Thyroid Not Improving? Your Adrenals Could Be the Missing Link

Don’t Forget the Adrenals: The Thyroid-Adrenal Connection

When addressing thyroid health, it’s crucial not to overlook the adrenal glands. These two systems are intricately connected, working together to regulate energy, metabolism, and stress responses. If your thyroid isn’t functioning well, your adrenals may also be struggling—and vice versa. This dynamic relationship means that supporting your adrenal glands can make a significant difference in how well your thyroid performs and how good you feel overall.

Let’s dive into how the adrenals and thyroid interact, the impact of stress on both systems, and practical steps you can take to support your adrenals for optimal thyroid health.

The Adrenal Glands: A Primer

The adrenal glands are two small, triangular organs that sit on top of your kidneys. They produce hormones such as cortisol, aldosterone, and adrenaline that help regulate:

  • Stress response
  • Blood pressure
  • Electrolyte balance
  • Energy levels

Cortisol, often called the “stress hormone,” plays a particularly important role. It helps your body respond to stress by increasing blood sugar, enhancing energy production, and reducing inflammation. While cortisol is essential for survival, chronic stress can lead to imbalances in cortisol levels, which in turn impact thyroid function.

The Thyroid-Adrenal Connection

The thyroid and adrenals are deeply interdependent. Here’s how they work together:

1. Chronic Stress and High Cortisol

Chronic stress leads to prolonged elevation of cortisol levels, which can disrupt thyroid function in several ways:

  • Impaired T4-to-T3 Conversion: Cortisol inhibits the activity of deiodinase enzymes that convert T4 (inactive thyroid hormone) into T3 (active thyroid hormone). This means less T3 is available for your cells to use, slowing your metabolism and energy production.
  • Increased Reverse T3 (rT3): High cortisol promotes the production of reverse T3, an inactive form of T3. Reverse T3 binds to the same receptors as T3, blocking its effects and further reducing thyroid hormone activity at the cellular level.
  • Reduced Cellular Sensitivity: Elevated cortisol can make cells less responsive to thyroid hormones by interfering with their uptake. Even if your thyroid hormone levels are normal on lab tests, you may still experience hypothyroid symptoms like fatigue, weight gain, and brain fog.

Research shows that individuals with chronic stress often exhibit altered thyroid function, including lower T3 levels and increased rT3. (Kyrou et al., 2007)

2. Low Adrenal Function and Thyroid Suppression

On the other end of the spectrum, low adrenal function—or what is commonly referred to as “adrenal fatigue”—can also hinder thyroid performance:

  • Metabolic Slowdown: When the adrenal glands fail to produce enough cortisol, the body compensates by slowing down metabolism to conserve energy. This can suppress thyroid function, leading to symptoms like fatigue, cold intolerance, and weight gain.
  • Thyroid Overburden: In the absence of adequate cortisol, the thyroid may work harder to maintain balance. This extra demand can strain the thyroid, leading to more pronounced hypothyroid symptoms.
  • Difficulty Coping with Stress: Low adrenal function often causes symptoms like low blood pressure, fatigue, and poor stress tolerance. These issues can further inhibit the thyroid’s ability to function optimally.

Recognizing Adrenal Imbalances

Adrenal imbalances can present as either high cortisol (overactive adrenals) or low cortisol (underactive adrenals). Understanding your adrenal state can help tailor your approach to support both systems effectively.

Signs of High Cortisol:

  • Difficulty falling or staying asleep
  • Feeling “wired but tired”
  • Midsection weight gain
  • Anxiety or irritability
  • Frequent colds or infections

Signs of Low Cortisol:

  • Fatigue, especially in the morning or afternoon
  • Low blood pressure or dizziness when standing
  • Craving salty foods
  • Difficulty handling stress
  • Brain fog or poor concentration

Testing cortisol levels through a saliva or urine adrenal panel can provide insights into your adrenal health and help guide treatment.

Supporting the Adrenals for Better Thyroid Function

When the adrenal glands are supported, they reduce the burden on the thyroid and enhance the body’s ability to maintain balance. Here are strategies to improve adrenal health:

1. Stress Management

Chronic stress is one of the biggest contributors to adrenal dysfunction. Incorporating stress-reducing practices into your daily routine can significantly improve adrenal function.

  • Meditation: Even 10 minutes a day can lower cortisol levels.
  • Yoga and Breathwork: Gentle movement and deep breathing help calm the nervous system.
  • Time in Nature: Spending time outdoors has been shown to reduce stress hormones.

2. Adaptogenic Herbs

Adaptogens are herbs that help the body adapt to stress and maintain balance. They can be particularly beneficial for adrenal support:

  • Ashwagandha: Supports both adrenal and thyroid function by lowering cortisol and improving energy. (Chandrasekhar et al., 2012)
  • Rhodiola: Helps combat fatigue and enhances mental focus, particularly in cases of low adrenal function.
  • Holy Basil: Reduces anxiety and promotes emotional resilience.

Adaptogens are generally safe for long-term use, but individual responses may vary.

3. Progesterone Support

Progesterone is a precursor to cortisol and plays a key role in balancing adrenal function. Low progesterone levels, often seen in chronic stress or during perimenopause, can exacerbate adrenal fatigue and impair thyroid function. Supplementing with bioidentical progesterone under medical supervision may help restore balance.

4. Nutrient Support

The adrenal glands rely on specific nutrients to function effectively:

  • Vitamin C: Essential for cortisol production and acts as an antioxidant to protect adrenal tissues. High levels of vitamin C are stored in the adrenal glands.
    • Sources: Bell peppers, oranges, strawberries, and broccoli.
    • Dosage: 500–2,000 mg/day, depending on individual needs.
  • B Vitamins: Particularly B5 (pantothenic acid) and B6 (pyridoxine), which are critical for adrenal hormone production and energy metabolism.
    • Sources: Eggs, poultry, bananas, and whole grains.
    • Dosage: B-complex vitamins with 25–50 mg of B6 are commonly used.
  • Magnesium: Helps regulate cortisol production and supports relaxation.
    • Sources: Almonds, spinach, and dark chocolate.
    • Dosage: 300–400 mg/day, preferably as magnesium glycinate or citrate.

5. Optimize Sleep

Sleep is vital for adrenal recovery and hormone regulation. Aim for 7–9 hours of quality sleep per night by:

  • Following a consistent bedtime routine.
  • Limiting screen time 1–2 hours before bed.
  • Using calming teas or supplements like melatonin if needed.

The Thyroid-Adrenal Partnership

Supporting your adrenals is like giving your thyroid a reliable partner. Together, these glands help maintain homeostasis and regulate energy production, metabolism, and stress response. When one system falters, the other often follows suit, creating a cascade of symptoms that can leave you feeling fatigued and overwhelmed.

By addressing adrenal health through stress management, adaptogens, nutrient support, and sleep optimization, you create the foundation for better thyroid function and overall well-being. Think of it as giving your thyroid a team of helpers so it doesn’t have to do all the work alone.

Conclusion

Adrenal health is often overlooked in thyroid treatment, but the two systems are inextricably linked. Chronic stress and cortisol imbalances can sabotage thyroid function, while low adrenal output can further suppress metabolism and energy levels. Addressing adrenal function is a vital piece of the puzzle for achieving optimal thyroid health.

Supporting the adrenals isn’t complicated—it’s about reducing stress, nourishing your body with the right nutrients, and considering targeted strategies like adaptogenic herbs or bioidentical progesterone. By giving your adrenals the care they need, you can set your thyroid up for success and reclaim your energy, resilience, and vitality.

By caring for both your adrenals and thyroid, you can support the delicate hormonal balance that keeps you energized and thriving.

  1. Kyrou, I., and Tsigos, C. “Stress mechanisms and metabolic complications.” Hormone and Metabolic Research. 2007;39(6):430–438.
  2. Chandrasekhar, K., et al. “A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum Ashwagandha extract in reducing stress and anxiety in adults.” Indian Journal of Psychological Medicine. 2012;34(3):255–262.
  3. Tsigos, C., and Chrousos, G. P. “Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress.” Journal of Psychosomatic Research. 2002;53(4):865–871.
  4. McEwen, B. S. “Stress, adaptation, and disease: Allostasis and allostatic load.” Annals of the New York Academy of Sciences. 1998;840:33–44.