I’ve been assessing and treating patients with Adrenal Fatigue for almost two decades. I’ve helped thousands of patients to regain their energy and vitality.
Over 30% of my patients come to me with thyroid disorders. Most of them have done research when they were prescribed thyroid medication, and many of them found no satisfying answers—and plenty of contradictions. Out of frustration or desperation, they popped the thyroid medication, even if they felt there must be something else at the root cause of its dysfunction.
Perhaps, you ended up on this page because you’re one of those people.
Some people are surprised by this, but 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.
The immediate and long-lasting suppression of our thyroid hormones occurs very purposefully, dramatically, and specifically during the stress response.
The normal thyroid
In a resting, normal setting, the thyroid works very similarly to the adrenal system, albeit without the circadian rhythm. In both, we see the hypothalamus and pituitary in the brain running the show.
Every cell in the body has receptors for thyroid hormone, and these cells are activated once that thyroid hormone binds to these receptors. Upon binding and activation, the cells then begin the metabolic maintenance or general daily tissue repair for which thyroid hormone is responsible (assisting in digestion, helping muscles work efficiently, assisting our cognitive function, and building bones and repairing tissue).
If low thyroid levels occur, it’s primarily due to our system using up what thyroid hormone we have. If the hypothalamus perceives low thyroid hormone levels, it then acts to stimulate the pituitary to do the work of stimulating the thyroid to begin production of more thyroid hormone.
The suppressed thyroid
When I began my work with adrenal patients, I was surprised to learn that excess cortisol suppresses and blocks thyroid function at every level possible. I have learned over time that this is likely the number one cause of hypothyroidism (low thyroid) in our day.
During a stress response, cortisol is released and then carried in the blood to every cell in the body. The cortisol that goes to the brain tells the hypothalamus to stop stimulating the pituitary and the thyroid because repair is now on the back burner. The cortisol that goes to the thyroid further blunts the process by telling the thyroid to stop production of its hormones.
This cortisol will also reach the actual thyroid hormone itself, shifting the direction toward less effective thyroid hormone (technically suppressed T4 to T3 conversion). Cortisol then even goes to each cell and makes the thyroid hormone receptors there less responsive to any thyroid hormone that may have survived the previous attempts at suppression.
And if that isn’t enough, cortisol actually goes so far as to convince the thyroid gland to release an inactive form of thyroid hormone called Reverse T3 (rT3). Once released into the bloodstream, rT3 binds to thyroid receptors, effectively inactivating these receptors so that any thyroid hormone that might still be lingering cannot bind and activate the cell.
Symptoms of thyroid suppression
The symptoms of thyroid suppression during the stress response in the short-term are negligible, as the body is meant to be running on adrenaline and cortisol (not requiring thyroid hormone) during the brief, aggressive attempt at survival. However, if one is to suppress the thyroid over weeks or months or years, then all metabolism slows.
In this light, you can think of metabolism as the utility and maintenance services of a city. Imagine if, in one fell swoop, the power company, gas company, waste management, and police and fire departments went on strike. This is actually a simplistic view of thyroid suppression; however, you can imagine the mayhem that would ensue. Garbage backs up, fires break out. There are accidents everywhere because there are no traffic lights or police to help with the chaos.
What this feels like in the body is low energy, leading to general sluggishness, fatigue, impaired cognition, and weakness. It leads to toxin buildup and constipation from no “garbage pickup.” It also leads to a slowdown in tissue repair and the building of new tissue, which compromises wound repair, decreases hair, nail, and skin growth, and even begins to compromise cardiac function.
How most doctors get it wrong
Although most doctors don’t really know how to recognize the symptoms of Adrenal Fatigue, most are aware of the symptoms of thyroid dysfunction that I just described. They may recognize the fatigue, sluggish bowels; dry skin, and hair loss that many (adrenal) patients have.
Of course, when they say, “You’ve got a thyroid issue,” they’re not completely on the wrong track. But they are potentially and dangerously missing the full picture of the adrenal contribution to these symptoms.
These doctors may even go so far as to treat the thyroid, whether the problem shows up on routine thyroid screening or not, because they simply want to help the patient.
These patients may feel a bit better with their engine (the thyroid) cranked up; that is, until the engine cranks up long enough to burn through the rest of the oil and gas (the adrenals). The patient crashes again, this time even harder than before. I cannot tell you how many times I have consulted with patients in which this scenario has played out precisely.
Can you relate?
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.
Doctors are supposed to have an intimate knowledge of the body’s physiology. However, this symptomatic treatment of thyroid disorders is troublesome for three unsettling reasons.
- 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.
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.
Why there’s no such thing as normal
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.
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.
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.
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.
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.
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).
Adrenal Fatigue is poorly understood, sometimes 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.
What happens when your engine can’t take it anymore?
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:
- Autoimmune thyroid problems (including Hashimoto’s thyroiditis and Graves’ disease)
- Development of thyroid nodules
- 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.
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.
Your stress response and thyroid function
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.
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.
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.
To find out more about how I treat Adrenal Fatigue and its many symptoms and conditions, simply start here.