How Adrenal Disorders Disguise Themselves as Thyroid Disease
Understanding the Basics of Hypothyroidism
According to the American Thyroid Association, hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone and, just like other hormone deficiencies, it can affect almost every aspect of your wellbeing. It can make you feel weak & fatigued, cause unordinary weight gain, and can lead to even more serious health concerns in left untreated. Low thyroid hormone levels during pregnancy can even harm the baby!
I know this is a scary thing to fathom but through understanding this disease, we have a better chance of catching, treating and preventing hypothyroidism all together. So let’s start with from the beginning.
What Causes Hypothyroidism?
With hypothyroidism being such an all-encompassing disease, it is often hard for us to pinpoint the exact root of the problem. The range of things that have been shown to cause low thyroid hormone levels are blood sugar imbalances, poor gastrointestinal health (aka gut health), and even elevated stress levels caused by the adrenal glands. Thyroid diseases can even be caused by separate diseases all together such as the case with Hashimoto's disease.
According to WebMD, “Hashimoto's thyroiditis is an autoimmune disease, a disorder in which the immune system turns against the body's own tissues. In people with Hashimoto's, the immune system attacks the thyroid. This can lead to hypothyroidism, a condition in which the thyroid does not make enough hormones for the body's needs.”
I think you can now begin to grasp the vast depth of this disease. Due to the complex nature of hypothyroidism we will begin to shift to one aspect of the cause of this disease and start to focus solely on the role that the adrenal glands, stress and cortisol levels play in hypothyroidism. (We will come back to the other causes in later posts so keep checking back.)
Understanding the Adrenal Glands and Stress
The Adrenal Glands
It really doesn’t matter whether you are thinking about stress in an emotional vs physical way or even short-term vs chronic. Your body reacts to stress in much of the same way regardless of the source or duration of the stress induced. The National Institute of Mental Health describes stress as, “the brain's response to any demand.”
These demands cause your adrenal glands to fire out hormones the hormones adrenaline and cortisol, which are also the hormones associated with the ‘flight-or-fight’ response you learned about in school. These two adrenal hormones are described by the Mayo Clinic as, “Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues.” This response worked great when we either had to outrun predators or conserve our energy during harsh winter conditions. Yet in today’s world of rest and relaxation it can cause unhealthy responses, especially when these stressors are chronic ones such as work or financial worries.
Stress and Its Effect on Health
Obvious daily stressors, like described above, are not the only factors to consider when thinking about stressing the body. Even internal happenings like sharp changes in blood sugar levels, allergies and ordinary inflammation can alert your adrenals to secrete more stress hormones. In essence, stress can be anything that disrupts your body’s natural balance.
Even though dysfunction of the adrenal glands due to stress is so common today, adrenal disorders are often missed by general physicians because its list of symptoms are so broad and mirror other problems or disorders. Adrenal problems are often not even tested for because these hormones play a role in every system in the body and it will hide behind other systems that it is affecting, such as menopause or food sensitivities.
You should consult with a specialist if you are experiencing one or more of these problems caused by adrenal stress:
- Decreased immunity
- Difficulty falling asleep, staying asleep and waking up
- Mood swings
- Sugar and caffeine cravings
- Irritability or lightheadedness between meals
- Eating to relieve fatigue
- Dizziness when moving from sitting or lying to standing
- Gastric ulcers
How Your Adrenal Glands Can Disrupt the Function of Your Thyroid Hormones
Thyroid function effects good majority of bodily functions too, just as most hormones in your body do. Symptoms of hypothyroidism can even be spurred about be weak adrenal function (just as Hashimoto’s disease can cause adrenal fatigue). If cases where adrenal problems lead to thyroid disorders, it is absolutely pointless to treat your thyroid without first fixing your adrenal glands. Sometimes, fixing your adrenal glands can even correct the thyroid function itself. Just like the other problems typical in western medicine, the practitioners get more wrapped up in treating the symptoms to make them manageable then curing the problem at its root.
The greatest way that your adrenals indirectly effect your thyroid’s functions is because of the impact they have on your blood sugar levels. Increases or decreases in the amount of cortisol produced by your adrenal glands can cause your blood levels to rise or fall drastically. This can lead to becoming either hypoglycemic or hyperglycemic. Blood sugar imbalances have been shown to cause numerous symptoms of hypothyroidism in some studies, such as this study published be the American Diabetes Association.
There are also more direct ways that enhanced stress on your adrenals can cause your thyroid to malfunction and we will go over some of the more important ones now.
Stress, The HPA axis and the Adrenal Gland
Apart from regulating your body’s reaction to stress, your adrenal glands are part of a complex system that regulate things like temperature, mood, sexual function, digestion, immune system, and energy consumption. Together your adrenals, hypothalamus and pituitary glands make up your hypothalamic-pituitary-adrenal (HPA) axis. If one of any of these three areas becomes imbalances, any of the functions listed above can be deeply impacted.
There have been numerous studies to show the exact impacts that prolonged adrenal stress on the HPA. Since your hypothalamic-pituitary-adrenal axis is composed of organs that regulate the production of thyroid hormones, if it becomes altered then so will the secretion of your thyroid hormones.
There have been numerous studies done to show that the chemicals released during stressful events suppress your HPA, and in turn, reduce the levels of thyroid stimulating hormone (TSH) in your system. TSH causes the thyroid gland to make two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body's metabolism. So if your HPA function decreases, your TSH levels will drop, causing T3 & T4 levels and your metabolism to decrease.
Stress Can Sabotage Your Immunity and Lead To Autoimmune Diseases
The immune system can be just as complex as the HPA axis and is regulated primarily by another 3 factors: The gastrointestinal tract, the lungs, and the blood-brain barrier. Together, they inhibit toxic and external materials from making their way into your blood and brain. Studies, like this one first published in 2006, show that stress weakens your these barriers making your immune system much more susceptible to foreign substances.
It is best to think of these three things as your first line of defense against harmful substances. When they become weak, your body becomes vulnerable to antigens and proteins passing into parts of the body where they do not belong. If your immune system functions at a low level for an extended period and this continuously happens again and again, the system becomes compromised all together and you can develop autoimmune diseases… such as the “thyroid” disorder Hashimoto’s disease that we discussed in the beginning of this discussion.
Reduced Thyroid Conversion Due To Adrenal Stress
It is important to understand the relationship that T3 and T4 play in your body. Although both are produced by the thyroid gland, 93% of the thyroids production is dedicated to secreting T4. T4 is an inactive form of thyroid hormone that must be converted to T3 to be used by your cells. Inflammatory cytokines both disrupt the HPA axis but also obstruct the conversion of unusable T4 to usable T3, as shown in this study.
This is what EndocrineWeb has to say about the T3-T4 connection, “T3 and T4 control your body's metabolism. If you don't have enough of them, then your metabolism slows down. Your metabolic rate dictates how quickly you process food, how fast your heart beats, how much heat your body creates—and even how quickly you can think. In essence, T3 and T4 are in charge of how your body uses energy… T3 and T4 are not equal in strength; T3 is the more active hormone of the two.”
Chronic Stress Inhibits Your Cells’ Thyroid Hormone Receptors
You can have all the T3 and T4 circulating in your bloodstream in the world but it will do nothing if it doesn’t first activate receptors on your cells. The same inflammatory cytokines mentioned above can cause the sensitivity of your cells’ hormone receptors to greatly diminish, including their thyroid receptors.
This may be easier to understand for those who have, or know someone close, who suffers from insulin resistance. In these individuals, their cells progressively lose sensitivity to insulin. The National Diabetes Information Clearinghouse (NDIC) describes insulin resistance as, “Insulin resistance is a condition in which the body produces insulin but does not use it effectively.” Adrenal stress can cause your cells to not use the thyroid hormones, such as T3 and T4, efficiently in much the same way. You can have plenty of thyroid hormones in your body but your cells will never become triggered to let them in to do their job and they are left floating around aimlessly. This is why it is often best to get the amount of “free” T3 and “free” T4 (i.e. the active amounts of the hormone) in your body tested instead of the total amount of T3 and T4 you produce.
Although there is no real, logical way for you to have your thyroid receptors checked, research suggests they are diminished by autoimmune diseases and other inflammatory conditions. That is why a patient with Hashimoto’s disease can undergo thyroid replacement therapy and still endure the symptoms of the disease itself. For these people, inflammation weakens the thyroid receptor site sensitivity so even though they have normal levels of thyroid hormones in their blood (such as TSH, T3 and T4) they still get the symptoms of hypothyroidism. Again, this is the reason you want to get your “free” thyroid hormone levels checked and possibly even “reverse” T3 and T4 levels.
Long-Term Stress Can Lead to Other Hormonal Imbalances
Remember that your adrenal glands release two significant hormones into your body to stimulate the fight-or-flight response in you? Well if not, cortisol is one of those hormones your adrenals secrete during a stress filled event. Keeping in mind that stress can be anything from inflammation, to financial worries, to physical stress; when your body secretes high levels of cortisol for extended periods of time, your liver functions at a lower and lower level and its ability to clear excess estrogen from your body is diminished.
Studies, such as this one published by the Journal of Thyroid in 2011, show that a surplus of estrogen in your system increases the level of thyroid binding globulin (TBG). Medscape describes thyroid binding globulin as, “a circulating protein that reversibly binds thyroid hormones3,5,3’-triiodothyronine (T3) and thyroxine (T4) and carries them in the bloodstream.” And that, “An increase in TBG may result in an increase in total T4 and T3 without an increase in hormone activity in the body. If additional thyroid hormone testing is indicative of hypo- or hyperthyroidism without any symptoms, TBG levels become more relevant. TBG levels can artificially suggest states of hypothyroidism or hyperthyroidism. Various nonthyroidal illnesses, medications, high estrogen states, and even prematurity can mimic hypothyroidism as a result of misleading laboratory findings. Increased TBG levels may be due to hypothyroidism, liver disease, and pregnancy. Decreased TBG levels may be due to hyperthyroidism, renal disease, liver disease, severe systemic illness, Cushing syndrome, medications, and malnutrition. Thus, the entire laboratory data collection evaluating thyroid function should be considered along with the current state of health.”
When TBG levels become too elevated, the percentage of the active form of these thyroid hormones decline (free T3 and free T4). Having low free T3, low free T4 and low T3 uptake on a lab test can indicate high levels of thyroid binding globulin in your system, especially if your total T3 and total T4 levels appear to be somewhat normal.
Other common culprits to elevated TBG levels are birth control pills and estrogen replacement therapy. If you are taking either of these medications and are experiencing symptoms on hypothyroidism, it is important to have to proper blood work evaluated by a thyroid specialist to determine the risks and rewards of continuing treatment or the possibility of alternative medical treatment options.
How To Bring Your Adrenals Back Into Balance
So now that you know all the ways that adrenal stress can hide behind a thyroidism the problem should be easy to fix, right? Well actually that couldn’t be further from the trust. Much like how adrenal issues can be the root of other issues in your body, other issues in your body are often the underlying root of excess adrenal stress. This can be any range of different things. From anemia, to mineral deficiencies, to toxins in the environment, and of course, chronic stress and inflammation.
Without correcting these affairs in your body, any effort to support the adrenal glands directly will be insufficient and unsuccessful. With that in mind, here are some guiding principles to promote the health of your adrenals:
- Cut out foods that cause of inflammation (especially refined flours, high-fructose corn syrup and industrial seed oil)
- Eat a diet that consists of a lot of wild cold water fish or supplement with a high quality fish oil that contains the sufficient amount of the Omega-3 fatty acids DHA & EPA
- Stabilize blood sugar levels by consuming less carbohydrates
- Avoid caffeine, tobacco and other stimulants all together or at least as much as possible
- Practice stress management and relaxation techniques (i.e. deep breathing exercises and meditation techniques)
- Don’t hesitate to enjoy life, have fun and laugh as much as possible!
Certain dietary supplements such as phosphatidyl serine and ginseng have been shown support the adrenals and improve your body’s ability to deal with stress. Remember though, as with all dietary supplements and medications, you should not take these things without the supervision of a trained medical professional.
Ways to Naturally Boost Adrenal Function
Cut Out Foods that Cause Inflammation
Deep Breathing Exercises
Eat more cold-water fish (Omega-3's)
Dietary Supplements that Boost Adrenal Function
Count Your Blessings
Hypothyroidism and Adrenal Disease
Have you ever undergone medical thyroid or adrenal treatment and if so, did it help your symptoms?
© 2014 David Em