More light is being shinned onto “adrenal fatigue” or HPA (hypothalamic, pituitary, adrenal) Axis Deregulation. Many of my clients have at least heard of the condition and are aware that it is often associated with fatigue. But what I am realizing that many people don’t know yet is how much adrenal dysfunction can effect other areas of the body. For instance, did you know that your thyroid problem could be an adrenal problem?
It isn’t unheard of for someone with an adrenal issue to have a thyroid issue as well, in fact I believe that it is all too common. Your adrenal glands are responsible for many functions in our bodies such as dealing with stress, blood sugar regulation, immune response, digestion, and they are part of the endocrine system that impacts major functions such as sex hormones and thyroid. Many practitioners focus on working on healing the thyroid but end up missing a key factor…the adrenals. The symptoms of adrenal fatigue and poor thyroid function do have some similarities such as fatigue, weight gain, constipation, depression, sleep disruption, or dry skin.
TSH– thyroid releasing hormone, stimulated the thyroid to make T4 and T3 hormones
TRH– thyrotropin releasing hormone, signals the part of the brain that releases TSH
TBG– thyroid binding globulin, binds hormones in circulation so that it can be transported all over the body
Free T4– inactive form of thyroid hormone, meaning it does not have the ability to bind to cells and create a metabolic response
Free T3– active form of thyroid hormone, responsible for binding to cells and creating metabolic responses
rT3– inactive reverse T3 which can bind to T3 receptor sites and block the conversion of T4 to T3
How the System Works
The hypothalamus in the brain releases TRH which tells the pituitary to release TSH and that signals to the thyroid to make hormones free T4 mostly (80-93%) and a little free T3 (7-20%).
T3 is the active form of thyroid hormone and it comes from the conversion of T4 into T3. Active T3 is formed when the liver removes one iodine molecule from T4.
The pituitary then senses the serum blood levels of T3 and shuts down the production of TSH so that there are adequate levels of thyroid hormone in the body (not too much). If the pituitary senses a low level then it kicks into action, releases TSH and triggers the thyroid to produce more free hormone (not too little). A little bit like overdraft protection in your bank account. If the bank senses that your account is getting low in money it will transfer over the amount of money you need to maintain a positive balance.
These free hormones are then readily absorbed into any cell in the body. Generally they are going to choose cells that are in close range (which we don’t want). In order to be able to deliver the hormones all over the body (like we want) our bodies bind up the hormones with TBG, which is produced in the liver. If you had too much TBG it would mean too little free T3 is available and if you had too little TBG it would mean too much free T3 is available to the body. Too little free T3 can cause unpleasant symptoms as well as dysfunction of the system. Too much free T3 can damage receptor sites, create deficiency, and cause even more serious hormone issues.
Many thyroid conditions are secondary to poor adrenal function as well as other dysfunctions in the body. Thyroid hypo function often is a result of something going wrong in the body and may be a symptom of something else. Gut dysfunction, toxic metals, estrogen dominance, blood sugar imbalances, and yes adrenal problems can all alter thyroid function. The more we can improve adrenal function and the more we can heal the body, the better thyroid function becomes if thyroid is a secondary problem.
The body deals with lots of stress from internal (food sensitivities, gut infections, blood sugar imbalances etc.) or external (busy job, bad relationship, etc.) sources. Cortisol is our stress hormone. When under stress, our bodies want to conserve resources so that it can put priority on helping you deal with stress. This is one reason sex hormones are affected by stress, the body doesn’t want to put its time and energy into making a baby so it shuts down the ability to do so. But stress can also decrease the thyroid function in order to decrease metabolism to be able to hold on to precious resources.
Cortisol affects the thyroid gland in many ways:
1| Cortisol can inhibit TSH from signaling the thyroid to make thyroid hormones, free T4 and free T3.
2| Cortisol can prevent less active T4 from converting to the more active T3.
3| Cortisol allows each T3 cell receptor to more readily accept T3.
4| Excess high cortisol (stress) can result in high output of rT3 which deactivates thyroid hormone (T3).
Bottom line: Healthy adrenal glands are needed to support thyroid function. If your HPA (hypothalamus pituitary adrenal) Axis is not properly making adequate cortisol, and you have what is more commonly knows as “adrenal fatigue,” then you can see how that might start to ultimately effect your thyroids ability to function properly. If you have been told that your thyroid levels are indicating dysfunction then it might be worth taking a look at your adrenals. Could your thyroid problem be an adrenal problem? I use DUTCH hormone testing with my clients. It is the most comprehensive hormone test available and can paint a picture as to what is going on with sex hormones, gut function, AND adrenal health. A great start for anyone with a thyroid problem.
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As a Registered Dietitian certified in Stress and Hormones by Functional Diagnostic Nutrition, I help clients get proper testing, assist in the process of reading those results using clinical correlation (treating the patient and not just the test results), and give them the proper tools (diet, supplements, and lifestyle) to start the healing process.