Why You Need to Address Adrenal Fatigue Before Thyroid Dysfunction

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The adrenal glands and the thyroid are two pivotal systems that are responsible for producing and regulating numerous hormones. If these glands become stressed or damaged they can produce too much or too little of a given hormone resulting in hormonal imbalances. Furthermore, research has shown that the adrenals and the thyroid gland have notable influence on one another meaning that as one system malfunctions, the other may become dysfunctional.

Without resolving an adrenal disorder, it can be incredibly challenging to restore thyroid functionality. Therefore, when treating adrenal and thyroid issues it’s important to have a strong understanding of the connection between these systems and how to effectively care for them.

The Adrenals and Adrenal Fatigue

The adrenals are essential to proper bodily function because they produce numerous hormones that impact various areas of health including weight management, energy level, and focus – learn even more about the adrenals here. Adrenal hormones also regulate inflammation, blood sugar, immune response, blood pressure, and stress. Therefore, adrenal disruption can cause dysfunction in a variety of areas resulting in highly undesirable symptoms. One of the most common but frequently overlooked contributors of adrenal dysfunction is adrenal fatigue.

Adrenal fatigue is typically caused by a chronic buildup of stress over a long period of time. Common sources of stress include work, social obligations, and acute stressors such as a surgery or the death of a loved one. Physical stressors such as changes in blood sugar, gut dysfunction and leaky gut syndrome, food sensitivities and intolerances, chronic infections, and immune dysfunction can also contribute to the development of adrenal fatigue.

When the body experiences constant stress, the adrenals become overworked and unable to produce essential hormones. This leads to multiple hormonal deficiencies, which prompts the development of many symptoms.

Some of the most common indicators of adrenal fatigue and hormone imbalance include:

  • Brain fog and difficulty focusing
  • Chronic or worsening fatigue
  • Food sensitivities
  • Insomnia
  • Irritability
  • Loss of appetite
  • Muscle weakness
  • Poor stress response
  • Reduced libido
  • Slowed metabolism
  • Weight fluctuations

Those who are familiar with thyroid conditions may recognize these symptoms. That is because both adrenal fatigue and thyroid disorders, specifically hypothyroidism, cause many similar issues.

To effectively restore bodily function and resolve these symptoms, optimization of both the adrenals and the thyroid may be required.

How the Adrenals Influence the Thyroid

Although the adrenals take the leading role when it comes to managing stress through the production of cortisol, the thyroid is also an important agent of hormone production and regulation.

Thyroid hormones in the form of T4 and T3 are essential for balancing cellular energy and activity throughout the body. The thyroid influences nearly every bodily function including heart rate, mental focus, weight management, stress response, body temperature and more.

Research shows that adrenal fatigue has an impact on thyroid function. Even at mild a degree of deficiency, adrenal fatigue can negatively affect thyroid hormone conversion, utilization, and production.

When the body experiences constant stress, the adrenals are pressured into producing cortisol at a greater volume. Ultimately, the increased production results in an overall deficiency because the adrenals simply cannot keep up with demand and become exhausted.

Cortisol is Key

To operate properly, the thyroid requires an appropriate amount of cortisol, also known as the stress hormone. Cortisol fluctuations that come with chronic stress causes the thyroid to experience significant dysfunction. An imbalance of cortisol in either direction disrupts thyroid function and impedes many important areas of wellness such as sleep quality, mood regulation, and energy level.

Too much cortisol promotes inflammation around the thyroid, which reduces thyroid receptor responsivity. If T3 is unable to enter the cell wall because adrenal dysfunction is inhibiting cellular receptivity, unused T3 may remain in the bloodstream. If T3 continues to build up, at a certain point it can become toxic and damage the liver.

Excess cortisol also blocks conversion of the storage form of thyroid hormone (T4) into the active form (T3). Cortisol inhibits 5’ deiodinase, which is an enzyme needed to convert T4 into T3. Poor conversion is a primary cause of hypothyroidism, which causes the thyroid to be incapable of properly influencing bodily function and regulating the many systems it oversees.

Worse still, hypothyroidism promotes the production of cortisol due to a negative feedback loop in the HPA axis. Because of this, thyroid disruption typically remains until the adrenals are optimized and cortisol levels return to normal.

Order of Operations

Treating adrenal-related thyroid dysfunction requires the adrenals to be balanced before moving on to treat the thyroid.

When the adrenals are fatigued, they can only manage a certain level of productivity and activity. Therefore, the thyroid downregulates, effectively slowing all bodily functions, to accommodate their activity level. Because of this interaction, treating an underactive thyroid through the typical method of providing additional thyroid hormones in the form of T4 and T3 does little to resolve the dysfunction. In fact, providing additional thyroid hormone may exacerbate the issue by triggering a greater demand for cortisol, thereby contributing further to adrenal fatigue.

In some ways the adrenals act as the regulator of thyroid activity. Because of this, it is essential that adrenal dysfunction be resolved prior to treating a thyroid disorder. If adrenal dysfunction is suspected, a series of blood tests can be done to assess levels of adrenal-related hormones in the blood. This may return results that indicate a decrease in hormone levels, which may be indicative of adrenal fatigue and/or thyroid dysfunction. This method of testing may reveal more serious forms of dysfunction, which better inform your approach and allows for individually optimized treatments.

Understanding adrenal fatigue, how it impacts the thyroid, and optimizing adrenal function before treating the thyroid is necessary for effective restoration of the adrenal-thyroid relationship and healthy hormone activity.


1. The Adrenal-Thyroid Relationship – What You Need To Know. The National Academy of Hypothyroidism. https://www.nahypothyroidism.org/the-adrenal-thyroid-relationship-what-you-need-to-know/

2. Hashimoto’s: How the Adrenals Cause All Kinds of Problems. Hashimoto’s Healing. https://hashimotoshealing.com/hashimotos-adrenals-cause-problems/

3. Adrenal Fatigue and Hypothyroidism. Adrenal Fatigue Coach. http://www.adrenalfatiguecoach.com/adrenal-fatigue-and-hypothyroidism/

4. How Adrenals Can Wreak Havoc. Stop The Thyroid Madness. https://stopthethyroidmadness.com/adrenal-info/

5. Addressing Thyroid and Adrenal Insufficiency. The Weston A. Price Foundation. https://www.westonaprice.org/health-topics/modern-diseases/low-metabolic-energy-therapies/

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.