Thyroid-Adrenal Connection



Seventy percent of people on thyroid replacement medication continue to suffer symptoms—symptoms that happen to mimic adrenal fatigue.


Learn about the…

Thyroid–Adrenal Connection

Many practitioners ignore the connection, but adrenal fatigue is often the hidden problem behind a person suffering from low thyroid.

Hand in Hand

It’s a little known fact, but the truth is the thyroid hormone in your body—whether from a pill or produced naturally—can only function as well as your adrenals do.

In other words, you may have plenty of thyroid hormone, but if your adrenals are fatigued, chances are you will feel:

  • Frustrated
  • Exhausted
  • Just not like “yourself”

What Is Adrenal Fatigue?

Let’s keep this simple. Your adrenals produce a stress-hormone hormone called cortisol. When cortisol levels get too low (or too high) because of constant stress on the body, you develop what we call adrenal fatigue.

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What does cortisol do?

Cortisol is needed for nearly all processes in the body, from blood-pressure regulation and kidney function to glucose control and immune function to protein synthesis and muscle building.

Cortisol is also released in response to stress of any type. Stress can be internal, such as an infection, food allergies or pregnancy, or it can be external, as in the loss of a loved one, divorce, a heated argument or just running late for an appointment.

We all have stress in our lives! In fact, most of us would agree we have too much of it. And too much stress for too long can damage our adrenals by forcing them to make excessive amounts of cortisol day after day. Eventually, the adrenals tire out, and when this happens, cortisol levels drop. And that’s a problem for the thyroid…

You see, one of cortisol’s most important functions is to act in concert with thyroid hormone at the receptor-gene level in each cell. In short, cortisol makes thyroid work more efficiently.

It’s also why people who have a cortisol imbalance as a result of adrenal fatigue often show hypothyroid symptoms in spite of showing normal thyroid hormone levels on their lab work.

Pickle Jar - iStock_000009328809XSmall copyOne way to think of the partnership between cortisol and thyroid hormone is to imagine trying to twist off the lid from a jar of pickles using one hand instead of two. Not easy, right? It’s a two-hand job!

Similarly, both thyroid and cortisol have to both be in our cells, bound to their respective receptors, to efficiently “twist the lid off the jar” and enact gene expression. Thus, when cortisol levels are low, thyroid is much less efficient at doing its job of increasing your energy.

This is why having the correct amount of cortisol—not too high or low—is critical for normal thyroid function.

So if you’re taking thyroid medication and you’re continuing to experience hypothyroid symptoms, such as fatigue, weight gain, intolerance to cold, hair loss, depression, and so on, it’s probably time to get your adrenals tested. Stop trying to open the pickle jar with one hand!

The Facts About Adrenal Testing

205 KP Full copyThere are numerous adrenal tests out there and a variety of ways to interpret them. It is absolutely crucial that you get the right testing done and you get it interpreted according to optimal lab values. (For details about “optimal” lab values versus “acceptable values,” see Essential Thyroid Labs: Which Tests Do I Really Need?

A good adrenal test checks not just your cortisol level but your pattern of cortisol production. This is important. The cortisol level in the body changes dramatically over the day, and examining how your cortisol production is cycling is extremely helpful in determining the root cause of adrenal fatigue or another imbalance.

At Natural Thyroid Healing, we test using the Adrenal Stress Profile test by BioHealth Laboratory, which is a saliva test. This test is superior to a blood test in many ways:

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  1. It checks the free form of cortisol, which is the form available to your body. It’s what your body is living off of, as opposed to what is protein bound, and inaccessible, in your blood.
  2. It’s more accurate. When you have blood drawn, you might feel anxiety at the sight of the needle. This anxiety can spike your cortisol level and give an inaccurate picture of your usual cortisol level—the level when you are not getting poked by a needle!
  3. It measures your cortisol throughout the day. Again, this is to assess your pattern of cortisol production, critical information that is virtually ignored by most physicians. And because this is a saliva test, all you have to do is collect a sample from your mouth four times in a day. That’s a lot easier—and cheaper—than going to a lab and doing four blood draws in a day!

The Importance of DHEA

In addition to looking at your cortisol levels and pattern of production, you will need to know your average level of dehydroepiandrosterone, or DHEA. The ratio between your cortisol and DHEA reveals 1) how chronic your stress has been and 2) whether you are experiencing shifts in your steroidal hormone pathways. If the latter is the case, you will notice that your body no longer responds as it used to to dieting and exercise. You’ll find yourself saying, “The things that used to work for me are no longer working!” (While that’s a frustrating place to be, don’t worry, it’s fixable!)

In addition, without knowing your DHEA-to-cortisol ratio, your cortisol test results could look normal when in fact you are actually in Stage Two of adrenal fatigue.

What?! iStock_000014622874XSmall copyAdditional measurements that are helpful include your levels of estradiol and estriol (your body’s two major estrogens), testosterone (for women too), progesterone and melatonin (your body’s sleep hormone). All of these tests are included in our Adrenal Stress Profile. This one test reveals LOADS of great information about your body!

A note on the Adrenal Stress Profile test by BioHealth Laboratory: BioHealth uses cutting edge technology and superior, reliable methods, which is why we use their adrenal test exclusively. For more information on their adrenal stress tests, click here. (We use test #205.)

Do You Suffer Adrenal Fatigue?

While no one can tell for sure whether they have adrenal fatigue without proper testing, we’ve developed a quick and easy Adrenal Fatigue Quiz to help you determine whether you should consider doing a full Adrenal Stress Profile. Go here – Adrenal Fatigue Quiz – to find out your adrenal fatigue score!

And remember, don’t guess…just test!

Q & A
1. I’m a registered nurse, and while I understand that the adrenal glands can “tire out,” I’m also wondering if low cortisol can come from other problems in the body (other than the adrenals)?

Great question! The answer is, “Yes!” When low cortisol originates from a problem with the adrenal glands themselves, we call this primary adrenal fatigue. But often low cortisol is the result of something affecting the adrenal glands. This is known as secondary adrenal fatigue. Secondary adrenal fatigue can result from problems within the hypothalamus-pituitary-adrenal (HPA) axis, for instance.

To briefly describe the HPA axis: The hypothalamus is like a watch tower that detects when the body is low on hormones such as cortisol. If the body is low on cortisol, the hypothalamus sends a message, in the form of corticotropin-releasing hormone, to the pituitary saying, “We need more cortisol.” The pituitary responds by sending the adrenals some adrenocorticotrophic hormone (ACTH), which says, “Hey, adrenals, make more cortisol!” If there are problems with the hypothalamus or pituitary gland, cortisol dysregulation can result.

Secondary adrenal fatigue can also result from nutritional deficiencies, toxicity or inflammation. For example, when the body experiences chronic inflammation, tumor necrosis factor can be released, which can bind to the receptor sites on the cells where ACTH fits, thus blocking out the ACTH. Since ACTH is what stimulates the adrenals to make cortisol, cortisol production is diminished.

Conventional doctors tend to focus primarily on primary adrenal fatigue and ignore secondary adrenal fatigue—a big mistake when it comes to balancing cortisol levels.

2. You talked about low cortisol being a problem, but isn’t high cortisol pretty bad too? I’ve heard that high cortisol can also affect the thyroid and cause BELLY FAT too….Is that true?

Absolutely—high cortisol is not good!

Too much cortisol, caused by excessive stressors to the adrenal glands, can decrease the responsiveness of the body’s tissues to the thyroid hormone signal—a condition known as thyroid resistance. When thyroid resistance occurs, thyroid hormone levels can be normal, but tissues fail to respond as efficiently to the thyroid signal.

Resistance caused by high cortisol is not restricted to thyroid hormone but applies to other hormones as well, such as insulin, progesterone, estrogens, testosterone, and even cortisol itself.

The effect of hormonal resistance is your tissues need greater levels of the hormone to create the same effect a lower amount would under normal conditions. That’s why chronic stress, which elevates cortisol levels, makes you feel so rotten—your hormones are working at optimal levels.

For example, if high cortisol leads to insulin resistance, higher-than-normal amounts of insulin are required to drive glucose into the cells, where it is used as fuel. Even with the higher amounts of insulin, less glucose makes it into the cells. The portion that doesn’t make it into the cells gets converted into fat and stored instead in your fat cells as “belly fat.”

3. I was told that my sugar cravings could be because I don’t have enough cortisol. I’m wondering if that can happen and if I should get tested.

Yes and yes. Here’s how it works. One of cortisol’s main jobs is to mobilize fuel from the body’s storage centers to be burned as energy. These fuels are glucose (carbohydrate), fatty acids (fat) and even protein (via a process called gluconeogenesis, by which our body’s tissue protein is broken down into amino acids and then into glucose).

If your cortisol is insufficient, the amount of fuel available for conversion into energy will be low. In the case of glucose, this will mean low blood sugar, which your body will feel as a craving for sugary and/or starchy foods. And because low blood sugar is very dangerous for the body, these cravings will be STRONG.

Low blood sugar also leads to forgetfulness and brain fog, and it can contribute to weight gain—more reasons to take the Adrenal Fatigue Quiz and determine whether you need to get tested for adrenal fatigue.

4. Can adrenal fatigue cause problems with bone loss and osteoporosis?

Yes! High cortisol activates nearly every biochemical pathway involved in bone resorption, or the dissolving of your bones. Cortisol specifically inhibits osteoblast activity, or bone building. It also suppresses the production of bone-building androgens (male hormones) in the gonads. This is big. We’ve observed, in fact, that people with high cortisol and low androgens tend to experience bone loss even when their progesterone and estrogen levels are normal.

Cortisol also diminished mineral absorption in the gut, decreasing the amount calcium and magnesium (both needed to build bone) taken in. And it increases the amount of calcium spilling out of your kidney tubules.

Thus, calcium supplementation and alendronate-type drugs used to inhibit bone resorption, such as Fosamax, will always fight a losing battle when cortisol levels are high.

5. How does adrenal fatigue affect my immune system? I used to never get sick, and now I get sick a lot. I’ve been trying to figure out why.

We all know that increased stress lowers the immune system. One reasons for this is that adequate levels of cortisol are necessary to activate the immune system. If we are exposed to harmful bacteria or viruses and the adrenals are just too tired to make more cortisol, we become vulnerable to infection.


Author: Kirsten Potter / Edited by Patrick Earvolino and Kirsten Potter / Published with Permission by Natural Thyroid Healing™



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