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Hypothyroidism and Mitochondria – Feel Like You’re Always Low On Fuel?

Hypothyroidism and Mitochondria

Mitochondria are found in almost every cell in the body. Though best known for producing energy, they also play a role in numerous biological processes. When mitochondrial function is impaired, the effects extend beyond energy, influencing everything from how you feel, to your risk of disease.

Thyroid hormones are key regulators of mitochondrial function. When thyroid hormone levels are low, as with hypothyroidism, mitochondria are impacted. Thus, it’s no surprise fatigue is a common complaint in both hypothyroid patients as well as those with mitochondrial disorders.

In addition, stress is a factor as it influences hormones, immune function, and blood sugar, all of which are linked to thyroid and mitochondrial function.

This is just the tip of the iceberg. The effects of thyroid and mitochondrial dysfunction are often experienced in several body systems leaving patients to feel defeated. It’s all interconnected though and with awareness, comes empowerment to make changes towards better health.

Hypothyroidism is a growing concern in the medical community. The connection between the thyroid and mitochondria has spurred extensive research over the past decade.

Hypothyroidism refers to an underactive thyroid. When your thyroid isn’t up to speed, neither are you. Although mitochondria produce energy, the term “mitochondria” isn’t always included in hypothyroid discussions. If mentioned at all, it’s likely to be discussed with mitochondrial patients who have secondary hypothyroid disorders – a “secondary” condition is one that occurs as a result of another condition. Dysfunctional mitochondria can trigger thyroid conditions in some individuals and vice versa. Regardless of which condition is primary, debilitating fatigue is generally a chief complaint.

To say mitochondria make energy sounds fairly simple, however, the biochemistry is quite complex and much of it remains unclear. Listed below are some symptoms of hypothyroidism, many of which are also experienced by those with mitochondrial disorders – you can find a complete list of hypothyroid symptoms here.

Since thyroid hormones help regulate mitochondria, mitochondrial and thyroid processes are negatively impacted when the thyroid hormone is lacking. The brain, heart, muscles, gastrointestinal tract, and immune system are some of the areas potentially affected.

Hypothyroidism also reduces production of new mitochondria and the ability to utilize oxygen (metabolism). Additionally, hypothyroidism leads to biochemical imbalances, i.e. oxidative stress, which perpetuates damage to mitochondria as well as to the thyroid itself. The effects may also be experienced in neurological and other mitochondrial processes including mental health, pain, and immunity.

Keeping the symptoms list in mind, notice the links to blood sugar regulation, sex hormones and stress response moving forward.

Thyroid: Relationship to Stress and Sex Hormones

Hypothyroid patients are generally familiar with the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine) as they are the basis of treatments. The thyroid hormones are also closely linked to other hormones i.e. Cortisol, sex hormones, and insulin. The thyroid gland is known as “the conductor” of them all.

In addition to the thyroid, the hypothalamus, pituitary, and adrenal glands act in a feedback loop otherwise known as the HPA-axis. Stress is an important trigger towards throwing the loop out of balance leading to consequences that may seem unrelated. Here are some examples:

  • Stress triggers adrenals to release cortisol. If the stress is chronic, it can lead to insulin resistance, which is one step closer to diabetes. Weight gain is a symptom of insulin resistance.
  • Chronic stress impacts balance and production of sex hormones, i.e. estrogen, progesterone and testosterone. These hormones are made from the same chemical in the body that produces cortisol. If one is always stressed, reproductive hormones are affected causing symptoms such as low libido and infertility.
  • Stress contributes to poor gut health where 20% of the thyroid hormones are produced.

Mitochondria also play a role in stress response. Consequently, difficulties handling stress are common in these patients. Remember mitochondria are in the cell and imbalances at that level can throw off important cell signaling. Ultimately the biochemical checks and balances that allow the body to perceive and appropriately respond to a stressor don’t work properly.

Role of Thyroid Hormones in Mitochondrial Function

Thyroid hormones have a direct impact on mitochondrial function and metabolism due to thyroid hormone receptors in the mitochondria. Thyroid hormones stimulate metabolism and respiration within the cell. Thus, increased levels of thyroid hormone mean a higher metabolism, i.e. excess is “hyperthyroidism”.

When thyroid hormones are reduced, less energy is produced and metabolism slows, affecting weight, body temperature regulation, and heart rate. By increasing thyroid hormone availability mitochondrial functions improve.

Looking at the ways digestion, stress, diet and lifestyle are positively or negatively influencing the situation is important. For instance, selenium, iodine, zinc and iron are all necessary to synthesize and metabolize the thyroid hormones. Perhaps they aren’t included in the diet, or maybe they aren’t being absorbed due to digestive issues, i.e. low stomach acid which is common in hypothyroidism.

Oxidative Stress and Why It Matters

Oxidative stress is the product of an imbalance relative to antioxidants. It is the basis of aging and disease. To put it in perspective, oxidation is the reason a car gets rusty and essentially this is what happens in the body. Antioxidants are essential for offsetting free radicals and restoring balance.

In hypothyroidism the availability of antioxidants is low and the resulting oxidative stress also damages mitochondria. This highlights the significance of the chief antioxidant and mitochondrial protector, glutathione. When glutathione is low and mitochondrial function is diminished it affects the following:

  • Energy
  • Neurotransmitters (which affect how you feel)
  • Muscles
  • Heart
  • Platelets
  • Vasodilatation
  • Glycogen metabolism

What Shall I Do?

Work with a qualified practitioner to:

  • Balance thyroid hormones so sufficient levels of active T3 are available for mitochondrial function.
  • Support digestive health including sufficient stomach acid for nutrient absorption will ensure vital nutrients such as iron, zinc and B-vitamins are available.
  • Address iron deficiency without going overboard. Too much iron is also harmful.
  • Supplements for stress and mitochondrial support include: B-vitamins, magnesium, coQ10, creatine, l-carnitine, lipoic acid, Resveratrol, Ashwagandha, Rhodiola, and vitamin D.

Here are some tips and resources for finding a qualified thyroid doctor.

On your own you can:

  • Exercise in moderation: yoga and swimming are especially restorative.
  • Rest, relax, and get sufficient sleep.
  • Eat a clean nutrient dense diet, which is void of gluten for hypothyroid sufferers.
  • Have a support system.

Unfortunately, there is no magic pill to overcome the issues discussed here. However, taking actions to manage stress through lifestyle, nutrition, and hormonal balancing are integral components towards better health.


1. Athea, Y. Garnier, A. Fortin, D. et. al. Mitochondrial and Energetic Cardiac Phenotype in Hypothyroid Rat. Relevance to Heart Failure. Pflugers Arch. 2007 Dec; 455(3): 431-442.

2. Holtorf Medical Group. Mitochondria And Glutathione: Behind the Scenes of Aging. Available at:

3. Jeanneteau, F. Ango-Lievano M. Linking Mitochondria to Synapses: New Insights for Stress-Related Neuropsychiatric Disorders. Neural Plasticity. 2016; 2016, Article ID 3985063.

4. Johnson, E. Calogero, A. Konstandi, M, Effects of short- and long-duration hypothyroidism on hypothalamic-pituitary-adrenal axis function in rats: in vitro and in situ studies. Endocrine. 2012 Dec;42(3):684-93.

5. Lanni, A. Moreno, M. Goglia, F. Mitochondrial Actions of Thyroid Hormone. Compr Physiol. 2016;6(4):1591-1607.

6. Mukherjee, S. Samanta, L. Roy, A. Bhanja, S. Chainy, N. Supplementation of T3 Recovers Hypothyroid Rat Liver Cells from Oxidatively Damaged Inner Mitochondrial Membrane Leading to Apoptosis. Biomed Res Int. 2014; 2014.

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Many other articles -some peer reviewed- advocate the use of l carnitine for hyper patients, but warn against its use on hypo patients. Your article however suggests supplementation gor hypothyroidism. Can you explain the rationale for this?

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