How adrenal stress can impact thyroid function

 
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Written by Alexandra Preston and Reine DuBois. Featuring Kristin Zanotti and Phil Baxter.

The thyroid is a small, butterfly-shaped gland that sits at the front of our throats. It contributes to a wide range of physical and mental processes, including weight control, mood, cognition, and menstruation. The Australian Thyroid Foundation lists the causes of thyroid disorders as iodine deficiency, infections, genetics, autoimmune disease, nodules and tumors. However, from a holistic perspective, adrenal stress may be another contributor to poor thyroid function. 

What the Adrenal Glands do for us

The adrenal glands produce hormones including cortisol, adrenaline, and the sex hormones. Cortisol, commonly known as the “stress hormone”, is actually necessary all day long and in a strictly controlled daily rhythm. It is meant to be at its lowest levels at around 4:30am in the morning and peak 30 minutes after waking up. The purpose of cortisol is to respond to all stressors, whether they be physical, mental, emotional, imagined, metabolic, or hormonal. Adrenal fatigue is an inability of these glands to produce enough cortisol to meet the demand. This is often caused by prolonged stress. It is not the same as Addison’s Disease, a failure of the adrenal glands. Our naturopath, Kristin Zanotti, writes that her adrenal cases typically feature “unrelenting fatigue, brain fog, and poor memory, low libido, intolerance to the cold, dry skin, sleep issues (wired and tired at night), sweating, weight gain, constipation and joint pain.”

How Adrenal Stress can cause thyroid problems

Adrenal stress can be a direct cause of hypothyroidism. A case series published in 2006 describes three patients with subclinical hypothyroidism, along with other endocrine issues. All suffered from adrenal insufficiency and required no thyroid hormone replacement once their levels of adrenal hormones were normalised. 

One way that adrenal stress can create a domino effect of health problems is through an increase in inflammation. Patients with severely low levels of cortisol are found to have much higher levels of certain inflammatory substances, which cause symptoms such as fatigue, flu-like symptoms, sleep disturbances and loss of appetite. Some of these, as you can see, overlap with those of thyroid problems. 

Phil Baxter our amazing inhouse acupuncturist understands, “The thyroid gland is the only endorcrine gland on the outside of the body, its on top of the throat meaning if the delicate structures of the throat becomes twisted due to chronic stress the tension can be released with visceral manipulation, leading to better nerve and blood flow to this organ”.
Kristin Zanotti Naturopath states that “Poor adrenal health can also predispose one to the formation of thyroid antibodies - proteins made by the immune system which work against proteins in the thyroid affecting the conversion of T4 to T3 (active thyroid hormone).”

How integrative care can help

If we suffer from thyroid problems and suspect adrenal involvement, what should we do? Kristin recommends booking in a combined appointment with an integrative naturopath and GP for a full health profile assessment including:

  • health history
  • diet
  • symptoms
  • basal morning temperature
  • cortisol response and mapping
  • nutritional and thyroid assessments

A full thyroid assessment includes “Physical palpation, testing of reflexes, blood or saliva testing of TSH (thyroid stimulating hormone), T4 and T3; reverse T3 and thyroid antibodies are tested if indicated.” 

For patients who test positive for adrenal involvement, she recommends “Managing stress as best you can: learning to say no, resting where possible, relaxing teas and restorative practices (yin yoga, meditation, yoga nidra). Your practitioner will prescribe suitable therapeutic supplements to restore thyroid health.” 

Phil Baxter also mentions “Acupuncture when applied very superficially can relax the tension around the thyroid gland and Chinese herbs like Rhemannia can strengthen the adrenal complex. 

The supplements prescribed depend on each individual patient’s needs, although nutritional depletion is a major risk for adrenal issues affecting the thyroid. As Kristin states, the most critical nutrients are “iodine, tyrosine, and selenium, as they are all involved in the physical makeup of thyroid hormone. 

Pregnancy utilises body reserves of iodine and it is important that this is assessed as it can predispose women to thyroid conditions.” She adds, “Cortisol is the hormone the body produces when under stress. Tyrosine is an amino acid needed to make cortisol. Tyrosine is also the amino acid needed to make thyroid hormone, thus high stress (high cortisol production) can predispose to deficiency of tyrosine and thus thyroid hormone production. Low protein diets can contribute to low tyrosine.” 

In addition, herbal medicines are prescribed to some patients, such as holy basil (Ocimum sanctum), also known as tulsi. It has been used for over three thousand years in Ayurvedic medicine and animal studies show that tulsi can help the body maintain homeostasis of cortisol, keeping levels in check so they do not become too high. In a human study, researchers demonstrated that 300 mg a day of tulsi leaf extract significantly improved cognitive function, including in reaction times, mistake rates on standardised tests and in anxiety. 

Each patient with a thyroid or adrenal condition, or both, is different, which is why there are many possible avenues of diagnosis and treatment. If the health issues described in this article are relevant to you, feel free to click the links above to learn more about integrative approach at The Health Lodge and book an appointment. 

References

1. http://www.thyroidfoundation.org.au/ 
2. https://www.aimedjournal.com/article/S2212-9626(14)00005-4/fulltext
3. https://www.ncbi.nlm.nih.gov/pubmed/17002934
4. https://academic.oup.com/jcem/article/81/6/2303/2875502
5. https://www.ncbi.nlm.nih.gov/pubmed/7593416
6. https://www.ncbi.nlm.nih.gov/pubmed/26899341
7. https://www.ncbi.nlm.nih.gov/pubmed/26571987