More ramblings. We've been discussing interactions between thyroid and adrenal function recently.
Another poster on this site mailed me the link to this piece on the management of cortisol/adrenal issues by highly respected thyroid doctor Dr. John C Lowe who passed quite recently:
It's interesting, because apart from being another source that sets out the adaptogen/adrenal supplement based approach to treating high cortisol and/or adrenal fatigue, it may in addition shine a little more light on the above issue, and on some of the symptoms that may arise during treatment of either as a result of these.
T3 Paul's book which covers circadian rhythm and its role in T3 supplementation very likely adds insight in this territory too - but i'm not yet up to speed on it.
Bear in mind that I'm no expert, and that this amounts to theorising by extension from what Dr. Lowe says.
His experience was seemingly that achieving proper T3 replacement may initially cause adrenal fatigue (and require the presumably short term low/naturally occurring/physiological level adrenal supplementation he mentions) as a result of improved liver function - because the resulting more rapid metabolism of cortisol can reduce the blood levels of cortisol. (this where the adrenals are already quite fatigued, but were just managing to cope while the patient was hypothyroid)
This is a guess - but it might also lead to surges of high cortisol and palpitation type symptoms at times too if the adrenals are misfiring (that's alternating between high and low outputs) as it seems they may do when they can't quite keep up. (see the Clymer manual linked before for the stages through which adrenal fatigue seemingly progresses - it suggests that cortisol output can progress from chronically high, to intermittently high and low, to low when fatigue sets in)
This faster processing by the liver is no doubt normally a good idea because it should result in faster clearing of cortisol after periods of stress.
Projecting from this again though, the converse is likely ( surprise!!) - that hypothyroidism leads to a reduced ability to handle stress, and to a tendency to run chronically raised levels of cortisol in response to a given level of stress. This because as above the ability of the liver to clear cortisol is reduced - not to mention that lots of other processes must also feel the effects.
High (and low) cortisol are meanwhile both well recognised as suppressing T3 conversion and reversing T3 to produce what should be short term hypothyroidism - but if the raised cortisol is chronic/longer term this hypothyroidism may become a significant cause of gut problems (correct gut function requires adequate thyroid), consequent auto immune illness, candida and the like. Which it's held can quickly feed into primary hypothyroidism (actual dysfunction of the gland) as well as a result of the resulting ineffective absorption of key nutrients/minerals etc in the gut among other issues.
Hypothyroidism/inadequate availability of T3 seems anyway likely to reduce adrenal capability along with the performance of just about every other cell based metabolic process in the body.
So it looks like we may have yet another mutually self reinforcing negative spiral - this time between adrenal and thyroid function - but with a lot of scope for variation in symptoms (and required treatments) depending on exactly what's going/not going on in each system.
There's potentially more than that to it too. Chronic stress/longer term raised cortisol it seems risks the possibility of HPA programming/learned/exaggerated stress responses (where the adrenal 'brain thermostat'/baseline cortisol level gets bounced into being set high by chronically high cortisol levels and remains stuck there) - as discussed in the Clymer manual and numerous research papers linked in previous posts on the high cortisol topic. (wonder if there could be any similar programming effect in play regarding our output of thyroid hormone?)
This is significant since these naturopathic docs commonly finger chronic stress and chronically raised cortisol and/or consequent adrenal fatigue as a common first cause of chronic fatigue and related metabolic illness, and as the common route to thyroid problems.
It's clearly unwise to permit stressful life situations/chronic stress to continue in our lives - so conversely it may be very important to find the courage to act determinedly but wisely to create the required change.
I'd a sluggish and fatty liver for years (was lectured by one doc that it was down to poor diet despite my going to enormous lengths to avoid problem foods and eat carefully) - yet one of the most pronounced symptoms when i upped my proportion of T3 a few months ago to get a big improvement in well being and especially gut function was gallstone like pains and a darkening of 'output' It's reasonable to bet that this was the liver clearing itself.
Reducing my cortisol levels (hope i can maintain it) has delivered a further very significant improvement in stamina and energy, and cleared remaining gout and joint/muscle aches - plus i'm losing weight quite rapidly.
These effects have all materialised as a result of supposedly minor changes - despite my long having in both cases been well within what conservative medicine regards as 'normal' blood hormone ranges...
I escaped symptoms of adrenal related issues like palpitations and got excellent results immediately upon upping the proportion T3 (but seem to need some T4 to feel well) - possibly because I'd by then already been on quite good thyroid replacement with a lower proportion of T3 for several years (i.e. it was only a step up), was well clear of stressful work situations and the like, and had completed several courses of adrenal supplementation.
So what is this saying? It's not advice, but the suggestion seems to be that small differences can count for a lot, and that there's likely scope for quite a wide range of interactions between thyroid and adrenals. It may also suggest that care is needed to avoid or at least safely and tolerably manage interactions when treating one, or other or both.
Guess I'm wondering what's out there by way of recognised guidelines in this area. (most of what we read tends to look at thyroid replacement or adrenals in isolation - but not both as a total system)
It sounds for example like there is a lot to be said for simultaneously treating both together (not exactly news for many of us) - but that perhaps it's advisable to progress slowly so as not to create a major imbalance in the capability of the two, and in order to give both systems time to adapt and literally grow into the new balance... (between tuning of receptors, gland growth and the like there seems to be considerable scope to adjust both responses and output)
PS. There's no significant discussion of the adrenal fatigue scenario here because that's not what i've experienced - and because i've no expertise in the area. It's perhaps worth mentioning however that should the issue of supplementation arise or even be considered that it's territory requiring great care.
This STTM page sets out a broad take on some posssibilities, and more to the point probably only some of the many and potentially serious pitfalls that can arise in the form of dependencies/side effects/HPA re-programming etc : stopthethyroidmadness.com/a...
Definitely best approached with expert professional assistance....