So how does it happen that the thyroid is both cause and effect of hormonal imbalance? Take a look at the various hormones in the body and how they work below.
Cortisol. First on our list is the “stress” hormone. Cortisol is manufactured and secreted from the adrenals (simplistically) and its primary objective is to raise blood sugar levels to optimal levels. I know what you are thinking. “But this is insulin’s job!”, however, during times of stress, the body, preparing or dealing with a threat, uses up glucose at really fast rates. (Your body uses glucose for fuel, prefers it actually, so don’t ever fall prey to those that will have you believe that the body prefers fat as fuel…. it doesn’t! That is merely an adaptive state of being meant for short periods of time like the very harsh parts of winter when food was scarce.) Cortisol, when balanced, restores equilibrium to blood sugar.
Where this goes horribly wrong is when cortisol is released all the time such as when you are chronically stressed either due to lifestyle or illness. This is when blood sugar and blood sugar handling issues develop.
Cortisol is catabolic to the body’s tissue in high doses, meaning it breaks them down. This occurs, specifically when there is there isn’t enough glucose stored to bring blood sugar back into balance. Cortisol breaks down the body’s tissues to use for fuel, breaking down proteins into usable fuel. This process is called gluconeogenesis. It should also be noted that cortisol breaks down the tissue of the hippocampus, the part of the brain responsible for memory. It might explain why we have a tendency to feel forgetful, fuzzy, and generally out of sorts when we are very stressed for long periods of time.
For your immune system to function properly, cortisol must be in balance. If you get sick more often than you should or find wounds a challenge to heal you might want to test your adrenal function.
Too much cortisol puts the brakes on TSH secretion. (Thyroid stimulating hormone). It also blocks thyroid hormone receptors and inhibits conversion of inactive T4 into active T3 when levels are too high. Ironically, cortisol is necessary for the process of conversion but only in amounts the body can manage. (Too much cortisol and the ability for your liver to detox properly also goes out the window.)
Note:: In my practice, when faced with adrenal fatigue, along with thyroid and hormonal imbalance, my first line of treatment is generally nourishing and/or rebuilding the adrenals. Once the adrenals are functioning properly, many times thyroid and hormonal levels return to normal function. Isn’t the body amazing??
Pregnenolone. Next up, we have pregnenolone, the grandmother of all hormones. Made of cholesterol (yes, that substance vilified in the mainstream media), mainly in the adrenal glands, it is the precursor to all those lovely sex hormones, including all the ones we are discussing here today. Clinical studies have shown those with low thyroid also tend to suffer low pregnenolone and low pregnenolone leads, very often, to low progesterone, and even to low testosterone. In men that’s definitely not a great thing but in women it is a challenge as well.
Pregnenolone is key in memory and concentration and those with brain fog should consider having their pregnenolone levels checked. I routinely order this test now in my own practice, especially for those clients with low thyroid or are experiencing adrenal fatigue or burnout.
Pregnenolone supplementation can be extremely helpful for those with adrenal burnout. When the adrenals are on burnout (marked by low cortisol production) pregnenolone converts directly to cortisol which nurtures the adrenal glands. While many of you are probably confused as to why we would want to supplement anything that converts to cortisol, remember, balanced cortisol is needed for a healthy conversion of inactive T4 to active T3. Too much cortisol, is, of course, bad but as bad as not making enough. If you aren’t making enough, pregnenolone can help restore adrenals and kickstart thyroid function.
It’s all a delicate diagnosis and treatment balance.
DHEA. This is one of the most overused supplements on the planet (sarcastically thanks Dr. Perricone). It is incredibly useful in the treatment of adrenal burnout but should, in my view as an Integrative Medicine practitioner, never be taken without proper testing and DHEA should be found to be low in levels before DHEA is ever taken and, even then, in minute amounts. It can cause hormonal imbalance when taken incorrectly or even for too long. People with low DHEA (which tend to stage 3 or 4 adrenal fatigue) also tend to have a low functioning thyroid.
DHEA is a key factor in tissue repair, immune function, muscle building, energy production, fat burning, and even liver function. It also can convert to testosterone and estrogen. Curiously, supplements tend to convert to testosterone for women and estrogen for men.
Testosterone. Created in the ovaries and adrenal glands for a woman, and in the testes and adrenals for men, it is a key factor in healthy metabolism. When thyroid function is impaired, as is the case with pregnenolone and DHEA, testosterone levels can be impaired. When the thyroid is treated and functioning normally, so testosterone levels usually normalize.
For those women who are asking “Why are you talking about testosterone on a woman’s website?” it might shock you to know that libido is affected greatly by testosterone levels. Unfortunately, when doctors treat women going through menopause with hormones, they often forget to include testosterone, of which levels tend to fall, therefore libido takes a hit.
Although I am a very firm believer in bio-identical hormone treatment, they should never be used lightly or without thorough testing first.
Testosterone supplementation can be very effective, when needed but many functions must be addressed before we resort to supplementing testosterone.
- Liver detoxification
- Estrogen metabolism
- GI microflora activity
- Insulin sensitivity
- Adrenal function
- Testosterone synthesis (how well is testosterone used in the body)
- 5-alpha reductase activity(converts testosterone into DHT. You know it as being responsible for hair loss.)
- Beta-glucuronidase activity (how the body breaks down complex carbohydrates)
- 17,20 lyase activity–progesterone to androstenedione (I could explain but your head would explode.)
- Aromatase activity (production of estrogen in men where testosterone is converted to estrogen. This is a bad thing!)
- Hypothalamic-Pituitary or HP feedback loops (how well is the brain sending signals to the body as to what it should do)
Now we are down to our two favorite hormones!
Progesterone. Progesterone is produced in the ovaries and small amounts in the adrenals in women. It is dominant in the second half of a woman’s cycle (luteal phase) and surges at Day 21. Now, if you want a baby and you have fertilized an egg, this surge is needed because progesterone helps build the uterine lining creating a hospitable, cushy, cosy environment for a wee embryo to grow.
By now, we all know that the thyroid is stimulated by progesterone but that low thyroid function can impair progesterone function. This is why women with low thyroid symptoms often have secondary infertility . I say secondary infertility because many times low progesterone can cause infertility and, in my view, the thyroid becomes the root cause of low progesterone which is the cause of infertility. Treat the low thyroid and get it functioning properly and progesterone levels will often balance.
Estrogen. Last but certainly not least, there is estrogen . Premenopausal women make it in their ovaries whilst postmenopausal women make it in their adrenal glands. A whole lot of it is absorbed and ingested in the form of xenoestrogens including chemicals, pesticides, and even good old natural phytoestrogens like soy and flax (among many other things).
Estrogen, in balance, helps ripen follicles into mature “eggs” ready for fertilization, can be protective against heart disease, boosts sex drive and aids in its function, is important for bone health and for brain function. It is a necessary hormone when in balance.
The flip side is estrogen dominance. Estrogen dominance has all sorts of nasty effects. Remember, we are inundated by foreign estrogens every single day. Hormones in meat, pesticides (Roundup sprayed both externally and genetically modified within vegetables and starches such as corn), soy, flax, and even chemicals in our personal care items can bind to estrogen receptors raising estrogen levels. On top of that, these foreign invaders cause a strain on our liver detoxification system which further impairs the detoxification of excess estrogen. Chronic stress affects estrogen dominance due to the fact that it can cause cortisol dysregulation which, in turn, affects thyroid function as it has a tendency to encourage T4 to be converted to RT3 (reverse T3) which is actually inactive. (A simplified explanation that will be explained later on in another post.) Estrogen dominance also encourages low thyroid function as excess estrogen binds to receptors to which thyroid hormone would bind. Two molecules cannot bind to the same receptor so, if excess estrogen binds to the receptors instead of thyroid hormone, thyroid function decreases.
A fun fact about stress and estrogen I’ll bet you didn’t know…. stress can activate inactive estrogens which lead to moodiness, irritability, water retention and even cystic and fibrotic breasts.
While bio-identical estrogen can be useful in clinical process during and post menopause, it should be noted that, in the presence of healthy function of adrenals, most women will possess enough estrogen that estrogen supplementation should not be necessary. It can be helpful if the adrenals are experiencing any dysfunction but better off avoided or used sparingly.
I know this all sounds very complicated; a little like balancing plates on stilts, but with the right practitioner on your side it is much less of a challenge to unravel the issues and get to the root. Apply today and get on the road to health and healing.