Saul Marcus, ND - Naturopathic Doctor

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14. Adrenal fatigue, stress, cortisol and hypothyroidism

Fight or flight

Imagine one of those old movies where the cavemen are get attacked by a saber toothed tiger, or even a dinosaur. In that prehistoric moment, the caveman has only two options, life or death

There is no other possible outcome.

In a life or death situation the body will do anything it can do to live, even at the expense of it's own health. Therefore, in that moment, profound changes take place that change individual biochemistry to maximize chance of immediate survival. This is called the "fight or flight," response.

The fight or flight response includes the following changes:

For long term health and vitality, all these changes are bad. But In terms of surviving a short term life or death, this response allows people to perform much more strenuous activity then would otherwise be possible. The fight or flight response is not bad. It helps protects us in emergency situations. [80]

The danger is when we live under stress for prolonged periods. High blood sugar, blood pressure, diabetes, poor immune function, and poor digestion are common problems millions of people live with, and are directly caused by the fight or flight response.

This fight or flight response is otherwise known as the stress response. It is triggered by the adrenal hormone cortisol.

The stress response and cortisol is not only triggered by life and death situations. In fact, stress simply means, the nonspecific response of the body to any demand. [81]

Some other examples of stressors are:

Cortisol and thyroid hormone

In addition to the above negative effects of cortisol (increased blood sugar, high blood pressure, poor digestion, poor immune function), it also lowers thyroid hormone. As discussed in section 10, when the body is pushed too hard, thyroid hormone and the metabolic rate goes down. This is the body's way of protecting itself, like putting on the emergency brakes in a car out of control.

The stress response and cortisol will lower thyroid hormone as a protective response is any extra demand, psychological, physical or biochemical

How cortisol lowers active T3:

  1. Cortisol decreases TSH, lowering thyroid hormone production.
  2. Cortisol inhibits the conversion of T4 to active T3, and increases the conversion of T4 to reverse T3. [82]

What happens if long term stress continues?

If the adrenals are put under stress long enough, they eventually become exhausted. At this point, the adrenals won't even be able to make a normal amount of cortisol.

Although too much cortisol is a bad thing, so is too little. Symptoms of low cortisol include:

The most common in both adrenal fatigue and hypothyroidism is fatigue. These two conditions often come together. Instead of thinking in terms of just hypothyroidism, or just poor adrenal function, it may be most wise to think in terms of a dysregulation of the hormonal system. This is triggered by long term factors such as stress, poor sleep, poor nutrition and toxicity and can not be corrected by only taking thyroid medications. Although hypothyroidism is much more well known among the lay public and medical doctors, I'm very confident that most holistic practitioners consider adrenal fatigue to be a much larger problem, and something that needs to be treated along with hypothyroidism.

Treatment for adrenal fatigue

There are two basic parts to treating adrenal fatigue

1. Treat the adrenal glands. Many supplements are good for the adrenals. Vitamins C, E and the B's. Herbs such as rhodiola, withania, ginseng, and licorice. Adrenal glandulars have been used over the last hundred years and are effective. Pregnenolone is a hormonal precursor to cortisol which is available as a supplement. Pregnenolone works very well, but only if you need it. Since pregnenolone is closer to hormone replace that vitamins or herbs it is important to test cortisol before taking pregnenolone. Blood tests for cortisol are not ideal. Saliva hormone tests are much better. There is more information on saliva tests for adrenal function on my general page about adrenal fatigue.

2. Resolve the original stress. This is perhaps the most important part of treating adrenal fatigue, and too often left out. The stress could be from work, home, a poor diet, chronic infection, poor digestion, or more. Anything that puts an extra demand on the body.