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Hashimoto's Disease: How Stress Affects Your Thyroid

Learn strategies to reduce stress in this article is about the impact of stress on Hashimoto's disease.
Hashimoto's Disease: How Stress Affects Your Thyroid
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In this article: 

  • What is Hashimoto's disease?
  • Impact of stress on the body
  • The adrenal-thyroid connection
  • Stress relief tips for Hashimoto's

What is Hashimoto's thyroiditis?

Hashimoto's thyroiditis is an autoimmune disorder, which means it occurs when immune cells attack healthy tissue instead of protecting it. In Hashimoto's thyroiditis, immune cells mistakenly attack the healthy thyroid tissue, causing inflammation of the thyroid.

The thyroid is a small gland located at the base of your neck that produces two hormones—one, thyroxine (T4), and the other, triiodothyronine (T3). These two hormones stimulate the metabolism of almost every tissue in the body—heart, brain, muscles, and other organs.

The pituitary gland in the brain regulates thyroid-stimulating hormone (TSH), which triggers the production of T4 and T3. When thyroid hormone levels in your body are low, the pituitary gland makes more TSH. Elevated TSH may signify that the body isn't producing enough thyroid hormones, indicative of hypothyroidism.

You will develop hypothyroidism if Hashimoto's attacks your thyroid to the point that the gland can no longer produce enough thyroid hormones for your body to function correctly.

Hypothyroidism is the condition in which your thyroid hormone production drops, causing virtually all of your body processes to slow down and change. This condition can feel like being stuck in second gear—everything slows down. 

Common symptoms of hypothyroidism include:

  • Tiredness, sluggishness
  • Depression
  • Trouble concentrating

Impact of stress on the body

Like any other system in your body, the endocrine system is sensitive to stress. Not to say all stress is bad. Some level of stress can be positive. For instance, stress can incentivize us to meet challenges or achieve goals, adding positive value to our lives.

However, many of us operate on a steady diet of unhealthy stress that leaves us depleted and our systems on overload. Research in the field of neuroendocrinology links the body's stress response to nearly two-thirds of all disease.

Researchers aren't entirely sure what causes Hashimoto's disease, but they suggest that stress may be an environmental trigger. Studies show that psychological and physiologic stressors affect the immune system, which may contribute to the development of autoimmune conditions.

Too much stress can throw our endocrine system out of balance, including the levels of thyroid hormones produced. In response to stress, our bodies sometimes slow the production of thyroid hormones to conserve energy; sometimes, stress increases these hormones.

The adrenal-thyroid connection

The adrenals are small glands located above the kidneys that produce the stress hormone cortisol. Cortisol controls how you respond to stress. It also controls how your body fights infection, adjusts blood sugar levels, and regulates blood pressure.

Stressful situations don't need to be near-death experiences. Stressful situations can be non-life-threatening, like running late, being stuck in traffic, or public speaking. Typically, cortisol acts as an anti-inflammatory hormone to prevent damage from stress. It helps to maintain and preserve fuel to keep us going.

However, chronic cortisol release and its associated hypothalamic-pituitary-adrenal (HPA) axis dysfunction may be one cause of autoimmune disease. The HPA is our central stress response system, connecting the central nervous system and the endocrine system. The hypothalamus signals the pituitary gland, which signals the adrenal glands to release cortisol.

Overview of the hypothalamic-pituitary-thyroid axis, or thyroid homeostasis
Overview of the hypothalamic-pituitary-thyroid axis

The cortisol exerts negative feedback to the hypothalamus to slow back down at a specific cortisol blood concentration. It's crucial to support healthy cortisol levels to ensure that the hypothalamus and pituitary glands maintain the appropriate sensitivity to cortisol's negative feedback. The pituitary gland and hypothalamus control the thyroid, so if they become maladapted, the thyroid may also be affected.

Some people explain this phenomenon as "adrenal fatigue"—when your adrenal gland can't keep up with your body's demand for hormones. When your adrenal glands aren't producing enough cortisol, and you have a thyroid problem, it may make your symptoms feel that much worse.

It's important to learn healthy ways to manage stress for a host of reasons—a sense of well-being, better sleep, less illness. Managing stress with healthy habits gives the entire endocrine system a break.

Stress management tips for Hashimoto's

Eat an anti-inflammatory diet

The more dietary stress you put on yourself, the more likely you are to experience inflammation. This inflammation can worsen your autoimmune reactions or interfere with your thyroid function.

Fuel your body with healthful foods. Refined sugars can spike blood sugar and cause it to crash, increasing your stress levels. Instead, reach for healthy, thyroid-friendly foods like avocados, eggs, and nuts full of healthy fats. These goods support satiety, mood regulation, sleep, and energy.

Download free mobile app to manage hypothyroidism and Hashimoto's with AIP diet

Prioritize sleep

Stress can keep you up at night, ruminating on all that you need to do or should've done or how little time you have left to do it. Hypothyroidism can already cause irregular sleep patterns, so stress certainly isn't helping the quality of sleep. 

Take steps that allow you to get seven to nine hours of sleep each night. A survey from the American Psychological Association says that adults who sleep fewer than eight hours a night report higher stress levels than those who sleep at least eight hours a night. Keep your room cool, dark, and comfortable, and practice a relaxing bedtime routine. You might consider turning off all electronics one hour before going to sleep and avoid alcohol or caffeine too close to bedtime. 

Move your body

Low thyroid hormone production can leave your muscles weak, achy, or stiff. In addition to reducing the body's levels of stress hormones, movement stimulates the production of endorphins, which are natural painkillers and mood elevators, according to Harvard Medical School. Don't overcomplicate this one, either. A 20-minute walk is all you need to soak in some benefits.  

Woman walking in nature as stress reduction strategy for Hashimoto's

Seek support

With more people working from home and our interactions shifting to virtual platforms, it's more important than ever to prioritize our social networks. Isolation and loneliness can profoundly affect our health, with impacts equal to those of obesity and smoking.

The flip side is that seeing your BFF has a protective effect on both physical and mental health. There are incredible health benefits to being around people we love. Positive social connections can lower stress levels, reduce inflammation in the body, increase longevity, and lower anxiety and depression. Having positive face-to-face interactions can kickstart a positive spiral of feeling emotionally and physically.

Leaning on a trusted person may help you manage stress. If not a friend, try a family member, therapist, support group, coworker, or religious institution. Don't be afraid to ask for help when you need it. 

Give thanks

Mom was right. Writing thank-you letters and keeping a gratitude journal can build resilience, reduce the tendency to compare ourselves to others, and improve our relationships. Cultivating an attitude of gratitude can decrease depression and lead to better sleep. Try writing or reciting five things you're grateful for as part of your bedtime routine and seeing for yourself whether you can nod off more quickly.

Practice mindfulness

The definition of mindfulness is applying your mind entirely to whatever you are doing or whatever is happening to you. This idea seems like an easy thing to do; after all, doesn't your mind have to be attentive to accomplish whatever task is at hand? However, our minds tend to veer off track. Consider how many times you wind up at your destination, not fully recalling how you got there or how many hours can pass mindlessly scrolling through social media.

Mindfulness is the "human ability to be fully present, aware of where we are and what we're doing, and not overly reactive or overwhelmed by what's going on around us."

An excellent place to start practicing mindfulness is during your meals. Mindful eating is about reaching a state of full attention to your experiences, cravings, and physical cues when eating, using mindfulness. Studies show that mindful eating can reduce stress and curb unhealthy behaviors like binge eating, emotional eating, or stress-eating.

To eat mindfully, do the following:
  • Notice your food—it's color, texture, smell, flavors, etc.
  • Take a few deep breaths before your first bite.
  • Eat slowly and without distraction.
  • Take breaks between bites and try putting down your utensil to relax and fully enjoy the dining experience.
  • Notice how the food feels in your mouth—the temperature, textures, taste, etc.
  • Pay attention to physical hunger cues and eat until you're full.

These practices allow you to replace automatic thought patterns with more conscious responses to your eating habits. You can also use this practice with any other behavior in your day—while you brush your teeth, while you stretch, while you fall asleep, etc. Tune into your body and notice your senses without passing any judgment on them. 


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Find an enjoyable meditation

Though not a substitute for your thyroid medication, some alternative therapies like deep breathing, yoga, or meditation may help you manage your thyroid symptoms.

Meditation is no longer considered the sole province of mystics and spiritual gurus. Research continues to prove various health benefits associated with meditation. 

Meditation refers to several diverse techniques like contemplation, concentration, use of nature sounds, guided meditation, meditative movement exercises, breathing exercises, or Mantra. These techniques work at different levels—including the senses, mind, intellect, and/or emotions. Some methods are easier to learn and practice than others. The original yogic texts say that the real purpose of meditation is to connect to your deep inner self. With this in mind, we encourage you to start with a short amount of time in a method that you think you'll enjoy so that you do not give up.  

Try this two-minute meditation:
  1. Find a comfortable position—sitting, standing, lying down—that feels calm and quiet to you.
  2. Set a time limit. We recommend you start small—try two minutes to start.
  3. Notice your body. Become aware of any tension. Some people find it helpful to scan the body, starting from the toes and moving to the top of the head. 
  4. Feel your breath. You don't need to do any particular kind of breathing. Simply feel the sensation of your breath as it goes in and out.
  5. Notice when your mind wanders. Your attention will likely go elsewhere from your breath. When you notice that has happened, simply return your attention to your breath. 
  6. Be kind to yourself. Don't beat yourself up for wandering thoughts. Just come back, kindly.
  7. Close with kindness. When you feel ready to complete your meditation, blink your eyes open and take a moment to notice your environment. Appreciate how your body feels right now and any thoughts and emotions that come up.

There are few among us who do not experience an overload of stress. Still, simple strategies can help us manage stress so our bodies can relax and heal some of the damage to our thyroid gland.


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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