The Adrenal Connection

In this post at the way bottom I wrote,

"Daniel wrote that he had read somewhere (Dr. Peatfield's book Your Thyroid and How to Keep it Healthy) that if your thyroid and your adrenals are working under par then you should begin strengthening the adrenals first. He likened the thyroid to the gas pedal of a car and the adrenals to the engine in a car. If you press down hard on the gas pedal (thyroid) you could blow your engine (adrenals). So always begin FIRST by strengthening the adrenals then strengthen the thyroid."

I know now where Daniel read about this thyroid adrenal connection I am learning more about it and it is so very practical and helpful to understand the working of a system rather than the function of the organ all by itself. Dr. Peatfield says this about the connection between the two glands,

"We must now consider the adrenal connection to hypothyroidism. The first point to make is a repetition of what I said earlier: if thyroid hormone is not being produced as it should, nothing works properly – including of course the adrenal glands. And this situation is compounded by the fact that low thyroid output is a stress inducing situation. To enable the system to cope with low thyroid output, the adrenals are obliged to produce an increased level of cortisol. This may work well, for a considerable period of time, if the thyroid deficiency isn’t too bad. But it slowly worsens and the adrenals are called upon to further compensate for the stress this produces. Eventually, of course, the adrenals begin to cope less well; and the continued strain causes adrenal exhaustion. The syndrome of low adrenal reserve is now present."

Durrant-Peatfield, Barry (2012-10-04). Your Thyroid and How to Keep it Healthy: Second edition of The Great Thyroid Scandal and How to Avoid It (Kindle Locations 1603-1609). Hammersmith Books Limited. Kindle Edition. 

To make up for the thyroid's poor performance the adrenals get extra work and could become overloaded. If the overloaded adrenals are also subjected to a bad diet, environmental toxins, prolonged stress etc. then they will not be able to keep up with the extra of work of support a low thyroid and then this happens.

"We saw earlier that the thyroid hormones have to be processed in the body to work; the chief one, thyroxine (T4) has to be converted into the active thyroid hormone tri-iodothyronine (T3), under the action of the 5’-deiodinase enzymes. With a low adrenal reserve this reaction doesn’t proceed as it should, and the body may become toxic with unused and unusable T4. The problem doesn’t end there; the T3 has to be taken up by the receptors within the cell wall, to be passed into the cell. This uptake is degraded in adrenal insufficiency; the receptors become dormant or may disappear or may become resistant. In this situation, even if T3 is available, the system can become toxic if it cannot be used properly. You can see how desperately important the adrenal glands are, and equally how important it is to provide adrenal support when low adrenal reserve is present. "

Durrant-Peatfield, Barry (2012-10-04). Your Thyroid and How to Keep it Healthy: Second edition of The Great Thyroid Scandal and How to Avoid It (Kindle Locations 1615-1621). Hammersmith Books Limited. Kindle Edition. 

Ideally at this point the hypothyroid patient should be given something (like desiccate adrenals) to support the over worked adrenals which gives these hardworking glands the building blocks to do the work asked of it. In addition to that, a good look at ones diet, toxic load from the environment and stress levels etc. will relieve the adrenals from their toxic load. Once the adrenals are thriving again THEN thyroid help can be administered. By using the metabolic temperature chart and by monitoring your pulse (see more about this below) it is easy to see how your body is responding to the dose of thyroid supplement (like desiccated thyroid glands) you are giving it. However if you fail to monitor it and rely only upon blood tests the result may be this,

"Thousands of people suffering from hypothyroidism are never quite well since, using the blood tests as a guide only, the endocrinologists with few exceptions oblige their patients to lurch from one dose to another. The patients may have windows of feeling better, but may feel either under-active, or toxic for much of the time. The great sadness is that when they say to their doctor, ‘Look, I really don’t feel right,’, they will be told, since the blood tests show that they are at the correct levels, they must therefore be right and perfectly well – whatever they may say. The patient is then probably offered Prozac (or other antidepressant), or counselling, or becomes labelled a ‘heart-sink’ patient, and you can see now why the blood tests may be completely misleading. If the thyroid supplementation isn’t being used properly and is not being processed into the tissues, it will cause the blood levels to be normal, or even raised. In this situation, which is likely to affect all hypothyroid sufferers sooner or later, if this is not taken account of the patient will never be well. Along with a number of other workers in this field, I have pointed this out many times to the deaf ears of the establishment."

Durrant-Peatfield, Barry (2012-10-04). Your Thyroid and How to Keep it Healthy: Second edition of The Great Thyroid Scandal and How to Avoid It (Kindle Locations 1624-1632). Hammersmith Books Limited. Kindle Edition. 

If one makes the mistake of treating the thyroid first Dr. Peatfield has a few suggestions to rectify the situation and get the bodies metabolism back on track.

"A problem often arises when those of us with low thyroid seek advice, and it becomes clear that low adrenal reserve is at least half the problem. The amount of thyroid hormone replacement, usually thyroxine, has been increased, either with very little benefit, or actually worsening the situation. If the adrenal support is then given, it has the effect of so much improving thyroid uptake and processing, that in a day or so, you actually become truly thyrotoxic, with palpitations, tremor, even a temperature. 

To deal with this situation low cunning is needed. The thyroxine must be stopped for 5-10 days to allow it to run down somewhat. (Remember that it has an eight day half life in the system, so this can be quite a slow process.) After these few days, natural adrenal glandular support is introduced, at low dose – even half a tablet – and after a few days without any problems of apparent overdose, the adrenal support can then be increased to one, and later more if required. At some point, usually within a week, the thyroid hormone can be restarted at half the original dose. 

All the time you have to monitor pulse and temperature, on a daily basis, morning and evening, and then be prepared to adjust the thyroid hormone dose up or down as seems necessary. A rapid rise of pulse, perhaps into the 90s per minute or a sudden rise of temperature to apparently normal levels, is likely to mean that the thyroid supplementation is too much and should be reduced or stopped for a day or so. Low adrenal reserve commonly means that as the day progresses, cortisol particularly becomes exhausted, and with it thyroid uptake and processing. Hence as the day goes on, one can feel more tired (more so than one should) than in the morning, and the pulse and temperature will show this by dropping. It is helpful to take the temperature and pulse in the evening (say 9 or 10 o’clock), to monitor the adrenal status. If the adrenal glands are becoming exhausted the temperature will drop and the pulse rate may do so as well. This regime is effective for the majority of people with adrenal and thyroid dysfunction. Moreover, it can be used safely with the minimum of medical supervision, since we are using food supplements rather than synthetic preparations."

Durrant-Peatfield, Barry (2012-10-04). Your Thyroid and How to Keep it Healthy: Second edition of The Great Thyroid Scandal and How to Avoid It (Kindle Locations 1697-1703). Hammersmith Books Limited. Kindle Edition. 

Things to look for to know whether or not you need adrenal support:

1. Where an abnormally low DHEA and an abnormally high cortisol show adrenal stress, or abnormally low cortisol and DHEA blood test shows weak adrenal function.

2. Many symptoms, and clinical signs, notably postural hypotension, suggest weak adrenal response.

3. The thyroid deficiency state has been present some considerable time and is getting worse.

4. Previous treatment with thyroxine has been unsuccessful or even worsened the situation.

5. There has been thyroid surgery or radioactive iodine ablation.

6. Thyroid blood tests are normal but the patient is clinically hypothyroid.

7. Previous major surgery or trauma/shock from an accident or life event.

8. If when you plot your temperatures daily and see a large variance of readings as is noted on this graph.

A= low adrenal reserve and hypothyroid state
B= improving adrenal performance but still a low thyroid
C= good adrenal performance but a hypothyroid state
D=good adrenal performance and improving thyroid state
E= ideal adrenal and thyroid performance