It’s time for a revolution! Women everywhere have had their adrenal thyroid symptoms overlooked for years. They’ve been told it’s in their heads, that they are just too stressed or too busy. For years, naturopathic doctors and functional medical doctors have been acknowledging these symptoms – realizing the strength of the mind-body connection – and letting patients know that when they physically feel symptoms in their bodies, it’s not in their heads.

When patients are stressed to their breaking point, the function of the body changes. The way their adrenal glands respond to chronic stress changes1. The way their thyroid acts when stress is present also changes2. The adrenal glands and the thyroid work together through the Hypothalamic-Pituitary-Adrenal (HPA) axis to make the body function as perfectly as it does when we are feeling well, to as broken as it feels when things have gone awry. However, the body in its innate wisdom does nothing without purpose.

What is adrenal fatigue?

We used to call the negative feedback that the adrenals give the hypothalamus to stop secreting cortisol, adrenal fatigue. In fact, many practitioners still call it that. There had to be a name to address the symptoms that patients were experiencing. However, it turns out the adrenal glands don’t actually get fatigued, they don’t get tired of producing cortisol and stop.

The body has a purpose – the body knows there is enough cortisol around. Metabolism or breakdown of cortisol has slowed, and so your body lets the adrenals know that they’ve done their job and they can stop production of cortisol1. It has been our job to help awaken the body to the cortisol again, and the way we do this is by supporting the adrenal glands in their production of cortisol, ensuring all the necessary nutrients are there for healthy adrenal gland function. We also do this by acknowledging that our patients’ physical symptoms are real! We remind our patients that the body is screaming that it needs a break and that it’s time for some serious self-care, some much needed R&R.

Science has finally caught up and we are able to explain the physiology behind some of the complexity of the body. We can understand the HPA axis in more detail and we can explain the function of the adrenals and the thyroid to our patients so they understand the important reasons behind the seemingly simple lifestyle recommendations that we make. After all, the word physician comes from the Latin word docere which means “to teach”.

“The Adrenal Thyroid Revolution” is a great resource for our patients about the adrenal thyroid connection, because we too, are very busy and we are stressed. We need more resources and this book is just what our patients need.

The adrenal thyroid revolution is here

The revolution is happening! More doctors are teaching their patients about how their bodies are functioning and why, which helps make change happen for the betterment of patient care. The adrenal thyroid revolution is real and women everywhere are so grateful that their doctors are recognizing that their symptoms are not in their heads.

The fact that the mind can create physical symptoms has been known in the art of medicine for decades, but somehow the art has fallen away from the practice of medicine. Perhaps as doctors ourselves, we’ve been too busy and too stressed. The art is coming back, a revolution is happening, and it’s thanks to Doctors like Dr. Aviva Romm who are making this happen. Her book “The Adrenal Thyroid Revolution” is a great resource for our patients about the adrenal thyroid connection, because we too, are very busy and we are stressed. We need more resources and this book is just what our patients need.

Let’s dive into this a little more. “Susy”, who’s been in a high-stress job for years, while trying to raise her family, presents to my office with a long list of symptoms:

  • weight gain
  • chronic fatigue
  • depression
  • anxiety/nervousness
  • frequent upper respiratory tract infections
  • decreased libido
  • constipation
  • dry skin
  • hair loss
  • hormonal imbalances

She has been told by her MD that it’s in her head, she should drink more water, exercise and take a sleeping pill. She feels unheard and frustrated that her physical symptoms are not being addressed. It’s easy to write off these symptoms as the result of chronic stress, but answering the question of “why am I feeling this way”, is so important to patients who need an explanation for their symptoms.

This is not an uncommon picture. We’ve been addressing “stress” for years and calling it adrenal fatigue, but this has been confusing because what we mean is not that the adrenals are fatigued and can no longer produce cortisol at all, but that the alarm signals are no longer going off when stress is around because the body has decided to protect itself from chronically high levels of cortisol.

This makes it hard to get out of bed in the morning and it makes us feel groggy during the day. The answer to this problem is not necessarily MORE cortisol secretion, but NORMAL cortisol secretion. We can test this for our patients who come in with these health concerns, who most commonly are women, with a 4-point saliva cortisol test3. Sometimes it is valuable to test thyroid function along with cortisol function, and even other hormones, like estrogen, progesterone, DHEA-S, and testosterone, because when the body has been under chronic stress for so long, it affects many things – the body is connected across all its systems.

Your senses take in the world around you and give messages to your brain – my world is a safe place, or there is an imminent threat and we are in danger! The body activates your sympathetic nervous system to help you run from that threat, or if the world is a safe place, the parasympathetic nervous system to promote conservation of energy, digestion, and removal of waste products4.

The problem with this system is that in our modern day-to-day life, the imminent threat might not be necessarily life-threatening and is most often an angry boss. Or, it could be the stress of too many pressing things on the to-do list. When the sympathetic nervous system kicks in it affects things like your libido because when you are in imminent danger, like running from a hungry tiger, reproduction isn’t a top priority! The message from your sympathetic nervous system to your adrenals to stimulate a rise in cortisol helps you run fast, see better to avoid the threat – it helps you survive!

Under chronic stress, our body diverts its resources to what is important for survival.

How do you connect the dots between thyroid and stress?

Your thyroid helps with this reaction too – if affects energy expenditure, blood pressure, heart rate all of which can help you run from that hungry tiger. However, under prolonged stress, your thyroid doesn’t react the same, thyroid hormone production is slowed, metabolism is slowed, bowel movements slow5. Patients come in with constipation, fatigue, weight gain – all because of how the chronic stress response affects the thyroid. They appear with hypothyroid symptoms, but sometimes on lab tests, their results appear normal. This doesn’t mean it is normal, and for many of these patients, we need to consider subclinical hypothyroidism to help these patients feel better6.

Under chronic stress, our body diverts its resources to what is important for survival. After many days or months of running from a hungry tiger, your body is tired, you probably feel depressed and anxious. How come you haven’t been able to outrun him, or outsmart him? Is he watching you now? Always be on the alert! This is exhausting! It’s easy to think you are having an adrenal crisis! Why aren’t those glands responding to the stress and helping me continue to run!?

But the good news is, you are not likely dealing with a true state of adrenal insufficiency, because those patients who are, have Addison’s disease and are dealing with:

  • extreme weakness,
  • significant symptoms of salt cravings,
  • loss of appetite, nausea,
  • darkening of the skin,
  • and extreme tiredness among other things.

Ruling this out for our patients who have such significant symptoms can be very important and being able to tell the difference is essential. However, this is much rarer.

So what do we do for these patients who are dealing with long-term extreme states of stress?

For one, we DO NOT tell them their symptoms are in their heads. That helps no one. We acknowledge their symptoms and we offer adrenal support supplements to help ensure their physiological systems have all the necessary nutrients to help push the biochemical pathways forward. In addition:

  • We use calming herbs and herbs that help the body adapt to stress.
  • We support their thyroid if necessary, taking in special consideration for all the nutrients that feed into the biochemical pathways that make active thyroid hormone.
  • We recommend self-care and teach our patients how to incorporate that into their busy lives.

The bottom line

Stress can be the root cause of patients’ symptoms because of how it affects the adrenal glands, the thyroid gland and so many other systems in the body. The modern world we are living in has such high expectations of people in general, but women are especially feeling this burden. Always be available by email, phone, or text. Be the best mother, wife, daughter, sister. Our society has expectations that mothers work and yet still take care of the majority of the responsibilities at home7.

For some people getting caught in the hamster wheel of life happens by accident or by unfortunate circumstances. For others, it’s out of necessity or it has slowly crept up on them over time and now they don’t know how to get it to stop. Although we can’t always help our patients change their life circumstances, we have tools that can help them cope better, survive those tumultuous years better, and perhaps most importantly, we can LISTEN, truly hear them and acknowledge that their symptoms are not in their heads.

The Fullscript collective helps guide our company to evolve, adapt, and support integrative medicine.

Learn more!