5 Ways that Stress Causes Hypothyroid Symptoms

stressguy

This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

We’ve already talked about how blood sugar imbalances and poor gut health can lead to hypothyroidism and Hashimoto’s. The harmful effects of adrenal stress complete the triad.

The adrenals are two walnut-shaped glands that sit atop the kidneys. They secrete hormones – such as cortisol, epinephrine and norepinephrine – that regulate the stress response. But these hormones play other crucial roles, many of which are directly related to thyroid health. In fact, as we’ll see in this article, proper thyroid function depends on healthy adrenal glands.

Most people are aware of the obvious forms of stress that affect the adrenal glands: impossibly full schedules, driving in traffic, financial problems, arguments with a spouse, losing a job and the many other emotional and psychological challenges of modern life.

But other factors not commonly considered when people think of “stress” place just as much of a burden on the adrenal glands. These include blood sugar swings, gut dysfunction, food intolerances (especially gluten), chronic infections, environmental toxins, autoimmune problems and inflammation. All of these conditions sound the alarm bells and cause the adrenals to pump out more stress hormones. In this context, stress is broadly defined as anything that disturbs the body’s natural balance (homeostasis).

Adrenal stress is probably the most common problem we encounter in functional medicine, because nearly everyone is dealing with at least one of the factors listed above. Symptoms of adrenal stress are diverse and nonspecific, because the adrenals affect every system in the body. But some of the more common symptoms are:

  • Fatigue
  • Headaches
  • Decreased immunity
  • Difficulty falling asleep, staying asleep and waking up
  • Mood swings
  • Sugar and caffeine cravings
  • Irritability or lightheadedness between meals
  • Eating to relieve fatigue
  • Dizziness when moving from sitting or lying to standing
  • Gastric ulcers

Weak adrenals can cause hypothyroid symptoms without any problem in the thyroid gland itself. In such cases, treating the thyroid is both unnecessary and ineffective, and addressing the adrenals themselves is the key to improving thyroid function.

The most significant indirect effect the adrenals have on thyroid function is via their influence on blood sugar. High or low cortisol – caused by any of the chronic stressors listed above – can cause hypoglycemica, hyperglycemia or both. And as we saw in a previous article, blood sugar imbalances cause hypothyroid symptoms in a variety of ways.

But adrenal stress also has more direct impacts on thyroid function. The following five mechanisms are the most important.

1) Adrenal stress disrupts the HPA axis

By now many people have heard of the hypothalamic-pituitary-adrenal (HPA) axis. It’s a complex network of interactions between the hypothalamus, the pituitary and the adrenal glands that regulates things such as temperature, digestion, immune system, mood, sexuality and energy usage – in addition to controlling the body’s reaction to stress and trauma.

Countless studies show that chronic adrenal stress depresses hypothalamic and pituitary function. And since these two organs direct thyroid hormone production, anything that disrupts the HPA axis will also suppress thyroid function.

Studies have shown that the inflammatory cytokines IL-1 beta, IL-6 and TNF-alpha, which are released during the stress response, down-regulate the HPA axis and reduce levels of thyroid stimulating hormone (TSH). Another study showed that one single injection of tumor necrosis factor alpha (TNF-alpha), an inflammatory peptide, reduced serum TSH, T3, free T4, free T3 and hypothalamic TRH for 5 days. TNF-alpha was also found to decrease the conversion of T4 to T3, reduce thyroid hormone uptake, and decrease the sensitivity of the thyroid to TSH.

2) Adrenal stress reduces conversion of T4 to T3

We discussed under-conversion of T4 to T3 in a prior article. Remember that although 93% of the hormone produced by the thyroid gland is T4, it is inactive in that form and must be converted into T3 before it can be used by the cells. The inflammatory cytokines I listed above not only disrupt the HPA axis, they also interfere with the conversion of T4 to T3.

The enzyme 5′-deiodinase catalyzes the conversion of T4 into T3 in peripheral tissues such as the liver and the gut. Both Th1 and Th2 inflammatory cytokines – IL-6, TNF-alpha, IFN-gamma and IL-1 beta – have been shown to suppress the conversion of T4 to T3. In patients without thyroid illness, as levels of IL-6 (a marker for inflammation) rise, levels of serum T3 fall. And injections of inflammatory cytokines into healthy human subjects resulted in a rapid reduction of serum T3 and TSH levels, and an increase in the inactive reverse T3 (rT3) form, while T4 and free T4 levels were only minimally changed.

3) Adrenal stress promotes autoimmunity by weakening immune barriers

The GI tract, lungs and the blood-brain barrier are the primary immune barriers in the body. They prevent foreign substances from entering the bloodstream and the brain. Adrenal stress weakens these barriers, weakens the immune system in general, and promotes poor immune system regulation.

As we discussed in my previous article on the gut-thyroid connection, when these immune barriers are breached large proteins and other antigens are able to pass into the bloodstream or brain where they don’t belong. If this happens repeatedly, the immune system gets thrown out of whack and we become more prone to autoimmune diseases – such as Hashimoto’s.

4) Adrenal stress causes thyroid hormone resistance

In order for thyroid hormone circulating in blood to have a physiological effect, it must first activate receptors on cells. Inflammatory cytokines have been shown to suppress thyroid receptor site sensitivity.

If you’re familiar with insulin resistance, where the cells gradually lose their sensitivity to insulin, this is a similar pattern. It’s as if the thyroid hormone is knocking on the cell’s door, but the cells don’t answer.

While there’s no practical way to measure receptor site sensitivity in a clinical setting, the research above suggests it is decreased in autoimmune and other inflammatory conditions. A perfect example of this in practice is the Hashimoto’s patient who is taking replacement hormones but still suffers from hypothyroid symptoms – often in spite of repeated changes in the dose and type of medication. In these patients, inflammation is depressing thyroid receptor site sensitivity and producing hypothyroid symptoms, even though lab markers like TSH, T4 and T3 may be normal.

5) Adrenal stress causes hormonal imbalances

Cortisol is one of the hormones released by the adrenals during the stress response. Prolonged cortisol elevations, caused by chronic stress, decrease the liver’s ability to clear excess estrogens from the blood. Excess estrogen increases levels of thyroid binding globulin (TBG), the proteins that thyroid hormone is attached to as it’s transported through the body.

When thyroid hormone is bound to TBG, it is inactive. It must be cleaved from TBG to become “free-fraction” before it can activate cellular receptors. (These free-fraction thyroid hormones are represented on lab tests as “free T4 [FT4]” and “free T3 [FT3]“.)

When TBG levels are high, the percentage of free thyroid hormones drops. This shows up on labs as low T3 uptake and low free T4/T3.

Aside from adrenal stress, the most common causes of elevated TBG secondary to excess estrogen are birth control pills and estrogen replacement (i.e. Premarin).

Balancing the adrenals

Here’s the tricky thing about adrenal stress: it’s almost always caused – at least in part – by something else. These causes include anemia, blood sugar swings, gut inflammation, food intolerances (especially gluten), essential fatty acid deficiencies, environmental toxins, and of course, chronic emotional and psychological stress.

When they exist, these conditions must be addressed or any attempt to support the adrenals directly will either fail or be only partially successful. With that in mind, here are some general guidelines for adrenal health:

  • Avoid or at least greatly minimize stimulants
  • Stabilize blood sugar (via a moderate or low-carb diet)
  • Practice stress management and relaxation techniques
  • Have fun, laugh and make pleasure a regular part of your life
  • Avoid dietary causes of inflammation (refined flours, high-fructose corn syrup and industrial seed oils in particular)
  • Ensure adequate intake of DHA & EPA

Specific nutrients such as phosphatidyl serine and adaptogenic botanicals like Panax ginseng, Siberian ginseng, Ashwagandha and Holy basil leaf extract are also helpful in modulating the stress response and supporting the adrenals. However, these are potent medicines and should be taken under the supervision of a trained practitioner.

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Comments Join the Conversation

  1. Jess says

    Thank you for tackling this complex and important issue! I wonder if you have any thoughts regarding cortisol and exercise. I know that exercise is important for reducing stress, but that intense or chronic exercise can increase your cortisol levels. However, the specifics of how much, what type, and recovery are a little overwhelming to me!
     
     
     
     

    • Chris Kresser says

      Yes, intense steady-state exercise can elevate cortisol levels. I think a mixture of low-intensity activity like walking, gardening, bicycling, etc. plus high-intensity interval strength training is the best approach.

  2. Charlotta (Sweden) says

    Is there a way to test for active contra inactive T3 or can one say anything obaout the common ration between the two? If I understand it right a regular blod test for FT3 really doesn’t say that much since you won’t know if it’s active or inactive T3?

  3. Chris Kresser says

    Free T3 is free T3.  The inactive forms of T3 are reverse T3 (RT3), T3 sulfate (T3S) and T3AC. FT3 is the right test for measuring active T3 in the body.

  4. Susan says

    The series keeps getting better, Chris. I’m the herbalist still skeptical of the problems with iodine, but everything else you say is right on! Especially good how you made the connection between adrenal stress and thyroid, since many herbalists (and other medicos) will say they are not connected.
    The only missing element here is that you didn’t address nutrient deficiencies as broadly as I would. Not only are most ‘mericans deficient (esp in minerals) because of our depleted food supply, but stress gobbles up additional nutrients (esp B vits). I would never turn to botanicals until diet is fixed, stress is reduced, and nutrients are supplemented. I would supplement first at a high level for a few weeks (as insulin levels stabilize with reduced-carb diet), then reducing supplementation to a maintanance level.
    Keep the great posts coming! -Susan in Florida

    • Mary says

      Hi Susan, I noticed you’re an herbalist from Florida. I live in Orlando and I’m very interested in being a herbalist. Do you have any advice as to where to study & how is it as a career choice? Thank you for any advice you have.

  5. Chris Kresser says

    Phoenix,

    I wouldn’t say that estrogen causes adrenal fatigue.  Excess estrogen can cause hypothyroid symptoms by decreasing levels of active T3.

    I don’t recommend direct hormone supplementation in cycling women.  Hormones are unbelievably potent substances, and taking them in cream form especially can cause serious imbalances because the body’s natural regulatory mechanisms are bypassed.  The best way to balance the hormones is to focus on adrenals, blood sugar, GI health and essential fatty acids.

     

    • Terri says

      I’ve been studying bio-identical hormones replacement therapy and believe it is a totally different substance. Suzanne Somers’ book, Ageless, is a good introduction, and T. S. Wiley’s Sex, Lies, and Menopause is full of good information to consider.

    • Pamm says

      Does this apply to women who has had complete hysterectomy? I’m 43yo with low estrogen low testosterone. I was wearing estrogen patch but my levels was not staying up so I’ve been switched to biodentical estrogen testosterone cream. Increasing my Estrogen causes me to go hypo and Lowers my t4 levels. So if there is another way to get it up please advise. Thanks

      • Tara says

        I disagree that you shouldn’t use hormones. Progesterone can be really helpful in an adrenal fatigue setting because it promotes sleep, calm, cortisol production. All good things

  6. Tyler says

    Chris, leaning on the side that I might be gluten intolerant, how would I truly go about finding out any food intolerances? Is there a definite way of testing besides eliminating the suspected cause entirely from the diet for a while and seeing the results?

    • Chris Kresser says

      Enterolab.com has the most accurate testing for gluten intolerance. However, as I mentioned in the article on gluten, the gold standard for identifying gluten intolerance is still the elimination/re-introduction test. This is what the top food allergists use because even the best tests are not infallible.

  7. Charlotta (Sweden) says

    Are you going to address the ovarian adrenal thyroid connection, if you consider there to be such a connection? And if so, do you believe that adrenal fatigue and/or thyroid problems can cause ovarian cysts and an early menopause?

  8. java says

    i have estrogen dominance and all associated symptoms.All my thyroid tests are within normal levels,but I show positive results for thyroid antibodies.What gives, any ideas ?
     

  9. Angela says

    Once a person has been on T3 & T4 replacement for years if they stop taking it will it cause problems? Does the thyroid become dependent on it to function after taking it for years and is there a recommended way on how to come off it? I’m concerned about the meds doctors have put me on over the years not to mention I’d like to quit spending the money on it. My T3 medication is very expensive.
    I’m also curious about your thoughts on MVP? A doctor put me on a beta blocker he said would control it even though others I know with MVP are not medicated. I became concerned when I read how that particular medication Cardizem is known to cause weight gain and I’ve had considered weight gain since I started taking it. I’ve since started working out 2 hours a day & eating healthy and now would like to just throw away all my medications. I’m just not sure if I am jeopardizing my health in any way by doing it or if I should stop cold turkey or gradually come off them?

  10. Chris Kresser says

    Angela: I can’t advise you on medication use.  I will say that those with Hashimoto’s and ongoing hypothyroidism often need to be on thyroid hormone replacement.  Thyroid hormone is so essential to proper function of the body that it’s not a good idea to have consistently low levels over a long period of time.  Eating healthy is helpful, but if you have an autoimmune condition attacking your thyroid gland, diet will not be sufficient to restore function.

    • Alisson says

      Chris, why wont diet alone fix it? Especially if gluten, is the MAIN culprit? Can you please be more specific?

      If you stop the triggers that are “causing” your immune system to flare and fix the leaky gut with probiotics why would you still need thyroid replacement? Perhaps if the thyroid is overly shrunk from the immune system damage? If so, how many years does that take and is there a way of knowing if your thyroid is gone? It’s confusing. Also, I know you cant advise on meds. But do you have a favorite Natural Thyroid Hormone that you notice?

      I have Hashi’s but normal blood tests and TSH. I also have little energy for 10+ years now after giving birth to my first child. I’m doing the adrenals circadian rhythm test to see if I need HC, to get my energy up. I’m too stressed out to follow a “perfect” diet. (I do the best I can to avoid sugar and stimulants and to get proper restorative sleep which inst exactly easy having a newborn baby. I often crave sugar if I eat only protein and veg)

      Finding a balance is tough! So I’m new and looking for basic direction and starting point. I would like some “right now” healthy energy to do basic tasks, but fix the underlying causes of the adrenal and Hashi’s along the way. Am I on the right track?

      Thanks.

  11. Jeanne says

    I have experienced that controlling adrenal stress and estrogen is critical to managing Hashimotos in my daughter. Adaptogenic botanicals like Panax ginseng, Siberian ginseng, Ashwagandha have helped her adrenals tremendously, but also seem to increase her estrogen levels (read they are mildly estrogenic) and that has caused problems. What is your opinion on their ability to do this?

  12. Perry says

    Hello Chris,

    You wrote:

    “Studies have shown that the inflammatory cytokines IL-1 beta, IL-6 and TNF-alpha, which are released during the stress response, down-regulate the HPA axis and reduce levels of thyroid stimulating hormone (TSH). Another study showed that one single injection of tumor necrosis factor alpha (TNF-alpha), an inflammatory peptide, reduced serum TSH, T3, free T4, free T3 and hypothalamic TRH for 5 days.”

    Does this mean that when one stops taking an anti-inflammatory such as Ibuprofen, it is possible a down regulation in thyroid activity could occur due to up tick in the inflammation factors mentioned in the study?

    Thank you

  13. Chris Kresser says

    I suppose it’s possible. But it’s possible that NSAIDs could suppress thyroid function via their disruption of eicosanoid signaling.

  14. says

    Wow! I learned a lot from this article. Also thanks to the mechanisms you shared. Does proper exercise would also prevent from adrenal stress and can help prevent causing hypothyroid?

  15. DeeCee says

    Thanks for this helpful info. When you say

    “Ensure adequate intake of DHA & EPA”

    what does that mean? How much might that be.

    Thanks.

  16. Gloria B says

    In addition to the symptoms listed, I also get a backache, right in the area where the adrenals are. I used to think is was a muscular problem, but every time it happens, I have also exhausted myself in some way or am in a greater than normal amount of stress. It is a great reminder for me to slow down and rest and take better care of myself. I am not sure if it could physically be possible to develop a back pain from irritated or overworked adrenals, but for me it seems to correlate.

    • Alisson says

      Gloria same things happens to me. If I get stressed the (sometimes) muscles of my tummy tighten, and I also get a back ache and tightening in the area of the kidneys. I often wondered if that was my adrenals “tightening” Now perhaps it is!

  17. amanda says

    i went thru a test for lupus it came back positive then they did the break down test for lupus and it came back as i don’t have it. i have fibro i wonder is this related in some way.

  18. Sandi says

    I have hashimoto’s and have been on Synthroid only for about a year and a half. I was initially diagnosed with high antibodies and a TSH of 5.3. Being on the medication helped, but I am still having symptoms, mostly fatigue and headaches. Also, it seems when I work out I suffer the next day. Now I am to the point where I cannot work out at all. Thinking and concentrating at work OR too much physical exercise seems to make my fatigue worse. As soon as I get home and relax for a bit I feel much better. Is this an adrenal issue? Is it still my thyroid?

    • todd says

      Sandi,

      I have the same exact issues. Have you had any success clearing them up? Can anyway reply. I need help.

  19. Carrie Yuen says

    I have an underactive thyroid with all the symptoms that go with it despite taking leverothyroxine. I also have chronic halitosis which can’t be blamed on any teeth, mouth or tonsil problems. Is it possible that these 2 conditions are in some way connected?

  20. Mary, medical student says

    Hi Chris!

    Thank you for an interesting article. I have some questions from across the pond :)
    I am wondering if you know anything about whether stress will have an impact in developing anti-TPO-antibodies in Hashimoto’s disease, considering that stress can weaken our immune system?

    I find this interesting because I am wondering if a patient with a positive anti-TPO, but without symptoms, could avoid developing a symptomatic hypothyreosis in the future by reducing stress as a prophylaxis.

    If you know more about this, or have literature to guide me to, it would be greatly appreciated.

    Thanks,
    Mary :)

  21. Katherine Watkins says

    Dear Chris,

    I have cortisol which is exceptionally high morning and midday, drops to normal 4 pm and 8 pm, low TSH, T4 and T3. I have been following a low carb diet for many years and for prolonged periods of time have been in ketogenesis. I have also done excessive amounts of training. I’ve been told i have to introduce back some carbs into my diet again, however, now I have done so I cannot keep my blood sugar down. My fasting blood sugar was low before and now it’s just high all the time, around 6.4 in the morning. What is your view on long term low carb diets and downregulation of TSH, and what does one do in a circumstance where blood sugar needs to be reduced but you cannot drop your carbs down too low so as to be in ketogenesis. Even at 70g of carbs a day my blood sugar is high. Any advice you have would be much appreciated…

    • Margaret says

      Low carb made you insulin resistant, that is your problem. It happened to me too. Try to increase your carbs to 150 g a day.

    • Pamm says

      Sounds like you need to add chromium to your diet. Google low chromium. It will help manage your blood sugars. We lose chromium in lots of ways. Also dehydration can cause high blood sugar readings.

  22. Hopeless in Chicago says

    Chris, first of all, thank you for this informative blog. It’s refreshing to read someone who has a real interest in explaining things in terms readers can understand instead of brushing off the frustrated people seeking help that their GP won’t give!

    I’m sort of overwhelmed/frustrated because I have a list of symptoms associated with hypothyroidism, minus the weight gain. But many of them are also associated with depression. And now I see they also gp along with adrenal dysfunction. (cold intolerance, low body temp/poor thermoregulation, CONSTANT fatigue, dry skin, brittle nails, night sweats, joint/muscle pain, headaches, dizziness) But…no weight gain. The problem is I take medication for ADHD which decreases appetite which could explain the lack of weight gain, and I simply can’t stop taking it to know for sure without going from really fatigued to a near comatose lack of energy. I also take escilatopram 10 mg for depression, but it doesn’t seem to do much. Again, when I’ve stopped taking that in the past, my body also gets pissed off and then I get really depressed.

    I’m at my wits end with this. I don’t know what to do, but I can’t function like this anymore. I’m 18 and I have the health problems and energy levels of a 60 year old!

    How can I figure out what the problem is without stopping the ADHD meds?

    Is there any way to rule one of them out without ordering a battery of blood tests?

    Please, please, please, if you have the time, write me back, even if it’s just to recommend getting the tests despite the costs. I’m just slowly losing the energy to “just push through it” like I have been doing for months. I’m poor enough that the decision to get the tests is a big one; I can’t afford to waste the money if they won’t help me, but I can’t afford to lie around anymore either!

    Thank you for your time either way, and for your amazing blog

    • maryfeveland@gmail.com says

      Hopeless in Chicago,

      I just read your post and feel that I should reply. At 25 I was in the same boat you are. I went to doctors begging for help. –(cold intolerance, low body temp/poor thermoregulation, CONSTANT fatigue, dry skin, brittle nails, night sweats, joint/muscle pain, headaches, dizziness)– I was on ADHD medicine as well. Then doctor suggested additional medications to combat effects from that medicine.

      I was miserable and no one had any answers.

      I started researching how ADHD medication acts on the body. I would suggest reading how it acts on your central nervous system.

      Two years later, I have my health back and feel better than I ever did. I no longer need ADHD medication nor any other one that the doctor prescribed.

      I starting taking fish oils every night. I take royal macca root from http://store.wholeworldbotanicals.com/Royal-Maca-Plus-for-Women-p/mac-dim-wom-vc-90.htm. A life savor! Also take a multi vitamin and b-complex supplement from Solgar.

      There is no fast and easy fix for your body right now. There just isn’t. It needs time to heal. Lots of good nutrition.

      I understand needing ADHD medication. I also understand what it does long term to your body. I had to weigh the pros and cons of using it.

      I’m not a doctor by any means! I just have struggled with this for so long and understand your frustration. I know its hard to find answers. Email me if you think I can help any further.

      maryfeveland@gmail.com

      Good luck!!

    • Carrie says

      Hi Hopeless in Chicago

      I got your post because I too have asked Chris a question and I get alerts from other responders as they come up. When I read everything you’d written I just wanted to write and say that I found Chris’ thyroid site through Mark’s Daily Apple. – http://www.marksdailyapple.com
      His paleo diet approach to many medical problems have helped thousands of people turn their life around by eating better and so giving up their reliance on medication. – Worth a look if you haven’t come across it yet.

      Carrie

    • Laren says

      Hi Hopeless in Chicago,

      It has been a few months since your post and I hope that you’ve been able to make some progress with your condition.

      I’m also in Chicago and suffered from hypothyroid systems and was not given proper treatment until finding a doctor that would not only perform the correct tests, but also treat properly.

      I’m not very familiar with ADHD meds, but I think it might also be necessary for you to have TSH, FT3,FT4, ferritin, TIBC and 24-hour saliva cortisol just to name a few.

      I have a great practitioner who’s not in the city, but is worth the drive. Let me know if you’d like her contact info.

      Keep up the good work with seeking out relevant health info and you’ll be sure to make great strides :)

      Laren

  23. says

    Doctor Chris, Here is my problem: chronic emotional and psychological stress is a part of my daily living environment and one I can not get away from for at least 3 more months.

    I have been working hard saving money and making a plan to get out and I know I will reach that goal. But for me, for now, I’m in it and there’s no where else to go so I have to endure it for 3 months longer. What is bothering me is that I want to LOSE some weight during this time – not gain any more! After reading your article, I finally know that this is the cause of all my problems. You may have just saved a life here :) I am 45, female, 200 lbs., 5 ft. 2″ tall, work 3 jobs, including 2 home based businesses, I live in the only county in the country with a 28% unemployment rate, and that is why I am getting out. I am launching a new company of my own which is solid, backed by supportive professionals that I know in the industry, and it is going to allow me to retire wealthy by the end of next year.

    However, I have PCOS, the fat gene runs in my family, I am fighting age, hormones, everything you can think of, but the biggest is stress. I just got married to my prince, and we will be doing this business (mostly him) and moving and there will be no stress on me afterward. But I am the heaviest I’ve ever been, despite the fact that I eat healthy natural organic unprocessed foods, “a clean diet” – what more can I possibly do? I was walking 4 miles a day which kept me down in the 160 range but I got plantar facitis in my foot and haven’t been able to walk on it for 5 months. Hence, the weight gain of 40 lbs during that time and my foot is still tender. And why do I gain so much weight in 5 months when I eat like a bird? I’m serious – my eating is perfect! I juice every day, twice a day, I do drink coffee every morning with 2 Tbl. half n’ half – but no sugar, and I have tried the no coffee vs. having coffee thing and for me I am messed up when I don’t have it, just my one cup a day.

    I don’t skip breakfast- I usually have yogurt with fruit and if I’m extra hungry I might have a piece of whole grain toast with a pat of butter. I have EXTREMELY low blood pressure so my doctor said I have to have some fat and salt in my diet. I fainted 2 years ago from it and almost didn’t make it. So now I listen to him. I am forced to add 3 kinds of salt to my food every day, per his orders: Himalayan pink sea salt, iodized table salt, and the kosher salt used in gourmet cooking. I take my daily dose of all the recommended vitamins, iron, minerals and krill oil.

    For lunch I always eat a big organic green salad with a little chicken or tuna on it, some beans, tomato, feta or parmesan cheese and I use only olive oil and lime juice for my dressing.

    For dinner I usually eat steamed, grilled or broiled fish/chicken/or steak, brown rice or sweet potato, and steamed fresh organic veggies, all in proper portion control. I drink 3 big bottles of alkaline water per day, and one cup of milk a day (the habit I can not break since being a kid), usually before bed, because it helps me sleep very well.

    It is a rare occasion if I am out with friends or family for a meal and indulge in a deli sandwich or pasta dish. That almost never happens. I don’t eat desserts – I don’t like them. If I want something sweet I have a baked apple or a nonfat frozen yogurt no sugar added. I haven’t eaten a donut in 12 years. I only snack on nuts, raw veggies, yogurt, fruit or irish oatmeal. I hate soda and sugary drinks! I don’t drink alcohol except once or twice a year I have a half glass of wine with a healthy natural gourmet meal at a friend’s house or restaurant.

    Please help me. Why am I 200 lbs??!! Why??!! My thyroid is normal, I’m not diabetic, not even insulin-resistant despite my PCOS. Why even when I walk 4 miles a day and eat like a saint can I never get down below 160? Your article is the answer. chronic emotional and psychological stress is the reason. I know that now. But I am still at a loss how to lose any weight while being here. Can I do anything different to help my adrenals Please help if you can. Maybe you have the answer I have not heard yet.

    • Mary says

      Hi Ann,
      A year ago my dad was 90 pounds overweight and could never loose it. He started running into heart problems so I decided to find an answer for it. Long story short, A year later, he is still 90lbs lighter and got off his medications!! Email me if interested in hearing his story !! Also my mom went from size 14 to size 6 & has never been happier!

      • Pamm says

        Hello I feel your pain. I too am 5’3. My weight got to 178 no matter how I ate. I have adrenal disease. I couldn’t lose any weight. I too had trouble with low sodium. 2 things changed for me. I developed reactive hypoglycemia so I had to eat high protein with complex carbs and healthy fat at every meal. Before that I was also juicing. Once I started eating this way I lost 10 pounds. I couldn’t believeit. I was eating more but it was the combination at each meal. I then started cardio local ymca got 2 stress fractures but continued to lose. My thyroid was checked even though In normal range I was having symptoms of being hypo dr increased synthroid by 15mg That’s when the rest of weight started coming off. With you being under constant stress you need to get your adrenals checked. Stress will cause problems with those and your thyroid. Your optimal level of free t4 level needs to be at 1.3 to feel your best. So ask dr for free t3 free t4 to be checked. Don’t give up. I’ve lost 25 pounds so far.

    • dave says

      I have lost 80lbs. It was a tough road, but it’s pretty straightforward. Calories in vs. Calories out. At the end of the day, you’ve got a budget of how many calories your body needed just to stay alive. This is your Basal Metabolic Rate (BMR); the number of calories you’d burn if you stayed in bed all day. Its different for everyone, however, everyone has it. For instance, mine is around 2000cals. (I’m 6’1/228lbs/48years young) http://www.bmi-calculator.net/bmr-calculator/ (I’m not sure how accurate that is, there are many sites and many calculators, but they all point to around 2000 for me.)

      The key to losing the weight, is to stay under this MBR. Remember the simple rule, calories in VS calories out. Exercise is a must as well. The human body was designed to run like hell, until something eats you. (think about the cavemen; if they even sat down for a rest, ants/scorpions whatever would crawl up their business!) If you can’t walk or run, get a bike. If you can’t bike, do situps till you puke. If you can’t do situps, do pushups, swim, etc…… Me, I skate. EVERY SINGLE DAY!

      I have hashimoto/hypothyroid. I know what the effects of hormones will do, and how hard it is to lose weight in light of these challenges. I have become almost vegetarian, I eat ZERO gluten, take in ZERO sugar (other than naturally occurring in fruit) and maintain my DHA/DHT Omega values by supplementation and a healthy fish filled diet. Once the weight starts coming off, you’ll be STOKED and eventually ADDICTED to your success. Trust me on this.

      Calories in VS calories out. I get around 2500 calories a day in, and output at least 1000 calories thru rigorous exercise. If I fudged either of these even a little, I’d blow up to the size of a HOUSE inside a month. (and have)

      GOOD LUCK!
      Dave

      • Corrector says

        Actually Dave, that is incorrect. You should NEVER go below your basal metabolic rate. You should go under your TDEE (total daily energy expenditure) which would be your basal metabolic rate plus anywhere from 600 to 1000 or more calories more, depending on your activity level . That is the number you subtract from.

        • Carrie says

          I am totally confused by this reply.

          What about the latest 5/7 diet we’ve been hearing so much about which tells us to eat 600 calories on 2 days a week? Then there’s the Primal Blueprint from Mark extolling the benefits of fasting from time to time? This is also backed up by other studies.

          Carrie

          • Corrector says

            Intermittent fasting does not equal eating below your metabolic rate. It means eating all of your calories within a specific window. The calories in a 5/2 diet when averaged over a week amounts to an overall deficit of around 500 calories below the TDEE.

    • Pamm says

      Annr wanted to add my biggest thing that helped me was recording my food in mobile app my fitness pal. It was a life saver because I then could see what I actually needed to change. I could scan my foods right into my smart phone. I would say this was what helped me the most. Because by doing this I realized I was taking in only 900-1000 calories a day. Which is not healthy. I now eat 1599-1800 cals a day.

  24. Caro says

    Hello Chris.
    Could you please advise if people with Hashimoto’s are ok to take supplements that increase Epinephrine and Norepinephrine? Any information about this would be much appreciated.

    Thank you.

  25. SunnyX says

    Great information. The longer I deal with “borderline” hypo, the more I believe in the emotional/stress factor. I’ve been in a miserable relationship for several years out of economic convenience with someone that I increasingly despise, and when we spend the most time together, my TSH increases. When we live apart due to employment conditions, I feel great and my TSH readings are normal. For a while, I thought it was coincidence, but it really has become a clear pattern. In a few months I will be moving into my own home and on with my life. I have a feeling that my general wellness, including thyroid health, will go back to normal once again.

  26. Louise says

    Hi Chris
    All the symptoms that are happening to me and I’ve been suffering for a while my blood pressure is a little low and my thyroid is stressed can you explain this

  27. Barbara M. says

    Hello Chris. Im new to your site. My condition has baffled doctors here in Seattle. I am hoping you can give me some information on what can be discussed with my doctors. I’ve had Hashimotos for years, treated with 75mcg Levoxyl. Following the recall switched me to generic. My doctor didn’t like my t levels and kept increasing overtime to 150mcg. I ended up being admitted to the hospital. Blood pressure and pulse very high, blood sugar was 33. Kept me overnight and said I was hyperthyroid. My doctor took me off thyroid meds for a week then have been slowly trying to increase doses. Tsh went from .53 to 6.7 (.40-5.0) range. My body is very swollen. My kidneys are burning. My gums are receding badly, ulcers in my mouth and loose teeth? All of this gets worse when my doctor raises my thyroid medication dosage. I have an upcoming thyroid, kidney ultrasound appt. Cortisol levels have been all over the place and when I tried a small amount of Cortex I became very sick? My thyroid is about 5 times its normal size. When they raise dosages, my gums hurt, heart races but I just shut down and sleep. Currently taking Tirosint 25 morning 25 afternoon. My kidneys and mouth burn and ache? Do you have any suggestions on what I need to discuss with my doctors? Thank you!

  28. sarah says

    Hi Chris,
    What are your thoughts on antithyroid foods (goitrogen)? I live
    on kale, broccoli, brussels, bok choy, cauliflower – and just learned that those vegetables are not great for people with hypothyroidism. This is what gets me confused…I’m eating healthy yet its not good for my hypothyroids? Does cooking them change make it any better?

    Thank you!

      • Sarah says

        I’m not on any medication. I just had a thyroid antibody test – showing hypothyroid – and will test again in a couple months to see if there’s a change. I’m talking about prevention – good greens and how they slow down thyroids? Is there a way to eat them and not have a negative effect especially if someone’s thyroid is slowing down?

        • Angela says

          Actually I read an article about this that the whole thing is bogus concerning goitrogen foods. There was never any studies that confirmed the harm of eating vegetables like broccoli and cauliflower, etc. One article stated someone thought it might be risky and then that one person’s opinion kept being repeated over and over again across the internet. Go ahead and eat the vegetables they do not cause any problem. I eat them regularly and have not seen my thyroid numbers change. The only foods that are actually unsafe are bread products not vegetables. In modern day bread they use bromide to make the dough rise and bromide will prevent absorption of iodine. It’s bromide you really need to watch out for.

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