Have you ever left the doctors office feeling like you might actually be crazy? You've got highly educated individuals telling you that it is all in your head and that your thyroid is "perfectly fine" so how could they be wrong? Maybe you are the crazy one?
Probably not.
Let me introduce you to your adrenal glands.
These little almond-sized glands sit right on top of your kidneys and are responsible for nearly every hormone produced in your body. They are small but mighty and conventional medicine does not give them the attention they deserve. I’ll let you in on a secret, you will never heal from thyroid disease if you do not understand the role your adrenal health plays in your condition.
Functional medicine uses a handy term called, adrenal fatigue, to address the problems with these little glands. Adrenal fatigue and hypothyroidism are like that annoying couple that never leave each other's side. If one is off, you can pretty much guarantee the other one is too.
The Adrenal-Thyroid Link
Ever wonder why you continue to have symptoms of thyroid disease even when your labs are optimal, or why you are still having thyroid flares even though you’ve optimized your medication, diet and lifestyle?
There is a fancy term known as the HPA axis. This stands for hypothalamus-pituitary adrenal axis and is largely responsible for regulating the body's reaction to stress, immune function, digestion, energy usage, and libido. Think of the hypothalamus (in the brain) as the boss, the pituitary (also in the brain) as the manager and the adrenals as the workers. The hypothalamus looks over the body and decides what is needed and in what amount, the pituitary uses the information and sends out a signal to the glands, in this case the adrenals, to produce more or less of a hormone and then the adrenals secrete the necessary hormones. Sounds simple enough, right? Well not exactly...
Though the adrenals are responsible for many essential hormones like, progesterone, DHEA and dopamine, to name a few, the one I want to focus on in this context is cortisol. Cortisol is a life-sustaining hormone that helps the body adapt to stressors. In addition to its stress tolerance capabilities, cortisol is needed to counteract inflammation, fight brain fog, prevent signs of premature aging, increase libido and fertility and regulate blood sugar. If we didn't have it we would live a pretty sad life. Like anything though, too much can be extremely destructive on the body. When my naturopathic doctor had first taught me about the role of cortisol in my thyroid condition, this is how she explained it:
Back in the day there were two main sources of stress, wide famine and being chased by a wild, hungry animal. In those stressful moments, the body goes into survival mode. It begins to prioritize essential needs like adrenaline and cortisol production, over non-essential needs like fertility and libido, hair growth, turning nutrients into energy, digesting foods, making our feel-good hormones, stabilizing blood sugar, and burning fat. This is your body’s way of protecting itself. Think about it, if there’s wide famine where you live, it’s probably not a great time to have babies, and it’s definitely a good time to hold on to some extra belly fat. This wasn’t such a concern because when the body returned to a relaxed state (escaped the wild animal or found a source of food) those non-essential needs became a priority again. We may not be dealing with wild animals or wide famine, but today’s stressors, though very different, are more consistent. Our bodies are learning to operate in survival mode, full-time. Our hypothalamus does not know the difference between being chased down by wild animals, and sitting in rush hour traffic, or the difference between not having food readily available, and planning a wedding. Our body sees all stress as equal and this is where our HPA-axis begins to struggle. If we have our hypothalamus (the stress sensor) constantly demanding more cortisol not only will we have an excess of this destructive hormone, but we also start to have weakened adrenals, leading to infertility, weight gain, hair loss, fatigue, low blood pressure and wacky blood sugar levels. Basically, we become foggy, fat and severely fatigued.
Treating hypothyroidism without addressing HPA dysfunction (adrenal fatigue) is why most thyroid patients remain symptomatic and continue to experience flare-ups well into their healing journey.
Symptoms of Adrenal Fatigue Include (but are not limited to):
difficulty waking up in the morning (never really feeling rested)
chronic fatigue (often that afternoon crash)
salt cravings
feeling dizzy or faint upon standing
brain fog
poor digestion
prone to infections
increased PMS
mild depression
decreased libido
weight gain
hair loss
trouble getting pregnant
Recognize any of these? The symptoms of adrenal fatigue are often closely related to symptoms of untreated thyroid disease. This is why you might have normal thyroid lab markers and still feel like crap. One of the biggest reasons patients continue to feel awful even after adequate thyroid treatment, is because no one is addressing the adrenals. You aren't crazy, you have adrenal fatigue.
The Autoimmune-Adrenal Connection
Get this... some research suggests that elevated cortisol for a prolonged period of time could actually be a root cause of Hashimoto's disease, rather than being a result of it. The immune system may be thrown out of balance by excess cortisol production or even depleted cortisol. Functional medicine researchers predict that stress, along with nutritional deficiencies and intestinal permeability, could all be root causes in the progression of autoimmune disease. Regardless of which came first, treating adrenal fatigue is a necessary tool to healing Hashimoto's disease.
So, How Do You Treat Adrenal Fatigue?
Treating adrenal fatigue was (and still is) the most frustrating part of my entire journey. Even with being in remission from Hashimoto’s, I still have thyroid flares in times of stress because my adrenal glands take a hit first. I can actually physically see my thyroid poking out of the neck when I become stressed because, as mentioned before, the two glands go hand-in-hand. Below are my top ten suggestions for healing the adrenals.
My Top Ten Suggestions
Supplement with Vitamin C, B complex, Iron, Copper, Zinc and Magnesium (all depleted with adrenal fatigue)
Add Adaptogenic herbs into your supplement routine. Adaptogens are herbs that support the body’s ability to handle stress from a chemical, physical, emotional and biological lens. My favourite adaptogenic blend is called Restore and can be found here.
Prioritize low impact workouts, yoga, walking, pilates etc, instead of HIIT, heavy weight lifting and intense cardio. If you’re an exercise junkie (ugh, I hate you), try incorporating yoga and meditation into your routine to allow the body to relax post-workout.
Low carb and high quality fats. Try adding in grains like quinoa, buckwheat or amaranth after 5pm. Paleo diets are fantastic, but sometimes small amounts of complex carbs in the evening can actually be beneficial for the adrenals.
Ask your integrative physician about adrenal glandular supplements (more below).
Limit your caffeine intake (I am still working on this). If you want to try a good decaf (is that an oxymoron?) try swiss-water filtered, organic. It’s actually pretty decent and doesn’t contain tons of nasty chemicals that you typically find in decaf coffee!
Try essential oils like lavender, roman chamomile and frankincense. (be weary if you have low blood pressure, though). If you’re into it, the bottom of your feet (where the arch is) is the reflexology point for the adrenal glands. Add a little frankincense there 5-6 times a day to help balance your cortisol levels.
Add celtic sea salt into your diet!
Eat your protein! The RDA for protein is the bare minimum and really should be double to triple that depending on your level of activity and your weight.
Take 1 hour each day for yourself. You can't always get rid of stress but you can change how you perceive it.
So, What’s the Deal With Adaptogens and Glandulars?
Adaptogens include a wide range of herbs such as, ashwagandha, astragalus, ginseng, maca, shizandra and more. They all work a little differently, but their main purpose is to help the body resist stress and relieve adrenal dysfunction. Truthfully, I think everyone can benefit from adaptogenic herbs. Adrenal glandular’s on the other hand, are more individualized. Glandulars are desiccated glands of animals, typically pigs, cows and sheep (I know, gross, but they really work). Glandulars have been used for nearly 100 years in medicine. The concern about adrenal glandular supplementation is that they are not regulated by the FDA (not that it means much these days). They could all be slightly different doses which can create an element of inconsistency in the body. For some, they work amazingly well, and for others they do not. Personally, I am a huge fan of them and find them highly effective in boosting energy, metabolism and getting me through a thyroid flare.
Just like everything else, finding a treatment plan that works for you on an individual level is imperative to your health and well-being. When navigating your way through Hashimoto's disease, know that it is not just the thyroid and the immune system that require all of your attention. Adrenal Fatigue happens to be the hardest part of my healing, and could be what is holding you back from whole-body recovery.
This last section of my remission series covers supplements very briefly. If you’re looking for a more detailed post about supplements and Hashimoto’s you can find that here.
My Supplement Routine
I was not going to include this section in my remission series, mainly because supplementing is so individual and requires you to be educated on what is right for your specific case. Supplements were/are such an integral component in my remission, and for this reason I have decided to share with you what worked for me. I recommend either having background knowledge in herbs, vitamins and supplements prior to self-dosing or work with an integrative physician to find what works best for you.
My Top Recommendations for Thyroid support
Adrenal adaptogen blends
B complex (get all your B’s at once!)
Curcumin (I use this in a joint-health blend to help with inflammation)
Vitamin D3 (I prefer liquid forms)
Glutamine (powder is great in smoothie and helps with leaky gut)
Liver support (should include N-Acetyl cysteine and milk thistle)
Magnesium (glycinate is my favourite)
Omega 3 (capsules or liquid)
Probiotic (if recommended by healthcare provider)
Thyroid support (selenium, iodine, zinc, tyrosine)
My Favourite Brands
NFH
CanPrev (Canada only)
AOR
HMF
MediHerb
Thorne
Aeryon Wellness
Pure Encapsulations
Designs for Health (Canada only)
Hashimoto's Disease does not have to be a life-sentence. Reducing your thyroid peroxidase antibodies (TPO) to below 35 is possible, no matter how big that number is when you start. There is no right way to do it, because the condition affects every patient in a different way. These 3 blog posts were meant as a general guideline for you to begin or continue on your journey to healing Hashimoto's. The rest is up to you.
Like the concept of the butterfly effect suggests, everything that has happened in your life has led you here.
Thank you,
Victoria
Diagnosed with Hashimoto’s Disease and Hypothyroidism, Victoria explores the reality of living with chronic illness through her blog, The Butterfly Effect.
Victoria seeks to spread awareness of autoimmunity and writes to inspire chronically ill patients to live wholesome lives beyond their health struggles.