Can anyone explain adrenal issues relating to h... - Thyroid UK

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Can anyone explain adrenal issues relating to hypothyroidism and how to manage it?

Pennygg profile image


I’ve just been away for a few days up in the alps (so at altitude) for an intense few days of snowboarding. It was an amazing time, but I definitely struggled with a few issues (I’m on 125mcgs of levothyroxine and last time I checked my levels were doing ok):

I got more fatigued than my friends, I got the shakes quite bad, i had trouble sleeping and while trying to sleep my heart was pounding. One night I probably only got 1 hour’s sleep!

About a year ago I visited a nutritionist who advised me that when I get the shakes and insomnia it’s probably due to adrenal issues which can be linked to the hypothyroidism. So do you think this is the issue here?

I was just wondering if anyone on here has any knowledge and experience of this and what the best strategy is for helping it. I know extreme exercise probably isn’t advised, but I will keep booking these trips because it’s what I really enjoy. So I’d be grateful for any advice be it with diet or supplements if that’s possible as I know how knowledgable many of you are.



13 Replies
SlowDragon profile image

Get your bloods tested just after an active week like this

Do you have high thyroid antibodies? This is Hashimoto's also called autoimmune thyroid disease

Low vitamin levels are very common. Have you had vitamin D, folate, ferritin and B12 tested. If low they can cause symptoms in own right and/or affect thyroid

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor.

Prof Toft - brilliant article just published

If thyroid dose isn't adequate then adrenals have to take up the difference. This can quickly cause adrenal exhaustion

in reply to SlowDragon

I agree this article is brilliant, but Dr. Toft seems to suggest it's possible to combine T3 and T4 and still maintain an in range TSH...which could make doctors unwilling to accept a suppressed TSH in patients taking both hormones although both FTs are in range...the only option with an acceptable suppression of TSH, according to what he says in the last paragraph, seems to be by taking high doses of LT4 only...


Can you post your recent thyroid results and ranges? 'Okay' is an opinion and doesn't mean your thyroid levels are optimal which is what is required.

Exercise depletes T3 so if T3 was low that may be why you got shakes and palpitations.


I had a thorough blood test in June. Is there a way to paste the results on here? Or is that too out of date?

Heloise profile image
Heloise in reply to Pennygg

Hi Penny, yes go ahead and post them. Is your TSH around 1.0? Is your FT4 in the upper part of the range? They should be.

Dr. Bergman is excellent in explaining adrenals which has to balance your thyroid output. Adrenals need vitamin c anc magnesium. Also needed is a lot of sleep to store cortisol but if you are often stressed you use up cortisol very quickly.

SlowDragon profile image
SlowDragonAdministrator in reply to Pennygg

June is quite a long time ago.

You may be ready for an increase or vitamin levels may have changed

Post results and members can advise


So many of us with hypothyroidism/ Hashimoto’s suffer with adrenal problems.

Google Dr. Alan Christianson. He is a US based HOLISTIC endocrinologist. He is a recognized expert on adrenal dysfunction. The man is brilliant. Most importantly, he is an independent thinker. He believes in delving into research and drawing his own conclusions on what science shows works and doesn't work. His common sense approach coupled with the science produces favorable results for so many. Having suffered several adrenal crashes myself, I can say that following his suggestions has helped me greatly. It's a slow go trying to build up adrenals, but it can be done. Slow and steady will win the day. Also, along with Vit C (w/rosehips and bioflavinoids), Pantothenic Acid (Vit B5) is also important for rebuilding adrenals (per Dr. C). I have good luck with 500 mg dose (B5) once daily and 2000-3000 mg Vit C (spaced through day). Taking a methyl form B-complex has helped improve my energy, as well.

Check out Dr. Christianson's website. There is some real quality of life improving info there, especially the importance of a whole foods diet and eating healthy starches for healing adrenals.

Hope you are on the road to recovery soon:)

There is an excellent article by Dr Henry Lindner on thyroid and adrenal matters. Type in "Henry Lindner", then go to the site "Hormone Restoration" to get the article. Inside the article there is a reference to Lindner's submission to the Scottish Parliament petition PE01463 which is also easily opened to read.

The first port of call is to look at your thyroid results. All the symptoms you've described sound like hypothyroid symptoms, although adrenal fatigue is quite intertwined.

Your thyroid dose is to some extent tuned to your usual activity level. If you do a great deal less or more at one particular time your usual dose may not get you through it. The adrenal system does then cover for you a bit.

Anecdotally I think that anyone on thyroid replacement will struggle to do a one-off high energy activity. The only way round it is to raise your every day activity level so it's closer to the holiday level, adjust your dose to that point then ration yourself on the holiday to make sure you don't go too far above that level. Or you may get away with it for shorter times, like a weekend of snowboarding. Those who self medicate will sometimes take a little extra when doing more activity.

But obviously useful to post your results and make sure you are on the right dose now, and have good vitamin levels.

Sounds like altitude sickness to me.

Hi again

Thanks for your responses. I will definitely have a look at the material you have advised.

Here are the blood results from June:

TSH 1.38 range 0.27-4.20

Free thyroxine 18.5 range 12.00-22.00

Total thyroxine T4 97.6 range 59.00-154.00

Free T3 3.94 range 3.10-6.80

Thyroglobulin antibody 69.680 range 0.00-115.00

Thyroid peroxidase antibodies 30.5 range 0.00-34.00

Vitamin B12 197 range 140.00-724.00

Folate (serum) 5.37 range 2.91-50.00

25 OH vitamin D 90.5 range 50.00-200.00

Inflammation marker CRP-High Sensitivity 0.1 range 0.00-5.00

Ferritin 124.7 range 13.00-150.00

Hopefully these make some sense to you guys.

Any advice is appreciated.



SlowDragon profile image
SlowDragonAdministrator in reply to Pennygg

Your FT3 is too low.

TSH on high side

Two options, you either try small dose of T3

Or increase Levo by 25mcgs

B12 and folate too low

I thought your vitamin D was 50 on that previous test, but picture very fuzzy

Have you considered trying gluten free diet. Your antibodies are borderline

Michael Moseley book Clever Guts is good at explaining leaky gut etc

Pennygg profile image
Pennygg in reply to SlowDragon

Thanks Slowdragon

I have been gluten free on and off for a couple of years and I’ve recently started a vitamin regime. I think I’ll go gluten free again after Christmas!

I think I might get an up to date gp blood test, I’ll see if they can do a more thorough test and see what they say and then I might try and find a private endocrinologist.

Does that sound like a good plan?

I did watch Michael Moseley’s programme on the gut. Very interesting, I’ve been interested in gut health for a while now. Might have to get his book too.

Thanks for your help.

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