February 27, 2010


This article is a general guideline for those feeling chronic fatigue and not knowing whether they should look at thyroid function as a contributing cause. In the case of thyroid function we could be talking about the cart before the horse because with chronic infection or chronic stress, thyroid function can become inhibited. Therefore, just because your search may lead you to a positive finding of “low thyroid function”, does not mean you have found the cause of your chronic fatigue!

The thyroid, just like the adrenal glands can be the canary in the mine field. Their function starts becoming imbalanced as a consequence to chronic exposure to environmental toxins, heavy metals, molds toxins, silent bacterial infections in the gut, chronic undiagnosed viral infections, viral attack to the thyroid, lack of hormonal feedback support as in the Pituitary-Thyroid-Adrenal Axis, and auto-immune antibodies developed against your thyroid, as well as chronic stress!

It is highly advisable to know exactly what your thyroid is doing if you are feeling persistent fatigue. Have a blood test done that includes the following: TSH, free T3, reverse T3, thyroglobulins, T4. Many doctors unfortunately still do not test for free T3 and miss a majority of low thyroid conditions as a result. One can have normal values in everything and then find their free T3 is low, and thus they do not have sufficient unbound thyroid hormone to use. In addition, thyroglobulines are not routinely tested and if that were done, auto-immune thyroid conditions could be caught in their early stages and reversed before they become chronic Hashimotos.

When it comes to the thyroid and the adrenals, not all glands are created equal in our body and some are stronger and some are weaker just by nature. Under stress, one may become symptomatic first. Lets look at the correlations and bear in mind that these are very general guidelines only to help you evaluate the need for serum thyroid hormones and salivary cortisol biorhythm levels. Bear in mind also that if you do test for thyroid and adrenal and don’t test for the other, patients do better in therapy when treatment modalities include support both glands to optimize their levels. It is a common medial oversight for practitioners to treat the thyroid and ignore testing and treating the adrenals.

Weight gain: When the adrenals are involved the weight gain is generally first to the belly and hips, while with thyroid it is more generalized, and is hard to loose in both cases.

Eyes: When thyroid is involved one can see the eyes as full or puffy with or without bags, whereas with adrenal issues the eyes can be more sunken when severe, and may have dark circles, and more likely to suffer night blindness and sensitivity to bright light.

Eyebrows: With low thyroid function people tend to loose the outer third or half of their eyebrows, either totally or they get thin. This does not happen with adrenal issues.

Hair: The adrenals tend to make the hair thinner and dry, and sparse on the forearms and lower legs. The thyroid also can cause hair to fall out easily, with a tendency for coarseness and even change in color to the hair prematurely.

Nails: With thyroid issues the nails thicken; with adrenal issues they get thin and brittle and in both cases they break easily.

Skin: With thyroid issues wound healing is delayed, sometimes with easy bruising, and tendency for the skin to thicken not thin, and be oily with a tendency for fluid retention. With adrenal issues the skin tends to be dry, thin and collagen can become depleted leading to wrinkling of skin especially seen over finger pads, with dry skin and an inability to hold one’s water. In mixed thyroid and adrenal conditions you can see a combination of thin, dry, poor healing, bruising skin!

Ligaments: With thyroid issues you see a decrease in flexibility. Their pains tend to focus on joints, muscles and the lower extremities. With adrenal issues you tend to see lax or loose ligaments and very flexible people, those with flat feet, being double jointed and may suffer strains and sprains easier. They tend to suffer headaches, migraines, and carpal tunnel syndromes.

Temperature: Thyroid conditions tend to have stable but low temperatures, below 98.6. Adrenal conditions tend to have problems with regulating their temperatures, suffering when its hot and being too cold when its cold and can also have lower body temperature that fluctuates more often. Thyroid issues tend to tolerate heat over cold. Adrenal issues tend to tolerate cold over heat.

Sweating: This is tricky because in the early stages affecting the glands, sweating may be excessive for adrenal issues but once they become chronic the patient tends to stop sweating. Thyroid issues can have a tendency to increased sweating.

Emotional Reactivity: Adrenal conditions tend to push the patient towards over-reactivity while the thyroid patient tends toward under-reactivity.

Immune Function: Adrenal conditions tend to push the immune system into a hyper-vigilant state resulting in allergies, food and environmental sensitivities, and auto-immune problems. As a result, adrenal conditions tend to make the patient more sensitive to drugs and supplements. Thyroid conditions tend towards the opposite, and as a result tend to suffer chronic infections such as sinus, bladder, skin and the like.

Sleep: If sleep is impacted, thyroid issues tend to cause a person to suffer from sleepiness, narcolepsy, sleep apnea or un-refreshed sleep in general. Adrenal issues tend to cause more often insomnia, the inability to fall asleep, to have night time munchies, to feel wired and tired and un-refreshed sleep as well.

Energy: A thyroid condition can make the patient feel sluggish, and have low motivation to do things. An adrenal condition can cause fatigue and sleepiness within an hour or two after a carbohydrate containing meal. It can cause the patient more likely to feel exhaustion with bouts of energy as in “wired and tired” where the patient can’t persevere, and recovery after exertion is delayed.

The Legs: If the patient suffers from edema in the legs it is more likely to be non-pitting edema for the thyroid condition, whereas with the adrenal condition the patient fatigues more from standing, walking is easier. But leg and body pains are common in both!

Blood pressure: The adrenal condition tends to have blood pressure that runs low 80/50 to 110/70 and tends to get light headed when getting up to stand from sitting or lying down. With thyroid conditions the blood pressure is normal to high and can have problems with regulating blood pressure on drugs.

Digestion: Mal-absorption is seen more often with those having adrenal problems over thyroid, and carbohydrate and salt cravings are common; whereas, fats are craved more with those challenged by thyroid issues. Food can pass through the bowels quicker with those that are adrenal challenged, while those suffering from thyroid issues can have a tendency for constipation.

Cholesterol: Adrenal issues can cause cholesterol to be low normal while thyroid issues can elevate cholesterol and have it be hard to manage without addressing the thyroid.  The HDL tends to be higher with adrenal issues and lower with thyroid issues. The cholesterol/HDL ratio for adrenal issues tends to be higher at 4.0 + while with thyroid is is under 4.0 in general.

Serum Potassium: A blood potassium tends to be under 4.0 for thyroid issues and over 4.0 for adrenal issues.

Serum Sodium: A blood sodium level of over 140 is more common among thyroid issues and under 140 for adrenal issues.

DHEA: DHEA affects and is affected by adrenal issues.

Testosterone: This hormone will be affected in some cases with adrenal issues and will tend to be lower than normal.

Blood Type: Adrenal issues seen more in blood type A; thyroid is more Type O.

Platlets: Adrenal issues will see platlets under 200 and thyroid, over 300.

For access to salivary cortisol testing, go to the online store at and order a Flex Matrix Cortisol kit. The price includes a consulation with a primary care provider to help guide you in your therapy options and from there you can obtain a requisition form to also have serum thyroid values tested. This is the best place to start to pin down what glands will need support while you then proceed to find the underlying cause(s) exhausting your thyroid/adrenals.

Please note:
Information on this site is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this site for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment.

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Anna Manayan

Anna Manayan