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Understanding the Adrenal-Thyroid Connection

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Dr. Sean Zager of Paloma Health shares about the connections between our thyroid and adrenal functions—or sometimes, dysfunctions.

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[00:00:00] Hey everybody. This is Dr. Sean Zager from Paloma here to talk to you today about the connections between our thyroid and adrenal function, and sometimes between our thyroid and adrenal dysfunction. I'll start by talking about these two very important glands in the body. The thyroid gland,  you may or may not know, is a butterfly shaped

gland that sits right in the front of the the neck here that produces thyroid hormone and really is central in determining our metabolism. You can think about thyroid function as the engine in our bodies, the adrenal glands are glands-- there's two of them and they sit on top of our kidneys.

What are the adrenal glands?

They're walnut shaped and they produce various hormones. The inside of the adrenal gland is called the medulla. And there are several hormones that are produced there such as epinephrin that you may have heard of before. But what I really want to focus on here is the function of the [00:01:00] adrenal cortex, which is the outer rind of the adrenal gland which produces a hormone called DHA for one that is a precursor to testosterone and estrogen.

It helps to regulate cortisol, which is the main hormone that I want to talk about today from the adrenal gland. Cortisol. The name itself comes from a cortex from the adrenal cortex and where it's produced and cortisol is our stress hormone. It's is really meant to be released when we're in times of acute stress to mobilize the resources in our body to create energy to ultimately be able to

counter manage or avoid the stress at hand. Now it's important to say at this point that humans are the only species on earth that experience chronic stress, right? If you take the example of a zebra running away from a lion on the savanna in Africa. When that lion begins to chase the zebra, cortisol will be produced along with other hormones.

And it will [00:02:00] help the zebra to have the wherewithal and the resources to run. And ultimately that cortisol production will come to an end either because when the zebra is back with its family relaxing later in the day, or when the zebra is dead, because the lion got it. Now, humans, we have the capacity for chronic stress that can last

for hours or days or a lifetime for some people. And in these cases, cortisol hormone can be chronically elevated, which can cause a host of problems. And then we'll talk about that. So I really want to focus here on the relationship between our thyroid hormone function and The our stress response as regulated by  the cortisol production from the adrenals as I was just talking about.

The importance of managing your thyroid health

So first of all, just want to say that this is another reason why it's so important to take good [00:03:00] care of our thyroids. If a person is walking around with untreated undiagnosed or mismanaged hypothyroidism it leads, over time, to increases in cortisol production. Now when chronic this can lead to a lot of symptoms that can be really disabling for people, and this can be sleep disturbance, weight, gain increased blood pressure, decreased ability to regulate blood sugar, decreased bone mineral density, muscle weakness, brain fog, mood swings, anxiety, and probably most notably progressive

fatigue that can become profound. So I'll just nail down one more time that if you are a person who has hypothyroidism or suspects that you might have hypothyroidism really important to get in with a knowledgeable practitioner who can make sure that your thyroid is managed appropriately. So that not only is your thyroid gland functioning the way that it should, but also [00:04:00] the rest of your body, which is so influenced by the thyroid by your thyroid hormone function is working well, including your adrenal glands and your cortisol balance.

Now taking good care of our adrenal glands and our cortisol regulation is just so important as well to our overall sense of wellness. And of course to our thyroid function, when cortisol levels are chronically elevated because often of chronic stress that is really not managed well, it creates an inflammatory response in the body and this disrupts, the normal function of what's called our hypothalamic pituitary pathway in our brain that controls so many of the hormones in our body including thyroid hormone.

And when cortisol is chronically elevated, our thyroid hormone production really goes down. So as you can tell, from what I'm saying, there's really an inverse relationship here where when our thyroid function is [00:05:00] low, our cortisol levels tend to run high and vice versa. When cortisol is higher, thyroid levels tend to run low and it leads to really the symptoms that I mentioned before and a sense of feeling unwell.

Understanding the four pillars of health

What to do to really help to manage this and keep the balance in our adrenal glands and hence our thyroid hormone production. So first I always, with every patient, I see, I always talk about what I call the four pillars of health. This would be diet, exercise, sleep, and stress management.

You can spin your wheels about medications and herbs and supplements. But until you get these four pillars really addressed and in some balance, none of the rest of the stuff is gonna matter.


So with diet, it's really trying to avoid known food triggers. Everybody is different in this way, gluten and dairy being being the classics and the most common food intolerances that we see. Really staying sticking to an anti-inflammatory diet with minimal unhealthy fats or [00:06:00] refined sugars that can be inflammatory.


Getting regular aerobic exercise,  there is good study out there that shows that when we do get good moderate at least moderate intensity exercise, we do experience a bump in cortisol production to help us be able to do that exercise in the long run. This helps our body become better at regulating cortisol. So when there are other stresses in our life,  those those of us who exercise have more of a capacity to keep cortisol levels at an even keel.


Good sleep. Of course this is just good sleep hygiene, making sure you're staying away from screens and a couple of hours, a couple hours before bed really sticking to a consistent sleep schedule, which is really important for cortisol balance and hormone and thyroid hormone balance.

Stress management

And then very much relatedly, stress management. We all have our own ways of doing this. The important thing is to have your own toolbox that is deep and broad and that you can draw from. I often encourage patients to [00:07:00] have both active forms of stress management, like exercise and also more passive quieting forms of stress management that might be

deep breathing exercises or guided imagery, meditation, listening to calming music. For some people it's taking a hot Epsom salt bath before bed, which obviously would help with sleep and certainly dialing stress. So these four pillars really all go together, and  I'd be remiss if I didn't at least mention them here, as we talk about, a therapeutic approach to this kind of hormone balancing.

Okay. Now it's fair to say that if there is ongoing inflammation in really any system of the body it leads to a stress response.   From the adrenals increased cortisol production, which as we mentioned can have its own deleterious effects. So to cure, to care for the adrenals you

really need to care for all the systems of the body. And this [00:08:00] just goes back to making sure that your GI tract is working well. Not only are you avoiding food triggers or inflammatory foods, but making sure that   working with your healthcare provider to make sure that there's no what I would call dysbiosis in the GI system, meaning that the ecology of the gut is off balance with any overgrowth of bacteria or yeast or parasites et cetera.

This means good immune support, making sure your immune function is working well, minimizing exposure to environmental toxins. So all of this goes together and I think that starts to inform a holistic approach to our healthcare and certainly to our hormone balance beyond this there can be some

herbs and supplements that are helpful for cortisol balance. And again, I'll just say of course, a big part of this is making sure that your thyroid hormone is well cared for working with your healthcare practitioner to assure that you're getting the right thyroid care.

Supplements and herbs for cortisol balance

And, very important for your cortisol balance, as we've said, but moving into [00:09:00] these options for supplements or herbs, I'll just mention a couple. First of all for some people actually supplementing with DHA, which is that other hormone produced by the adrenal cortex, aside from cortisol, if cortisol levels are off balance, particularly if cortisol levels are high and there are ways to test for DHE levels as well.

You can work with your healthcare provider on that. If DHA levels are low, which we often see because the two help to regulate each other, when the cortisol levels are high and unregulated in that way, DHT levels are often low supplementing with some DHA can be helpful to bring down cortisol levels.

And at the same time, helping to give a little pep in the step and some increased energy. In addition, there is a whole class of herbs called adaptogenic herbs that are used for adrenal support and have been used for adrenal support for millennia. In general, this is one of my favorite class of herbs.

Actually I'm drinking some adaptogenic herbal tea right here. In general, adaptogens are [00:10:00] herbs that they're really ancient tonics that have been used all over the world. And really use to improve our capacity, to manage stress, both physical and mental. Adaptogens help can help to support energy, mental clarity, immune defense, sleep, quality and really an overall sense of sustained wellness.

So some examples of, and I should say these adaptogenic herbs, there's a lot of overlap in their effects, but there are many, and they all have different features in broad strokes. I'll mention that some of them are stimulating adaptogenic herbs include Rhodiola cordyceps, which is actually a mushroom Asian or Korean ginseng also called Panax ginseng.

Siberian ginseng also called eleuthero. Astragalus. Schisandra.   These are examples of some more stimulating adaptogenic herbs. Some other more calming adaptogenic herbs would include ashwagandha from the [00:11:00] Indian sub-continent. Holy basal. That would be another one. I should mention too, that adaptogenic herbs also include things like tumeric, licorice, even goji berry.

A note from Dr. Sean Zager

And I would encourage you to work with your healthcare provider to talk about how to  most appropriately for you incorporate these into your healthcare regimen or even into your diet. Some of these herbs can be used for cooking, meal preparation, smoothies, what have you? So anyway, in sum, I just want to say that

I think that thyroid and adrenal hormone balance is as central as anything you could talk about with your healthcare practitioner, to your sense of energy, to your sense of stress management, to your sleep quality, and so many other of our experiences in our body and in our health. So please work with your healthcare provider to make sure that you are

taken care of in an optimal way. And of course we're always here at Paloma to help you out. I hope this has been [00:12:00] helpful and happy holidays to everybody. Bye-bye.

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