What Happens if I Take Thyroxine with Adrenal Problems?


What Happens if I Take Thyroxine with Adrenal Problems?

Even if the adrenal insufficiency is slight, it will adversely affect thyroid conversion, tissue uptake, and thyroid response.

If the T4–T3 conversion doesn’t happen as it should, the body can become toxic through unused T4. If it is converted, but the T3 cannot enter the cell walls due to adrenal insufficiency, the T3 cannot be used, and may reach toxic levels. In either case, T4 and TSH blood tests will appear normal, but the patient may feel really unwell. (6) If a physician raises the thyroxine dose in this scenario, the situation worsens still further.

The reaction varies with degrees of adrenal insufficiency. Symptoms may include: a sudden feeling of exhaustion, nausea, headache, inability to concentrate, trembling, muscle weakness, loss of peripheral circulation leading to numbness, lack of muscle control, giddiness, slurred speech, and cognitive impairment.

And as the literature included with this drug points out, the result can be extremely serious in anyone suffering from severe adrenal insufficiency:

“Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids [a too-rapid withdrawal of cortisol]. Patients known to suffer from adrenal insufficiency should therefore be treated with replacement glucocorticoids before starting any Levothyroxine sodium treatment. Failure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiated.(2)

Adrenal insufficiency must always be addressed before starting any thyroxine treatment.

17 Replies

  • CC, It kind of begs the question why GPs and endocrinologists don't seem to believe in adrenal insufficiency when the Levothyroxine PIL is so specific about the contraindications.

  • I did take Nutri Adrenal Extra for approx 2 months before starting NDT but wonder if lack of progress means my adrenal needs more work. Just started 2 grains/140mg of Naturethroid.

  • CC, it can take a few months to adjust to NDT so it may be that you need more time.

  • Hi Clutter, thank you.

  • A really good find cc120, I always wondered how one would feel if this happened. thanks

  • You're welcome, the adrenal - thyroid connection is a tricky one, what comes first the chicken or the egg. According to Dr Lam: drlam.com/articles/adrenalf... - (here he includes a chart comparing adrenal fatigue and hypothyroidism symptoms) then talks about how hypothyroidism can be primary or secondary and this effects your treatment.

    On the following link he talks about Anxiety and Adrenal Fatigue Syndrome: drlam.com/blog/anxiety-and-...

  • thanks, definitely the egg in my case :-)

  • I was trying the Circadian T3 Method (CT3M or T3CM) for Adrenals stopthethyroidmadness.com/t... - a great way to treat your low cortisol! Using only NDT, but it was so difficult not eating for 4 hours so I could take my iron, then in an hour my calcium. Now more often than not I take the NDT just before I going bed. I am planning to buy some licorice tincture and multi-vits and mins, to help adrenal. Not sure if I should try cortisone as did: galathea

    'I did a saliva test with Genova, looked at where my levels were low and then took cortisone. 90 mins before a drop was due, so, where I saw my 1 pm level was low,I took the cortisone at. 11.30 am, and so on. I took cortisone for two years, gradually tapering off as I felt I needed to. It worked, results were fast and I would do it all again if I needed to. However, since getting on to the correct meds ( for me) My adrenals no longer have to compensate, so all my levels are fine.'


  • My problem is high cortisol, I'm hoping as Jackie (below) says, that getting thyroid straight will improve cortisol. glad CT3M worked for you

  • Hi Flatfeet1, I believe my cortisol or is it andrenaline, high evening and night. Don't know if the CT3M would have worked for me as didn't try it for long enough.

    Here is an interesting article explaining how adrenaline and cortisol work together/effect each other:


  • My Endo says that the only good tests is through a doc. 24 hour urine collection, cortione prescribed for mid night and then a blood test 9am.It could be done by your doc with written permission from a private hospital, it is also done nHS. iron needs to be taken with food.


  • Hi My Endo believes in treting Adrenal but not until thyroid OK as it does alter.On T4 she reduces it and gives t3 as well.I had before and after tests, the adrenals were improved when thyroid right.

    It can take up to a year to have the thyroid right for you.


  • Hi Jackie - thank you, I'm still perplexed about this and wonder if it differs for each person depending on the primary cause. I have a strong suspicion that in my case it was my adrenal exhaustion that caused thyroid problem, mainly cause I've always been very anxious and worried, but not always so lacking in energy as I am now. In the article drlam.com/articles/adrenalf... mentions how adrenal issues are indicated if initial improvement on NDT, followed by no improvement until NDT is increased to required levels. I don't seem to be improving along the lines of the initial energy boost.

  • Hi I think in reality not much known about thyroid so if you think it helps no harm in trying it, so long as not taking huge doses of cortisone.I cannot take any cortisone, heart.


  • Hi I think in reality not much known about thyroid so if you think it helps no harm in trying it, so long as not taking huge doses of cortisone.I cannot take any cortisone, heart.


  • Does adrenal insufficiency mean no cortisol is produced?

  • I was diagnosed as having Hashimotos 21 years ago. Have been on Levo 100mcg per day ever since. Have suffered from a list of symptoms though and never felt well. GP and Endo (saw Endo two years ago) think that I am 'in range' so no action required! I have all the symptoms of adrenal fatigue, but when GP or Endo did Adrenal tests - had bloods (cortisole, I think) and also 24 or 48 hr wee tests (buckets). They did not think my Adrenals were bad, so again no action. Bloods were in Feb this year, wee tests were a couple of years ago. Any help?

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