide more precise interventions. This approach helps identify the most impactful changes and can reduce the trial-and-error process often experienced in thyroid care.
Freebies
- Dr. Sam Shay’s 3-Day Lifestyle & Nutrition Guide
- Free Masterclass – Discover what type of testing you might need, learn about working with Dr. Sam, and discover how to boost your mood, energy, and more.
Guest Resources / Connect with Dr. Sam Shay
- Book a discovery call with Dr. Shay
- Learn more on Dr. Shay’s Website
- Follow Dr. Shay on Instagram, Facebook and YouTube
- DIY functional genetics program (self-directed)
- 1-hour complete comedy special: “NeuroSpicy: Love, Live & Comedy on the Spectrum”
Supplements We Discussed
- CoQ10 – Supports mitochondrial energy production and cellular resilience.
- L-Carnitine – Helps shuttle fatty acids into mitochondria for energy (“carnitine shuttle”). Consider Rootcology Carnitine Blend.
- Magnesium – Supports energy metabolism, stress response, and hundreds of enzymatic reactions. Consider Rootcology Magnesium Citrate Powder.
- Riboflavin (Vitamin B2) – Key cofactor for mitochondrial energy pathways.
- Glycine – An amino acid that supports detox pathways and cellular repair processes.
- Vitamin B6 – Important for amino acid metabolism and neurotransmitter support. Consider Rootcology P5P.
- Alpha Lipoic Acid – Supports glucose metabolism and antioxidant defenses.
- Fish Oil (Omega-3s) – Helps support a healthy inflammatory response. Consider Pure Encapsulation EPA/DHA Essentials.
- Vitamin D – Immune and inflammation support; commonly low in Hashimoto’s. Consider Pure Encapsulations Vitamin D 5000.
- Iron / Ferritin support – Needed for oxygen delivery and energy production; a deficiency in iron can worsen fatigue. Consider Pure Encapsulations OptiFerin-C.
- Zinc & Selenium – Nutrients that support thyroid hormone metabolism and immune balance. Consider Pure Encapsulations Zinc 30 and Rootcology Selenium + Myo-Inositol.
- Tyrosine – A building block used in thyroid hormone production.
Testing Resources
- Thyroid labs (full panel): TSH, free T3, free T4, reverse T3; antibodies (TPO, thyroglobulin, TSH receptor). Read more about thyroid tests in my article on the Top 10 Thyroid Tests and How to Interpret Them.
- Mitochondrial testing:
- Gut testing:
- Nutritional testing:
- Mold (mycotoxin) testing:
- Heavy Metal / Mercury testing:
- Genetic Testing
Books and Articles About Thyroid Health, Hashimoto’s & Root Causes
- Adrenal Transformation Protocol: A 4-Week Plan to Release Stress Symptoms and Go from Surviving to Thriving by Dr. Izabella Wentz – A simple program to help you balance mood and mental health by identifying adrenal triggers, balancing the stress response, and building resilience to future stress.
- Top 10 Thyroid Tests and How to Interpret Them
- Is Gluten the Root Cause of Your Thyroid Condition?
- Healing Food Sensitivities
- Food Sensitivities and Hashimoto’s
- 6 Root Causes Behind Leaky Gut and Autoimmunity
- How Balancing Iron Levels Can Help Your Thyroid
- Mold: A Potential Trigger of Hashimoto’s
- 11 Strategies to Overcome Hashimoto’s Fatigue
- How Does Carnitine Support Hashimoto’s?
- Are Your Adrenals Sabotaging Your Health?
- The Mitochondria, Adrenal, and Thyroid Connection
- The Benefits of Vitamin D for Your Thyroid
- Studies on Magnesium and Thyroid Health
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, is now available!
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About Our Guest
Dr. Sam is a functional medicine expert, speaker, and comedian who has helped countless women achieve vibrant health through personalized, data-driven strategies. Specializing in energy optimization, brain health, and overcoming fatigue and stress, Dr. Sam combines his medical expertise with his unique comedic perspective to make health transformation accessible, engaging, and empowering.
His 25+ years of experience have led him to create the Neuro-Harmony Model and “DNA-Decoded”: two comprehensive frameworks designed to nurture and optimize mental, emotional, and physical health. These models provide clear, actionable strategies to help women manage stress, improve focus, and sustain overall well-being.
Dr. Sam also uses his platform to support women who face unique challenges during major life transitions, providing actionable tools and strategies to support physical, mental, and emotional well-being. Drawing on his deep understanding of functional medicine, he blends humor and science to help people tap into their full potential, both in health and in life.
Dr. Sam has been featured on hundreds of podcasts and stages, sharing his approach to unlocking human potential through functional medicine. He is also a Stand-Up Comic advocating for people on the Spectrum with his clean, observational comedy. His free comedy special, “NeuroSpicy: Love, Life & Comedy on the Spectrum,” is available for free on YouTube. Dr. Shay helps neurodiverse adults, parents of children on the spectrum, and those with neurodiverse parents through his Neuro-Harmony Model to bridge understanding, build resilience, and create harmony.
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