The Adrenal Glands and Hypothyroidism

Read on to learn about how your adrenal glands could be stopping you from feeling better, while on thyroid medication. You can also see the Stop The Thyroid Madness website for more info.

Do one or more of these sound like you:

  • Struggling to get to sleep or stay asleep, or waking up within a few hours after you do fall asleep?
  • Not waking up feeling refreshed in the morning? Perhaps you wake up feeling even worse than went you went to bed the night before?
  • Are you not doing as well on natural desiccated thyroid (NDT) as you had hoped? E.g. having strange reactions or hyperthyroid symptoms when trying to raise NDT or T3? Such as anxiety or shakiness.
  • Have a tendency to be over emotional, get irritated easily and have anxiety a lot?
  • In blood test results, do you have high Free T3 readings, but with continuing hypothyroid-type symptoms?

Have you/are you:

  • Been hypothyroid for several years before being diagnosed?
  • After being diagnosed, been put on T4-only medications like Levothyroxine and still not felt well?
  • Been through chronic emotional, mental or biological stress of any kind?

Do any of these symptoms sound like you?

Perhaps when you exercise, you suddenly feel light-headed, a blood sugar drop and faint?

Well then! Your adrenals may have been working hard to keep you going during any of the above stressful situations, and so you may now have adrenal fatigue. 


The adrenal glands are part of the endocrine system, just like the thyroid. They handle many hormones that are important for a lot of bodily processes, such as handling stress. This where cortisol is produced.

According to James Wilson’s book Adrenal Fatigue, the adrenals first respond to stress by providing you with extra cortisol, but the body can only keep up with high cortisol for so long. So after this, the cortisol starts to fall, leading to low cortisol. In between this, you could have combined highs and lows. You could have high, low or combined high and low cortisol causing these symptoms. This is called adrenal fatigue.  Cortisol has a variety of important functions, including: the metabolism of carbohydrates, proteins and fats, affecting blood sugar levels in your blood, helping reduce inflammation and helping you deal with stress. The latter is especially huge.

I suffer from adrenal fatigue at the moment, after being left hypothyroid for too long without treatment, and then being held to Levothyroxine when I did get treatment, which wasn’t the right medication for me. My doctor and endocrinologist (thyroid specialist) refused to test my adrenal function, when I asked, so I arranged for it to be done privately. When I got the results back, they showed that my cortisol was elevated 24 hours a day, causing adrenal fatigue and on-going symptoms; mainly fatigue. I am currently working to bring the high cortisol down. You can read my other blog post to learn more about that.

It is worth bearing in mind that adrenal fatigue isn’t commonly recognised as a real problem, by a lot of doctors. They tend to only recognise Addison’s Diseasewhere the adrenal glands do not produce sufficient steroid hormones and are flat-out not working, or Cushing’s Syndrome, which is the production of excessive cortisol by the adrenal glandsBut adrenal problems can include elevated, lowered or mixed levels of cortisol, without it being the full blown condition of one of those two. This is very real. Thousands of people report symptoms and problems, especially thyroid related, with adrenal fatigue (high, low or mixed cortisol levels). You should read James Wilson’s book for more info. 

In terms of exercising, Sara Gottfried explains in her book that a sign of adrenal issues can even include trying to exercise, only to find you crash, feeling light-headed and faint. This is due to cortisol being part of the glucocorticoid family, a substance that raises your glucose level. It’s cortisol’s job, to give you energy. When you have this reaction to exercise, it’s a sign you’ve used up your main energy supply as you’re perhaps low on cortisol and so don’t have enough ready to use.

So, adrenal fatigue could be caused by low, high or combined low and high cortisol. What’s the difference?

Low cortisol

This is not the same as the disease called Addison’s, low cortisol is actually a long-term situation where, though your adrenals may still work, they are either out-of-sync or inhibited. As explained above, this happens when they first produced elevated cortisol, then combined highs and lows of cortisol, and then low cortisol.

High cortisol

High cortisol has very similar symptoms to low cortisol, and is usually the first stage before low cortisol, as explained above. If you can catch it while it’s like this, you may have an easier time fixing your adrenal fatigue. As mentioned above, this is what I have.

High bedtime cortisol can cause disruption of your sleep pattern, resulting in problems falling asleep, or staying asleep, so this could be a key sign!

Combined high and low cortisol

This stage is thought to come between high cortisol and low cortisol, when the adrenals cannot keep up with high cortisol any longer, and so it starts to drop at certain points.

Stop The Thyroid Madness  suggest that the below can help lower high cortisol.

  • Phosphatidyl serine (PS) 
  • Seriphos 
  • Zinc 
  • Certain adaptogen herbs, e.g. Holy Basil.  

Stop The Thyroid Madness  suggest that the below can help low cortisol.

Over-the-counter Adrenal Cortex. If three or more are seriously low in the ranges, they turn to prescription HC aka hydrocortisone. i.e. without replacing the cortisol you need, you can’t get out of your hypothyroid state. Cortisol is needed to allow T3 to enter your cells.

Stop The Thyroid Madness  suggest that the below can help a mix of high and low cortisol.

Patients use certain adaptogens which help even out your body’s response to stress, both raising low and lowering high.  Examples include Ashwagandha, Rhodiola, Relora, Eleuthero, Maca, Schisandra, etc.

Usually lifestyle and dietary changes also need to be made, in order to recover from adrenal fatigue. Lots of info on this can be found in James Wilson’s great book.

Dysfunctional adrenals can result in high amounts of T3 from your thyroid meds to build in the blood, making your free T3 results look high, but with continuing hypo symptoms, or causing hyper-like symptoms. Fixing your cortisol levels should fix this.

Order or ask for a 24 hour saliva test, testing your cortisol levels at four key points of the day, to find out if you have adrenal fatigue. If your doctor won’t do this, you can very simply order it yourself and complete it at home. A UK test can be found here and a US test here. Most doctors will only test it with a one time urine or blood sample, which is not as accurate. Four samples taken over a 24 hour day show how your rhythm of cortisol production is working. It should be highest in the morning, tailing off throughout the day. Only four saliva samples taken in one day will tell you this accurately.

I urge you not to make any changes to your personal health regime before consulting a doctor and/or pharmacist, first. You could cause more harm than good if this isn’t suitable for you.

It is never wise to guess whether you have low or high cortisol, symptoms for both are similar.

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I run a Facebook group, called Thyroid Family: Hypothyroidism Advice & Support Group. This group is for underactive thyroid/hypothyroidism patients only, and not medical professionals or anyone else. If you have any questions on living with hypothyroidism, or want some support, help or advice, please join us. 

I also run a group for the spouses, partners and other halves of hypothyroid patients, called Hypothyroid Patients Other Halves – Support & Advice Group. This is for the other halves only and not patients. 



9 thoughts on “The Adrenal Glands and Hypothyroidism

  1. Can I take a test for this even if I have no diagnosis of thyroid problems at all? (I,m trying to convince my doctor. I’ve just made a list of 38 of the symptoms you have listed under Hashimoto’s that I have but I don’t think even 38 symptoms will convince him!) I am diagnosed with fibromyalgia. I am funding your sites very useful, thank you.


  2. Yes anyone can get it tested 🙂 it must be done via a 24 hr saliva test though, which most docs won’t do. If you’re lucky they’ll do a one time blood or urine sample which isn’t accurate.

    Oh dear, sorry to hear you have so many!! Have they not even ran a thyroid panel to check?


  3. Hi, the article is interesting I feel I have nearly all the symptoms.
    I have under active thyroid after pregnancy 2 & 1-2 years ago.
    Also fibromyalgia
    I have latest set of blood results I’ve you would like a look?
    In the U.K.
    Any advice would be appreciated
    On a small budget also.
    Thank you.


  4. My thyroid peroxidase antibodies are at 482. The normal range is 0-25. My pcp and endocrinologist state increase of meds i warranted since tsh, t3 and t4 are within normal range but i feel terrible. Considering change to naturethroid to increase my dree t3 and reverse t3 levels. Help.


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