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“Seventy percent of people on thyroid replacement medication continue to suffer symptoms—symptoms that happen to mimic adrenal fatigue” ([1.www.naturalthyroidhealing.com/portfolio/thyroid-adrenal-connection]),([2.https://www.drlam.com/articles/adrenalfatiguevshypothyroidism.asp])

Adrenal Fatigue and Hypothyroidism

Are you having problems with your adrenal glands or your thyroid gland? Or both? It is not uncommon for individuals that suffer from Adrenal Fatigue to also experience some degree of thyroid dysfunction. If you want to find out why you should also look at your thyroid gland when you have adrenal gland problems, make sure you continue reading.

The Thyroid Gland

The thyroid gland, or just the “thyroid”, is a butterfly shaped gland, which is situated at the front of the neck, just underneath the Adam’s apple and is wrapped around the windpipe (see image above). The thyroid gland takes iodine found in many foods and converts it to the two primary hormones: Thyroxine (T4) and Triiodothyronine (T3). T3 and T4 are then released in the bloodstream and travel throughout the body where they control metabolism (conversion of food and oxygen to energy). Hypothyroidism (or underactive thyroid disease), occurs when your thyroid gland does not make enough thyroid hormones. If your body doesn’t have enough thyroid hormones, your metabolism and body processes slow down ([3. http://www.iodine-resource.com/benefits-of-iodine.html]). That means your body produces less energy, and your metabolism becomes sluggish. Symptoms of Hypothyroidism can resemble symptoms of Adrenal Fatigue and other diseases. There are however several “classic” hypothyroid symptoms related to a sluggish metabolism such as fatigue, tiredness, obesity, depression, coldness, high cholesterol as well as slow thinking, speech and movements. Causes of Hypothyroidism are:

• Hashimoto’s thyroiditis
• Radiation therapy to the neck area.
• Radioactive iodine treatment
• Use of certain medications.
• Thyroid surgery
• Too little iodine in the diet
• Treatment for hyperthyroidism
• Pregnancy
• Problems with the thyroid at birth
• Pituitary gland damage or disorder
• Disorder of the hypothalamus
• Stress

How Stress Can Lead To Thyroid Symptoms

We have discussed how stress can lead to Adrenal Fatigue. But research shows that stress can also cause a slowing of the thyroid, also known as hypothyroidism. ([3. Helmreich, D., et al. 2005. Relation between the hypothalamic-pituitary-thyroid (HPT) axis and the hypothalamic-pituitary-adrenal (HPA) axis during repeated stress. Neuroendocrinology, 81, 183–92. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/16020927]) Both your adrenal glands and thyroid gland produce hormones and provide feedback to the brain via feedback loops. These feedback loops are crucial to maintain stable conditions in your body. They continually monitor and adjust your hormone levels to values that are within a safe range so that the body continues to function successfully. The adrenal glands are part of a broader neuroendocrine structure called the HPA axis (Hypothalamic-Pituitary-Adrenal axis) and the thyroid gland is part of the HPT axis (Hypothalamic-Pituitary-Thyroid axis). Both the HPA axis and HPT axis operate through feedback loops. As you can see from the diagram below, the hormones from each loop interact and thyroid hormone and cortisol work in concert. Your body needs just the right amount of cortisol in order for your thyroid to function optimally. Too much cortisol as a result from acute stress or too little as a result from continuous stress over time may lead to problems. Imbalances along each axis may lead to either overactive or underactive adrenal glands and also an underactive thyroid. The working of the endocrine system is very complicated, so below is a simplified version that explains why stress may lead to thyroid dysfunction: In response to a stressful experience the master stress hormone Corticotropin Releasing Hormone (CRH) is released by the hypothalamus. This hormone signals the pituitary to release thyroid-stimulating hormone (TSH), which then sends a message to the adrenal glands to produce cortisol. But both CRH and cortisol can inhibit TSH and the conversion of T4 to T3, our most active thyroid hormone. That’s the reason why chronic stress over time, which results in adrenal imbalance, whether overactive or eventually underactive, also inhibits thyroid function. Many Adrenal Fatigue symptoms are so similar to Hypothyroidism that the two are frequently confused or misdiagnosed. To add to this confusion, tests for adrenal and thyroid dysfunction are often hard to interpret correctly. But although Adrenal Fatigue may resemble Hypothyroidism in some regards, there are also significant differences between the two. The diurnal cycle of adrenal function usually means that certain times of the day/night will be more troublesome than others; this circadian cycle is not present in thyroid problems. Similarities between Adrenal Fatigue and Hypothyroidism as well as common differences are listed below:

Adrenal Fatigue & Hypothyroidism Similarities ([3.http://ericbakker.com/adrenal-thyroid-connection]),([4.http://www.thyroiduk.org.uk]),([5.Wilson, James, Adrenal Fatigue: The 21st Century Stress Syndrome. (2001)]): Fatigue Low body temperature Poor concentration Loss of drive Cold hands Impaired memory Insomnia Decreased libido Overreacting to trivial matters Hypoglycaemia Decreased immunity Upper respiratory tract infections Both are very common conditions Usually missed or misdiagnosed

Looking for help with Stress? Grab your FREE Stress Management Workbook today!   Common Differences Between Adrenal Fatigue Differences & Hypothyroidism ([6.http://www.pharmaceutical.co.nz/adrenal-fatigue-vs-hypothyroidism]),([7.https://www.drlam.com/articles/adrenalfatiguevshypothyroidism.asp]):
Adrenal Fatigue	Hypothyroidism
Fatigue: early morning & mid-afternoon	Fatigue: all day long
Feels worse in the morning & best after 6pm	Feels relatively same all day long
Body temperature low if severe	Low basal body temperature
Sensitive to cold	Intolerance to cold
Hair loss: in men on lateral calf	Hair loss: scalp, brows
Mild constipation, often alternates with diarrhea	Stubborn constipation
Normal eyebrows	Loss of outer 1/3 of eyebrows
Stamina varies, often within day	Can’t increase stamina
Depression more intermittent	Depression mores constant
Hypoglycaemia, especially under stress	Hypoglycaemia not as marked
Diurnal energy patterns	Energy more constantly low
Cravings for salt or salty foods, or high fats, with protein & caffeine	Cravings for sweets, refined CHO’s or high energy food that don’t require digestion
Addition of salt improves symptoms	Addition of salt doesn’t change symptoms
Frequently tired at 9.30pm, but can push themselves through	Crashes by 9.30pm at night
Second wind at 11pm is frequent	No second wind at 11pm
Often feels better if can sleep until 9am	Time they get up makes no difference
Cardiac: can have lower volume & weaker contraction if severe	Cardiac: bradycardia most common sign
Weight gain: not always present could be loss instead can be calorie related	Weight gain (not always present & not related to calorie intake)
Weight distribution: abdominal apron	Weight distribution: hips & thighs
Weight loss: usually decreases gradually with exercise, decreased stress & Carbohydrate intake	Weight loss: very difficult without treatment
Menstruation: heavy onset, often lighter by 3-4th day or may skip 3-4th & return on 5th day	Menstruation: heavy & longer
Estrogen/ progesterone therapy may help some but doesn’t change Adrenal Fatigue symptoms	Estrogen/ progesterone therapy may increase symptoms if thyroid is not treated

Treatment for Adrenal Fatigue & Hypothyroidism

When both the thyroid gland and the adrenal glands are weak, repairing the adrenal glands should precede thyroid repair. ([9.http://www.stopthethyroidmadness.com/adrenal-info/]),([10. http://www.westonaprice.org/modern-diseases/low-metabolic-energy-therapies/]) One way of looking at thyroid-adrenal connection is to think of the thyroid as “generating” the energy whereas the adrenal glands need to be able to “handle” that energy. If the thyroid-generated energy is too much for the adrenal glands’ ability to handle it, the body will down-regulate the thyroid energy as much as it can to accommodate what the adrenal glands can safely handle. If the adrenal glands are weak even normal thyroid activity places a burden on them. Using thyroid medication that contains T4 and/or T3 then offers little or no benefit as the thryoid medication pushes the system to function at a higher energy level than the adrenal glands can handle. The improvement of hypothyroid symptoms is short lived if the adrenal glands are not supported, but when the adrenal glands are functioning well, the thyroid hormones can do their job and hypothyroid symptoms will improve. The following website is an excellent resource for more information about Hypothyroidism and thyroid treatment: http://www.stopthethyroidmadness.com/ Also, if you wish to learn more about iodine deficiency, the most common cause of hypothyroidism, make sure to visit Jill Van Eps’ website at http://www.iodine-resource.com/. Jill personally lived through iodine deficiency and created her website containing helpful information that she gathered along the way.

References & Further Reading