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December 30, 2022 9 min read

Do you often feel fatigued, overwhelmed, and exhausted? Most of us do at some point in our lives. But if these feelings persist? It could be a sign of something more serious - adrenal fatigue and hypothyroidism. The tricky part is that some of the symptoms of these two conditions overlap, making it harder to distinguish between them. Sometimes, they can co-occur together, so treating them can seem challenging. But don't worry; in this article, we will explore the link between hypothyroidism and adrenal fatigue, as well as discuss possible treatment options to get your best self back.

What is the thyroid gland?

The thyroid is a butterfly-shaped thyroid gland located at the front of your neck, just below Adam's apple. It's a major endocrine gland that plays a vital role in controlling your metabolism and energy levels. It produces two main hormones: thyroxine (T4) and triiodothyronine (T3). These two hormones regulate your body temperature, digestion, heart rate, and other essential bodily functions. If your thyroid doesn't function properly, your body can't work properly.

What is hypothyroidism?

Hypothyroidism, also known as underactive thyroid, occurs when your thyroid doesn't produce and release enough thyroid hormone into your bloodstream. This causes your metabolism to slow down, so your whole body will be impacted. Hypothyroidism is pretty common. Although estimates vary a lot, one study found that almost 5 out of 100 Americans ages 12 years and older have this condition. Furthermore, hypothyroidism affects more women than men.

What are the symptoms of hypothyroidism?

Hypothyroidism can cause a variety of symptoms, such as feeling cold more often than usual and having dry skin, as well as fatigue and exhaustion with no explanation.

You might also notice other changes in your energy levels, such as increased feelings of sluggishness or depression. Moreover, if you find that you're gaining weight or you're finding it hard to lose weight even with a healthy diet and regular exercise, then this could be a sign of hypothyroidism too.

What causes hypothyroidism?

There are a number of conditions and problems that can cause hypothyroidism. The most common is an autoimmune thyroid disease called Hashimoto's thyroiditis. This autoimmune thyroid disease happens when your immune system creates antibodies that mistakenly target your thyroid gland. As a result, it affects your thyroid gland's ability to produce enough hormones.

Aside from Hashimoto's thyroiditis, hypothyroidism may also be caused by the following things:

  • Thyroid surgery to remove all or part of your thyroid gland, also known as thyroidectomy, is usually done to treat thyroid cancer. Without a thyroid gland, you won't have enough thyroid hormones.

  • Thyroiditis is a condition when your thyroid becomes too inflamed, usually due to an infection or an autoimmune disorder.

  • The pituitary disorder causes your pituitary gland to produce an insufficient amount of thyroid-stimulating hormone (TSH), a hormone that controls the production and release of thyroid hormones. In rare cases, this may lead to hypothyroidism.

Other things that may cause hypothyroidism include problems present at birth, pregnancy, radiation therapy, certain medicine, and lack of iodine.

What are the adrenal glands?

The adrenal glands, which are small, triangular-shaped glands located on top of each kidney, are responsible for producing important hormones. Adrenal glands secrete hormones cortisol, aldosterone, and adrenaline, which help control the immune system, blood pressure, stress response, metabolism, and other important processes.

What is adrenal fatigue?

Adrenal fatigue is somewhat controversial because it isn't accepted as an official medical diagnosis. The term has been used to explain a group of symptoms that occur when a person experiences prolonged mental, emotional, or physical stress, causing their adrenal gland to stop producing enough cortisol hormones to support optimal body function.

What are the symptoms of adrenal fatigue?

Adrenal fatigue symptoms allegedly include:

  • Fatigue

  • Weight gain

  • Sleep troubles

  • Fluctuation of body temperature

It's important to note that the symptoms of adrenal fatigue, such as feeling exhausted, weak, or sad, are common and non-specific. This means that they can be present in a variety of illnesses and can also occur as a result of a busy, stressful lifestyle.

If you are experiencing these symptoms, it's important to speak with a healthcare provider to get a proper diagnosis. It's possible that you may be experiencing depression, obstructive sleep apnea, adrenal insufficiency, or another health issue. Seeking a proper diagnosis is crucial in order to find the most effective treatment plan and feel better. It's not advisable to rely on an unproven diagnosis like adrenal fatigue, as this may not address the root cause of your symptoms.

What is the connection between hypothyroidism and adrenal fatigue?

Since some of the symptoms of hypothyroidism and adrenal fatigue are similar, the two can sometimes be confused. Plus, people with hypothyroidism often have a weak adrenal function. This is because the adrenal and thyroid glands work hand in hand to supply your body with essential hormones that keep it working properly. While the thyroid produces hormones that regulate your metabolism and energy, the adrenal glands produce other hormones that your body can't do without.

Moreover, there is a close relationship between thyroid disorders and adrenal fatigue because of the way that these conditions can affect the hormonal circuit, which consists of the thyroid, adrenal glands, and ovaries or testes. When one part of this circuit malfunctions, it can have an impact on the other parts as well. For example, if your adrenal glands become exhausted due to the high cortisol demand in adrenal fatigue, it can lead to thyroid, ovarian, or testicular dysfunction. Similarly, if your thyroid gland is not functioning properly for some other reason, it can affect your adrenal health and increase stress, potentially worsening adrenal fatigue.

When you're under stress, your adrenal glands produce more cortisol, a hormone often referred to as the "stress hormone." This activates your body's NeuroEndoMetabolic (NEM) stress response, which causes a number of physiological changes that help you prepare to either fight or flee the source of the stress. These changes also protect your body from the harmful effects of excessive stress.

However, if you experience chronic stress, as many people do in today's world, your body may need high levels of cortisol on a constant basis. This can lead to adrenal fatigue. Chronically elevated cortisol levels can also interfere with the NEM stress response, as the body is unable to rest and repair itself. This can lead to imbalances and malfunctions in the body.

Hypothyroidism is also linked with higher cortisol levels, which is thought to occur because your body has decreased ability to eliminate cortisol. In contrast, low TSH levels have been linked with lowered TSH levels.

The hypothalamic-pituitary-adrenal (HPA) axis is another mechanism through which the thyroid and adrenals are linked. The HPA axis is responsible for controlling the more than 50 hormones produced by the adrenal glands, including cortisol. The hypothalamus and pituitary gland both play a role in regulating thyroid hormone production. Therefore, conditions that affect the pituitary or hypothalamus can also impact the adrenal and thyroid glands. In addition, if the HPA axis is disrupted due to adrenal fatigue, it can also affect thyroid health.

If your hypothyroidism is caused by adrenal fatigue, it's called secondary hypothyroidism. Aside from hypothyroidism, hyperthyroidism and adrenal fatigue are sometimes linked as well.

What if I have both hypothyroidism and adrenal dysfunction?

What about adrenal insufficiency?

Adrenal insufficiency is another adrenal dysfunction that shares some common symptoms with hypothyroidism. Unlike adrenal fatigue, however, this condition is an official medical diagnosis. With this condition, your adrenal glands don't produce enough hormones. Thus, you have low cortisol levels, causing symptoms like decreased appetite, fatigue, weakness, changes in weight, and low blood pressure.

There are two types of adrenal insufficiency: primary (Addison's disease) and secondary. Addison's disease is an autoimmune disease that can potentially destroy the adrenal glands. Secondary adrenal insufficiency, on the other hand, is usually caused by a problem with the hormones secreted by the pituitary glands or the hypothalamus that triggers to adrenal glands to release cortisol and other hormones.

How do I know if I have hypothyroidism or adrenal dysfunction?

Hypothyroidism and adrenal dysfunction like adrenal fatigue and adrenal insufficiency can be difficult from one another. Plus, the conditions can coexist. One way to know for sure whether you have adrenal or thyroid dysfunction is by using laboratory tests.

Unfortunately, there is no standard blood test for adrenal fatigue since it's not a recognized medical condition. A saliva or urine test can be used to assess adrenal function, but it's important to consult with a healthcare professional for a proper evaluation.

To determine whether you have adrenal insufficiency, you'll have to take a cortisol blood test. If the result of this test shows that your cortisol levels are low, your doctor may order an adrenocorticotropic hormone (ACTH) stimulation test. The pituitary gland releases ACTH to stimulate your adrenal glands to release cortisol. If your cortisol levels don't increase during the test, you have primary adrenal insufficiency. In this case, your doctor may order more lab tests to measure other hormone levels like aldosterone and renin. Various imaging studies, such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound, can be used to look for abnormalities in your adrenal glands.

For hypothyroidism, your doctor may use a thyroid-stimulating hormone (TSH) test. An elevated TSH level typically indicates that the thyroid is not producing enough hormones, so the pituitary continues to release TSH in an attempt to compensate.

Aside from TSH, your total and free T4, total and free T3, reverse T3, anti-TPO, and anti-thyroglobulin may also get tested. These tests can provide a more detailed picture of your body's thyroid function, including thyroid autoimmunity as indicated by elevated thyroid antibodies, which can be present in Hashimoto's disease. These lab tests can provide important information about thyroid hormone conversion and other aspects of thyroid function that might not be shown by a TSH test.

What if I have both hypothyroidism and adrenal dysfunction?

The following ways may help you overcome both hypothyroidism and adrenal dysfunction:

Thyroid hormone replacement therapy

Obviously, you need to address your hypothyroidism. And the only way to do this is by taking thyroid hormone replacement medication. The standard approach to treat this condition is by taking levothyroxine or synthetic thyroid hormone T4, such as Synthroid and Levoxyl. However, natural desiccated thyroid (NDT), such as Armour Thyroid and VitaliThy, has been gaining popularity as the preferred choice for many individuals looking to treat their hypothyroidism. This thyroid medication is made from the dried and powdered thyroid glands of pigs. Thus, it contains natural forms of T4 and T3 hormones. This combination is much closer to what your body naturally produces, which may explain why NDT provides better relief from hypothyroid symptoms.

Brand names of NDT, like Armour Thyroid, can be hard to find, but many alternatives are available. One of them is VitaliThy, a natural desiccated thyroid you can buy online. Although it's classified as an NDT supplement, it actually consists of Thyroid (USP), just like Armour Thyroid. Therefore, it can work very effectively in easing your hypothyroid symptoms and helping you lead a healthy life.

If you have adrenal insufficiency, it's important to get your cortisol levels to their optimal range first. Taking thyroid hormone medication before you correct your low cortisol can only worsen your condition.

Take supplements for adrenal fatigue

You can consider taking supplements to support your adrenal glands if you have adrenal fatigue. It's important, however, to only do this under the surveillance of your doctor.

Hormone supplementation for adrenal sufficiency

If you have adrenal insufficiency, you'll need to take hormone supplements to replace the hormones your adrenal glands don't make enough of. For low cortisol, you'll need to take glucocorticoids like prednisolone and hydrocortisone. If you have low mineralocorticoid hormones, your doctor will prescribe Florinef. Lastly, dehydroepiandrosterone may be given if you're a woman with low libido and low energy levels.

Get enough sleep

Getting enough sleep is an important factor in maintaining a healthy thyroid and adrenal function. If you are not getting the recommended seven to nine hours of sleep that most adults need to function effectively, this could be impacting your thyroid and adrenals.

Manage your stress

Managing stress is also critical for maintaining healthy adrenal and thyroid function. Even if some stress is inevitable, there are things you can do to reduce stress in your life, such as avoiding upsetting media and news, limiting contact with high-stress individuals, switching to a lower-stress career or avoiding the night shift, and avoiding multitasking. A therapist or life coach may be able to help you develop a stress management strategy that works for you, including incorporating stress-reducing activities into your daily routine.

Nutrient-rich diet to support your low thyroid hormone and adrenal fatigue

What you eat can have a significant impact on adrenal and thyroid function. To support these glands, it's important to avoid consuming large amounts of added sugar, highly processed foods, and caffeine. Instead, consider choosing a diet that is rich in whole, nutritious foods like fiber, essential vitamins, and minerals. This can help support healthy thyroid and adrenal function.

Regular exercise

Exercise may not be the first thing that comes to mind when you're feeling tired, but regular, low-intensity physical activity can actually help boost energy levels. It has been shown to oxygenate the blood, improve heart and lung function, reduce fatigue by 65%, and increase energy by 20%.

However, it's important to be mindful of the type of exercise you do when you are trying to support your adrenal function. High-intensity and endurance exercises can put additional stress on the adrenals, so it's best to limit these types of workouts until your adrenals are back in balance. Instead, try incorporating techniques like deep, proper breathing, yoga, qi gong, tai chi, or crafts and manual labor into your regular exercise routine. These activities can help regulate stress hormones, lower heart and blood pressure, and reduce breathing rates. Guided meditation or Transformational Breath Meditation can also be helpful for regulating the breath and reducing stress.

Conclusion: hypothyroidism and adrenal dysfunction

Low thyroid hormones and adrenal dysfunction are conditions that can occur separately or together. They can share the same symptoms, so diagnosing which one you have can take some time.

If you have both adrenal dysfunction and hypothyroidism, it's best to address problems with your adrenals first. This is because addressing your low thyroid hormone when you have problems with your adrenals may only cause further problems.

Wojciech Majda
Wojciech Majda


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