The Stress-Adrenal-Thyroid Connection
This article is going to be about the Stress-Adrenal-Thyroid Connection. When it comes to stress our adrenal glands are always involved. The adrenal glands are two small glands in which sit on top of each kidney. In Latin, the word “adrenal” literally means above the kidneys. The adrenal gland is made up of an outer portion called the cortex and an inner portion called the medulla. Each portion secretes different hormones that serve various different functions in the body.
Stress And Our Adrenal Glands
Yes, that lovely word “stress.” We all have too much to give, with so little time to do much for our own selves. Our adrenals are considered our stress glands because they are at work in time of physiologic and emotional stressors. One of the substances that the adrenals secrete under times of stress is a glucocorticoid hormone called cortisol. Typically in the clinic when I talk about stress people normally think of the emotional or physical related stressors. These are things like being overworked, or something unfavorable or dramatic going on with friends and family, or someone yelling at you. While yes these can play a factor into the overall health of our adrenal glands, they take a back seat to the third category of stressors which is chemically induced stressors. These pose a more immediate threat on our adrenals and if left unchecked can turn into adrenal fatigue.
These chemically related stressors include:
- Blood sugar irregularities
- Inflammation from: food sensitivities, infections, untreated autoimmune conditions, and environmental toxins
- Caffeine, Nicotine, Alcohol, Sugars, Partially Hydrogenated oils, and some artificial sweeteners
The thing about the adrenals, is they are usually never really the cause of a problem in and of themselves (except in rare cases like an autoimmune disease against the adrenals or a tumor growth). The adrenals are almost always a downstream problem, meaning something else is driving them out of normal function. Because of this, they are almost always some degree of adrenal dysfunction in every one of our patients. It is a surprise when someone is chronically ill and we see perfectly functioning adrenal glands.
Symptoms of adrenal dysfunction can include:
- Brain Fog/ Fatigue
- Difficulty staying asleep (especially waking up a few hours after going to bed, typically around 2 – 4am)
- Slow starter – Waking up feeling like you could use another 5 hours of sleep
- Classic afternoon crash (typically around 3 – 5pm)
- Difficulty falling asleep
- Sugar or Salt Cravings
- Mood Swings
- Poor Immune Regulation
- Gastric Ulcers
- Transient spells of Dizziness
Is there really an Adrenal-Thyroid Connection?
Since adrenal fatigue is not a medically recognized entity, there is very little research that has been done on it. There have however been association studies showing that when the adrenal stress hormone cortisol is higher it does tend to lower/alter thyroid hormone levels (1,2). One study also looked at people with subclinical hypothyroidism in the presence of adrenal insufficiency and found that the hypothyroidism was reversed when they treated the adrenal insufficiency (3). Another functionally oriented case study showed that when you simply treat the areas of the body that can impact the adrenal glands, the patient’s thyroid symptoms improved greatly (4).
How does the adrenal glands mess with thyroid hormones?
The adrenal glands can alter thyroid physiology in 4 different ways.
1.) Chronic Adrenal Stress inhibits the Hypothalamus and pituitary glands release of other stimulating hormones
Remember the Hypothalamus and the pituitary glands role in thyroid health that we went over at the beginning of this Thyroid series? The hypothalamus and the pituitary gland are considered to be like the air traffic control tower for the bodies endocrine system. These two areas of the brain are responsible for picking up minute changes in hormone levels and then responding appropriately. This system has a direct impact on virtually every cell in the body and regulated things such as: temperature, mood, metabolism, sexuality, digestion, and the immune system.
If the hypothalamic pituitary axis is like the air traffic control tower of our bodies endocrine system, then cortisol is like the clouds/fog that can mess with the ability to orchestrate the bodies endocrine system properly. There has been a few studies that show that chronic adrenal stress depresses the hypothalamus and pituitary function. (5) This is one of the reasons why the previous studies (1,2,3)showed depressed thyroid output with adrenal dysfunction.
2.) Chronic adrenal stress can lead to a decreased T4 to T3 conversion
By now you should know that much of the active thyroid hormone (T3) in our bodies does not come from the thyroid gland itself. The majority of thyroid hormone coming from the thyroid gland is inactive T4 and needs to be converted to T3 in different tissues. Initially when our Adrenal glands are being stressed and release more cortisol the T4 to T3 conversion is enhanced. This was shown in two different animal studies (6,7). However, when the adrenal glands are being stimulated for a chronic period of time, they tend to fatigue and produce less cortisol. The decrease in cortisol hampers our ability to convert T4 into active T3.
3.) Chronic Adrenal Stress can leave a poor immune system unchecked and promote autoimmunity
One of the many actions that cortisol does is, that it’s a potent anti-inflammatory agent. This means that the more cortisol is secreted the less inflamed our bodies are. In fact, when people get injections in the knee or joints to dampen inflammation and therefore dampen pain, most of the time it is cortisone (a molecule close to our own cortisol). Cortisol, like any other hormone, can’t be too high or too low. It has to be just right. When cortisol is too high it tends to weaken our barriers in our body, which can in turn promote further inflammation and autoimmunity. When cortisol is too low, it leaves the immune system unchecked and can promote autoimmunity. There have been several studies linking stress with decreased immunity in animals (8) as well as a reduction of thyroid hormone levels (9). Because the close association between stress and our immune system, stress has been reported in some cases to contribute to the development of autoimmune diseases. (10)
4.) Chronic Adrenal Stress can affect the cells ability to utilize thyroid hormone
Just like blood glucose, circulating levels of hormones in the blood are relatively useless until they get inside of the cell. One study took the serum of individuals to cell cultures and found that the group of individuals who were stressed showed a decreased ability of uptake of thyroid hormone inside the cell, while the non-stressed group showed a normal uptake (11). Another study found that significant physiological stress was associated with up to a 79% reduction in tissue levels of T4 and T3 without a rise in TSH (12)
What are some things you can do to prevent adrenal fatigue?
- For those with adrenal related issues it is better to eat smaller meals more frequently throughout the day never go more than 3 hours without eating
- Be sure to have your laboratory tests run by your doctor to check for any chemical related stressors like the ones listed at the beginning of this article
- Avoid inflammatory food, and other common adrenal stressors like: caffeine, alcohol, nicotine, or sugar
- Stress tends to use up our B-vitamin stores, so taking a good quality B-vitamin can help with recovery
- Adaptogenic herbs and botanicals can help hasten the recovery as well