In some cases, including autoimmune polyglandular syndromes, both autoimmune hypothyroidism and autoimmune adrenal insufficiency can occur. Often, in these cases correcting the adrenal problem can reverse the hypothyroidism. In diagnosing patients with both disorders, tests for both thyroid antibodies and adrenal antibodies are essential. It's important to distinguish autoimmune adrenal insufficiency from the more common adrenal exhaustion.
Proper diagnosis is important. In one study, researchers found several young patients misdiagnosed with subclinical hypothyroidism alone who had severe autoimmune adrenal insufficiency (Addison’s disease) with an associated mild hypothyroidism. In these cases, thyroid function normalized once the adrenal disorder was treated. In addition, in some cases of combined adrenal insufficiency and subclinical hypothyroidism, instituting thyroid replacement hormone before initiating corticosteroid therapy is effective in preventing adrenal crisis.
Occasionally, especially in subclinical hypothyroidism and associated adrenal exhaustion, these conditions can be reversed through dietary and lifestyle changes, including detoxification methods and nutritional supplements. Furthermore, according to Dr. Mark Hyman, when replacement hormone is required, contrary to popular myth, it may not be needed for life.
Symptoms in Thyroadrenal Disorders
Younger patients with thyroadrenal problems may show signs of decreased growth, delayed puberty, listlessness, weight loss, orthostatic dizziness, and fatigue. In young patients with additional symptoms of diabetes, seizures may also occur.
In older patients, symptoms of thyroadrenal problems include weight gain, depression, low blood pressure, constipation and fatigue.
The Effects of Corticosteroids
Several theories have been proposed to explain why corticosteroids can sometimes reverse hypothyroidism. Corticosteroids reduce inflammation as well as immune system activity. In patients with Hashimoto’s thyroiditis and adrenal insufficiency, corticosteroids can lower levels of thyroid antibodies sufficiently to decrease the autoimmune thyroid activity. Also, the ability of the thyroid hormone T3 to react with the body’s cells is diminished in states of corticosteroid deficiency. In addition, the conversion of T4 to the more active hormone T3 is diminished when corticosteroid levels are low. Lastly, it’s suspected that lowered thyroid function is a natural mechanism designed to protect the body when adrenal function is low.
Precautions
In the absence of autoimmune adrenal insufficiency, corticosteroids may improve symptoms of hypothyroidism temporarily but may eventually have untoward effects, including the development of secondary adrenal insufficiency, a condition primarily related to the use of corticosteroids. Elevated corticosteroid levels also have significant side effects.
For instance, elevated cortisol levels reduce sensitivity to leptin, the hormone that tells your brain when you’re full. Over time, increased cortisol levels lead to weight gain. Other effects of excess corticosteroids include bone loss, increased abdominal fat, reduced libido, increased risk of metabolic syndrome, lowered HDL levels, increased triglyceride and insulin levels, and increased blood pressure. In addition, elevated corticosteroid levels can interfere with the normal circadian rhythm that guides hormone production. This, in turn, can interfere with growth hormone production and normal sleep.
A Natural Approach
Certain substances are known to interfere with proper functioning of the immune system as well as the adrenal and thyroid glands, including refined sugars, allergens, chemical toxins, high-fructose corn syrup, trans fats, alcohol, tobacco, gluten protein, and many different drugs. In addition, both physical and psychological stress have detrimental effects.
Foods that help restore thyroid and adrenal function include fish, especially sardines and salmon, dandelion and mustard greens, seaweed and sea vegetables, which are natural sources of iodine. It's important to avoid refined iodized salt and processed foods, which are laden with iodized salt and chemical preservatives. It's also important to avoid excess soy protein, which can interfere with thyroid function, especially in patients on thyroid medications.
Helpful Supplements
Herbs used to help reduce stress and improve immune system and adrenal function include ginseng, rhodiola, Siberian ginseng, ashwaganda, and licorice. It’s important to support the adrenal glands, which may be exhausted in long-standing hypothyroidism, when starting thyroid replacement hormone.
Supplements used to improve immune system, adrenal, and thyroid function include N-acetylcysteine (NAC), acetyl-L-carnitine, omega-3 oils, and the antioxidants alpha lipoic acid, selenium, zinc, vitamins A, B, C, D, and E.
Recommended lifestyle changes include daily exercise to reduce body fat and toxin stores, saunas to help with detoxification, eating whole natural foods, and avoiding water sources containing chlorine and fluoride. A thorough detoxification program with an emphasis on avoiding foods with chemical additives should be followed for at least 3 weeks.
When thyroid replacement hormone is needed, Dr. Mark Hyman recommends using a natural product containing dried porcine thyroid such as Armour thyroid.
Resources:
Hussein D. Abdullatif and Ambika P. Ashraf, Reversible Subclinical Hypothyroidism in the Presence of Adrenal Insufficiency, Medscape by WebMD Oct 2006.
Mark Hyman, Ultra-Metabolism, New York: Scribner Publishing, 2006.
Elaine Moore - I'm a retired medical technologist and medical writer with more than 30 years experience working in hospital laboratories. Currently, I ...
