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What is the Adrenal – Thyroid Connection?

Thyroid Disease and Adrenal Dysfunction

Thyroid malfunctions are known to be incredibly challenging to resolve. There are multiple aspects of the dysfunction that contribute to diagnosis and treatment difficulties. Poor testing methods, inadequate action, lack of knowledge, and the nature of the condition itself cause resolution of thyroid disease to be an arduous task. One aspect of thyroid health that is often overlooked is one’s adrenal function. Even though adrenal fatigue is frequently misdiagnosed as hypothyroidism, it is rarely considered as a possible contributing factor of thyroid malfunction. It is essential that doctors and patients alike are aware of the numerous factors, including the adrenals, that are involved in thyroid health.

A Brief Peek at the Thyroid

A properly functioning thyroid is a critical element of one’s health. This small gland maintains and produces hormones and regulates one’s metabolism. Metabolic dysfunction leads to erratic energy levels and fatigue. When the metabolism falters and is unable to properly regulate one’s energy levels, other systems, such as the adrenals, must step in to assist in balancing blood glucose. Hypothyroidism, or underactive thyroid, is a common cause of reduced metabolism.

Hypothyroid symptoms include:

Treatment of hypothyroidism, as well as adrenal insufficiency, usually consists of hormone replacement therapy or supplementation with the appropriate hormone(s) to make up for deficits. If balancing thyroid levels and function through proper thyroid hormone supplementation is not effective, it may signify the presence of adrenal dysfunction. Inadequate adrenal hormones can frequently be resolved with proper hormone supplementation but the condition must be recognized and respected as a contributing factor.

When the body experiences adrenal dysfunction standard methods of treatment for thyroid malfunction can cause more harm than good. Thyroid hormone helps speed up one’s metabolism which can accelerate adrenal fatigue, leading to greater symptom intensity. Furthermore, the body may become entirely unresponsive to thyroid replacement treatments when the adrenals are overly fatigued. Some medical professionals believe this occurs because thyroid hormones entering cells require adrenal hormone assistance to be effective. Therefore, poor adrenal function may reduce thyroid hormone availability even if adequate amounts are being produced.

The Body’s Stress Response

Like the thyroid, the adrenals assist in hormone control. Poor adrenal function can contribute to reduced thyroid function. Over 150 hormones are produced by the adrenals including; adrenaline, estrogen, progesterone, testosterone and DHEA (Dehydroepiandrosterone). Another of the most widely impactful hormones produced by the adrenals is cortisol, also known as the stress hormone. This hormone is released during the body’s natural stress response and increases blood glucose levels. A temporary increase of blood glucose can aid in rebalancing an energy deficit and increase responsiveness and awareness. Cortisol is also the primary hormone utilized to manage long-term stress.

When the body’s stress response is triggered, the adrenals induce a temporary energy-surge. The hormones produced by the adrenals are instrumental in the body’s stress response. Many recognize this reaction as the “fight or flight” response. Triggering this response can provide a temporary spike in various systems, which makes it easier to combat (fight) or run (flight) from a perceived threat. Release of adrenal hormones facilitates an increase in blood pressure, heart rate, muscle blood flow, and increase of sugar conversion into energy. A short-term intensification in these areas can be greatly beneficial in times of crisis but if regularly triggered, it can cause long-lasting damage. Furthermore, constant triggering of one’s stress response can lead to severe adrenal fatigue.

Adrenal Dysfunction

When the adrenals are regularly activated without reprieve, regardless if the cause is physiological or emotional, the adrenals can become fatigued. Overactive adrenals trigger an autoimmune response that causes inflammation to occur throughout the body. This response further prompts the production and release of cortisol. Extreme cortisol levels, high or low, are expressed by two different conditions. Cushing’s disease is typified by dangerously high levels of cortisol in one’s system. Alternatively, Addison’s disease is recognized through extremely low cortisol levels. Excess production or exhaustion of cortisol can have a tremendous impact on the body.

Symptoms of adrenal fatigue include:

  • Fatigue
  • Non-restorative sleep
  • Inability to handle stress
  • Depression
  • Craving sugary or salty foods
  • Increased energy at night
  • Fatigue after mild exertion
  • Difficulty thinking clear or concentrating
  • Poor digestion
  • Increased severity or newly developed food or environmental allergies
  • PMS
  • Reduced blood pressure
  • Sensitivity to cold
  • Weakness and muscle/joint pain
  • Poor sleep
  • Reduced immune function
  • Anxiety

These symptoms are often misconstrued as being caused by hypothyroidism but are more likely due to adrenal fatigue. Treatment of these symptoms with thyroid hormones can induce a negative response rather than help resolve symptoms. It may even accelerate adrenal fatigue.

Before a severe adrenal deficit occurs, the body usually enters a hyperactive state of adrenal production. Adrenals working overtime promotes heightened function but it also quickly saps its resources. After the body is no longer capable of maintaining a heightened state of stress the adrenals ultimately crash. Without resolving adrenal fatigue, it may not be possible to resolve thyroid dysfunction through traditional methods.

Respecting the Adrenal – Thyroid Connection

The prevalence of adrenal dysfunction appears to be increasing. Some health experts suggest that near 80% of the population is experiencing some degree of adrenal malfunction. Unfortunately, most medical practitioners only recognize it as an issue when it reaches the extremes of Addison’s or Cushing’s disease. If one also suffers from a thyroid malfunction, the two conditions compound on each other and can increase the intensity of symptoms such as fatigue, cold sensitivity, depression and insomnia.

Without properly recognizing and treating adrenal insufficiency, the likelihood of resolving a thyroid condition is slim. It is important that doctors are willing to explore and diagnose the multiple contributing factors of thyroid disorders, including adrenal dysfunction, instead of discounting or ignoring them. Most of all, the interactive nature of the adrenals and the thyroid must be respected and responded to appropriately.

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Miss Em.
Miss Em.
5 years ago

I lived through a terrible adrenal crash that resulted in a state of catabolic wasting. I rapidly lost my muscles to the point it wound me up in a wheel chair. It is a very long road to recovery when your adrenals get wasted. Just now, a year later a doctor is checking my Reverse T3 & Reverse T3 Ratio along with a routine thyroid check.
TSH 2.48 (uIU/ML 0.450 – 4.500)
T4 Free 1.21 (ng/dl 0.82 – 1.77)
T3 Total 120 (ng/dl 71 – 180)
T3 Reverse 17.9 (ng/dl 9.2 – 24.1)
T3/rT3 Ratio 6.7 (Not Estab)
It is crucial to get the correct knowledge to balance a persons health and well being. I can’t understand why a Lab would offer a panel for tests that they don’t provide a reference range on. Could you help me to understand the Reverse T3 Ratio? What is the best range for optimum adrenal & thyroid health?

5 years ago
Reply to  Miss Em.

You need to have your Free T3 tested… it gives a much clearer picture to overall thryoid availablilty.. your reverse T3 is way too hig.. it should be around 10 :-( your rt3/t3 ratio should be above 20 (which HAS been established!) which is why one feels so crappy. Many things factor into a high reverse T3 because we live in a toxic world… along with adrenals, mold toxicity, metals, gluten, pesticides, fertilizers, fluoride, chlorine, low iodine, bromines in foods and environment, low iron… the list is endless…. it IS possible to have a high reverse t3 not even taking thyroid meds. After elimintating and adressing all factors, the only other treatment is to take straight T3; ie cytomel or generics or sr compounded.
Bad adrenals will affect how much you are able to take, if at all.
What lab did you use? And don’t worry, even WITH lab ranges, the ranges are incorrect because they are created using random results including sick hypothyroid ppl :-( there are much smaller ranges for OPTIMAL :-)

5 years ago
Reply to  Miss Em.

RT3 needs to be around 10 and under. If it’s above 10, T4 meds need to be stopped, or lowered, and T3 intake needs to be increased slowly till there are no hypo or hyper symptoms. Then have labs done to see where you are. Sadly many doctors won’t test RT3 because they don’t understand it’s importance or just plain don’t believe in it. Knowing that number is crucial to our health.

Miss Em.
Miss Em.
4 years ago
Reply to  Miss Em.

Thank you so much for both of your replies. I am in a remote area of Northern California,. suffering horribly and don’t have the help I desperately need. This information is very much appreciated.

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