Thyroid UK
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I'm wondering if my lack of progress with NDT is due to:

I'm wondering if my lack of progress with NDT is due to adrenal issues as according to this article:

Administering thyroid medication in cases of advanced adrenal fatigue without concurrent attention to adrenal recovery will often fail. In many cases, it is analogous to pouring oil onto a fire. An already weak adrenal system in a low energy state may not be able to carry the burden of extra energy output. What the adrenals need is rest, not extra work. *****Thyroid medication administered under such circumstances may lead to a temporary relief of symptoms and a slight boost in energy at first. However, this is often short lived. Ultimately, fatigue returns as the thyroid medication further weakens the pre-existing adrenal fatigue condition and often precipitates an adrenal crisis. The overall fatigue level continues to increase well beyond what the medication is trying to combat. Only by increasing the thyroid medication dosage or switching to more powerful thyroid drugs can the worsening fatigue be avoided****'....

... Weak adrenals and thyroid, when present concurrently and not attended to properly, start an adverse reinforcing vicious downward spiral of adrenal dysfunction. Those requiring an ever increasing dose of thyroid medication to keep fatigue away may end up becoming dependent not only on the heavy dose of strong thyroid medication, but have to suffer the side-effect symptoms of toxic thyroid (such as heart palpitation) as medication dosage is being increased. They feel "wired and tired" as mentioned earlier, with constant fatigue, unable to fall asleep and feeling anxious throughout the day. Internally, their adrenals continue to weaken as the stimulatory properties of thyroid medication are negated by the continued overwhelming rejection of the adrenal glands, resulting in a body that continues to be down-regulated to conserve energy. This is the worse of both worlds and it happens too frequently and often goes unnoticed. Clinicians and patients alike are baffled by what appears to be clinical contradictions - improving laboratory TSH levels (as a result of increased medications) or high TSH levels that refuse to come down, rising need of thyroid medication to maintain energy and worsening symptoms of adrenal fatigue with continued low basal body temperature, metabolic imbalances, weight gain and increased sluggishness.

8 Replies

Interesting article - thanks for posting


You're welcome : )


hi cc20 i think your on to something there i recenlty come believe my problems started with adrenals currently going to see dr p for more help, and was exhausted after having my baby even when i was put on good amounts of levo as had post thyroidsm and i was converting but i think id been left so long it had a big impact on the adrenals to start with, i now realize the adrenals seem to be the key and once they are working better it helps everything work bette,r i know you are prob more clued up than me just to say as well this awful fatigue i get i recognise it from my first child before the big thyrod problems started but it was less severe. and i did not know what it was after lots of gp visits saying i was fine and im sure i was exhausted and it got better over time, unlike now with the thyroid kicked its harder to bounce back i know it adrenal fatigue as i begin to wake up after 6pm and feel at best after 9pm but then cant sleep if i go past 11 pm so what your saying i think is spot on i just wanted to say i totally understand what you have posted its makes total sense



Hi Sara, their seems to be 2 schools of thought on fixing adrenal first then thyroid, and fix thyroid and adrenal will fix itself. Here is another article from Dr Lam, first a chart comparing hypothyroid and adrenal exhaustion symptoms. Underneath the chart he talks about how :

'Hypothyroidism can be primary or secondary. Primary hypothyroidism can easily be cured with administration of thyroid replacement therapy. If hypothyroid symptoms such as low body temperature, fatigue, dry skin and weight gain persist despite thyroid replacement therapy regardless of laboratory values, one must look elsewhere for the cause of the low thyroid function.

Secondary hypothyroidism is low thyroid function caused by malfunction of another organ system. One of the most frequently overlooked causes is adrenal fatigue. Adrenal fatigue is perhaps the most common cause of secondary low thyroid function, both clinically and sub-clinically. Low adrenal function often leads to low thyroid function, classically evidenced by high levels of thyroid binding globulin (TBG), low free T4, low free T3, high TSH, slow ankle reflex and low body temperature. Few physicians are trained to detect this connection. Fortunately, secondary hypothyroidism can be reversed when the underlying root problem (such as adrenal fatigue) is resolved.'

Though I had got an energy boost in the first 2/3 weeks of starting Naturethroid at 30mg (gradually increasing to 130mg in over 3 months) I never again felt a similar energy boost, so I was suspecting this was due to my adrenal needing work. I did take some Nutri Adrenal Extra (prescribed by Dr P) for a month or two before starting on NDT, but found that when increased amounts from 1 x 3 a day, to 2 x 3 a day, I started to wake in the early am with anxiety and negative thoughts, and couldn't go back to sleep for a couple of hours. I reduced back to 1 a day. He also prescribed Nutri-thyroid but when I asked for any additional advice on this forum, a lot of members replied that the Nutri meds had done nothing to help with their symptoms. So decided to self-medicate with the Naturethroid instead.

I have been complaining of lack of improvement the last couple of weeks, but members said that 1. fix thyroid and your adrenal will improve and 2. It takes longer for the NDT to have the optimum effect. And, in fact, just the last few days, I have started to feel better.

I also take half a dose of Seriphos a day, as though my cortisol is lowish during the day, in the evening and night I think must increase as I begin to feel anxious and stressed. If I take a whole capsule, I found that this gives me a fuggy head the next day.

Here is an interesting article of adrenalines effect on cortisol and cortisols effect on the mind and body.


thanks for information im will refer back to glad you feeling bit brighter its difficult whats right for a individual it seems a mine field when i see everyones posts i really hope this is the way forward for you and wish you all the best in your recovery you seem to have learned so much to help yourself which is brilliant you should be really proud of yourself on what you have done despite all the obstacles.might have a look at the naturethyroid to keep in mind



Hi Sara, thank you. Don't be surprised if Dr P starts you on Nutri Adrenal Extra, then after 3 weeks adds Nutri Thyroid. When this happened to me I posted up treatment recommendation which most said hadn't had any effect at all on their symptoms, and only Thyroxine, either Levy or NDT actually helped. Have you had B12, folate, iron, ferritin, vit D3, cortisone all tested? I will probably try Thiroyd next due to finances, but would stick with Naturethroid if I could. Take care.


well your spot on thats what he thinks might help lol! i dont. have so many symptoms as the beginning last august were so many last august its mainly faitigue, and few other bits had salvia cortisol test done dec 13 shows was suffering low cortisol all day better in the evening had all vitimans all look alright on the high side rather than low . been taken good amount of all vitimans especialy the b12 folic acid d3. over 12 months as well iron over 100 now so pleased with that iv been so ill after i had my baby so many things to deal with im at the point were the fatigue and a few other bits is all thats left to deal with now but its enough, it did not suprise me he said adrenals is the main because i kind of guessed with the patterns and salvia test,as i knew the virus i caught after baby had caused some damage it also seemed to damage my gallbladder which was removed 2 months ago after 7months of waiting for nhs awful, so strange viruses i think the operation has knocked me back a bit so am having to learn to be patient with myself i seem to be able to convert t4 to t3 as have a decent free t3 so i think the trying the nutri thyroid wont do any harm i have read some people feel it helped along side the levothyroxine but not for others as you said, im trying not to overcomplicate things like swapping to the ndt or adding t3 until i know its essential iv been ill a long time with the gallbladder so its not helped matters and im still recovering i feel tons better compared to 6 weeks ago after the the operation but not right , all very expensive doing it yourself but what else can we do give up! well i hope you continue to feel brighter im sure you will find the right plan to suit you with a bit of tweaking thanks for the posts i will be referring back to them best wishes



Hi Sara, I have read that anaesthetic depletes B12 level. I see that you have been supplementing with B12, have your levels increased satisfactorily? If not, the best and quickest way is via B12 injections. I can provide info if you decide to go that course, which is not more expensive than oral supplements.

Sorry to hear about your virus and gall bladder removal and I hope you've been advised on the forum about these, if you've put up posts. If not, you should do so.

I'm glad you seem to be converting T4 to T3 but if that is the case, why do you think you are so tired still? Nutri Thyroid won't do any harm but as I've said many on here thought did no good either, though some did say helped along with Levy!

Does your cortisol get too high during evening / night, ie do you get anxious and difficulty sleeping. Or is it a good level?



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