The Adrenal-Thyroid Connection

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Did you know that spending too much time stuck survival mode can impact your thyroid health? It does so through a profound adrenal-thyroid connection. And what is one of the main things that triggers survival mode? Chronic stress!

The impact of stress on our health is myriad and far-reaching. And how can we not be feeling it right now? As if keeping up with our own life-demands wasn't enough, we're worried about big global issues: the economy, safety in public and in our kids schools, the political climate, the health of the planet we depend on. It's a lot to deal with. On top of that, there are numerous hidden stressors affecting our health: environmental toxin exposures, insults to our microbiome, difficulty getting enough or good quality sleep, and more.

Because each of us is a living, breathing, complex whole organism, when any one aspect of our lives is affected, each of our internal ecosystems is impacted.. Today I'm going to focus on the very specific impact of stress on a gland that has enormous influence on our metabolism and weight, mood, and hormones: your thyroid. The important takeaway here is the while stressors may now be a chronic part of our lives, there are things you can do to rein it in so it doesn't wreak havoc on your health – or tank your thyroid. And there are things you can do to reverse it if it is already affecting you.

The HPA Axis: Your Innate Alarm System

When you experience stress, or any threat to your well-being, your brain goes into high alert, activating an ancient system designed to protect you from a wide variety of threats and dangers. It largely does this by rapidly mobilizing the energy you need to evade, escape, over overpower the immediate hazard. In the extreme, it's what gives the super powers you hear in those rescue stories where some lifts a car off of someone. In the more day to day, it's what makes your heart race, causes you to feel like fleeing a stressful environment, or makes you suspicious of someone in the elevator with you if there ‘vibe' feels off.

This warning system is activated in two small parts of the your brain called your amygdala – they are like a surveillance camera scanning your house perimeter for danger, If danger is perceived, a message goes to your Hypothalamic Pituitary Adrenal (HPA Axis).

Your hypothalamus which acts like your alarm system, calls 911, your pituitary gland .with a chemical alert that there seems to be a threat. which then relays that message out to your adrenal glands, where your adrenaline and cortisol act like the police, fire department, and an ambulance service – ready to respond by getting you away from the danger (by creating a fight, flight, or freeze reaction), and getting your body ready to deal with possible inflammation, infection, injury, hemorrhage, and shock.

It's an elegant system, and when it gets triggered by an actual threat it can help you avoid danger, and in an emergency, is truly lifesaving. It's our survival mode. Unfortunately, modern life is keeping most of us in a state of chronic stress activation much of the time, with little time to pause between putting out fires in our lives, or keeping up with relentless demands.

These are just a handful of the situations that keep us in chronic survival mode. I’m sure you can probably relate to one or more:

• A periodically or chronically stressful work environment/boss/co-workers
• A stressful home situation or relationship
• Financial stress
• Illness in yourself or a family member
• Episodes of low blood sugar because you’ve been too busy to eat much more than a cup of coffee and a muffin, or you’ve skipped meals all together
• Poor sleep making you feel irritable, crave sugar, and feel at the end of your rope
• Being overwhelmed by things to do, and feeling like you’re never going to get them done
• Getting stuck in traffic on your way to a meeting or to pick your kids up at school
• Running late and getting stressed out about it
• Having to get your taxes in and your bills paid

These are all real stressors that activate the HPA axis – and are even more activating if you’ve been fired from a job, experienced a relationship trauma as a child or adult, been exposed to vulnerability due to severe financial stress, or any other stressful past trauma, or perceived potential disaster, because then your perception of each incident as a possible threatening trigger is even higher.

When chronically activated, the HPA axis puts us in a state of on-going survival mode, and this can have a huge impact on numerous aspects of our health, leading to:

• Overweight, especially around the middle, and difficult or near impossible weight loss
• Difficultly falling asleep, poor sleep, or waking up tired even after a full night of sleep
• Poor immunity, getting sick a lot
• Chronic exhaustion, overwhelm, poor emotional, mental or physical resilience
• Irritability, anxiety, feeling tired and wired, depression, hopelessness
• Sugar, caffeine, and other food cravings
• Episodes of low blood sugar
• Insulin resistance, metabolic syndrome, high blood pressure, high cholesterol
• Poor mental function, concentration, or memory problems
• Hormonal problems from irregular periods to fibroids to infertility to PCOS to hypothyroid

The Adrenal-Thyroid Connection

Your thyroid is a butterfly-shaped gland at the front of your neck. It performs literally hundreds, if not thousands, of essential functions related to growth, metabolism, hormonal control, and utilizing and conserving energy depending on what your body needs moment to moment.

When you are under prolonged, or recurrent chronic stress, your adrenal system tells your body to conserve, rather than expend too much energy. It does this for two reasons: immediately, it's diverting energy away from what might be called ‘optimistic' activities like digestion and sex drive, toward handling the emergency your brain perceives that you're facing, or that you actually are up against, and on a very primitive level, famine is one of those emergencies that our HPA Axis is programmed to respond to by shifting us from energy expending activities like metabolism, reproductive functions and sex drive, to energy saving behaviors like slowed metabolism and weight gain. As such, cortisol puts a kabash on thyroid function, It’s like a an automatic stop on your bank account to protect you from over-drafting.

The problem is, a slow thyroid not only makes you feel crappy – it can cause you to feel exhausted, depressed, and sluggish, there can be much bigger symptoms that affect your sense of well-being, physical comfort, and your long-term health.

Untreated Hashimoto’s and hypothyroidism can cause:

• Fatigue and exhaustion
• Weight gain, and with it increased risk of obesity, diabetes, and heart disease
• High cholesterol due to the role of the thyroid in fat metabolism
• Depression – as many as 15% of women on antidepressants have an undetected thyroid problem as the cause of their depression – but their thyroid problem hasn’t been diagnosed so they are being misdiagnosed and mistreated. That’s one reason that antidepressants don’t help a subset of women.
• Anxiety also often accompanies thyroid problems.
• Decreased cognitive function – the thyroid is responsible for helping us maintain brain health, and even slight thyroid dysfunction can impair memory and concentration. Studies of women in their 60s have shown that even marginally slow thyroid function can cause dementia-like symptoms, and that treatment can dramatically improve cognitive function and have a brain-protective effect.
• Increased risk of cardiac arrhythmias and congestive heart failure due to the regulatory control of the thyroid on heart rate and rhythm.

Impaired thyroid function can also have a devastating impact on fertility, pregnancy, and motherhood, and is often an undetected source of anguish, loss, and struggle. Women with hypothyroidism:

• May contend with fertility problems
• Have an increased risk of miscarriage and preterm birth
• Have a much higher risk of developing prenatal and postpartum depression, making what would otherwise be a beautiful time in their lives potentially traumatic.

Severe hypothyroidism in pregnancy has now been shown to not only increase the risk of developmental problems in the baby but also increase the risk of autism.

And there’s more:

The thyroid impacts bone health and strength. It affects libido – if you have no energy, you’re not going to be in the mood, understandably. It can also lead to all manner of hormonal imbalances. Women with Hashimoto’s are also at risk of developing additional autoimmune conditions – autoimmune disease is a whole body process, and often more than one system gets attacked. And the hair loss that often accompanies Hashimoto’s can have a tremendous impact on a woman’s self-confidence about her appearance – and is often terribly worrisome.

The impact of hypothyroidism on women’s lives is often dramatic and sometimes devastating, with fatigue and poor concentration, for example, impacting career and financial success, and also affecting personal relationships.

Because the most common symptoms of hypothyroidism – weight gain, depression, anxiety, brain fog, sleep problems, and fatigue – are also among those that are the most likely to be chalked up by doctors (and by us!) to “just stress,” women can go for years with a missed diagnosis – or never get one at all, leaving many feeling confused, blaming themselves, feeling like they’re doing something wrong or aren’t doing enough to have more energy and feel better. They’re driving themselves crazy dieting but can’t lose weight, beating themselves up for not being happier people, and suffering from the grief of fertility problems and miscarriages – all because of a problem for which there’s easy detection and treatment.

While there are many factors that can cause Hypothyroidism and Hashimoto's, which I discuss at length and show you how to heal in my book The Adrenal Thyroid Revolution, which you can get a copy of here, I want to focus on one that you can start to address today, at home, and that can have a profound impact on how you feel – and your thyroid health, particularly if it's an underlying, or “root cause” for you.

How Stress Affects Your Thyroid

Stress can have direct and indirect effects on your thyroid function. Here are some of the major ways this happens:

Reduced Thyroid Function

When you are under stress, immune system chemicals called inflammatory cytokines (which have names like IL-1 beta, IL-6 and TNF-alpha) are released. These “down regulate” (medical speak for decrease) the production of the key thyroid related hormones TSH, T3, and T4, make the thyroid less sensitive to TSH which stimulates the productions of thyroid hormone production. It's like having a perfectly functioning ceiling light, but the light switch is broken – the light can be turned on.

Reduced Active Thyroid Hormone Production

While your thyroid produces your thyroid hormones, it mostly produces an inactive form called T4. This has to be converted to a form called T3, which does the heavy lifting of thyroid actions in your body. This conversion happens largely in your liver. However, when you're under stress, or when you are sick, your body's conversion of T4 to T3 is decreased; instead your body stockpiles the inactive form by binding and holding it in a form called reverse T3 (rT3), making it unusable until the stress passes.

Reduced Thyroid Hormone Sensitivity

Chronic inflammation also makes the thyroid hormone receptors on your cells less sensitive to the active form of thyroid hormone, such that thyroid hormone can’t do its job. This is called thyroid hormone resistance.

The Stress-Immunity Impact

Chronic stress has a major impact on your immunity – over time increasing your risk of developing chronic inflammation and autoimmunity. It’s also a vicious cycle, because the more our body perceives stress due to inflammation, the more the stress response system gets triggered. We pump out more cortisol, one of our key stress and inflammation protection hormones, which in turn causes us to gain more weight, break down muscle for fuel, and store extra fuel as harmful forms of cholesterol.

Hashimoto’s thyroiditis, or autoimmune hypothyroidism is responsible for about 90% of all thyroid dysfunction in the US, most of which affects women.

The Stress-Gut Impact

Remember how I also said that chronic stress diverts energy away from important functions like digestion? This can also have an impact on your thyroid function and your ability to heal your thyroid. Stress affects the gut in two main ways that can directly impact thyroid health. One is by harming the microbiome, and the other is by causing leaky gut.

When you are under stress, blood flow gets directed away from the lining of your gut, and also, the chemical environment of stress has a direct impact on your gut flora leading to overgrowth of the more harmful species at the expense of the good guys. Both of these gut changes can lead to a condition called leaky gut which makes you more susceptible to all manner of food triggers and harmful gut bug triggers from gluten to dairy to numerous other foods, and to developing a condition called “endotoxemia,” all of which in turn can lead to inflammation in your body significant enough to ultimately lead to autoimmune conditions.

Cutting out food triggers as part of reducing the stress your body is under is an important part of healing the adrenal-thyroid connection. An elimination diet and 4R program can help you to identify food triggers, heal your gut lining, and improve your gut flora.

The Stress-Estrogen Impact

Cortisol reduces our ability to clear estrogen from our system through our liver. Increased estrogen up regulates (medical speak for increases) the production of a carrier protein called thyroid binding globulin (TBG) which does exactly what it sounds like – binds onto thyroid hormone. Bound forms of thyroid hormone are not very active – so your thyroid function goes down even when your thyroid is pumping out the stuff like it’s supposed to. The active free form just doesn’t get to your cells where it’s supposed to do its good work.

Healing the Adrenal-Thyroid Connection

You can nip these vicious cycles of the stress-adrenal-thyroid connection in the bud – or kick them in the butt! Here’s what you’ve gotta do:

Become familiar with your signs of stress response, or “being stuck in survival mode.” Once you learn to recognize them, you can learn to respond quickly with a relaxation response, rather than react with a prolonged stress response. See # 3 below for relaxation response techniques.

Identify those areas of your life that need attention so that you can get out of survival mode and into a life that you love living. This might mean saying no to some things you’ve taken on, rethinking how you approach your work:life ratio, take more time for self care so you can have the resilience to cope with what’s on your plate, rethink your economics to want less of what you don’t really need and earn more so you can have what you do need, reaching out to friends (oxytocin, the love hormone gets released when we connect with peeps we love, and this is a counterbalancing hormone to the stress system).

Develop a regular “stress decompression” practice. We all need tools for on the spot stress reduction, and also regular self-care habits that keep our nervous system well fueled for meeting life’s inevitable stresses. My favorite exercise for traffic jams, the sudden urge to quit your job or throw something at your boss is called “the quickie.” Here’s how to do it:  Center yourself wherever you are, sitting or standing or lying down, feeling the parts of your body touching the ground…just feel that grounding with the earth. Breathe naturally at first, then after a few breaths, inhale for 4 counts while saying I am in your mind. Then exhale for 4 counts while saying at peace to yourself. Repeat this I am…at peace cycle at least 4 times.

Keep your blood sugar balanced. You’re feeling shaky, in a hot or cold sweat, and losing your concentration. Maybe you’re a little nauseated or even faint. You realize you haven’t eating since this morning and it’s already mid-afternoon. Ok you’ve eaten at little bit, but just coffee and a Danish – not real food! Most of us gals know the feeling – we’ve been there at one time or another. The blood sugar crash, or “food emergency,” is super common – and it takes a major toll on the adrenal stress system. You see, your brain is DEPENDENT on a steady supply of sugar to keep it happily humming. Low blood sugar is a brain emergency of the highest magnitude. So you’ve got to’ feed your head. Regularly. With protein, good quality fats, and carbs from whole grains and veggies. My top tips for keeping your blood sugar steady are: eat protein at breakfast, don’t skip meals, graze on high protein snacks if your blood sugar tends to tank, and keep a healthy emergency food stash within reach.

Heal your gut. Our gut health has a tremendous impact on our thyroid function and health. Healing leaky gut and/or microbiome disturbance can be a game changer in reducing thyroid inflammation, antibodies, and also improving your energy, mood, sleep, weight, and getting rid of sugar cravings. For a complete plan for healing your gut, grab your copy of The Adrenal Thyroid Revolution. Numerous women have experienced major improvements in their gut health and symptoms, in as short as one week, and reductions in thyroid antibodies in just a month.

Use adaptogens to support your adrenal stress response and cool down your immune-inflammatory reactions. Adaptogens are a special class of herbal medicines that have been used in Traditional Chinese and Ayurvedic medicines for centuries to promote a sense of well being.  The term adaptogen refers to the unique ability of these herbs to help you adapt to the stress in your life. They do this by “normalizing” or “regulating” the adrenal stress response. Adaptogens help your body to cope more effectively with the demands of everyday life. They provide a sustained sense of calm, and while they increase energy, with the exception of Chinese ginseng, they are non-stimulating. In addition to their effects on stress adaptation, adaptogens have profound antioxidant and anti-inflammatory effects that protect your cells from damage from a variety of chemical exposures. Also, one of the definitions of adaptogens is that they are non-toxic, even with long-term use. You can rely on these herbs to be safe and gentle. My “Top Five” are Holy Basil, Ashwagandha, Rhodiola, American Ginseng, and Reishi. Click here to read more about these herbs and their specific benefits.

Taking care of your stress system will help quiet down your inflammatory responses, allowing your thyroid to more effectively produce thyroid hormones and revert Hashimoto’s antibodies (I’ve seen this happen many times!), and allow your cells to convert and use those thyroid hormones. In the process, you’ll find yourself more energetic, resting better, losing those love handles you just don't love and couldn’t get a handle on, your cravings will fade, and life will seem so much easier!

To your thyroid health!

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