5 Ways That Stress Causes Hypothyroid Symptoms | Chris Kresser

5 Ways That Stress Causes Hypothyroid Symptoms

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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.

142 Comments

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  1. I GOT IN A CAR ACCIDENT & THEY FOUND I HAVE 2 NODULES ON THE RT. SIDE OF MY THYROID, WHICH
    ONE IS CALCIFIED. I HAVE AN APPT. WITH AN ENDOC.
    AND I WANT BLOOD TESTS & URINE TEST & WANT TO
    KNOW IF MY THYROID IS AFFECTING THE ADRENOL GLAND OR VICE OR VERSA
    I HAVE NO WEIGHT GAIN OR LOSS, I AM VERY NERVOUS,
    CAN’T SLEEP & VERY IRRITABLE, SCRATCH MY ARMS,
    MY NAILS ARE BRITTLE, AND HAVE EXTREME ANXIETY.
    I HOPE TO GOD THIS ENDOC. DR. HELPS ME. I FEEL
    CRAZED, AND I NEED AN ANSWER. AUG 6 IS WITH THE
    THE ENDOC. DR. I HOPE TO GET A SOLUTION.

    • To Marie. I set up estate sales. I hit my head so hard on a short door way that I had a concussion. Left side of thyroid blew up to egg size. I had sonogram then biopsy. A centimeter of cancer was found so I had one thyroid and the the other side removed. Do over I would have both done at same time fyi

  2. So…I know I have Adrenal Fatigue because of extreme long term stress and I have almost every single one of the symptoms. I have a lot of hypothyroid symptoms too. My free T4 is .82 ng/dl, free T3 is 2.5 pg/ml and TSH is 1.5. My reverse T3 was 15.7–unfortunately I didn’t have it measured until a couple weeks after my free T3. From what I’ve read, my T4 and T3, although considered within range (barely), are suboptimal, and my FT3:RT3 ratio is low. I am having to self-treat/medicate because I can’t afford to see a good doctor. After reading your article, I’m trying to figure out if what you’re saying is that Adrenal Fatigue sufferers should not be taking thyroid hormones? I have been taking James Wilson’s supplements for adrenal fatigue, Progesterall cream and Thyroid-S. Are you of the opinion that I shouldn’t be taking the thyroid supplement?

  3. Good ideas that talk about stress, now i have stress but not everyday it just sometimes. I really happy to follow these ideas to solve my problem. I think get better after i follow these ideas.

  4. Hi Chris: I have been taking levothyroxin for 21 years. Three months ago my dosage was changed from .88 mcg to 112mcg. Given the health issues of dental infections, repeated stressful situations, and the intake of ibuprofen, could you give me an unbiased opinion as to what is going on. For 21 years, I was on .88 mcg. Ibuprofen is only taken when necessary, and never more than 2-3 days. I experience muscle weakness (not pain) if I walk 200 yards or more. Thank you for your input.

  5. Hi, I’ve read over and over that iodine is essential for Thyroid function but NOT if you have Hashimotos. Is this true and if so can you explain why the difference?? Thank you from Australia!

  6. 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!

      • 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?

        • 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.

    • SARAH– you must cook all your cruciferous veggies– this eliminates the issues associated with potential thyroid upset. Read all about it on one of chris kressers post– he’s also got a few pod-casts that discuss the idea of goitrogen issues– educate yourself on the topic rather than listen to all our opinions.. again,,, cook them well and don’t do raw kale shakes or raw cruciferous … that’s an issue you dont want to invite if you are managing thyroid issues. good luck HK

      • I did the kale shakes and I’ve been sick since may 2014 I’m dizzy, fatigued, tired, sleep problems, lack of energy, brain fog!!! Continues to worsen…
        I also have hair thinning the dry skin, I was told that my T4 was not working but that the hormone was producing even though the t4 was not functioning properly!! Doctors won’t give hypothyroid Meds .
        I also have continued stress in my life single mom to a disabled child now 31 year old adult !! Plz help with any info thx
        Sincerely
        Fifi

  7. 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!

    • It’s not as easy to get over it as your husband said, he would think different if it was him, I’m going weds. For a IV w meds. In it & blood withdrawal to check my adrenal glands, I have been hypo thyroid for about 20 years now & for the last year could spend all my time in bed, I have to force myself to do anything & this was not me even w hypothyroid, I’m a complete wreck & praying its that & I can be treated

      • I feel the exact same way I could sleep around the clock, no energy, no motivation & I’m getting tested weds for adrenal glands, I’m hypothyroid for 20 years now on 100 mcg. But the last year as been hell w no energy!

  8. 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

  9. 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.

  10. 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.

  11. 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.

    • 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!

      • 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.

      • Dear Mary, Hi I am Elizabeth and am very interested in your father’s weight loss. I have fought Chronic Fatigue for 31 years. I took a huge turn for worse and am blessed to be in Incline Village seeing Dr. Peterson. I live in Florida and must be able to get out of bed as I am single and a special Ed teacher. When my downward turn occurred I packed on over 20 ilbs. luckily I was very thin to begin with.Sorry to be so wordy but so aporeciate your knowledge. Fondly, Elizabeth

    • 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

      • 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.

        • 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

          • 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.

    • 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.

    • I am going through the exact same issue right now,and I can’t find a Dr. To even look into my issues.40 lbs in 5 months??

    • I feel the exact same way I could sleep around the clock, no energy, no motivation & I’m getting tested weds for adrenal glands, I’m hypothyroid for 20 years now on 100 mcg. But the last year as been hell w no energy! Coffee has more antioxidants in it than tea & actually helps prevent type 2 diabeties if you drink 3 to 4 cups aday. White flour, crackers junk food, bananas, whole wheat, yogurt, artificial sweeteners, sugar, pasta( I buy dreamfields only 4 carbs) , potatoes, corn, all bad for you!

      • I have a foot that needs complete reconstruction, heel moved & all & can’t walk or exercise on it, I don’t like sitting down to a full plate of any meal lately it turns me off so I’m eatting cheerios every night or peanut butter on a pita bread or rounds that have only 100 calories & no soda or duet soda at all but not losing weight:( having hypothyroid really sucks & I’m hoping my adrenal glands show something so I can be treated & feel better:(((((

  12. 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

    • 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.

      [email protected]

      Good luck!!

      • When I discovered maca root powder I loved it… but found it cause hypo symptoms… looked it up..it is also of the brasica/cruciferous family… stopped eating it, my hair stopped falling out. All things in moderation, but no maca for me.

    • 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

    • 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

      • Could you please give me your doctor number? My endocrinologist diagnosed me with hypothyroidism and empty Sella syndrome, but failed to test for the adrenals, and refused to test when asked. I have had a history of chronic emotional and psychological stress, which my psychiatrist did not factor in, and assumed the psych meds weren’t working because I was “non-compliant” when all along, I had a thyroid thing going on. Also have nodules on my thyroid. Please provide the number to your endo, as I, too, live in the Chicagoland area, and good doctors are hard to find. Thanks.

    • Have you had your B12 Levels Checked? My son 19yo also experienced alot of the same symptoms and his b12 was very low. He started taking 5,000 a day and feeling much better. Also Vitamin d3 would be very helpful. If you don’t have insurance to get your thyroid levels checked you can order your own on my med lab.com. If you can get a doctor to order thyroid order Free t3, free t4 & tsh with Reverse t3. Hope you feel better soon.

  13. 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…

    • 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.

    • 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.

    • Do a hair elements test with DirectLabs to see if your chromium is chronically low. This would most likely explain your blood-sugar issues. Supplement with Chromium Polynicotinate.

  14. 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 🙂

  15. 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?

  16. 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?

    • Sandi,

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

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