The Adrenal-Thyroid Connection: Part II

The Connection between Chronic Stress and Thyroid Function

In short, the stressful world in which we live can prompt the pituitary gland to secrete elevated levels of ACTH hormone (adrenal hormone) into the bloodstream; a common response when our body is under distress.  When this happens, the ACTH hormone (adrenal hormone) triggers the adrenal cortex (part of the adrenal gland) to make cortisol and send it out through the bloodstream in huge amounts.

Elevated Cortisol Leads to Many Disorders

When you have elevated levels of cortisol in your blood, that can have an adverse affect on many of your organs leading to disorders and diseases like hyperglycemia (low blood sugar), a weakened immune system, bone demineralization (the loss of minerals in our bones) and other undesirable outcomes.

 Elevated Cortisol Blocks Thyroid Function

Elevated cortisol levels can also keep your thyroid from working correctly as it suppresses the creation and release of the thyroid hormone. The result is a sort of thyroid blockade, producing symptoms and signs of an underactive thyroid that won’t always respond to thyroid hormone replacement therapy.

Thyroid and Adrenal Support Supplements Improve Health

If you are dealing with stress and showing signs of an underactive thyroid, but your conventional doctor says your blood thyroid tests are normal, ask your doctor to place you on a trial of Thyroid Support Supplement in combination with an Adrenal Support Supplement for eight weeks. In many cases you will feel better and show improvement in other areas of your health, including having a lower fasting glucose, fewer colds and flus, improved hair and skin texture, more energy, improved memory and concentration, and the list goes on.

What’s in a Good Thyroid and Adrenal

Support Supplement?

Here is a list of the important supplements and nutrients you want to include when taking the Thyroid Support Supplement and/or Adrenal Support Supplement:

Thyroid Support Supplement – to include in combination the following supplements (see example below)

Two capsules contain:

• Coleus Forskohlin (10% extract)
• 200 mg
• Iodine (from kelp powder)
• 300 mcg
• L-Tyrosine
• 500 mg
• Gum Guggul (2.5% Guggulsterone)
• 300 mg

Adrenal Support Supplement – to include in combination of the following supplements (see example below)

Two capsules contain:

• Rhodiola Rosea (3.5% Rosavins)
• 200 mg
• Ashwaghanda (5% Withanolides)
• 450 mg
• Schisandra (2% Schizandrins)
• 200 mg
• Vitamin B6 (Pyridoxine)
• 50 mg
• Pantothenic acid (Vitamin B5)
• 50 mg
• Magnesium (Hydroxide)
• 170 mg
• Vitamin C (Ascorbic Acid)
• 100 mg
• Zinc (Citrate)
• 10 mg

How Do Thyroid Tests Work?

Typically when your doctor suspects that you may have an underactive thyroid, they will have you take a fasting blood test to see what your TSH (thyroid stimulating hormone) blood level is.  Higher levels/numbers of TSH in your blood will indicate an underactive thyroid, and as a result, the higher the numbers, the more stimulation your thyroid gland will need to force it to create and secrete thyroid hormone.

Standard Thyroid Tests Miss the Mark

Conventional medical practitioners have been taught that the normal range for TSH levels should be 0.2 and 5.5 mU/L. But Dr. Philip Ell Miller, the past president of the Life Extension Foundation, believes the ideal range for TSH levels should actually be between 1.0 and 2.0 mU/L, and that any value above 2.0 mU/L suggests an under active thyroid.

So it’s easy to see why so many who have been told that they have normal thyroid function – after showing up to their doctor’s office with classic symptoms of an underactive thyroid – actually do have a thyroid problem, but it’s not being addressed.

The Benefits of Thyroid Support Supplement

It is possible to lower TSH levels as high as 4.0 mU/L down to the ideal range of 1.0 to 2.0 mU/L by implementing the Thyroid Support Supplement cocktail, which I outlined above. However, a TSH level of  4.0 mU/L most often indicates the need to take a Thyroid Support Supplement, in addition to a prescribed thyroid replacement therapy/medication.

Synthetic vs. Dessicated Thyroid Replacement

When thyroid replacement is needed, most conventional doctors will prescribe a synthetic replacement drug, such as Synthroid or Levothyroxine which are synthetic versions of the T4 thyroid hormone.

Many holistic medical doctors and naturopaths can provide solid, objective evidence that prescription-based dessicated (or porcine source which is a mixture of beef and pork thyroid) tablets will provide a more effective approach to thyroid replacement therapy than synthetic thyroid drugs (e.g. Synthroid or Levothyroxine).

Dessicated Thyroid; the Superior Thyroid Solution

It is important to note that our bodies will change  T4 thyroid hormone into T3, and that T3 thyroid hormone is the most active form of thyroid hormone available. Dessicated thyroid tablets contain both T3 and T4 thyroid hormones, whereas synthetic thyroid drugs only contain T4 thyroid hormones.

Most holistic practitioners claim that the inclusion of T3 in dessicated thyroid explains the superior results it provides, as many thyroid patients have difficulty converting T4 to the more active T3.

Blood Tests You Need

If your thyroid levels have never been tested past conventional methods and you’re having issues, find a health practitioner who is open to holistic or naturopathic health practices.

Once you find the right medical practitioner, here is a list of things they should either be aware of or test for:

1. Thyroid (TSH) Levels

• If your TSH level is above 4.0 mU/L – Ask a holistically-minded doctor to prescribe a dessicated thyroid and add this to your daily Thyroid Support Supplement regime. (Even if you have been prescribed thyroid replacement medication – whether synthetic or dessicated – this additional thyroid support can improve the efficacy of your prescription.)

• If your  TSH level is between 2.0 and 4.0 mU/L (considered thyroid dysfunction level) – Try adding to your regime a Thyroid Support Supplement for 2 to 3 months to see if your TSH levels drop into the ideal range of 1.0 to 2.0 mU/L.  If your TSH levels remain the same, ask your health practitioner to prescribe a thyroid replacement medication (preferably dessicated thyroid).

2. Free T3 and T4 Blood Levels

It’s helpful to know if your blood levels are free of T4 and T3. Free levels are considered ‘unbound levels’ of thyroxin hormone (meaning, they’re free to exert their effects on tissues throughout your body).

Ideal free levels for T3 and T4, according to Dr. Miller, are:

• T4  – 1.2 to 1.4 ng/dL (Conventional medicine accepts a range between 0.7  and 1.53 ng/d as normal.)

• T3 – 2.8 to 3.2 pg/ml (Conventional medicine accepts a range between 2.6 and 4.8 pg/ml as normal.)

Holistically-minded doctors believe if the free T4 level is below 1.2 ng/dL and/or the free T3 level is below 2.8 pg/nl, thyroid replacement therapy is most likely required.

In many cases, conventional doctors will not order free T3 and free T4 blood tests, so you if you are experiencing thyroid-type symptoms, be sure to also  request free T3 and T4 panels to be taken at the same time you have your  TSH levels tested.

3. Cortisol Blood Levels

Even though most conventional doctors won’t, they actually should test your cortisol blood levels because the DHEA and DHEA to cortisol ratio can help determine whether or not your symptoms could be complicated by stress (based on levels of adrenal function).

The ideal range for blood cortisol is 9 to 14 mcg/dL. Cortisol levels above this range suggests an elevation in cortisol, which can interfere with the production of thyroid hormone or even block the effects of thyroid hormone altogether (for both T4 and T3). This can happen whether the thyroid hormone is naturally secreted by your thyroid gland, ingested as a synthetic T4 thyroid replacement drug (like Synthroid) or taken as dessicated thyroid tablets.

4. DHEA Blood Levels

It’s also important to know what your DHEA blood levels (dehydroepiandrosterone) are because DHEA levels can decline during adrenal stress response. This happens because adrenal glands use cholesterol to manufacture both cortisol and DHEA. When they up-regulate the biochemical pathway that synthesizes cortisol, DHEA synthesis automatically declines as a result.

Since DHEA is the precursor molecule from which the body makes testosterone and estrogen, it is easy to see why people who have adrenal fatigue often report a decline in libido, sexual performance, lean body mass and an increase in abdominal fat (not to mention the adverse affects it has on bone density). People often experience these symptoms as part of a larger combination of symptoms due to the adrenal stress response process.

When testing, it’s important to understand what the ideal levels of DHEA are and how they can affect your body:

Ideal DHEA blood levels are:

• Men: 250 to 450 mcg/dL
• Women: 150 to 350 mcg/dL

5. The Ratio of DHEA to Cortisol

The ideal ratio of DHEA to cortisol is 15 to 25:1. When both the DHEA to cortisol ratio and DHEA levels are low, some doctors will prescribe DHEA supplementation to counterbalance the effects of high cortisone due to the stress response and/or the aging process.

The danger in this is that DHEA supplementation can increase the risk of prostate, breast and endometrial cancers. As a result, I do not recommend DHEA supplementation as the first course of action. Instead I prefer my patients supplement using a combination of B-vitamins, vitamin C, zinc and Adaptogen Herbs (see the Adrenal Support Supplement outline, above).

This combination of supplements have shown to decrease the amount of cortisol that is released from the adrenal glands, while providing anti-stress and anti-fatigue benefits where there has been adrenal dysfunction resulting from stress.

6. Include Daily Saliva Testing for Cortisol

One way your doctor can to tell if you have adrenal dysfunction is by diurnal (daily) testing cortisol levels in your saliva. This method of testing is supported by the World Health Organization which has indicated that saliva testing of cortisol levels is a reliable index of the effects it can have on body tissues.

Our adrenal glands produce cortisol 24 hours a day, with cortisol output at its highest within the first hour after wakening and then it will decline steadily throughout the day, reaching its lowest level during sleep.

The Saliva Cortisol Test simply involves spitting into a test tube. The cortisol is measured four times – in the morning around 8 a.m., at noon around 12 p.m., in the evening around 4 p.m., and at night (most effective when done between 11 p.m. and midnight). Other steroid hormones – estrogen, progesterone, DHEAS and testosterone – can also be measured along with the 8 a.m. cortisol saliva testing, if desired.

Once the sample set is complete, the tubes are then mailed to the lab for analysis in a mailing envelope that was included with the kit. The lab results are typically mailed back within two weeks.

In Summary

1. Choose the Right Doctor – Many conventional doctors use outdated points of reference to measure their patients’ thyroid functions. But if you are having these issues, it’s important to seek help from an open-minded medical practitioner, a holistic doctor or naturopath with additional training through the Life Extension Foundation and/or the American Academy of Anti-Aging Medicine look at your blood work so they can correctly evaluate your situation.

2. Test for Free T3 and T4 – One thing that is seldom included when TSH blood levels are tested is the free T4 and T3 blood level test. This should always be included when testing for thyroid dysfunction, in order to receive a complete and accurate thyroid profile.

3. Test the Following at the Same Time:

• Adrenal Levels
• Cortisol Levels
• DHEA Levels
• DHEA to Cortisol Ratio
• Saliva Cortisol Testing should also be included in order for your doctor to gain insight into your diurnal (daily) output of cortisol.

4. Test Adrenal and Thyroid Levels at the Same Time – It’s important to remember that having high levels of cortisol could block the effects of the thyroid hormone in your body and it could be a major contributing factor to the inability of your thyroid to make and secrete optimal levels of thyroid hormone. Because of this, testing of your adrenal and thyroid levels should be done at the same time.

5. Take Vitamin and Mineral Supplements w/Adaptogens – these have shown remarkable results in helping to lower cortisol levels and improve other effects of stress on body tissues (including brain function). Whenever stress response is a contributing factor, these nutrients should be used as part of your overall health management strategy.

6. Add in Thyroid Support Supplements – can bolster thyroid function and improve the conversion of T4 to T3 (T3 is the most active form of thyroid hormone). This thyroid supplement combination could be the only supplement needed when  TSH levels are between 2 to 4 mU/L. When TSH levels are above 4mU/L, you will most likely need thyroid hormone replacement (ideally, dessicated thyroid).

If your thyroid levels are such that you require prescribed thyroid replacement therapy, additional thyroid support supplements will help your prescribed medication to work better. It’s important to speak with your holistic or naturopathic health professional about taking this in conjunction with your existing prescribed replacement therapy, as it can make a big difference in your health and wellbeing.

References:

• The Stress of Life (revised edition). Selye H. McGraw-Hill. 1976

• The Life Extension Revolution. Miller PL. Bantom Books. 2005

• The Official Anti-Aging Revolution. Klatz R. and Goldman R. Basic Health Publications. 2007.

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• Calhoun KE, Pommier RF, Muller P, Fletcher WS, Toth-Fejel S. Dehydroepiandrosterone sulfate causes proliferation of estrogen receptor-positive breast cancer cells despite treatment with fulvestrant. Arch Surg 2003 Aug;138(8):879-83
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• www.stopthethyroidmadness.com
• www.armourthyroid.com
• http://www.virginiahopkinstestkits.com/cortisolzava.html
• http://www.thyroid-info.com/articles/shamesadrenal.html
• http://www.naturalelixir.com/stresscontrol.html