The aim of this article is to give you an in-depth knowledge of the thyroid-adrenal connection.
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The thyroid and adrenal glands are intimately connected. Quite often, well-meaning doctors treat thyroid disorders before identifying or addressing the ever-present underlying Adrenal Fatigue.
Before you jump into medicating yourself, it’s important to have an understanding of how your thyroid disorder is affected by Adrenal Dysfunction.
Patients with Adrenal Fatigue are a cut above the rest. By way of more than 300,000 patient interactions, we at Clymer have learned a great deal about our patients. They are conscientious, “Type-A” personalities, caring folks, possessing above-average intelligence.
In addition to those traits, my patients have educated themselves about their health challenges.
If you’ve found this page, I bet you are one of them. Once your GP or endocrinologist diagnosed you with a thyroid disorder, you were probably searching the net the very next hour for all the whats and wherefores.
#1 My personal journey with Adrenal Fatigue
I have endured my own personal battle with Adrenal Fatigue.
I’ve been there, and it’s what brought me here. Like all of my patients, first and foremost, I was exhausted. I could barely keep up with my studies. Certainly, the weekend passed without any social interaction—I spent it sleeping. My body hurt. I was always sick. My digestion was a mess.
It was only by chance that I discovered my symptoms were the results of something bigger. While I was studying Naturopathic Medicine at Bastyr University, I happened upon a book, Chronic Fatigue Unmasked, by Dr. Gerald Poesnecker, and it opened my eyes.
All my symptoms were there: profound fatigue, gastrointestinal issues, chronic illness. The list went on.
To me, one of the most exciting areas of my studies was the effect of the adrenal hormones on thyroid function. I already had an intensely personal interest in the study of Adrenal Fatigue, but its tie to the working of the endocrine system was fascinating to me.
After graduation, I made my way to Clymer Healing Center to perform my residency with the founder in the field of Adrenal Fatigue, Dr. Gerald Poesnecker. He became my mentor. After his passing, I refined and built upon Dr. Poesnecker’s proven methods for assessing and treating Adrenal Fatigue.
In the video at the bottom of this page, I share my journey with Adrenal Fatigue.
#2 Can you relate?
Many people speak to their GPs or even specialists, such as endocrinologists, about their suspected thyroid dysfunction.
They could be experiencing any one or combination of the following:
- Weight gain
- Cold hands and feet
- Frequent bruising
Are you scratching your head wondering why you have all the symptoms of a thyroid disorder but your lab work always appears normal?
Perhaps, if you’re on thyroid medication for hypothyroidism, your gut may be telling you that shouldn’t be.
You’re gaining weight even when you’re eating all “the right things?”
These are complaints in common with most of my adrenal-thyroid patients.
#3 What is the thyroid-adrenal connection?
The thyroid is well-accepted as being the engine of the body, driving your energy and metabolism.
The adrenals are your oil and gas.
When the body realizes that the oil and gas (the adrenals) are running low, it slows the engine (the thyroid) so that it doesn’t burn out.
The suppression of your thyroid function due to chronic stress and Adrenal Dysfunction is an effort of the body to slow down. This is a deliberate suppression.
The result of this slowdown leads to the many familiar symptoms of low thyroid or hypothyroidism such as:
- Dry skin
- Hair loss
- Weight gain
- Poor reflexes
Some symptoms of thyroid dysfunction are less well known:
- Development of thyroid nodules
- Autoimmune thyroid problems (including Hashimoto’s thyroiditis and Grave’s disease)
- Goiter or swelling of the thyroid
- Weakened immune system
Most of all, a suppressed or under-active thyroid leads to decreased energy levels; it causes both central and peripheral fatigue.
Thyroid dysfunction makes us tired. We gain weight. It slows our bowels, our brain, our reflexes, among other things.
Cranking up your engine with hypothyroid medication, like so many doctors will, without first addressing the low oil and gas is never a good idea. You may see temporary improvement until you burn through the rest of the oil and gas (adrenals), but you will soon completely burn out the engine (thyroid).
In short, address the Adrenal Fatigue, and then address the thyroid disorder.
#4 Does your bucket runneth over?
I use a metaphor to help my patients understand Adrenal Fatigue.
Our genetic capacity for stress is developed at conception and shaped throughout life, half from mom, half from dad. In utero, our adrenals get an idea of how stressful the outside world is through a shared circulation between mom and baby.
We are all born into the world with a certain size bucket of tolerance for stress, any stress.
We only have one bucket to hold all kinds of stress. There is no separation of various stressors from one another.
Whether it be an injury, a chemical toxin, an annoying text message from your brother, or fear of debt, all stressors go into the same bucket, though some may be weighted more than others.
Our bucket holds everything! Until it can’t.
By design, this bucket was meant for extreme, acute stressors, such as a plague, famine, or a predator. If a tiger were to lunge at you, your bucket would immediately and completely fill with “stress.”
If you lived through the experience with the tiger, then your bucket would empty again and be ready for the next time.
The problem with living in our present society is that we now use our stress response bucket quite differently from its designed purpose.
Chronic, low-level stress comprises our world. We no longer have to fear for our safety from predators, no longer have to worry about starvation (most of us at least), and no longer deal with deadly plagues. However, we do fill our bucket with multiple chronic, perpetual stressors.
The list of chronic stressors is long and ever-changing, and you likely know your list better than I do. We are bombarded by so much constant stress these days that we don’t think twice about it, just as you wouldn’t notice a watch on your wrist after only a few minutes of wearing it.
When you remain in this stress response too often—whether your mortgage is past due or you’ve got some tigers in your neighborhood that I don’t know about—your body compensates. But when it compensates for too long, this over-activates the organs of stress and shuts down the organs of relaxation (such as those in your immune system and digestive systems and those of reproductive and thyroid function).
This is Adrenal Fatigue.
#5 Fighting tigers…and losing the battle
While the body is busy “fighting tigers” and suppressing energy metabolism, the chronic stress physiology suppresses the rest-and-digest organs, including but not limited to digestion, the immune system, the reproductive system, and the thyroid function.
This makes sense, physiologically speaking. If you were running from a tiger, you wouldn’t want an ounce of your energy going anywhere else.
When the body is in a chronic stress response (aka fight-or-flight or sympathetic overdrive), multiple physiologic effects occur.
- An over-utilization of fuel and nutrients
- An overproduction of free radicals leading to oxidative stress
- Dysregulated sugar and energy metabolism (mitochondrial function)
- Neurotransmitter dysregulation
- Decreased blood flow to the brain and peripheral muscles
All of these physiological breakdowns due to Adrenal Fatigue lead to system dysfunction, particularly to that of your thyroid.
When the body is in a stress response, or a state of HPA axis over-stimulation, which happens in the earlier stages of Adrenal Fatigue, the body releases excess cortisol and adrenaline.
Cortisol and adrenaline suppress thyroid hormone production at every level possible in the body. The thyroid hormone is then suppressed at the hypothalamus (TRH), at the pituitary (TSH), and at the level of the thyroid: decreased T4 and T3 production. Stress hormones suppress the conversion of T4 to T3 (less active to more active hormone).
Stress hormones decrease the receptivity of the individual cells to thyroid hormone. And just in case that wasn’t enough of a shutdown, stress hormones trigger the release of an inactive form of thyroid hormone (called reverse T3).
Reverse T3 binds up any remaining thyroid receptors; if there were any functional thyroid hormone left, it is blocked from getting to the cell receptor, thus triggering a response. It’s a quite concerted, comprehensive, and rather elegant effort to slow the thyroid.
#6 The hard truth about Hashimoto’s
The connection between the adrenals and the thyroid is quite well established, although not well known (though this is improving). I have never had a patient with autoimmune disease of any kind—doubly so for autoimmune thyroid disease—who did not have underlying Adrenal Fatigue at the root.
The Adrenal Dysfunction causes a suppression of thyroid hormone production on many levels and a suppression and shift in the immune system. This combination invariably adds up to autoimmune thyroid disease, most commonly Hashimoto’s thyroiditis.
Hashimoto’s thyroiditis will never heal unless the underlying Adrenal Dysfunction is healed.
While thyroid hormone support here is often necessary, there is more to healing. The deeper conditions that created the Hashimoto’s in the first place must be addressed. We must pay some attention to the imbalanced immune system, as well as the underlying Adrenal Fatigue.
Balance the immune and adrenal functions, and you have a chance of getting away from a life of taking a fixed dose of thyroid hormone. You’ll regain the dynamic responsiveness of your entire endocrine system, which is essential to good health and well-being.
#7 Why there’s no such thing as normal
Often, my patients show me “normal” thyroid panels.
It’s relatively common for my new patients to plop down binders and folders full of entirely “normal” test results on my desk from some of the most exclusive “world famous” clinics in the country.
Doctors are supposed to have an intimate knowledge of the body’s physiology. However, this symptomatic treatment of thyroid disorders is troublesome.
- You end up on a specialist merry-go-round.
- You never get to the root cause.
- You’re left to suffer from an underlying condition that’s only getting worse.
Historically, the testing for thyroid function has been lacking. Reference ranges seem to be almost subjective these days. There is some reading between the lines.
For instance, the accepted normal ranges for TSH have changed over the years. Many doctors practicing integrative and holistic medicine, myself included, look for an optimal range of TSH to be between 1-2. I have found that the closer the TSH is to 1.0, the better people feel. In practice, however, we can not only look at the TSH as a marker for improvement.
Ultimately, we can still use these blood tests to assess thyroid function; we just have to read between the lines:
- Free T4
- Free T 3
- Anti-TPO Ab
- Anti-Thyroglobulin Ab
And should your blood work or testing land in the normal range—or close to it—conventional doctors will chase your symptoms. While they’re busy putting Band-Aids on your symptoms, the root of the dysfunction is creeping into disease.
#8 Why confused GPs get their glands mixed up
I’ve come to the point where I assume no one has a grasp of Adrenal Fatigue and its myriad effects on bodily systems. I’m occasionally and pleasantly surprised when someone does or even tries.
When it comes to the thyroid-adrenal connection, the obvious question is, “Why would the body so purposefully and effectively block the effects of thyroid hormone just because a person is in a stress response?”
My conclusion is that there must be a protective effect of the suppression of thyroid function in times of stress. This is how I came up with the engine/oil/gas analogy.
When the body is in a stress response, there is an overuse of resources (including the oil and gas of the adrenals). This happens because the body is perpetually running from a proverbial tiger. As such, the body knows that if the engine (thyroid) keeps running at full-tilt, it will deplete its resource of oil and gas (adrenals).
To conserve resources, the body slows the engine to deal with the stress, and the body shifts out of a stress response. The levels of stress hormones diminish, thus slowing the engine until the oil and gas supply can recover. Makes sense, right?
But what if the stress response never shuts off? What if we are under chronic, perpetual stress over time? Great question, and this is the key problem: The thyroid—your “engine”—is chronically slowed, and you develop symptoms problematic enough that you go to the doctor.
The underlying cause of the problem, the Adrenal Fatigue, is poorly understood, unrecognized, and certainly underappreciated. This leads well-meaning doctors to discover and then treat the thyroid disorder only. Patients may feel temporarily better, but it makes things worse over the long term.
I have seen this same story play out so many times over the years that I have grown increasingly frustrated with the current medical system. Well-meaning doctors, both conventional and alternative, make this crucial mistake every day, and that makes their unsuspecting, trusting patients worse.
I now consider it as bordering on malpractice to address a person’s thyroid dysfunction without first assessing and treating their adrenal glands.
#9 Healing a troubled thyroid
- If you suspect thyroid problems, assess the adrenals properly.
- Get appropriate preliminary testing for thyroid function.
- Treat the Adrenal Fatigue FIRST for a minimum of 3-6 months.
The most important treatment for adrenal-thyroid dysfunction is healing from the ground up.
- Not chasing symptoms without identifying their root causes.
- Reviewing testing with a more discerning eye, an eye towards trends and dysfunction.
- Paying close attention to the subtle changes in blood work.
- Understanding that, if left unchecked, dysfunction will lead to full-fledged disease…and treating it before it does.
- Controlling your symptoms while focusing on healing the dysfunction at its root.
- Identifying and treating disease, but also looking for trends of dysfunction (pre-disease, if you will).
By managing and healing the Adrenal Fatigue, any other treatment that you may be utilizing for your condition will have a stronger effect and be much more beneficial.
Remember, though the thyroid is compromised, the primary underlying cause of the thyroid’s dysfunction is Adrenal Fatigue. Treat it, and you’ll be far more successful in balancing the thyroid hormones and healing the thyroid gland.
#10 The next step
In over a decade of seeing thousands of patients both in my office and via telephone or Skype, I have discovered that once someone has Adrenal Dysfunction, a physiologic shift occurs. This shift creates debilitating and frustrating symptoms and dysfunctions in all the systems of the body.
Many well-educated and well-intentioned doctors will focus on these individual symptoms: low thyroid, low testosterone, overwhelming fatigue, mitochondrial dysfunction, chronic inflammation and pain, oxidative stress, allergies, chronic infection, irritable bowel syndrome, etc.
It is a mistake for doctors, both conventional and alternative, to focus on only one part of this dysfunctional process.
The primary goal must always be to treat the underlying Adrenal Fatigue and chronic activation of the stress response. Failure to do so wastes your precious resources of time, money, and most important, energy.
I have an intensely personal interest in the study of the adrenals and their tie to the rest of the endocrine system. In the video below, I share my journey with Adrenal Dysfunction. To reach out to us here at the Clymer Healing Center simply fill out this short application form.