Susan:
Hey everyone. It's Dr. Susan Peirce Thompson. On this week's vlog, I am interviewing my dear old friend. It's been a while, Dr. Isabella Wentz. Isabella, thank you for joining me on the Bright Line Eating® Podcast.
Dr. Isabella Wentz:
Susan, it's so great to be here with you.
Susan:
Yeah. And weekly vlog, of course, this always goes out in multiple formats. Isabella and I, I haven't seen you in so long. It's been eight years. You were pregnant with your first child the last time I saw you and you just had your second. Congratulations.
Dr. Isabella Wentz:
Thank you. So sweet. Yeah, we go way back and it's funny how time flies, doesn't it?
Susan:
It's remarkable. You blink and so much time has passed. What you've done is you've changed your expertise. Well, not changed your expertise, but you are always a thyroid expert and you just published a groundbreaking book on irritable bowel syndrome. You're a Doctor of Pharmacy, I believe. Tell us a little bit about your story and how did you come to write a book on IBS?
Dr. Isabella Wentz:
In full disclosure, I was never interested in IBS or thyroid disorders during pharmacy school. That is until life decided that I should be interested in these conditions by giving them to me. I started off with IBS during my pharmacy training, and it was awful. Medications really didn't do the trick in helping me resolve my symptoms. As time went on, I ended up with more and more symptoms, chronic issues like acid reflux, carpal tunnel, hair loss, anxiety, panic attacks, so on and so forth.
Susan:
Carpal tunnel comes from IBS?
Dr. Isabella Wentz:
In both arms.
Susan:
Really?
Dr. Isabella Wentz:
It's all connected actually. Yeah. It is all connected. I ended up getting a diagnosis of Hashimoto's thyroiditis, which is the most common reason of thyroid dysfunction in the United States. I have it. You have that too. Oh yeah. That was six years after my IBS diagnosis. What got me to, I guess, become really passionate about thyroid disorders and made me become the thyroid pharmacist was figuring out the gut and thyroid connection. Many of the things that I did to get my autoimmune thyroid condition into remission really focused on the health of my gut. And so, I really focused my career on helping people with Hashimoto's get themselves into remission, get rid of all their symptoms. And within ... A big body of my work has always focused on gut health. And the last few years, I kind of thought about what can I really do to impact people? Many times, with autoimmunity, they end up having a lifetime of symptoms and struggles. Sometimes we can reverse a lot of things, but many times, for example, a person with thyroid dysfunction still has to take thyroid hormone if they've had an autoimmune attack against their thyroid for so long that they essentially burn out their thyroid gland. And so, because IBS oftentimes precedes many autoimmune conditions, getting to a person when they're newly diagnosed with IBS, I feel like is the best preventative medicine that we can do because if we can figure out what's driving their gut dysfunction, then we can get rid of their constipation, diarrhea, bloating, so on and so forth, but we can also prevent a lifetime of illness. All disease begins in the gut. And so-
Susan:
Interesting.
Dr. Isabella Wentz:
Interestingly, carpal tunnel, to give you an example, for me, the carpal tunnel was coming from a dairy sensitivity, and the dairy sensitivity was also causing my acid reflux and IBS. Underneath the dairy sensitivity, there's also nutrient deficiencies that lead to people becoming sensitized to dairy. The IBS book really expands on a lot of the work that I've done in the last 10 plus years on figuring out the root causes of autoimmunity and illness in general.
Susan:
Interesting. Interesting. Okay. Let's start at the beginning because now I'm curious, do I have IBS? Have I had IBS? Is that related to my Hashimoto's? How would I know if I have IBS? How would one of our listeners who is asking themselves that question, those questions, how would they know if they have IBS? What is IBS?
Dr. Isabella Wentz:
Irritable bowel syndrome is essentially your digestion is off. It's a label that's given to people through conventional medicine when they've had recurrent abdominal pain, bloating, gas, changes in bowel habits such as diarrhea, constipation. Sometimes they might be predominantly diarrhea prone or sometimes they might be predominantly constipation prone. Sometimes they might go between the two. And when this begins to impact people's quality of life, and this, when it happens for more than a couple of months, that's generally going to be a reason for somebody to get the IBS label. Now, I will say IBS is just the label. It doesn't really tell us why your digestion is off.
Susan:
It sounds very nondescript, like almost how a colic in a baby just means your baby cries all the time and we don't know why. You're like, okay, that doesn't actually mean anything. Is it kind of like that?
Dr. Isabella Wentz:
Yeah. Yeah. Okay. It's kind of like there is this cluster of symptoms and we're going to give it a name The symptoms can vary. Some people might have stomach aches, or some people might have diarrhea. What's interesting is that in autoimmunity, we need three things to be present, and that's going to be genetic predisposition, some kind of a triggering event, and then also gut permeability, which is known as a leaky gut. This can be asymptomatic or this can actually be associated with IBS. The people that I've worked with with thyroid disease, they almost always have some kind of a gut disturbance. For many people, it might be IBS symptoms or IBS-like symptoms. They might carry that diagnosis, but for others, as many as 50%, the gut issues are actually asymptomatic. There is gut inflammation happening or there is some kind of a gut situation going there, but that they don't have any symptoms or maybe they don't know that they have symptoms. I know many people that I've worked with and talked to, they would go poop every two weeks and they thought that was normal for them or they would have to strain with bowel movements and they thought that was normal or they would have multiple bowel movements a day like four or five or stomach pains after eating or bloating. A lot of times these symptoms are so common that they are brushed off as normal, but they're definitely not common.
Susan:
Wow. In your book, you've got a whole bunch of different chapters about different angles on it. So, have you uncovered that IBS is actually potentially, it could be this or it could be that or it could be this or it could be that? Is that how it goes?
Dr. Isabella Wentz:
Exactly. So, IBS, again, is just like a wastebasket diagnosis and the treatment approaches right now with conventional medicine is like less than 25% of people actually get symptom relief. And again, the treatment approaches are very much like band-aid treatments where getting to the root cause- Take
Susan:
Prilosec, right? Yeah. So that your stomach doesn't make acid anymore. Then you can't digest your food, but at least when it's coming up your throat, it won't hurt so bad. Yeah.
Dr. Isabella Wentz:
Or take Imodium to slow down your diarrhea or take some laxatives to go poop or MiraLAX. This is something that I feel like even if people do get symptom resolution, the underlying causes are still there and then they're going to lead to low grade inflammation and other kinds of health challenges. In my research and my experience with clients, there are various causes. Stress is one of the causes that I know I was told when I was in grad school, my physician was like, "Oh, you're stressed. You're in pharmacy school. Of course you're going to have problems. Stress is causing your symptoms." And I think he wasn't wrong. Stress can definitely contribute, but it's not just a condition that's all in a person's head. Stress can definitely make digestion worse. It can slow down our digestive juices. It can suppress our hydrochloric acid. It can prevent our gut immune system from working properly to keep infections at bay. And it can also act whenever we release adrenaline, this acts as super fuel for some of our opportunistic and pathogenic bacteria. But beyond stress, there are also a lot of physiological things going on in a person with IBS. For one person, it might be small intestinal bacterial overgrowth. Another person might have protozoal infections that are, yes, found in Western countries. You do not need to be a world traveler to have those. There are enzyme deficiencies. There are going to be food sensitivities, things like dairy sensitivity we talked about, but also many other foods and food additives can produce IBS symptoms. There are also things like celiac disease, inflammatory bowel disease, all kinds of infections that hormonal imbalances that can be a root cause of IBS. The tricky thing is every one of them requires a different treatment approach. So, it's not like you should just take more fiber or just take a probiotic. If you have a dysbiosis, then taking probiotics is going to be a treatment approach. But if you have celiac disease, then you need to get off of gluten, for example. So, there's all these different approaches. I think conventional medicine and even unfortunately integrative medicine, functional medicine, sometimes they will still give everybody the same thing even with those symptoms without really figuring out the cause.
Susan:
Yeah. Where do you recommend people start then? How do you figure out ... If someone's listening and they're like, okay, well, I have some bloating, I have some constipation or diarrhea, I have some stomach pain, where do they start to figure out what might be causing it?
Dr. Isabella Wentz:
A good place would be like an elimination diet to figure out some of the most common reactive foods, gluten, dairy, soy are some of the more reactive foods that people tend to have issues with when they have IBS. The other things to consider is you might have issues with fat malabsorption. So, fatty foods might trigger you. And this might not be like, you should stay off of fatty foods forever because we do need fat. This might be, we actually need to do some repair on your digestive tract. We might actually need some enzymes like ox bile or pancreatic enzymes to support fat digestion, or we might need to figure out what kind of infection or imbalance is causing this dysfunction. The other thing would be the other foods include raw foods and vegetables. Some people really have an issue with like lettuce, raw lettuce and blueberries when they have blueberries.
Susan:
Blueberries?
Dr. Isabella Wentz:
Yeah. Seems random, but when they have IBS, they might react to foods like that. Interesting. And this is actually a sign that your gut microbiome is out of balance. You would want to incorporate, you might temporarily want to limit those foods and eat well-cooked foods, but you would also want to incorporate some resistant starch, some butyrate and beneficial bacteria to help you grow more of the bacteria that help with veggie digestion. Then there would be others type of things if somebody is, especially if they have inflammatory bowel disease, I would really look into-
Susan:
Let's pause there on the elimination diet part, because I'm thinking about someone who does Bright Line Eating. If someone's doing Bright Line Eating, they're probably already off gluten. There are ways to eat gluten that don't involve eating flour for sure. You can boil up a bunch of wheat berries and eat it for breakfast with yogurt and whatever. But giving up soy and giving up dairy, a lot of people on Bright Line Eating would eat both of those. And then we eat a ton of vegetables in Bright Line Eating. So, someone could absolutely be finding that raw vegetables are triggering them. Do you go through the elimination diet in your book, like really map out how to do it?
Dr. Isabella Wentz:
Yes, we do go through that. So, how to eliminate foods. And generally speaking, you do want to eliminate them for three weeks or so just to figure out what's causing a reaction. I know when I first was like, okay, I'll just give it a day. I don't feel any different, right? You don't want to give it at least three days is like you might start seeing results, but definitely by three weeks you'd be able to tell a difference. And you can cook your vegetables, right?
Susan:
Yeah.
Dr. Isabella Wentz:
So you can do that. If you react to things like onions, for example, you might have something called-
Susan:
I have a friend, can't have any onion or garlic at all. Yeah.
Dr. Isabella Wentz:
And so, in that case, she might have something like SIBO. The tricky part about food sensitivities is that I think a lot of functional medicine, integrative medicine has been like, okay, if you have food sensitivities, don't eat those foods. But as you know, that can be very restrictive and then we run out of good foods to eat. And so, what we want to think about is why are you reacting to these foods? If you have something like SIBO, small intestinal bacterial overgrowth, then your elimination diet is going to be helpful with your symptoms, but it's not going to be the treatment. You would want to actually go further with that, potentially get tested for SIBO, and then you would take some treatments for that. I love utilizing herbal remedies. There are also antibiotics that can be utilized as well as the elemental diet, which is like a temporary diet that helps with eradicating the bacterial overgrowth in the small intestine. So again, figuring out which foods trigger you is going to be really important. One, for symptom relief, and two, for figuring out what might be out of balance with your body. Okay, fatty foods, there's a chance you have digestive enzyme deficiencies with lipase or pancreatic enzymes or your bile. And then the other thing would be optimizing your digestive process, which is something everybody can do right at home.
Susan:
Do you have a copy of your book behind you there somewhere? It's Finding and Treating the Root Cause of IBS. There it is. You always write the thickest, most encyclopedic, comprehensive books, like really, really beautiful, intense books. Have you been happy with the response you've been getting to this book?
Dr. Isabella Wentz:
I have been. I think it's given people a lot of answers where they might have been working with IBS for over a decade plus, and they really haven't gotten a lot of results because they've been chasing one particular, I guess, thought pattern that maybe it was SIBO and they needed to be on a low FODMAP diet or they were too stressed. And so, they can go down that road where there are actual answers in this book that help people feel better.
Susan:
And other options that it could be something else that's going on and you give them multiple sort of hallways to walk down and explore.
Dr. Isabella Wentz:
Yeah, absolutely. My hope is that more people will be able to take this information and really take charge of their own health. I think the other thing people have been really excited about is food sensitivities don't have to be permanent. A lot of times we can reverse them if we figure out what the imbalance is. I mentioned dairy sensitivity. Sometimes this could be a carnitine deficiency. When people are deficient in carnitine, for example, they might not be able to tolerate dairy foods and replenishing carnitine can be helpful. Constipation is also a sign of carnitine deficiency and brain fog.
Susan:
Wow. Okay. That's really hopeful and helpful. I love it. I love it. How did you figure all this out? It's amazing to me how you, both with a thyroid and with IBS have figured out so much stuff that is not just commonly known in West. I know you didn't learn it in pharmacy school, right? How did you figure all this out?
Dr. Isabella Wentz:
Yeah, I tend to be a little bit obsessive, I guess. I'm writing a book right now.
Susan:
What?
Dr. Isabella Wentz:
I'm kind of like a dog with a bone. If there's a problem in my head, I try to figure it out and I have a very solution-focused brain, and I've gone through a lot of training with functional medicine. I've worked with a lot of clients. I do a lot of research on PubMed and sometimes it's accidents actually. So, things happen by total accident where I will be like, oh, well, maybe somebody can utilize this or we do this type of test and somebody might be deficient in a nutrient and all of a sudden things shift for them or an infection might come out and we treat that infection and then things shift and then I'll start seeing those patterns where, for example, people who are brain sensitive, many times they would have an infection like blastocystis hominus and we would treat that and the brain sensitivity would go away. So, just a really good obsessive pattern recognizing person, I guess.
Susan:
Yeah. I'm writing a book right now on the dopamine dominant brain and you have one. Just saying.
Dr. Isabella Wentz:
I definitely have one of those brains, so I'm super, super excited to read that book. You'll have to send me an advanced copy, so maybe that might help me.
Susan:
I think you'll find it fascinating. Yeah. Some of us really are next level in how we dive into things and thank God, right? Yay, we need trailblazers in the world. I love it. What are you most hoping that this book will change for people? What's your hope with this book?
Dr. Isabella Wentz:
I really hope that it gives people answers to why they've been having digestive symptoms. That's a really big, big hope of mine. So, even if they have irritable bowel syndrome or inflammatory bowel disease, which is more intense, where people can have rectal bleeding and some people have had to have their colons removed and it's just like a condition that causes people to lose a lot of weight, I have answers for that. I have protocols for that that have been tried and tested on how to reverse these conditions. And sometimes we can do it in mere weeks, even in people that have had symptoms for decades. So, that's really a big hope of mine that people will be able to use this information and heal themselves from what they're struggling with right now. And then potentially reverse other types of conditions. We know that IBS is tied to anxiety, fibromyalgia, autoimmunity, like pretty much A to Z conditions are related to our gut health. And so, healing the gut can help a lot of these conditions and can help prevent additional conditions down the road. That's my hope for people is to offer them an opportunity to heal so they can move on with their life and do what they're meant to do and enjoy life and enjoy all the foods that they're wanting to enjoy and live in a very vital, happy life.
Susan:
I love it. I love it. And Isabella, do you have a clinical practice still?
Dr. Isabella Wentz:
I do work with a limited amount of clients. Right now, I am kind of transitioning out of maternity leave. I have a four-month-old baby that's going to turn five months soon. And so, right now I'm focused on my book and baby, but I will be starting to take clients a little bit probably after the summer again.
Susan:
Nice. Beautiful, beautiful. You're in Austin, Texas now. You didn't used to be, you used to be in Colorado, but now you're in Austin.
Dr. Isabella Wentz:
I did used to be in Colorado and I actually spent time in Los Angeles and Chicago and Europe. I grew up in Europe, and I had an opportunity to live there about 10 years ago. And so, I'm a citizen of the world, I guess.
Susan:
I love it. I love it. Any last thoughts, Isabella, that you want to leave the Bright Line Eating community with?
Dr. Isabella Wentz:
I am excited to be here and I'm so excited for your work, Susan. I think people oftentimes find that life gives them struggles and we can get into this victim mentality that this is happening to me and you feel like it's not fair. I do encourage you to shift your mindset and really focus on the things that you can do and take charge of your health and educate yourself and take your best foot forward every day.
Susan:
Beautiful. Well, Isabella, it's so good to see you again. It's been way too long. Thank you so much for writing this book on irritable bowel syndrome, the definitive encyclopedic tome on irritable bowel syndrome. I know it's going to help so many people, and I'm just so glad to get to share it with the Bright Line Eating community. Thank you, my dear.
Dr. Isabella Wentz:
Thank you so much for having me, Susan. Such a pleasure.
