The relevance of the immune system goes far beyond natural defenses. Along with the endocrine and nervous systems, the immune system is one of the three great regulating systems of the body, affecting all other systems and functions.
Clinical Strategies for Optimizing Thyroid Hormones
Presented by: Izabella Wentz, PharmD+
Thyroid health is foundational to numerous bodily functions, including energy levels, metabolism, digestion, mental health, fertility, stress resilience and more. In this webinar, Dr. Wentz, a nationally acclaimed thyroid specialist, will explain how essential vitamins, minerals and botanicals can be used to support optimal thyroid hormone metabolism, adrenal balance and thyroid-to-adrenal interaction. The discussion will address the role of nutrient insufficiencies, the impact of stress on thyroid function and factors involved in the T4 to T3 conversion process.‡
Learning Objectives:
Learn how to leverage essential nutrients (including vitamins A, D, zinc and selenium) to support thyroid cell metabolism and hormone function.‡
Discover how stress and adrenal function can influence thyroid hormone balance and review important methodologies for managing stress.
Understand the mechanisms of T4 to T3 conversion and how to support a healthy balance of these hormones in your patients.
About the Speaker
Izabella Wentz, PharmD, FASCP+, is a nationally acclaimed thyroid specialist and licensed pharmacist who has dedicated her career to helping practitioners and patients understand and properly address thyroid function, particularly in the >90% of cases involving an immunological component. Dr. Wentz is the author of several best-selling books, including New York Times best seller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause and is dedicated to educating the public and healthcare professionals about functional medicine approaches to optimizing thyroid function and overall health.
+Izabella Wentz, PharmD is a retained advisor for Pure Encapsulations.
The adrenal glands are designed to keep basal rates of corticosteroids, mineralocorticoids and sex hormones and to robustly secrete stress hormones for resilient protection during a stressful moment. However, stress can overwhelm these glands leading to various stages of the adrenal response. In this webinar, Dr. Peter Bongiorno explains how most cases of stress and anxiety are a normal reaction to what we put our bodies and minds through. He will cover the workings of the HPA axis and reveal the true relevance of early, mid and late adrenal response. By learning from his 21 years of clinical experience managing these various stages, you can gain strategies for bringing your patients back to resilience.
Learning Objectives:
Recognize the impact of stress on adrenal function
Understand the workings of the Hypothalamic-Pituitary-Adrenal (HPA) axis
Identify the stages of adrenal response: early, mid and late, how they occur and the methods to test for them
Acquire practical strategies and clinical insights from Dr. Bongiorno to address various stages of adrenal response and enhance patient resilience
About the Speaker
Peter Bongiorno, ND, LAc+, is dedicated to bringing effective holistic healing to the practice of mental health. In 2004, he established two thriving practices NYC Integrative, in New York City and Long Island. Prior to earning his naturopathic doctorate from Bastyr University, he researched at the National Institutes of Mental Health and Yale University, studying stress and the HPA axis. He authored the first integrative medicine textbook for depression in 2008. He has written numerous publications since then including three more books on mental health, including How Come They're Happy and I'm Not?
+Dr. Bongiorno is a retained advisor for Pure Encapsulations.
Longevity & Cellular Aging: An Integrative Approach to Healthy Aging
Presented by: Angela D. Mazza, DO, ABAARM, FAAMFM, ECNU+
Longevity is a word we hear a lot lately. But how do we define it and, more importantly, how do we achieve it? In this webinar, Dr. Angela Mazza will help clinicians navigate the sometimes-overwhelming task of addressing longevity to help their patients achieve both a healthy lifespan and healthspan. Important lifestyle factors will be reviewed along with personalized approaches foundational to longevity medicine.
Learning Objectives:
Learn why addressing healthspan is essential to healthy aging
Review key learnings from “blue zones” and how they contribute to longevity
Discover the “hallmarks of healthy aging” at the cellular level
Find out which integrative approaches can support healthy aging
About the Speaker
Angela D. Mazza, DO, ABAARM, FAAMFM, ECNU+, is triple board-certified in Endocrinology, Internal Medicine, and Anti-Aging and Regenerative Medicine and is a renowned thyroid specialist. She is founder of the Metabolic Center for Wellness in Oviedo, FL, the only center in Central Florida offering radiofrequency ablation procedures. Highly regarded for her individualized approach to patient care, Dr. Mazza is passionate about helping her patients achieve metabolic and hormonal balance and empowers each of them to achieve their unique goals through targeted interventions and lifestyle management. Dr. Mazza is author of Thyroid Talk: An Integrative Guide to Thyroid Health and hosts the podcast “Thyroid Talk with Dr. Angela Mazza.”
+Dr. Mazza is a paid advisor for Pure Encapsulations.
A Three-Step Approach to Immune System Balance: Addressing Self-Tissue Response
The Immune System & Functional Medicine
The relevance of the immune system goes far beyond natural defenses. Along with the endocrine and nervous
systems, the immune system is one of the three great regulating systems of the body, affecting all other systems
and functions.
In fact, the more we learn about immunology, the more we realize that practically all the patterns seen commonly
in a functional medicine practice have a fundamentally immunological basis.
Immunology is at the root of many common clinical objectives, including:
Tolerance of self-tissue
Digestive health
Cytokine balance
Brain function, mood and cognition
Joint function
Glucose homeostasis
Sinus and respiratory health
Cardiovascular function
While support for a healthy immune response is essential in all patients, it is particularly important in
patients with self-tissue response.
This blog will provide a brief introduction to a three-step approach that addresses the immunological basis of
patterns seen commonly in your patients and in particular in patients with self-tissue response.
Useful interventions related to this three-step approach can be found in Pure Encapsulations’ Self-Tissue Response Protocol, developed with functional immunology thought leader Dr. Samuel
Yanuck, and a more in depth review of this information is available in our Self-Tissue Response Brochure and PureResponse®
platform.
Self-Tissue Response: A Three Step Approach
Each step supports a key aspect of the immune system. Interventions for each step are intended to be continued
indefinitely or modified as needed to maintain immune homeostasis.
Step 1. Promote T-Helper Cell Balance
T helper cells are a class of lymphocyte that help the immune system respond appropriately. They begin as naive T
cells and become, when activated, unique T helper cell types. Which type they become depends on cytokines and
other factors in their micro-environment at the time of their activation.
Below are four major T helper cell types and their roles in maintaining immune system balance:
Th1 cells: Support host microbial defenses
Th2 cells: Help activate eosinophils and mast cells
Th17 cells: Respond to the extracellular microbial environment
Treg cells: Modulate the effects of other T cells
A balanced profile of T helper cells is crucial for immune defenses and tissue homeostasis. Unfortunately, many
factors commonly seen in clinical practice can drive an imbalance in T helper cell types. Often, this occurs as
an increase in the number and activity of Th2 cells (Th2 response) and a decrease in the number and activity of
Th1 cells (Th1 response). In turn, this imbalance leads to the expansion of Th17 cells which, through a cascade
of effects, can make the patient more susceptible to developing an immune response directed at self-tissue.
Supporting a healthy profile of T helper cells is, therefore, an important first step in fostering a healthy
immune system and modulating self-tissue response. Clinicians may wish to consider Th1 Support and Th2 Modulator. For more
information refer to Pure Encapsulations’ Self-Tissue Response Protocol.
Step 2. Modulate Cytokine Activation
Cytokines are messenger molecules that orchestrate immune system function. NFkB is a protein complex that induces
gene expression of a mixture of cytokines that initiate immune activation, which can increase self-tissue
response. Persistent NFkB increase can drive STAT3 expression, which increases Th17 response, which promotes
self-tissue response.
Step 2 modulates the expression of NFkB, which supports cytokine balance, a healthy T cell repertoire and tissue
homeostasis. While supporting cytokine balance (Step 2) is an essential step, it is crucial to first support a
balanced T helper cell profile (Step 1).
The interconnectedness of elements in the immune system is often bidirectional. In some patients, progress
depends upon addressing factors you would normally think of as downstream from the mechanisms discussed in Steps
1 and 2.
For instance, G.I., sinus, lung, or bladder mucosal function, or mast cell activation can affect T cell
polarization or cytokine production. Therefore, modulating mast cell activation or supporting GI mucosal health
can also contribute to a healthy T helper cell profile.
Personalize your plan of care by identifying formulas that match the circumstances of your patient’s case. The
following may be useful:
Innate Immune
Support promotes healthy cellular immune response to support innate immunity‡
Epi-Integrity promotes
healthy modulation of mucosal immune responses to support GI integrity in a great-tasting powder‡
Perilla extract supports
healthy modulation of Th2 cytokines and mucosal health‡
Hist Reset modulates mast cell
and immune mediator activation‡
Bringing It All Together
Modulating self-tissue response can sometimes feel overwhelming, but this three-step approach offers a simple and
reliable strategy that addresses the immunological basis of patterns seen commonly in your patients.
Cogence® is an online course—built by Dr. Samuel Yanuck, DC — that offers an in-depth functional
immunology learning experience. Designed to connect underlying immunology with clinical applications,
Cogence® creates a rigorous yet intuitive program that will allow you to navigate each patient's
unique clinical pattern.
At Pure Encapsulations®, we have made a unique commitment to provide functional medicine practitioners
with full access to this course at no additional cost, assuming the full cost of membership.
Your complimentary Cogence® membership will give you access to over 200 instructional videos, each 20
to 90 minutes long and grouped into 22 modules, covering a wide range of topics. Tackle the whole course, or use
it as a learning library, picking videos about topics related to your patient’s cases.
Drug-Nutrient Interaction
Checker: Provides valuable information on potential interactions between your patients'
prescriptions, over-the-counter medications and nutritional supplements.
PureInsight™: Our streamlined platform easily
collects patient data and provides valuable recommendations to help achieve their health goals.
Virtual Dispensary: Our Pure Patient
Direct program provides healthcare providers with access to our virtual dispensary to help simplify patient
sales and reduce in-office inventory.
Self-Tissue Response: Core Immunology and Clinical Strategies
Presented by: Sam Yanuck, DC+
Increasing your knowledge of functional immunology can give you a valuable advantage in
your practice because much of what is seen in functional medicine practice has an
immunological basis. This is especially true in cases involving self-tissue response, where
the presence of other common factors like GI function, autonomic function, metabolism,
food responses and environmental factors can all play a role. This webinar will explore the
underlying immunology of self-tissue response, describe connections to other factors
common in these cases and present interventions that can support the immunological
health of your patients.
You’ll come away with knowledge of the following key objectives:
Review the immunological mechanisms that underly all self-tissue response.
Learn to see complex cases as a map of the patient’s immunological factors.
Recognize the connections between the immune system and the larger functional
medicine picture.
Identify and address key immunological leverage points to support the health and well-
being of your patients.
About the Speaker
Samuel F. Yanuck, DC+, is the CEO and Director of Education for Cogence®, an online functional immunology course, serving nearly 10,000 clinician participants from more than 60 countries around the world. He is an adjunct assistant professor in the Program on Integrative Medicine at the University of North Carolina School of Medicine. Dr. Yanuck co-directs the Yanuck Center for Life and Health, a functional medicine clinic in Chapel Hill, North Carolina, where he’s been seeing patients from everywhere since 1992. Dr. Yanuck helped co-develop the PureResponse™ exclusive.
+Dr. Yanuck is retained advisor to Pure Encapsulations.
Discover the link between stress, occasional anxiousness, and thyroid health. Learn how lifestyle factors and nutrients can support balance and overall well-being
What Is the Connection Between Stress, Occasional
Anxiousness and Thyroid Health?
Table of Contents:
1. Introduction 2. The Interconnected Web 2.1 The Role of Thyroid Hormones 2.2 The Hypothalamus-Pituitary-Thyroid-Adrenal (HPTA) Axis 2.3 Mood and Neurotransmitter Dysregulation 3. Lifestyle Components to Support Healthy Thyroid Function 4. Nutrient Solutions to Support Thyroid Function 5. Pure Encapsulations Nutrient Solutions 6. Conclusion 7. Resources
By: Kim Ross, DCN, CNS, LDN, IFMCP
Introduction
Occasional stress and anxious feelings have implications for thyroid health. A poll conducted in 2024 by the American Psychiatric Association revealed that 43% of adults in the United States experience increased feelings of occasional anxiousness, with 53% of those polled attributing this feeling to stress.1 The American Thyroid Association reports that approximately 12% of the U.S. population will experience changes in thyroid function at some point in their lives 2, though the data on the prevalence varies from 4.6%-14.4%.3 Suboptimal thyroid function is characterized by compromised thyroid hormone production or conversion of thyroxine (T4) to triiodothyronine (T3). Thyroid antibodies may also be present, with or without changes in thyroid hormone levels, resulting in a self-tissue response. Low mood is a common symptom of changes in thyroid hormone levels, with 63% of adults with suboptimal thyroid function having some degree of anxious feelings.4
Conventional intervention approaches often focus on symptom management rather than addressing the root causes of stress, mood dysregulation and thyroid-related symptoms. For example, the most common medical intervention for thyroid support is the use of synthetic T4 medications, which may stabilize thyroid hormone levels but can exacerbate anxious feelings in some patients.5
Pharmaceuticals used for mood regulation have variable efficacy and carry risks that should be carefully considered.6 These limitations underscore the need for a nutrient-focused, integrative approach to supporting thyroid health, resilience and emotional balance.
It’s important to note that any recommendations are not meant to treat, cure, or prevent diseases or be a substitute for medical, diagnostic, and treatment options. Dietary supplements are not intended to replace the use of any medications prescribed.
The Interconnected Web
It can be a challenge deciding optimal clinical recommendations when patients present with occasional stress, anxiousness and changes with thyroid function, with or without the presence of thyroid antibodies. It can be helpful to review the interconnected web between the three to help determine the appropriate and most optimal course of action.
The Hypothalamus-Pituitary-Thyroid (HPT) Axis
The hypothalamus-pituitary-thyroid (HPT) axis is the neuroendocrine system that controls the production of thyroid hormones through a feedback loop. Thyroid stimulating hormone (TSH), is produced by the pituitary gland, which signals the thyroid gland to produce thyroid hormones, primarily thyroxine (T4). Once T4 is secreted, it is bound to transport proteins and carried to the cells and tissues where it passes through a series of metabolic transformations. It is then activated to triiodothyronine (T3) or inactivated into reverse T3 (rT3). This entire process is largely influenced by nutrient (in)sufficiency, stress and other lifestyle factors. However, loss of self-tolerance is another influential factor in this process. Thyroid antibodies may be present with or without abnormalities in the production of TSH, T4 and/or T3 and can contribute to a suboptimal thyroid. Genetics, cytokine dysregulation, diet and lifestyle factors are commonly noted as contributors to loss of self-tolerance.7,8
The Role of Thyroid Hormones
Thyroid hormones play a role in the development, differentiation and metabolic maintenance of virtually all tissues, which is a topic that is beyond the scope of this blog. Of interest, thyroid hormones help regulate the body’s response to stress. Additionally, thyroid hormones directly influence the synthesis, release and degradation of key neurotransmitters associated with stress and mood regulation, including serotonin, dopamine and gamma-aminobutyric acid (GABA).
The Hypothalamus-Pituitary-Thyroid-Adrenal (HPTA) Axis
Suboptimal thyroid function often disrupts the hypothalamic-pituitary-adrenal (HPA) axis, which can alter one’s ability to maintain resilience to the stressors of life while also worsening occasional anxious feelings. There are two categories of stressors:
External: Such as post-traumatic events, work, relationships and finances.
Physiological: Such as nutrient insufficiencies, toxin burden, overactivation of the immune system and cytokine function.
When an individual experiences stress, the HPA axis is activated, leading to increased production of cortisol. This is when the interconnected hypothalamic-pituitary-thyroid-adrenal (HPTA) axis becomes apparent. Elevated cortisol levels can inhibit the conversion of T4 to its active form T3, resulting in suboptimal thyroid function. Additionally, stress can lead to changes in production of reverse T3, which is biologically inactive and competes with T3 for cellular receptors.9 Finally, stress has been implicated as a trigger for loss of self-tolerance and an increased production of thyroid antibodies.10 The feedback loop in the HPTA axis creates a potential pathway through which stress and low functioning thyroid are interconnected.
Mood and Neurotransmitter Dysregulation
The relationship between stress and suboptimal thyroid can also contribute to the development of occasional anxious feelings. Thyroid hormones play a role in regulating the central nervous system (CNS) and the limbic system, which are critical for mood stabilization and emotional processing. Thyroid function in need of support can affect the synthesis and availability of neurotransmitters such as serotonin, dopamine and gamma-aminobutyric acid (GABA), which are essential for maintaining a calm and balanced emotional state.11 In fact, nutrients that are needed for the proper production of thyroid hormones also play a role as co-factors for the production of these neurotransmitters, including, but not limited to, B vitamins, zinc, vitamin C and the amino acid tyrosine.‡
Image created using BioRender.com.
Lifestyle Components to Support Healthy Thyroid Function
Nutrition: A nutrient-dense diet that supports thyroid health, neurotransmitter production, and modulates cytokine response can be effective in managing stress and emotional well-being. Emphasizing foods rich in selenium (e.g., Brazil nuts), iodine (e.g., seaweed, seafood, dairy, eggs, poultry) and zinc (e.g., pumpkin seeds, lean meats) should serve as a foundation. The Mediterranean Diet, known for its anti-inflammatory properties, has been shown to improve emotional regulation and support the neuroendocrine system.12
Exercise: Aerobic activities, such as walking or cycling, have been found to enhance the conversion of T4 to T3 and increase the sensitivity of cellular receptors to thyroid hormones. Additionally, yoga and tai chi, which integrate physical movement with mindfulness, have demonstrated efficacy in reducing stress and promoting thyroid health.13
Sleep: Suboptimal thyroid function may lead to sleep disturbances. Poor sleep aggravates occasional anxiety by impacting neurotransmitters and can lead to the increased production of stress hormones. Prioritizing 7-9 hours of restorative sleep per night, maintaining a consistent sleep schedule and creating a calming pre-sleep routine can help optimize thyroid function, modulate stress responses and promote a calm mood.
Stress Management: Mind-body practices such as mindfulness meditation, deep breathing exercises, guided imagery and progressive muscle relaxation have been shown to provide effectiveness on the psychological and physiological levels.14
Nutrient Solutions to Support Thyroid Function‡
Iodine is a vital nutrient for the synthesis of T4. While adequate iodine intake is essential for maintaining thyroid function, it should be approached cautiously, especially in individuals with a self-tissue response.‡
Selenium is a critical cofactor for the enzyme deiodinase, which converts T4 to T3. Generally, individuals will consume enough of this nutrient in their diet. It is important to be aware of potential selenium toxicity from excess consumption.15
Zinc is an essential trace mineral involved in the conversion of T4 to T3 and is a needed cofactor for the regulation of neurotransmitters. B Vitamins particularly B6, B9 (folate) and B12, play a role in T4 production, and neurotransmitter synthesis. These vitamins also help improve the body’s response to stress.‡
Myo-inositol is the primary form of inositol found in the central nervous system. It plays an important role in cell membrane formation and serves as part of the phosphatidylinositol secondary messenger system, supporting serotonin, norepinephrine and cholinergic receptor function.16‡
Studies have shown that combined use of Selenium methionine and Myo-inositol can support feelings of well-being, thyroid hormone production and healthy TSH, TPO and TG antibody levels.17,18 ‡
L-Tyrosine is an amino acid that serves as a precursor for the synthesis of thyroid hormones and the neurotransmitter, dopamine.
GABA is an inhibitory neurotransmitter and amino acid that promotes calmness and relaxation. It plays a significant role in regulating the HPA axis and reducing the body's stress response. ‡
L-Theanine, an amino acid found in green tea, has been shown to promote relaxation by modulating glutamate (the excitatory neurotransmitter) function, and possibly the GABA, system as well.19 ‡
Ashwagandha (Withania somnifera) is an adaptogenic herb known for its ability to reduce stress and support thyroid health. Research indicates that ashwagandha can lower cortisol levels, support thyroid hormone production and enhance overall well-being.20
Pure Encapsulations® Nutrient Solutions
Pure Encapsulations® provides uniquely formulated products made with high-quality, pure ingredients backed by verifiable science to complement your plan of care and support healthy aging in your patients.‡
Thyroid Support Complex: Supports optimal thyroid gland function, healthy thyroid cell metabolism and thyroid hormone function‡
Suggested Use: As a dietary supplement, take 2 capsules daily, with a meal.
Daily Stress Formula: Promotes mental relaxation and moderates the effects of occasional stress, supports the body’s resilience when faced with occasional stress and helps moderate mild fatigue under stressful conditions‡
Suggested Use: As a dietary supplement, take 3 capsules daily, with or between meals.
L-Theanine: Promotes relaxation, with Suntheanine®, without causing drowsiness‡
Suggested Use: As a dietary supplement, children ages 8-18, take 1 capsule, 1-2 times daily, between meals. Adults, take 2 capsules, 1-3 times daily, between meals.
Zinc 30: Broad physiological support, including immune function and emotional wellness‡
Suggested Use: As a dietary supplement, take 1 capsule, 1-2 times daily, with a meal.
Suggested Use: As a dietary supplement, take 1 capsule daily, with a meal, or as directed by a health professional.
GABA: Promotes relaxation and moderates occasional stress. May also support immune health during occasional stress.‡
Suggested Use: As a dietary supplement, take 1 capsule daily, between meals, or as directed by a health professional.
DopaPlus 180’s:Promotes the production of dopamine to support daily cognitive function and performance on mental tasks while also supporting mood.‡
Suggested Use: As a dietary supplement, take 3 capsules, 1-2 times daily, with low protein foods.
SeroPlus:Promotes serotonin synthesis to support relaxation, moderate occasional stress and maintain healthy eating behavior. Provides neurotransmitter precursors to help balance serotonin function and maintains healthy serotonin activity and reuptake.‡
Suggested Use: As a dietary supplement, take 2 capsules, 1-2 times daily, between meals.
NeuroPure 120’s: Provides enhanced support for emotional balance and mood stability while supporting overall neurotransmitter function and neuronal health.‡
Suggested Use: As a dietary supplement, take 2 capsules, 1-2 times daily, between meals.
Inositol Complex: May support healthy mood, emotional wellness and behavior and helps lessen occasional nervous tension.‡
Suggested Use: as a dietary supplement, take 1 capsule, twice daily with meals.
Conclusion
The intricate connection between stress, occasional anxiousness, and thyroid health underscores the importance of a holistic approach to wellness. By understanding the role of the HPT and HPTA axes, as well as the impact of lifestyle factors and nutrient support, individuals can take proactive steps to better manage their thyroid health and emotional well-being. Prioritizing a nutrient-dense diet, stress management techniques, quality sleep, and appropriate supplementation can create a foundation for resilience and balance. While navigating these interconnections can be complex, informed choices and integrative strategies offer a pathway to improved overall health
Resources
Thyroid Support Protocol‡: Designed by our clinician partners to help you deliver the most effective care and support for your patient's thyroid.
Drug-Nutrient Interaction Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.
PureInsight™: Our streamlined platform easily collects patient data and provides valuable recommendations to help achieve their health goals.
Virtual Dispensary: Our Pure Patient Direct program provides account holders FREE access to our virtual dispensary to help simplify patient sales and reduce in-office inventory.