Even after lots of reading on here I still have trouble getting my head around the exact connection between the adrenal glands and the thyroid. Hope someone can explain. These are what I know or think I know:
1. I read on here that when you are hypothyroid the adrenals try to compensate to support your metabolism
2. The adrenals are affected by lack of thyroid hormones as well so they can struggle too
3. Adrenal glands produce adrenaline and corticosteroids
4. Adrenaline is the "Fight or flight" hormone that increases metabolism, makes the heart beat faster, blood vessels to the muscles dilate etc, while suppressing activity of non vital processes such as digestion.
If this is all correct, which hormones actually support the thyroid? Discussions mostly talk about steroids, but if adrenaline increases metabolism, how come that isn't involved instead or as well as. Or is it? And what role do adrenal steroids play?
If I am tired but struggling to concentrate on something while feeling a bit hypo, I sometimes get very hot - like a hot flush but not quite the same (I've had those for years so don't take much notice usually). These flushes are more frequent than normal as well. Could that be because the adrenals are increasing their production?
The Hypothalamic-Pituitary-Adrenal Axis (HPA axis) helps us respond to stress.
Pituitary stimulation by the hypothalamus will signal the adrenal glands to release cortisol and the thyroid to release T4//T3. Yes, you are right in saying cortisol compensates low thyroid hormone but remember all hormones work together, so if there is a shortfall somewhere, there are always repercussions somewhere up/down the line.
Yes, adrenaline is used but usually more as a front line stress hormone. Cortisol steps in to support more long term stress (ie long term inadequate thyroid hormone). It also helps control the way our bodies use fats, proteins & carbs and reduces inflammatory reactions. Another adrenal hormone, aldosterone regulates sodium and potassium in the blood and helps maintain blood volume/pressure.
When these hormones become deficient through compensating for low thyroid hormone, the systems they regulate may dysfunction and that is why people with worn out adrenals often have salt cravings or uncontrolled insulin surges, blood sugar issues, etc ...
Re sex hormones, when cortisol becomes low the adrenals may sequester progesterone to help make cortisol. This drop in progesterone creates a progesterone/oestrogen imbalance called oestrogen dominance. Both cortisol and DHEA-S compete for the same precursor, pregnenolone. The extra used for low cortisol levels leaves a shortfall for DHEA-S which is the precursor of oestrogen and testosterone, leaving them short and suddenly all sex hormones are messed up as well.
Prolonged cortisol elevations decreases the liver’s ability to clear excess oestrogens from the blood and an excess increases thyroid TBG levels (proteins that thyroid hormone is attached to as it’s transported through the body). When thyroid hormone is bound to TBG, it is inactive as must be cleaved from TBG to become “free-fraction” before it can activate cellular receptors.
There are many other negative repercussions of poor adrenal function such as impairing thyroid hormone conversion or reducing thyroid hormone receptor sensitivity, etc .... but they can recover with certain hormone replacements, optimal iron & nutrients and a sympathetic life style.
Thanks. A lot to take in, but at least I know now that both cortisol and adrenaline may be involved in trying to compensate for low thyroid hormones. I don't seem to have many symptoms of adrenal problems so far, which is a relief. I've never had my sex hormones tested but am way past the menopause so not sure what difference that makes - except for the hot flushes which show little sign of stopping after over 20 years!
When the body is low in thyroid hormone for a long period of time then the adrenal glands try to compensate until eventually they too become depleted in cortisol. So you then end up with a thyroid/adrenal problem. I always recommend an adrenal stress test, available from Genova, to ensure the adrenals can cope with the administration of thyroid hormone. If the saliva test comes back low then an adrenal supplement, I recommend Nutri Adrenal Extra in the first instance for a few weeks to increase adrenal strength before administrating thyroid hormone if necessary.
Of course it may just be an adrenal problem which will show after the test is carried out. Saliva is the most accurate way of testing adrenal dysfunction
Thank you. I am already on levothyroxine but they have reduced it which I believe was a mistake in spite of my T4 being near the top of the range.
How much does the adrenal test cost? Is it a blood or a saliva test?
"the adrenal glands try to compensate until eventually they too become depleted in cortisol."
Is that because the energy supplied through the thyroid gland is too little for the adrenals to make enough of their hormone? So it's a vicious circle...
Really, if you have an actual problem with your adrenal glands, such as Addison's, you’re very poorly. I’d be wary of tests and adrenal fatigue which isn’t a recognised condition. All these things have feedback loops which maintain homeostasis. If there’s an actual impairment eg diabetes (insulin) hypothyroidism (thyroxine) or addisons (adrenal gland) it needs medically managing correctly in order to maintain homeostasis.
Balancing thyroid levels, nutrition and healthy lifestyle including managing stress effectively will help anyone.
Thanks, I am rather wary of the term "Adrenal fatigue", though it does make sense that the adrenals might struggle to compensate for thyroid hormone deficiency. I expect there would be little point testing unless there are definite symptoms.
I don't think I have a major problem with my adrenals but wanted to know how these things interact. It was partly out of curiosity and partly to have some idea if there might be a problem at some stage if I'm undermedicated with thyroxine
If there’s a problem with low thyroxine I does impact the whole system but is much more complex and the ‘fix’ is to get levels right.
I have had an addisons test myself. In reality the reasons for testing was loosing weight, very weak. However this was actually due to chronic stress, undiagnosed asthma (so chronic exhaustion) and a swing of too little thyroxine then far too much for a while. My periods hadn’t returned as I was breastfeeding (this was the symptom that seemed to upset the endo the most despite me pointing out this was normal if you were practising extended bf on demand.)
My cortisol responded very well to the test and I put on a little fat. The main ‘issue’ was I was effectively in a cfs state and I had to recover slowly. Second pregnancy really helped and I’m now fine though I think I’ve been on too much thyroxine again recently and suffered a bit from that.
There can be many causes of not feeling right and it’s a bit chicken and egg.
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