As a chronic fatigue syndrome sufferer I have come to realise just how pivotal healthy thyroid and adrenal gland function are to recovery. If your thyroid or adrenal function is below par effectively treating these issues can make a huge difference to how you feel and your ability to function.
Research has demonstrated that the function of the thyroid and its hormones in those of us with chronic fatigue syndrome and other chronic illnesses can be adversely affected by a variety of factors and through a variety of different mechanisms. Unfortunately, routine medical examinations and blood tests are woefully inadequate when it comes to detecting thyroid problems.
Standard thyroid blood tests typically only look at levels of thyroid stimulating hormone (TSH) and thyroxine (T4). T4 is actually the inactive form of thyroid hormone which has little affect on the cells. The active form known as T3 is rarely tested for. As we will see this can give an incomplete or entirely false view of how thyroid hormones are actually doing their job of regulating metabolism at the cellular level.
Currently most doctors (working from standard blood tests) only recognise two types of hypothyroidism (low thyroid function.) The first is known as 'primary hypothyroidism' and this occurs when the thyroid itself is not producing enough hormones. The second type results from a failure of the tissues which stimulate the thyroid; the hypothalamus and pituitary gland.
However, in his book 'Your Thyroid and How to Keep it Healthy' Dr. Barry Durrant-Peatfield describes how you can experience all the symptoms of hypothyroidism even if standard thyroid blood testing appears normal:
1. Conversion Failure - This is a failure of the systems which convert the inactive T4 hormone into the active T3 form. The enzyme required for this conversion needs adequate amounts of selenium to function so any degree of selenium deficiency may reduce thyroid function. Heavy metals such as mercury which those with CFS and environmental illnesses often have problems with are known to displace selenium. The process also requires other mineral cofactors such as calcium, magnesium, zinc and mangenese. Other chemical contaminants such as fluoride also prevent the conversion of T4 to T3. Unfortunately fluoride is widely added to water supplies and toothpastes so make sure to filter your water and buy fluoride-free toothpaste if you think you have thyroid issues!
2. Receptor Uptake Failure - As well as there not being enough T3 due to conversion failure there may be a problem with the hormone not working effectively when it reaches the cells. Each cell has receptors which should recognise thyroid hormones but these may become resistant so the message doesn't get through as strongly and symptoms of hypothyroidism result. Suggested reasons for this resistance include autoimmune reactions, other hormonal imbalances (e.g. adrenal fatigue), and toxicity whether from environmental toxins or those produced excessively in the body.
3. Adrenal Insufficiency - Dr. Durrant-Peatfield reports that poor adrenal function with reduced output of the hormones cortisol and DHEA can reduce thyroid function in every way; thyroid hormone production, T4>T3 conversion, and receptor uptake. Adrenal dysfunction is known to be a problem in CFS and t has been suggested that function can be reduced in otherwise healthy people by chronic stress and other factors.
Symptoms associated with hypothyroidism:
Cold hands and feet
Poor concentration and mental sluggishness
Low blood pressure/heart rate
*there are many more
My Experience with Thyroid Issues
During my teens I saw an enlightened doctor who recognised that low thyroid function was an issue in CFS. At that time I was given a trial of thyroxine. Unfortunately this didn't have any noticeable effect so we gave up on that avenue of treatment (mainly because I wasn't a very willing patient at that time!). More recently however after a lot of research on the issue I decided that it was probably worth having a trial of T3 medication. This was effective. VERY effective. Even at very low doses it was like a switch had been flipped in my head. I had suffered terribly from lethargy, apathy, depression, fatigue, and general sluggishness. The T3 medication improved all of these drastically and made me feel like myself for the first time in years. It brought tears to my eyes as I had literally forgotten what it was like to feel like myself and feel alive. The fact that it only took a small dose probably suggests that mine was a conversion problem. Others may require larger doses to see an effect if receptor sensitivity is an issue. From my experience I would advise all those with CFS and related illnesses (including depression) or symptoms suggestive of hypothyroidism to work with a doctor who recognises the intricacies of thyroid function. Do not stop at trying thyroxine, make sure you see how you feel on T3 medication or a natural alternative such as Armour thyroid.
Low adrenal function (adrenal fatigue, adrenal exhaustion, burnout) is even more controversial than low thyroid function. Put simply the medical profession in general doesn't believe that people can be ill as a result of low output of adrenal hormones unless the adrenal glands are failing completely. This is known as Addison's Disease or adrenal insufficiency.
Research has shown however that those of us with CFS are often low in both cortisol and DHEA and that this can contribute to our symptoms. Researcher Hans Seyle also showed that the adrenal glands of rats exposed to chronic stress eventually reduce their output of these hormones and the glands themselves actually withered.
Levels of adrenal hormones can now be tested at home by taking samples of saliva throughout the day which are then posted to a lab. These tests are known as Adrenal Stress Index (ASI) tests. An ASI can reveal how much DHEA and cortisol you are producing throughout the day, indicating if corrective measures may be needed. Doctors specializing in environmental illnesses and other healthcare providers such as nutritionists may order these tests for you but you can also order them yourself. Of course you should enlist the help of a helthcare professional to interpret the results and monitor treatment.
Symptoms associated with adrenal fatigue include:
Inability to get going in the morning
Inability to cope with stress
Low blood pressure
Tendancy to get a second wind at night (becoming more alive as the day goes on)
Allergies and sensitivities
*there are many more
My Experience with Adrenal Issues
Since I had all the typical signs of adrenal problems I had an ASI carried out which revealed DHEA right on the borderline of an outright deficiency with cortisol levels that were slightly low but varied wildly throughout the day, being very high at night and low in the morning when they are supposed to rise to help you get going!
As with T3 thyroid hormones my response to treatment for my adrenal problems can only be described as spectacular. I took DHEA (again at very low doses - 10mg every other day) and within a week I was feeling a lot better. Again I felt more like myself, this time mainly because I felt so much more relaxed and free from stress. Tasks which would have filled me with dread and left me extremely tense I could now handle without a problem and even enjoy as I felt a sense of well-being and confidence. Besides this I slept soundly and felt refreshed in the morning, was able to get up much earlier, and could even handle some aerobic exercise. My blood sugar levels which had been highly erratic stabilized and the severity of my allergies was much reduced.
I had previously taken licorice supplements since they are said to help with adrenal issues by increasing the activity of cortisol. These too had a powerful effect, providing me with the energy to motivate myself to start tasks and again allowing me to get out of bed earlier. A word of warning though; increasing cortisol levels although motivating and energy boosting can actually leave you feeling even more stressed if your DHEA is too low.
A Final Point
My personal experience has taught me that DHEA acts as a counter-balance to substances which have a stimulating effect on the body including thyroid hormones and cortisol. If you don't have sufficient DHEA then taking thyroid hormones, cortisol, or any stimulant (caffeine, nicotine, sugar etc) will likely leave you feeling stressed and overstimulated very easily. Dr. Durrant-Peatfield suggests that adrenal problems must be addressed if thyroid treatment is to be successful. My own experience tells me that this is indeed the case.
My aim with this blog was to tell you a bit about the things that can go wrong with the thyroid and adrenal systems which may very well be missed by most doctors but can have a profound affect on your health and how you feel. When you work with a healthcare practitioner who is knowledgeable in these issues the results of treatment can be dramatic. If you sufgfer from CFS or related chronic illness and haven't looked into your thyroid and adrenal function it is something that is well worth doing and could go a long way to getting you back on your feet!
About: Matthew Hogg ("Maff")
Diagnosed with M.E./chronic fatigue syndrome aged only 11 years old and subsequently associated illnesses including irritable bowel syndrome (IBS) and multiple chemical sensitivity (MCS). Despite his own struggles he has constantly sought to educate and support others suffering from such "invisible illnesses" through his website, The Environmental Illness Resource. He fully recovered from MCS using his own approach and holds a Bachelor of Science Degree in Nutritional Health.