Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Are Your Adrenals Sabotaging Your Health?

Medically reviewed and written by Izabella Wentz, PharmD, FASCP on April 9, 2020

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Those of us with Hashimoto’s often blame our thyroid for the many signs and symptoms we experience. Hair loss? Thyroid! Weight gain? THYROID! Fatigue? It’s gotta be the thyroid!

Treating hypothyroidism without treating the adrenals is one of the biggest reasons people continue to feel exhausted despite receiving treatment with thyroid hormones. Patients may initially report feeling more energetic after starting thyroid hormones, but this is usually followed by feeling worse and worse until they are right back to where they were before they started the thyroid medications. At this point, they will likely go back to their physicians to check blood work and will be told that everything is normal.

The patient begins to feel crazy… but that’s when another layer of what is broken in Hashimoto’s becomes unraveled. Many symptoms of hypothyroidism overlap with symptoms of underactive adrenals. However, physicians don’t routinely check adrenal function in those with Hashimoto’s.

In this article, I’ll discuss:

  • What are the adrenals?
  • What causes adrenal dysfunction?
  • Symptoms of adrenal dysfunction
  • How to test your adrenal function
  • The Root Cause approach to recovering from adrenal fatigue

What Are the Adrenals?

The adrenals are two small glands, located on top of each kidney, that release hormones such as cortisol and adrenaline. These “stress hormones” impact many important functions throughout the body. They help establish your stress tolerance, tame inflammation, regulate blood sugar and body fat, control potassium and sodium levels (impacting blood sugar), and influence sex drive and anti-aging… among other things.

You may have heard that the stress hormone cortisol is “bad.” This is misleading — while high levels of cortisol are problematic, what could be equally or more problematic is having low levels of cortisol, especially when it comes to having an autoimmune disease and fatigue.

Cortisol is a hormone that is required for life — we could not live without it, and it is an important anti-inflammatory hormone. In fact, it gets released whenever we have inflammation, to cool things down.

I have found that the majority of people with Hashimoto’s have low levels of cortisol.

What Causes Adrenal Fatigue?

In most cases of adrenal fatigue, the problems generally originate in a communication breakdown that occurs within the hypothalamic-pituitary-adrenal axis, otherwise known as the HPA axis. The HPA axis describes the interactive feedback loop that takes place between these three endocrine glands.

The hypothalamus is like the CEO of our body’s production of hormones. It scans messages from our environment and other endocrine glands, as well as checks the body’s overall hormonal status, before passing on the order for more hormones to the pituitary gland. The pituitary gland then acts as a project manager and will pull together individual workers (like the thyroid gland, the adrenal gland, and the gonads) to do their jobs. The pituitary will also make sure the workers have adequate resources to do their jobs by managing growth (and repair), and electrolyte/water balance.

The HPA axis works in response to two types of stress: immediate stress and chronic stress. Let’s see how the responses to each type differ.

In cases of immediate stress, the hypothalamus senses stress and sets off a hormone cascade that leads to the activation of our fight or flight response. As part of this response, the adrenals pump out extra hormones and our bodies go from the state of relaxing, digesting and healing, to a survival state.

Our body’s energy is shifted from activities not essential to survival, like growing beautiful hair, metabolizing nutrients into energy, making hormones, and digesting and repairing itself, to instead focusing its resources to meet the great, stress-induced demand for cortisol and adrenaline.

Then, once we’ve escaped from the threatening bear or gotten out of the way of the oncoming car, the demand for emergency levels of hormones settles down, and the focus once again turns to parasympathetic response, focused on body maintenance and upkeep.

In cases of chronic stress, the never-ending presence of stressful, yet non-life-threatening situations, can lead to the constant activation of the stress response.

To help meet the demand for cortisol, your body will decrease the production of other hormones normally produced by the adrenals such as progesterone, DHEA, and testosterone.

Eventually, with enough chronic stress, the HPA axis becomes overwhelmed and desensitized to the usual feedback loop, and stops sending messages to the adrenals to produce more hormones or less hormones, no matter what’s happening. Additionally, a person may run out of nutrients that are required for proper adrenal function.

One of the most common causes of adrenal fatigue is stress, which creates an intense demand for stress hormones such as cortisol and adrenaline. There are four main types of stress to consider:

  1. Sleep disorders
  2. Mental/emotional stress
  3. Metabolic/glycemic dysregulation
  4. Chronic inflammation
  • Sleep Disorders: One of the fastest ways to induce adrenal dysfunction is through sleep deprivation. In fact, sleep deprivation is used in lab animals to suppress the hypothalamic-pituitary and adrenal axis (HPA) axis. Sleep deprivation can be caused by insomnia, sleep apnea and shift work.
  • Mental Stress: Feelings such as grief, guilt, fear, anxiety, excitement, and embarrassment can be classified as stress. This stress is based on our perception, not on the nature of the individual stress. For example, public speaking may cause plenty of mental stress for someone with social anxiety, but another person who enjoys speaking in front of others may perceive the experience as pleasurable. Situations that are new, unpredictable, and threaten the ego, or that involve feeling a loss of control, are perceived as stressful.
  • Glycemic Dysregulation: Researchers in Poland have found that up to 50 percent of patients with Hashimoto’s have an impaired tolerance to carbohydrates. This means that after consuming carbohydrate-rich foods, their blood sugar levels would spike up very high, causing a great amount of insulin release. The role of insulin is to clear blood sugar out of our cells, so a large insulin release is followed by a rapid drop of blood sugar (hypoglycemia). Symptoms of hypoglycemia are very unpleasant and may include irritability, fainting, lightheadedness, or tremors. Hypoglycemia necessitates the release of cortisol to help maintain the glucose supply to the brain and counteracts insulin, causing insulin resistance. (This is also linked to the type 2 diabetes epidemic).
  • Inflammation: Chronic inflammation may occur from joint pain, obesity, toxic burden, inflammation in the GI tract from irritable bowel disorders, pathogens, or food sensitivities. These conditions will signal cortisol for its anti-inflammatory effect.

Common Symptoms of Adrenal Dysfunction

Many of those with Hashimoto’s initially report feeling more energetic after starting thyroid hormones, but this is usually followed by feeling worse and worse until they are right back to where they were before they started the thyroid medications. At this point, they will likely go back to their physicians to check blood work and will be told that everything is normal.

They begin to feel crazy… but that’s when another layer of what is broken in Hashimoto’s becomes unraveled. Many symptoms of hypothyroidism overlap with symptoms of underactive adrenals. However, physicians don’t routinely check adrenal function in those with Hashimoto’s.

Symptoms of poor adrenal function may include the following:

  • Feeling overwhelmed
  • Feeling tired despite adequate sleep
  • Trouble falling asleep or staying asleep
  • Difficulty getting up in the morning
  • Dependency on caffeine
  • Cravings for salty foods (a.k.a. the “I just ate a whole bag of chips syndrome”)
  • Cravings for sweet foods
  • Increased effort required for everyday activities
  • Intolerance to exercise
  • Low blood pressure
  • Feeling faint/dizzy when getting up quickly
  • Easily startled
  • Mental fog or trouble concentrating
  • Alternating diarrhea/constipation
  • Low blood sugar
  • Decreased sex drive
  • Decreased ability to handle stress
  • Longer healing time
  • Mild depression
  • Less enjoyment in life
  • Feeling worse after skipping meals
  • Increased PMS
  • Reduced ability to make decisions
  • Reduced productivity
  • Poor memory

… do any of these sound familiar?

Testing for Adrenal Issues

In addition to looking at your symptoms (above), you can determine if you have adrenal dysfunction by utilizing the assessments below.

The Irritability Test

Irritability and overwhelm are two cardinal signs of adrenal dysfunction. My best test for determining adrenal issues is being snappy or short-tempered, feeling overwhelmed, or finding other people annoying. For example, I can always tell that my adrenals are overwhelmed when my mom calls to say hello, and I feel like this is too much of a demand!

Blood Pressure Test

People with adrenal fatigue often have low blood pressure and/or a drop in blood pressure after standing up from a lying down or sitting position (orthostatic hypotension). If your blood pressure is below 120/80 mmHg, this may mean that your adrenals are underactive, or that you are dehydrated. Symptoms may include dizziness or lightheadedness when standing up from a sitting/lying down position.

Pupil Contraction

People with low adrenal function may often have difficulty with contracting their pupils. Usually our pupils dilate (enlarge) in the dark, and contract (get smaller) in the light. Symptoms of adrenal dysfunction may include light sensitivity, difficulty seeing in bright lights, having to wear sunglasses on most days, or as I like to call it, feeling like a vampire in daylight!

Unstable Temperatures

If you are keeping track of your first morning temperatures, low and unstable morning temperatures may be suggestive of adrenal insufficiency. In contrast, pure hypothyroidism usually results in temperatures that are low, but rather stable, on a daily basis.

The Whole Bag of Chips Test

Have you ever eaten (or wanted to eat) an entire bag of chips in one sitting? You’re not alone! Salt cravings are a cardinal sign of adrenal issues. With adrenal issues, we may find ourselves with intense cravings for salty foods like crackers, chips, pretzels, and olives.

Hormone Testing

Adrenal saliva tests provide a way to test our current adrenal function. These tests are generally only available from functional medicine and integrative health care professionals.

Normally functioning adrenals are supposed to put out the most cortisol in the morning, and the levels of cortisol should decline during the day until very little cortisol is secreted at bedtime. A cortisol kick in the morning helps us to get out of bed bright eyed and bushy tailed, ready to face the day. Low cortisol secretion at bedtime helps us relax and sleep.

Some people with adrenal dysfunction have the opposite pattern — they can’t get up in the morning and drag their feet until the early afternoon, feel slightly human for a few hours between 2pm and 8pm, then get a second wind at bedtime. These people often have a flipped cortisol rhythm, where their adrenals put out very little cortisol in the morning and too much in the evening, causing them to be alert and sleepy at the wrong times.

Other people may have abnormally low cortisol readings all day, everyday. These poor souls wake up tired and the fatigue lasts all day — I have been there, and it’s not fun. This low cortisol causes inflammation to go unchecked in the body, prevents healing, and causes the person to be sluggish for most of the day.

If you’re going to go down the road of adrenal saliva testing, I recommend the Adrenal Stress Profile test by ZRT.

The Conventional Approach to Adrenal Fatigue

The adrenals are a source of disagreement between conventional medical doctors and natural practitioners. Conventional medical doctors only recognize Addison’s disease as an adrenal insufficiency disorder, but do not recognize “adrenal fatigue” as a medical diagnosis.

When my integrative doctor first suggested that I get tested for adrenal fatigue, I “Googled” the term and found a “reputable source” that adrenal fatigue was a made up disorder and did not exist.

Being a skeptical pharmacist, I put-off testing my adrenals — I had just ventured into the world of alternative medicine, and was always afraid of people trying to take advantage of me and take my money, not realizing that they were simply trying to help.

But then I got to a point where I was just so exhausted and irritable, despite taking thyroid medications and following a gluten free diet.

I started talking to Carter Black, RPh, my compounding pharmacist, about the symptoms I was experiencing, and he suggested that I have my adrenals tested. Mr. Black had specialized in hormones for many years and told me that the interventions for adrenal fatigue did indeed work well for many of his patients.

Finally it stuck: maybe it was hearing it from a fellow pharmacist, or maybe because he didn’t have any adrenal test kits to sell to me that I decided to try it out.

Sure enough, I had an advanced stage of adrenal fatigue, and the recommended treatments for the adrenal fatigue helped me feel tremendously better!

I now recommend the adrenal saliva test to all of my clients with Hashimoto’s, and have found that 90 percent of my clients (who do the test) have some degree of adrenal fatigue. So trust me, adrenal fatigue does exist!

The Root Cause Approach to Recovering From Adrenal Fatigue

There are six main pillars of my Adrenal Recovery Protocol:

  • Rest
  • Balance blood sugar
  • De-Stress
  • Reduce inflammation
  • Replenish nutrients
  • Build resilience with supplements

1. Rest

Sleep is the reset button for the adrenals. The fastest way to get into adrenal fatigue is through sleep deprivation. The fastest way to get out, is to get plenty of sleep. When we sleep, our body releases human growth hormone and repairs itself. Make sure to get at least seven hours of sleep each night, and go to sleep before 10 pm. If you can pull it off, I actually recommend getting 10-12 hours of sleep per night for one month in my adrenal-focused recovery protocols.

However, in the real world, I know not all of us are able to achieve a good night’s sleep every night, let alone sleep for 10-12 hours. Whether our kids are waking us up every two hours, or we’re working abnormal hours, getting eight hours of restful sleep every night can seem out of reach for many of us. In such cases, I recommend aiming for those 10 to 12 hours in a combination of sleep and relaxation (such as taking a warm Epsom salt bath), and trying to get as much sleep as you possibly can.

Be sure to read my article on the Sleep Apnea and Hashimoto’s connection if you have unrefreshed sleep, snoring, and/or a scalloped tongue.

2. Balance Blood Sugar

Stabilizing your blood sugar through diet is a crucial step in overcoming adrenal fatigue and thyroid conditions. Balancing your blood sugar can create noticeable improvements in how you feel each day.

Aim first and foremost to eat more fats and proteins and less sugary and starchy carbs. When consuming carbohydrate-rich foods, your blood sugar goes up too high, too quickly, causing symptoms such as nervousness, lightheadedness, anxiety, and fatigue. These swings in blood sugar can weaken your adrenals and cause a spike in your thyroid antibodies.

Check out my article on stabilizing your blood sugar with diet for more information.

3. Reduce Stress

The most important strategy for combating adrenal fatigue does not involve dieting, supplements, medications, or testing. This strategy, however, is often the hardest to implement.

That strategy is… stress reduction.

Reducing my stress was probably the hardest lifestyle change for me to implement. I only had two settings, “GO” and “SLEEP.” I did not know how to relax, smell the roses, turn-off, or unwind.

So, I came up with this list of strategies to make myself more relaxed and shift my body into a state of relaxing, digesting, and healing. I hope some of my strategies will resonate with you, but many of you will want to come up with your own list. Many of these items may be really difficult to implement, especially for those of us with responsibilities like jobs, children, or elderly relatives who need our care. However, somehow, you HAVE to schedule time for yourself.

We often expect our doctors to heal us, but the healing comes from within just the same. No one else will do it for you. Put it in your planner if you must.

Strategies to reduce stress:

Do your best to eliminate, simplify, delegate, automate.  Having fewer commitments on our plate, especially in the evenings, can allow for us to go to bed at a deliciously early time… and not feel guilty about it. If you are feeling overwhelmed, reflect on areas in your life that you can work on. For example, are you being bombarded by extra responsibilities around the house? If so, speak up and see if you can delegate some of your tasks to others.

Shift your mindset. Thinking positive thoughts and practicing meditation can shift your body into “rest, digest, and heal” mode. In essence, positive thoughts and relaxation can send your body messages to promote healing. Even pausing to practice yogic breathing can lead to increased feelings of calm.

One of my favorite yogic-breathing techniques is the 4-7-8 exercise, where you breathe in for a count of 4, hold your breath for a count of 7, and then breathe out for a count of 8.

Positive thoughts can also come in the form of affirmations, which you can repeat throughout the day. Some of the affirmations I’ve found most helpful are:

  • “I love myself.”
  • “I am powerful.”
  • “I am healing.”
  • “I am loved.”
  • “The world is a safe and beautiful place.”
  • “I am beautiful.”

I also recommend practicing mindfulness as a way of diminishing stress. This means pausing and truly being present in the moment; taking time to notice all of the beauty, kindness, and good things that are present in the world. And if at first you don’t see it, try looking a bit harder — you might just be surprised as you suddenly become aware of the beauty in the trees or the kindness of strangers. 🙂

Be mindful of what you’re listening to. In the modern world, we are constantly bombarded with toxicity… and I don’t just mean from pesticides and pollution. News channels are meant to set off our fight or flight response, releasing adrenaline to keep us glued to the TV, waiting for the latest updates, social media algorithms are set up to keep us scrolling, talk radio features controversy… you get the idea. We need to stay somewhat connected, so we can be informed. However, I recommend tuning out the negative news, shows, social media, etc. that trigger you, and focusing only on the information you need.

I also suggest incorporating more healing sounds instead. Choose to listen to healing music on a daily basis, whether that’s classical, instrumental, gospel, whatever you prefer.

Here are a few of my favorites. (I like listening to music on YouTube, Pandora or Spotify!):

  • Medicine for the People
  • Enya
  • Lullabies (They work for babies, as well as for adults! :-))
  • “Flow state” music

I also recently rediscovered a form of healing music called Wholetones. This healing music uses specific frequencies to help facilitate restorative sleep and create a sense of peace. My baby boy, Dimitry, used to get very stressed out in the car, often crying in his car seat. While playing lullabies helped a bit, Dimitry immediately stopped fussing and started sleeping with the Wholetones music! I don’t know if this is a coincidence, but I’ve kept that CD in my car player ever since!

Orderliness and predictability are your friends. Plan your life that way when you can. Get organized, and keep your space neat and clean. Schedule times to clean the house and catch up on life. Make sure you schedule down time as well.

Laughter Rx. Laughter is known to boost oxytocin levels. Reach out to your partner or call a friend, and do some positive bonding — but only if doing so gives you energy. Are you an extrovert or an introvert? Does socializing give you energy, or take away your energy? In some cases, the answer depends on the person and the situation. If you are energized by socializing, know that bonding with dear friends and sharing laughter, can boost oxytocin and help counter the negative effects of our stress hormone, cortisol! Even if you’re an introvert, there are other ways to laugh, like watching a funny movie, show or stand-up comedy, or reading or listening to a funny book. Just be sure to do whatever makes you laugh!

Start a journal. Make a list of what makes you feel better and what makes you feel worse, and be mindful of those things. Focus on doing more of the things that make you feel good, big or small (i.e. having a warm cup of your favorite tea), and less of the things that make you feel worse. You can also use your journal to start a daily gratitude exercise. Often in times of increased stress, especially when we’re not feeling well, or feel like we do not have control, it can be difficult to remember the good things in our lives. Starting each morning by writing down three things you are grateful for, may help to shift your entire day!

I also created this handy graphic which includes a recap of the strategies above, so you can share, print, or save it, and refer to it whenever you need a reminder!

Strategies to Reduce Stress

4. Reduce Inflammation

Food sensitivities are a common source of inflammation. Gluten, dairy and soy are the most common reactive foods in Hashimoto’s, and eliminating them will eliminate inflammation in your body. Elimination diets and food sensitivity testing may help you determine additional foods that may need to be removed from your diet. I have an article on food sensitivities you can read for more information.

Chronic infections are also a common source of inflammation in the body. Common infections include H. pylori, Blastocystis hominis and Candida, but there are numerous potential infections that can be root causes as well.

5. Replenish Nutrients

The salt cravings and feelings of dehydration that occur with adrenal fatigue are our body’s way of letting us know that we need more salt. Rather than reaching for processed foods or thyroid toxic iodized salt, including a good-quality sea salt in your diet may help if you feel a bit dizzy getting up in the morning or after a hot bath, or have other symptoms of adrenal fatigue. I like to recommend buying a pink or grey sea salt and making yourself a salty drink each morning, such as sole, and sipping it throughout the day. Homemade bone broths with plenty of sea salt are also a great and tasty way to rehydrate.

6. Build Resilience with Supplements

While supplements often need to be individualized for people depending on their level of adrenal dysfunction (which needs to be determined via testing), I have found that most people with Hashimoto’s feel better when they utilize the ABC’s of adrenal supplements.

The ABC’s are: Adrenal Adaptogens, B Vitamins, and Vitamin C.

Adaptogenic herbs are any natural herb products that supplement the body’s ability to deal with stressors. In order to be considered an adaptogen, an herb must possess several qualities. First, the herb must be non toxic to the patient at normal doses. Secondly, the herb should help the entire body to cope with stress. Finally, the herb should help the body to return to “normal” regardless of how stress is currently affecting the person’s functioning. In other words, an adaptogenic herb needs to be able to both tone down overactive systems and boost underactive systems in the body. Adaptogens are thought to normalize the hypothalamic-pituitary-adrenal (HPA) axis.

Adaptogenic herbs include: Ashwagandha, astragalus, reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schizandra, spikenard, and suma. These are examples of herbs that may increase the body’s ability to resist stress, and have been helpful in relieving adrenal dysfunction when used in combination with vitamins and minerals.

I personally love using adaptogens. I always joke that adaptogens make other people in my life much easier to tolerate. 🙂 I have taken adrenal adaptogens on and off since 2012. I like to use more of them around holidays and periods of stress, and they really help me stay balanced. I did stop them during pregnancy, and getting back on them is one of the things I looked forward to the most, with the exception of my little one’s arrival of course. 🙂

Vitamin C and B Vitamins become depleted during high cortisol production.

Pantothenic acid and Biotin (vitamins in the “B” family) deficiency in particular have been linked to decreased adrenal function in animals and humans.

Vitamin C is an important antioxidant that helps support the adrenals, mitochondria, collagen production, and the eradication of Epstein-barr viral infections, along with many other potential viruses.

While some may wish to obtain these supplements from natural whole food sources, due to gut issues, people with Hashimoto’s usually have an impaired ability to extract vitamins and minerals from food.

Rootcology Adrenal Support

Rootcology Adrenal Support Supplement

I created the supplement Rootcology Adrenal Support to use a combination of the ABC’s I recommend for balancing adrenals: Adaptogens, B Vitamins and Vitamin C.

I included Ashwagandha in the blend, as ashwagandha has research-supported benefits for thyroid health. Please note, ashwagandha is a nightshade, so if you have nightshade sensitivity, you may be sensitive to ashwagandha. (However, some people may only be sensitive to certain nightshades and may tolerate it).

I also added licorice to this blend. Licorice was one of the herbs that helped me the most in overcoming fatigue. Licorice root extract prevents the breakdown of cortisol into inactive cortisone. Thus, it keeps our cortisol around longer, giving us more energy. It may be helpful for those with low cortisol and low blood pressure. Please note, it should not be used by those with water retention or high blood pressure.

I generally recommend using the ABC’s long-term, as life is inevitably full of stress. For added convenience, you can subscribe to get Adrenal Support delivered straight to your door on a monthly or bimonthly basis. As a bonus, the Subscribe & Save option will give you a 10% off discount!

If you are unable to get the Rootcology brand of supplements in your country, or have high blood pressure, the following formula is comparable to the Rootcology Adrenal Support, but contains different ingredients. 

Alternative ABC Blend


Daily Stress Formula– This blend of adaptogenic herbs, vitamins, minerals, and amino acids is designed to support the adrenals and provide a powerful defense from the mental and physical factors associated with occasional stress. The formula synergistically supports mental relaxation while counteracting the metabolic effects of occasional stress as well.

Additional Supportive Nutrients

In some cases, you may benefit from additional B vitamins and vitamin C, as well as magnesium, to support your adrenals.

B Complex Plus– B vitamins play an important role in cell metabolism, thyroid function, and adrenal function. They become depleted in stressful situations that often precede the development of autoimmunity. Four especially important B vitamins are pantothenic acid (B5), thiamine or benfotiamine (B1), biotin (B7), and cobalamin (B12). This exceptional combination of B vitamins, including Vitamins B1, B2, B3, B5, B6, B12, biotin, and folate (as Metafolin L-5-MTHF) should be helpful for most people with low energy levels. B vitamins are water-soluble vitamins and do not build up in the body, so the risk for toxicity is almost nonexistent.

BenfoMax– Thiamine is one of the B vitamins, known as B1. It supports blood sugar function, the adrenals, and can boost our energy levels. It also has the important roles of converting carbohydrates into energy and aiding with the digestion of proteins and fats. Thiamine is required for proper release of hydrochloric acid in our stomachs, which is needed for proper protein digestion. (Most people with Hashimoto’s have little or no stomach acid.) The latest research suggests that a mild deficiency may exist in people with autoimmune disease and related malabsorption issues. If you’ve been struggling with fatigue, low stomach acid, carbohydrate intolerance, low blood pressure, and your adrenals, you may benefit from up to 600 mg of Thiamine a day.

Rootcology Electrolyte Blend SupplementVitamin C– Vitamin C is essential for supporting adrenal function. I recommend doses of 500 mg to 3,000 mg per day, as tolerated. My favorite way to get vitamin C is through Rootcology’s Electrolyte Blend, as it’s important for adrenal function to stay hydrated and keep our electrolytes in balance. (This also helps to strengthen the body’s immune response.)
Rootcology_Magnesium_Citrate

Magnesium Citrate– As magnesium is depleted by stress and is often difficult to obtain from foods, most people will benefit from long-term supplementation. It is also excellent for promoting relaxation.

Advanced Strategies

While many cases of adrenal dysfunction are caused by current stress and removing or modifying how we respond to those stressors can help with overcoming adrenal dysfunction, in some cases, additional interventions may be needed to address past traumatic stress, as well as chronically altered release of adrenal hormones.

Traumatic Stress

Traumatic stress may lead to a chronic pattern of adrenal hormone dysfunction. Various types of traumas and abuse have been tied to autoimmune conditions and thyroid hormone abnormalities. Many of my clients have experienced significant traumas such as the loss of a loved one and/or being in an abusive relationship before the onset of Hashimoto’s. Some of us have also experienced childhood trauma, which can set the tone for altered hormone patterns in adulthood.

Resolving traumatic stress usually requires a targeted therapy (I prefer neurofeedback and EMDR), and is a bit beyond the scope of this article, so until I have a chance to write an article on this topic, I have dedicated an entire chapter to it in my book, Hashimoto’s Protocol to this subject.

Supplemental Hormones

A variety of hormones and adrenal-supporting substances may be used based on your lab test results and adrenal insufficiency stage.

Although most of these hormones are available over the counter at health food stores, they are certainly not benign and should be used under the supervision of a trained professional with extreme caution. Not everyone will need all of these supplements.

Your practitioner may utilize pregnenolone, DHEA, 7-Keto, adrenal glandulars and in some cases, the medication hydrocortisone to rebalance your adrenals.

The Takeaway

The adrenals are two small glands that release very important “stress hormones,” which impact many functions throughout the body, including stress tolerance, inflammation, blood sugar, and body fat. When the body is under constant stress, the adrenal glands eventually become overwhelmed and desensitized, resulting in adrenal dysfunction.

Supporting the adrenals is one of the first things I recommend for all of my clients, as adrenal dysfunction is almost always a factor in Hashimoto’s. It can result in many of the symptoms we often perceive to be a result of our thyroid condition, like fatigue, feeling overwhelmed, trouble concentrating, and a decreased ability to handle stress.

By taking a root cause approach, including getting more rest, balancing blood sugar, reducing stress and inflammation, replenishing nutrients, and building resilience with supplements (like the ABC’s in Rootcology’s Adrenal Support), we can help to reduce the impact of stress on the adrenals… and reduce or eliminate many of those symptoms!

Looking for more info about the adrenal glands? I cover adrenal protocols in my book Hashimoto’s Protocol.

I wish you the best of luck on your healing journey!

P.S. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter of my Root Cause book for free by signing up for my weekly newsletter. You will also receive occasional updates about new research, resources, giveaways, and helpful information.

References

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  7. Wang X, Ping F, Qi C, Xiao X. Delayed diagnosis with autoimmune polyglandular syndrome type 2 causing acute adrenal crisis. Medicine (Baltimore). 2016; 95(42):e5062. doi:10.1097/md.0000000000005062.
  8. Blahd W. Adrenal Fatigue: Is It Real?. WebMD Reference. https://www.webmd.com/a-to-z-guides/adrenal-fatigue-is-it-real#1. Published January 23, 2017. Accessed February 25, 2018.
  9. Endocrine Society. The Myth of Adrenal Fatigue. Hormone Health Network. https://www.hormone.org/hormones-and-health/myth-vs-fact/adrenal-fatigue. Accessed February 25, 2018.
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Note: Originally published in September 2013, this article has been revised and updated for accuracy and thoroughness.

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      • Stella – thank you for following this page. I‘ve found that an inability to manage stress is often at the core of the condition. Most people can trace back the development of Hashimoto’s and autoimmune conditions to a particularly stressful time period. Stress is inherent, and it’s how we handle our stress that matters. I recommend self-management stress-reducing habits like mindfulness, yoga, and meditation. Meditation has specifically been found to be helpful in building resilience to stress. If you have a history of childhood trauma like I do, your stress response could be severely impacted, leading you to overreact and get into a ‘fight or flight’ state at the easiest provocations. I recommend therapies like the self-guided tapping, self-help books, neurofeedback or therapist guided EMDR to reset your stress response. https://thyroidpharmacist.com/articles/are-your-adrenals-sabotaging-your-health/

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    • There are several HPA stress profile tests to choose from when you click on the link you provided. Which one do you recommend?

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  3. I believe you. I am crying too. My doctor sent me to an Endo who has ignored my adrenal FAILURE for a year. Even after me being so ” in her face about it”….she told me she had it under control. Im sick now. Pursue and dont give up. Fight for yourself and keep moving to the next doctor till they have it right! Bless you!
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  4. Hollie,
    Thank you for sharing your story, and I hope that you have found a doctor that will listen, and I am glad that you are taking charge of your own health. Keep me posted on your progress
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  5. I have been ignored for 40+ years and even if I had loads of money, I still wouldn’t be able to reverse my autoimmunity and reach optimum health. But just listening to Dr Wentz and hearing her optimistic voice has cheered me up somewhat. Here in UK I can not find a doctor that would REALLY listen!
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  6. I feel the same way. My blood pressure goes up and down and it’s my opinion that my adrenal glands are stressed and that’s why the higher blood pressure! I can’t get any doctor to listen to me not even my endo. Other than that he’s been great for me. The doctors just want to give me blood pressure meds and it was so high that I tried everything they gave me and it jacked my blood pressure up so high. What they didn’t tell me was blood,pressure meds contain sulfur and I’m allergic. Great!!
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  7. My Endo said they they don’t deal with Adrenals because they don’t know what to do about it. At least she was honest 🙂
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  8. You’re not alone! I recently started seeing an acupuncturist. They have their own way of testing for issues. Holistic/ natural belief is that thyroid problems are not a disease but a symptom brought on by adrenal problems. If you can afford it, I highly recommend you see an acupuncturist. I started seeing mine just last week and I can’t begin to tell you how much better I’m feeling! It’s like Dr. Wentz said in a previous post, don’t let another human being tell you what is and isn’t wrong with your body. If you know something is wrong, something’s wrong. There are people out there who are willing to listen and help you, but they may not be the people you’re used to seeing. I’ve always found “alternative” medicine to be far more compassionate and understanding. And as far as “alternative,” acupuncture has been practiced for 5,000 years. There’s a reason people keep using it! Good luck!
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  9. Michaela,
    Thank you for writing, and I wholeheartedly agree with you. I am so glad that you have found a compassionate and caring acupuncturist. I had a wonderful experience with mine as well. Hope that this site has been helpful in your journey 🙂
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  10. Lisa,
    Find a doctor that will listen. Work on balancing your blood sugar, get plenty of rest. Check out my book for a whole chapter on how this works and what you can do about it. It does get better, I promise!
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  12. I feel like crying.. Happy to know that this is true and not in my head… My husband who researches everything, walks out of the room when I try to talk about.. Even read bits of this article.. This is so hurtful.. And he has turned our college daughters into not believing me. Even though I always lied and stood up for him to everyone that he’s just so busy, he doesn’t have much time for us…
    Yes… We all lived together… I have found out how he has used these last 2 crazy years to turn everyone against me. Would not touch me for over a year because of the weight gain. My normal weight 118 for 30 years.. Lost all but 20 lbs, now he’s interested… Now I want something more in every sence of the word!!! We have been married 24 years, 6 years together before.. I have never been more hurt and have no idea what was ever real?
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  13. I know how you feel. My family jut treats me like the boy who cried wolf, because my story has been going on or years. And now after menopause juggling different hormones! Sometimes I feel paralyzed with too much going on. It’s complicated, what ever you do keep taking your thyroid medication daily on an empty belly with lots of water! Eat clean. Find an alternative doctor. I understand, you’ll be ok!
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  14. Renee, Feel so sorry for you that your husband is being a “jerk” about your being sick. Bad enough not having a Dr. that will listen. Mine will not do much either. Congratulations on loosing your weight . I need to do that, but no matter what I try, nothing works. Did you have a special diet you used? Might let your daughters know I understand this is heditary, so they may, suffer someday.. get better soon.
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  15. Me too! I’ve had so many health problems, including breast cancer, that no one believes nor wants to hear me talk about nearly every single thing you just listed.
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  16. It’s sad when people we care about don’t believe us or those in the medical profession who won’t listen to us. I believe you! Hang in there.
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  17. Me, too. doctoredr says I’m starting menopause and need to work out. I’m too tired to work out and the salt cravings are ridiculous!
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  18. What do you think of the ondamed for treating thyroid and adrenals. Also, do you believe that your endocrine system will shut down due to heavy metals in your body?
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  19. Sandy, unfortunately I am not familiar with Ondamed, so I would not be able to advise you on its effectiveness and use. I do have helpful lifestyle and functional medicine strategies that I have explored in detail in my book if you are looking for effective ways to help both organs. Heavy metals can wreak havoc on our detox and hormonal pathways for sure and can trigger chronic disease, usually, however, it seems to start with the stress/adrenals. Hope that helps and keep me posted on your progress
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  20. How do you get rid of heavy metals in your body??? I’ve had foot detoxes and scalp analysis and both say Heavy metals-my foot bath had little metal shavings-I’m on 100 levothyroxine-still have all the symptoms you just said with adrenal fatigue!!!!
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  21. Thank you. I have fibro and had my thyroid removed almost 30 years ago when I had cancer. I’m tired all the time, low energy, frazzled more easily recently. 65 years old, but still want to be active.
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  22. Ann,
    Thank you for writing. I can appreciate the effect the thyroid can have on the whole body. Many patients are unfortunately under-dosed on thyroid meds, so I would start there…please take a look at the archives on this blog for helpful strategies as well as my book.
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  23. That describes how I feel to a tee. I don’t know how to relax. It is awful to feel that way. My body and mind seems to jump from one task to the next at school and home. I am a teacher and the profession does not lend itself to relaxation.
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  24. Hi Michelle,
    Thanks for writing, many of us with autoimmune conditions tend to be that way. This characteristic unfortunately contributes to the vicious cycle. I had to make myself a list and learn how to relax. I still have to remind myself now. Not to get all philosophical on you, but it did help me to do some soul searching and asking myself why I always needed to be so busy and active. I am more scientific then spiritual, but read a book called the “Healing Code” and thought it had some good points about the effect of stress and how to reprogram yourself. Hope that helps and I wish you all the best in your journey. Keep me posted 🙂
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  25. @LIsa I completely know how you feel. I cried as well, because no matter how many times you try to tell people, your Dr., your family how you feel, nobody truly understands what you are going through. I can.
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  26. Hi Rhonda,
    Unfortunately we need to take charge of our own health, my hope is that this site and my book will give you the tools and inspiration to do so.
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  27. Can someone please tell me if powdered broccoli sprouts are high in iodine? I’m trying to lower my iodine intake to get my antibodies down. Also, are broccoli sprouts considered raw cruciferous?
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  31. Hello I’m new to this journey into endocrinology as I have only been diagnosed a few weeks with underactive thyroid. As I already have B12 anaemia my symptoms were put down to this until I caused a fuss. I do hope I dont have an uphill battle should this medication not be the wonderous answer to my prayers that the gp seems to think. It seems as if you all have the same fight to be taken seriously. Keep up the great stories & advice, knowledge is power so they say. Best wishes
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  33. I have wake up nightly with nocturnal tachacharydia sometimes 3 times a night. I have heard hashi’s can cause this is this true. I am on anxiety meds and levothyroxine. Thank you for you input. I am going to have food allergy testing soon. I have had these symptoms forever. I appreciate your feedback and am very interested in your book.
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  37. I intend to get your book and read it. I have recently been diagnosed with hypothyroid. I do not know if it is Hashimotos or not. I have an appointment with a endocrinologist in December but recently found a doctor that prescribed Armour because my brief stint with Synthoid was painful. I was under a lot of stress this summer with a new job, husband diagnosed with cancer and kids coming home from summer. I think adrenal issues have played a part in my current thyroid problems. I am interested in taking the vitamin and wondered does the Daily Stress Formula take the place of a multivitamin or is it in addition to?
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  38. Hope the book will help you 🙂 The Daily Stress Formula would be in addition to a multi-vitamin. It contains extra B vitamins that are often deficient in adrenal fatigue as well as adaptogens.
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  39. I have been suffering for the past 15 years. Each thyroid specialist told me that my lab is within range and I should not feel tired, foggy, and depleted of energey. This all changed when I found a Functional Medicine physician in Austin TX 2 yeasrs ago. Dr. Lisa Harte is working with me and I am slowly returning to normal. My hair stopped falling out, I no longer feel exhausted at 3 pm every day, and my bones don’t hurt as much.
    Message to all, if your doc will not listen to you, find another one, and another until you find the right one to recognize your needs.
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  40. I fully agree Eliza- we all need doctors that will listen. Glad that you found your doctor and are feeling better 🙂
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  41. Just wanted to.let everyone know that age and stress plays a part in all of this… stress depletes hormones -sex and adrenal hormones…hormones also lower with age and for some reason cortisol rises as we lose our sex hormones… I have adrenal disorder, low DHEA and low testosterone as a result of 5 months of intense stress…I am 41 and testosterone drops in half by age 40 so there is no way my body will ever recover from this stress response… I am now using a bioidentical dhea hormone to support the adrenals and hopefully raise my DHEA and testosterone… ladies please make sure to test your SEX hormones along with adrenal hormones…because there are three legs to the hormonal axis -these r thyroid, adrenals and sex hormones -estrogens (estradiol, estrone, and estriol) testosterone and progesterone… our. Sex hormones play a vital role in our mental and Physical health… because low progesterone means low GABA -calming neurotransmitter in the brain… estrogen -low seratonin and GABA… testosterone -low dopamine.. etc… this is why we can develop anxiety, panic attacks, depression, etc…. saliva testing- ZRT female profile III …can be ordered on line from home… simple easy saliva test -results in 5-10 days… then find a functional medicine Dr in your area at functionalmedicine.org …these Drs are specially trained in getting to root cause by finding imbalances in the body… Hope this helps someone suffering to find all the missing links to their illness
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  43. Just wanted to share that I used ZRT for FOUR different adrenal tests and was still very symptomatic of adrenal insufficiency. I finally found a specialist in California and he said that in his over 3,000 patients he’s treated, ZRT labs are very in accurate. I retested through BioHealth labs and found out I was in Stage 3 adrenal fatigue!!!!…..and ZRT tests showed I was “normal”…..beware!!!!
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    • I just did an adrenal test with ZRT. It shows I have some issues, but I’m having a hard time reading all the results. I wish I would’ve seen your comment about them before I did this. I’ll give BioHealth a try. Thanks for posting.

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  44. I TRULY believe I am in adrenal fatigue and insufficiency. Now to just get my dr on board. I really want to try the ZRT lab testing for everything!!! Then I could take the results to my dr to show him. He does listen to me, just goes by the old “standards”, so I feel confident that If I can get he testing done, he will gladly fully participate in getting me on track. Thank you so much for the informative webinar. I’ve learned so much!!!!
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  45. Melissa, I would estimate that the majority of people with Hashimoto’s are in adrenal fatigue. I’m so glad that you found the webinar helpful. Hope you’ll start feeling better soon!
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  46. This sounds like me I’ve had an under active thyroid for twelve years now I’ve been diagnosed with hyper parathyroid but the symptoms are the same
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  48. And even your 21 things to try is overwhelming for me!! Brain fog! Exhausted reading what needs to be done to escape this nightmare.
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  49. Raine- sorry to hear that. Be kind to yourself and get some rest. Resting is the most important thing for the adrenals.
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  51. Cieta,
    Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target 🙁 We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system.
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  52. This is exactly what I need. Now I know why I still feel bad. My stress levels have been out if control for last five years from a bad marriage (he’s my toxic person) to loosing my brother and my best friend my cousin to our business failing. I crave sugar not salt and gained alot of weight and I’m struggling to stop eating it. My present doctor is good but she doesn’t check my adrenals and suggested antidepressants. I’m going to get your book and try to get her to listen and work on the stress. Thank you for the information.
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  53. Hi Izabella,
    This sounds exactly like me! Except I also have celiac’s disease. I recently went to Mayo Clinic because my adrenals are so enlarged, both of them. Mayo doesn’t believe in adrenal fatigue and put me on an estrogen patch and progesterone, horrible, and I was totally bloated! I quit both after 3 weeks. I then went to a naturopath MD in Chicago, and she gave me cortisol(all natural) that I took for 2 weeks along with nature thyroid. I couldn’t figure out why I felt so awful, turned the cortisol bottle over and it contained 3 different formas of wheat. I am just furious and sick, right now have a horrible sinus infection. I’ve had all blood tests and saliva tests, all came back abnormal. What do I do???
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  54. Adrenals has to be healed for thyroid meds to work. Or even not needing them at all. Blood sugar, diet and sleep helped the most. I also took cortex from Thorne for over a year and Cordyceps in the beginning for about 2 months. Plus AIP diet etc. And total life style change. Could not tolerate any thyroid meds before that without crashing. For autoimmune, Hashis, most should avoid night shades, so I would personally avoid the stress formula since it contains a night shade, Ashwaganda.
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  55. I have suffered since 2004 from Hashimoto’s. I was on prescr. drugs 1st and requested Armour from my new Endo. Feeling better on the Armour but still not the old me…just don’t feel right. I am going to order this book because I believe we have to do what is best for our health. I believe our body can do amazing healing if it is given the chance to do so. I went to a Chiro./nutritional several years ago but had to leave due to $. Worst thing I ever had to do, he was treating my Hashimoto’s with Adrenal supplement, changed my diet, etc….exactly like everyone is talking about here. I know I found the best place to be for me and I look forward to healing and feeling like my younger version of me….I miss her so deeply!
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  56. Dr. Wentz,
    It’s important to discuss AI thyroid conditions but what about us who have hypothyroidism but no antibodies? Would you still give the same recommendations? I’ve tried T4, combination of T3/T4 and now T3 but my body don’t seem to utilize it. My saliva results are fair but I think it’s some sort of inflammation but it’s so hard to figure it out. My holistic doctor doesn’t have a clue any more what to try next.
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  57. Hi Izabella , I got a virus in. 96 leaving me I’ll for years , I have all the above symtems have just found a functional medicine dr getting tests done , you say to keep blood sugar level mine is low , what foods are best for this carbs or protein and how often should I eat thanks for all the information and hope
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  58. I have Hashimotos and had a saliva test done and my cortisol levels were so high they were off the chart for the entire test. MD put me on quercetin, DHEA, glycemic control, homocysteine supplements. Trying a new compounded t4/t3 thyroid med. Up to 3 grains dosage. Am I going in the right direction?
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  59. hi there, I hit rock bottom with my adrenals sept of last year and was housebound for 13 weeks with searing headaches and a 35.4 temp! since taking lots of vits and now 2ml HC cream as well I can do more with my life but im still limited. should I try HC pills? I have an underactive thyroid I take t4 and t3 and all bloods are in range in fact free t3 is pretty much at the top of the range. body temp is stable now 36.9 but am still exhausted still get back to back viruses/candida, sinusitis tonsilittus all the time and low grade migraines all the time.
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  60. I was diagnosed with Hoshimoto and Hypothyroidism ( taking L-thyroxine 150mg), Sleep Apnea (on CPAP machine), Celiac disease, Chronic fatigue syndrome, Depression ( on EffexorXR 37.5 mg 3 x a day) Had stage two estrogen fueled Breast Cancer ( on Exemestane 25mg. Cancer free 11 years. I can really use some advise in where to start with my healing process. I feel in dint have a very good dr. Who listens. I discuss my constant tiredness only to be met with take vitamins. I know it is more than that. Do you recommen
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  61. Dear Izabella:
    Thanks so for sharing this important info. I don’t know what to say, but I have 3 excellent docs working with me and no one can get me to sleep at night- no one! I get these insane bouts with anxiety (not too sure where they come from), and I get wired and can’t sleep. Actually, most nights I can fall asleep, but I wake up, sometimes a lot, sometimes it’s once, but it’s deadly and I NEVER fall back to sleep. I know my adrenals are KICKED, because I’m like a zombie all day long, but I just can’t find the correct adoptagen. I have tried MANY, with doctor support. I have not tried the one you did, but I am always wiling to. I also wondered if low iodine would have anything to contribute to this issue as well! Please, any suggestions would be greatly appreciated. I am at my wits end!
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  62. So excited ans grateful to hear so many success stories and sharing of experiences. My journey has been so familiar to everyone I read! I fired my doctor after I quit gluten and dairy and told her how better I was. She wouldn’t hear of it. I’m still working on my adrenal support with naturopath and diet. I’m juicing a lot but need to be eating more protein which I’m starting now. Let’s keep sharing and owning our health and not listening to the naysayers. Do whatever it takes. The journey is emotional but the well being is so worth it. YIN yoga is so good for calming and meditation. I now teach Yin restorative and can share the gift with others. So glad I found Dr. I yahoo woot woot!
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  63. Your book mentions checking for virus that cause inflammation. My Epstein-Barr results were early antigen ab igg=12.6,nuclear antigen ab igg=181,virus capsid ab igg=269, all high and virus capsid ab igm=less than 10, negative.
    Could this be causing inflammation? My NP didn’t think so.
    I couldn’t find the article referenced in the book. The website stopped linking to articles written in that year. I have had thyroid and adrenal problems for 20 years.
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  64. Was very glad to have someone refer me to this sight.. Thirteen years ago I was finally diagnosed with Addison’s Disease. At the same time my doctor told me I had Hosimotos. I take steroids every day because my adrenal glads produce nothing. But, since being put on the steroids my thyroid has not flip flopped as I call it. No one understands any of this except someone who has gone through it.
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  65. I looked at the ingredients in that daily stress formula and I see it contains lemon balm. I thought that suppressed thyroid function? I have Hashimoto’s and struggle on and off with adrenal fatigue. Would the supplement help me or harm me? Thank you.
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  67. I was diagnosed with late stage Lyme disease, Hashimoto, and adrenal fatigue. It took years and many Dr ‘s to find the right one. I found a great Integrated Dr. She is amazing! Anyway the only way I could get my mind to stop racing and muscles to stop cramping was by taking GABA. I’m not sure how Dr. Wentz feels about but It has been a life saver.
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  69. I started Paleo six weeks ago and felt great then my doctor put me on supplements and I’m sick as a dog and I cannot stay asleep I just stopped all the supplements. I’m so tired and sick I get up at 1 o’clock or 2 o’clock in the morning and I have to get up the word to go to work. I tried everything I just want to die
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  70. I haven’t had my adrenals tested yet but I imagine they are depleted. I have Hashi’s and am hypo. So this is something that can heal? What can I do now to help them heal? I do yoga, I eat right,……hmmm , maybe just a matter of time. Just want to start NOW to build up my adrenal function. What is the best thing to do right NOW?
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  71. So many of us have this problem!!! What is really going on!!! Seems like an environmental thing!!!! What is CAUSING THIS???
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  72. I have Hashimoto’s with adrenal fatigue. Can I take Maca powder even though it is a night shade? I took 1/2 teaspoon last week and had a crazy side ache. Not sure what that meant.
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  73. This is so me with high cortisol all day.. I cannot continue living how I feel.. the shakiness is uncomfortable and I can’t be a mother like I used to be… my children don’t understand why their mom is no longer herself since they have disabilities 🙁
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  74. I was diagnosed with Graves’ Disease when I was 26, and it was treated with radioactive iodine. I’ve been living with all the symptoms you describe for adrenal fatigue. Does your book help those of us with Graves Disease?
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  75. Hi Dr. Wentz, I am now on a t4, t3 med (novothyral in Germany). Mental fog is much improved, BUT I have had a large amount of dizzy and black out spells during the day and want to figure out where this is coming from. Could it be adrenal fatigue? I went back to your book and am trying to figure out how to tackle this problem. Can you direct me a bit? My doctor does not know what the problem is….
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  76. Hey Dr. Wentz, I have Hashimoto’s and high cortisol. A long time ago I tried Thyroid Support from Gaia that contains L-Tyrosene and it made me feel overly anxious. If the Daily Stress Formula from Pure Encapsulations contains L-Tyrosene (250mg), is that a good idea? Are there any other adaptogen recommendations that don’t include it? Thanks so much!

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    • Ilya- Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

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      • My ft3 was at 2.51, my free t4 at 0.96, my tsh at 9.42. I have gotten the tsh down three points by just dropping gluten, sugar and caffeine. My question is, would I be a good candidate for your adrenal supplement? My concern is that Ashwagandha can up my t4, and don’t I want it to drop, and my t3 come up??
        Thanks

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        • Tiana – thank you for following this page. I wish I could give you more direct advice but, each person will react differently. I would advise you to ask your personal pharmacist or a trusted clinician who’s care you are under. I am not able to respond directly to these types of questions here. Adaptogenic herbs include ashwagandha, astragalus reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schizandra, spikenard, and suma. These are examples of herbs that may increase the body’s ability to resist stress, and have been helpful in relieving adrenal dysfunction when used in combination with vitamins and minerals. Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements, and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

          I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement, and the book will help uncover your root cause. This will help you figure out your supplementation.

          Hashimoto’s Root Cause
          http://www.amazon.com/gp/product/0615825796?ie=UTF8…

          Hashimoto’s Protocol
          https://thyroidpharmacist.com/protocol

          Reply

  77. Dear Dr. Thank you very much for your post. The last year my partner was diagnosed with Hashimoto and two months later a thyroid carcinoma, she was operated, extracted the whole thyroid and received radioactive iodine. Now, she are taking Euthirox 100 mg. She still hypothyroid and always has cold and very tired (but not sleep good!), also have tachycardia and irritable bowel. Recently we start the diet that you recommended and she feeling better. I would like to know if for she applies this information of adrenal fatigue? Although she hasn’t thyroid? I think her brain has not yet learned that her thyroid is not! Thank you very much!

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  78. I am very touched by all the emails. These interactive issues are complex but Dr Wentz has outlined step by step ideas to begin with.
    Personally I believe anyone with an autoimmune condition could just try some of the diet changes, you might get a big surprise. Feeling better is good who knows if a full remission is possible or not. Some people have had them!

    Get a notebook. I started with getting dairy and wheat out of my diet, getting more sleep and walking briefly in the morning or when I can.
    Try to get a routine and note how you feel. I take multivitamins with lots of B vitamins, fish oil, vitamin D and minerals. If I miss the multivitamin, I get teary and reactive.

    Record little pleasures- plant blooming in the garden, seeing a baby, be kind to yourself and model how you want to be treated. Say no and take time for yourself, let others take more responsibility.

    People, even our loved ones can’t listen to non stop complaining. If they don’t know what to do they may react by being unsupportive because they feel helpless. Ask for things which would help.
    I want to share dinner making- which night could you do?
    Lets go to …..something relaxing and fun. Lets watch…..

    Find people who understand, read these blogs. Ask for the tests you need at the Drs. I have found a helpful naturopath. She has given be alkylysed minerals to take and they helped to remove excess copper from my system. Filter your water. After 1 month I noticed a big improvement.
    I thought I was alright to eat some 100% rye bread but I’m not feeling good again. I get mucous in my throat if I have any dairy.
    The pieces to your puzzle come to you gradually. If you’ve observing and noting every day, you’ll work out the mystery with help!!

    I got a little off track again and overwhelmed but now I’m going to make a big list of all the things I am doing and new ones I’m trying when I can.
    I still need another thyroid test. I had one a year ago so that will make a good comparison.

    If you begin to take responsibility for your health and stick to it, family and friends will notice your resolve, you will probably feel better.

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  79. I have been tested and I do not have Hashimoto’s but I am having problems regulating my thyroid. I Am a flight attendant and travel overseas . My adrenals are blown and managing stress and sleep is a challenge. I have always had a healthy diet but it is difficult while traveling. Do you have any advice for me please .

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  80. The stress formula you recommend (by pure encapsulations) can be VERY dangerous
    to someone with Hashimoto’s. Lemon balm is a big no no especially when it comes to a balanced immune system.

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  81. Hello,
    I tried various combination adaptogenic herbs this year and they give me insomnia, causing me to wake up between 2-4am and unable to get back to sleep. This starts on day 2 of treatment and persists for months after discontinuation.
    I have low cortisol and am thinking of taking Dr James Wilson’s Adrenal Rebuilder (adrenal and other glandular extracts with the hormones removed). In his book, he recommends eating protein before bed to prevent waking up with adrenaline due hypoglycemia caused by low cortisol. I eat a handful of walnuts before bed and that does prevent the adrenaline surge but does not prevent me from waking up and having too many thoughts running through my head. At this point, it may just be anxiety from insomnia that is preventing me from getting back to sleep. I am sleeping later, like 4-5am instead of 2-3am. In the book he also recommended taking an adrenal cell extract with cortisol before bed to prevent waking up due to low cortisol, or even exercising before bed. I don’t have any cell extracts yet but I tried exercising and that did help a bit but I still had restless sleep. I tried licorice root tea and that helped a bit but I still couldn’t fall back asleep.
    I am doing your 90-day Hashi’s protocol and just started Adrenal Program but am hesitant to try the adaptogens due to previous ill experience with them. I have borderline low hypothyroid so went on NDT but RT3 went higher so went on T3-only med but it gave me brain fog, low energy and anxiety so I stopped taking it as well (I had just started them and was on really low doses for only a few months). My ferritin went from 90 to 40 while on NDT 1/2 gr daily x 1 mo then Cytomel 5mcg BID x 1 mo. Thyroid antibodies are negative.
    My AM serum cortisol has been in range of 6-9 in past year. I had SIBO and Candida for a few years and did a rigorous program to eradicate them, which I believe resulted in my adrenal fatigue (or just worsened it severely). My progesterone is low so I’ve been on oral Progesterone, started with 25mg daily on days 1-28 then increased to 40mg daily on days 1-28 after my last trial of adaptogens. I have also been increasing my melatonin dose from 1mg qhs to 5mg qhs.
    Thanks for writing your book. I lost a few pounds of water weight (toxins?) during the liver flush and am hopeful that the adrenal program, in addition to Dr Wilson’s supplements, will help tremendously. I probably won’t do the GI program since I did one last year with the SIBO/Candida program and I get anxiety from glutamine (even Mag Glycinate).
    Yours in healing,
    Sierra

    Reply

  82. Hi Izabella, I was diagnosed with hypothyroid three years ago, over that time my doctor would call me back in for lab work redo because my liver enzymes were elevated from time to time. Each time labs would show a decrease and wouldnt say anything else. Recently, I was applying for life insurance but wouldnt get coverage becuz liver enzymes were elevated. I went to a specialist, he tested me for eveything possible all test read negative but liver enzymes were still slightly elevated and he had no diagnosis for it. I am on a paleo diet and no gluten or processed sugars, no soy etc… I have your first book and because of it I was able to reverse hypothyroid but still a have this liver issue with no diagnosis. Hope you could shed some light. I do use honey at times for sweetener in my green smoothies and blueberries. Thank You

    Reply

  84. Hi Izabella
    I was diagnosed with Hypothyroid about a year ago. Nothing was tested except TSH (16). I was put on levothyroxine and have felt worse ever since. I have taken Levothyroxine, Synthroid, T3, Amour and now Tirosint over the last year. I also have hashimoto’s which I insisted they test for (800). The thyroid medications have only made me feel worse over the last year and I am wishing I would have never started them as my originally complaints were weight gain, tired and swollen. Now I have hot flashes, night sweats, headaches, brain fog, panic attacks, dizziness and an over sense of going crazy! I would like to stop the thyroid medication but have a fear that I will send myself into the ER. I have been gulten, soy, dairy, caffeine free for 50 days and take selenium, vitamin E, B12, Vitamin D3, probiotic. I am wondering if I ever needed this medicine in the first place and can these other supplements help me reverse my condition. I am also waiting on tests for food sensitivity and female hormones. Thanks!

    Reply

    • Sarah – thank you for following this page. The most common triggers in Hashimoto’s are: nutrient deficiencies, food sensitivities, intestinal permeability (leaky gut), stress, an impaired ability to get rid of toxins and in some cases, infections. Optimizing your health starts with food. Figuring out which foods nourish you, and which ones cause you harm is the single most important thing you can learn in your health journey.

      I’ve found that recognizing and eliminating reactive foods can be a life-changer for most people with Hashimoto’s.

      Reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity in particular has been implicated in causing a Selenium deficiency, a well known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten.

      Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods that they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are some articles which I wrote:

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      TAILORING YOUR THYROID DIET
      https://thyroidpharmacist.com/articles/tailoring-your-thyroid-diet-to-your-needs

      DAIRY AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/got-hashimotos-you-may-want-to-reconsider-dairy

      Reply

  85. Dr. Wentz,
    I’ve read most of your books, eat according to the SIP diet. My adrenal are low functioning, I have difficulty taking my thyroid meds and I often have stress responses to supplements especially, all B vitamins.
    It’s all maddening.
    The information regarding accupunture sounds great will certainly look into that as an alternative.
    Keep the faith ladies. Remember, you are while perfect and complete.

    Reply

    • Glenna – thank you for following this page. Having Hashimoto’s can feel very stressful. Having out of range thyroid hormones, adrenal fatigue, negative food sensitivities and low nutrient levels can lead to feelings of anxiety, hopelessness and stress. Treating these issues one at a time is the best plan of action. You can recover and regain your health! My new book Hashimoto’s Protocol is a step by step guide to the interventions that helped 80% of the people 80% of the time. I hope you check it out.

      Hashimoto’s Protocol
      http://amzn.to/2B5J1mq

      Reply

  86. Wow…. I knew it wasn’t all in my head and that something is wrong in my body! I just didn’t know what. My thyroid was so low one year that I started having severe panic attacks. As in I shook so badly I looked like I was having a seizure. I couldn’t sleep for days. Found out my thyroid was so low that I was close to going into a coma.

    It took 2 years but the correct synthroid dosage was found. But now I’ve become anemic, b12 deficient, and I’m still low on vitamin d even though I take the highest prescription amount. They can’t give me anymore. I’ve been feeling like my body has been shutting down on me and I’ve been so lost. I also have been obsessively craving salt and chips. Even that part was on this page! And now thanks to you I now have a good idea of what’s going on! My entire adrenal system is haywire right now! Thank you thank you!

    Now I just need to find a good specialist and/ or endocrinologist near Omaha, NE. Any recommendations?

    Reply

  87. Thank you so much for all this. I hate being sick soooooooo much!!! I’m terrified about this adrenal stuff. I am a competitive athlete. If I have what seems to be stage 2 adrenal fatigue, do I have to stop training? (I race bicycles.) I haven’t found a whole lot of information online about endurance training and adrenal fatigue. Can I ride easy – keeping my heart rate low? Is this going to put me back? What can I do to stay fit – or at least not lose all of my fitness??? Thank you, Sharon

    Reply

    • Sharon – you are very welcome! I would recommend anyone embarking on a program of exercise starts slowly and progresses at their own pace. Exercise can be very healthy, but for people with Hashimoto’s it can create stress. Stress causes our adrenals to pump out extra hormones, and shifts our body from a relaxing, digesting, healing state to a fight or flight state. The body’s energy is shifted from doing “useless” things like growing beautiful hair, metabolizing, making hormones, digesting and repairing itself, and instead, all of the body’s resources are reserved to make cortisol and adrenaline that is pumped through our veins so that we can keep going. Eventually, we run out of nutrients that are required for proper adrenal function and we get to a state of adrenal fatigue. This is when our body is no longer able to heal itself and we feel drained.

      Replenishing nutrients and using adaptogens, that balance out the adrenals can be helpful for everyone. The Daily Stress Formula from Pure Encapsulations contains nutrients and adaptogens that can help your body repair itself.

      ADRENAL SUPPORT
      https://www.rootcology.com/products/adrenal-support

      Reply

  88. thank you, I purchased 4 of your books and am just now reading them.
    I have hashimotos and adrenal fatigue. Finding a competent doctor in the south is most difficult. they cannot read the tests! only TSH. I have asked 3.5 years now to have my adrenals improved only to be told adrenal glands are unnecessary.
    My doc cannot read or interpret blood tests. Saw a low TSH and reduced my synthroid and stopped T3. told me to see endocronologist. New patients takes 4 months to get in. My naturopathic has me on vitamins for adrenals now.
    I went VEGAN 1.5 months ago and changed blood panel.

    Reply

    • Pam – you are very welcome! I appreciate you sharing your journey. <3 Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it's important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress.Every six weeks is usually a good schedule for testing your thyroid hormones. Here are the tests you need for diagnosis. Most endocrinologists don't run them all so you will have to request them. Make sure to request a copy of your labs as well.
      Top 10 Thyroid Tests and how to Interpret them.
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests

      If you cannot find a Functional Medicine practitioner in your area, it is possible to work with a
      practitioner remotely via Skype or some other online video platform. Here are some links that might help:

      CLINICIAN DATABASE
      https://www.thyroidpharmacistconsulting.com/clinician-database.html

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://ifm.org/find-a-practitioner/

      Reply

  89. I was diagnosed 8 years ago with Addisons disease (wrongly) as I wasn’t able to produce cortisol. My levels were virtually zero. After being put on Cortisone daily I actually got worse and worse to loosing the use of my arms and legs with zero strength. Thankfully a Dr was clever to test me for CIRS (mold toxicity) and Lymes disease, both of which I had which was the cause of producing no cortisol. Now after getting out of the moldy environment and numerous diet changes, weekly Vit c IV’s, I now have a life back and my body is now producing it’s own cortisol and I have been able to come off cortisone steriods. There is Hope, even though it is hard to see it sometimes. Never give up and always Look For The Root Cause.

    Reply

    • Kim – thank you for sharing your journey! My mission is to collect 10,000 success stories with the hope of submitting them to a medical journal in the future. Understandably, you are probably very busy, but if you have some time, please do you mind sharing your full story with me here at this link? https://thyroidpharmacist.com/testimonial/

      These stories will go a long way in helping others who are going through a similar journey to yours. Thank you for your consideration!

      Reply

      • Sorry for the delay but I have finally submitted my story. I just want to ask whether we are ever notified when and where our stories are published if they are. Thanks

        Reply

  90. hello. I have had thyroid problems for 15 years or more. I am on armour. It wasnt until two years ago that i landed in the hospital with severe health issues, kidney stones, kidney, bladder and uti infections. Was at that time diagnosed with Type II Diabetes. I also was told i had hashimotos. 7 years ago i had surgery to repair a hyatal hernia. it was in the area of the diaphragm, upper stomach and lower throat area. I have been in pain ever since. It affects my pulse rate which can be up to 180. I also know it is affecting my Diabetes. the drs cant see to find what is causing the pain. although they suspect it may be neurological. took gabapentin and helped to reduce the pain considerable….I was wondering can Hashimotos be contributing to the pain? Im am even considering CBD oil or mecial marijuana, due to being unable to take prescription pain meds. Thank you

    Reply

    • Brenda – thank you for reaching out and sharing your journey. <3 I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It's a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.

      CLINICIAN DATABASE
      https://www.thyroidpharmacistconsulting.com/pages/clinician-database

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://ifm.org/find-a-practitioner/

      http://www.thyroidpharmacistconsulting.com/recommended-compounding-pharmacies.html

      Reply

    • Jill – thank you for reaching out. I am very hesitant in recommending iodine in Hashimoto’s. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.

      I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein. Here are the links to my books :

      Hashimoto’s Protocol
      http://amzn.to/2B5J1mq

      Hashimoto’s Root Cause
      http://amzn.to/2DoeC80

      You may also find this article helpful as well:
      IODINE AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/iodine-hashimotos/

      Reply

  92. I jumped the gun a little on my previous post…
    I have been on medication for hypothyroidism for over ten years, three years ago I was diagnosed with Hashimoto’s (who knows how long I’ve actually had either of them). I have always struggled with my weight and other little symptoms here and there. Right after my diagnosis, I tried the AIP diet… to no avail – I didn’t feel ANY different. Therefore, I didn’t think much of my diagnosis until I came home from a trip to Thailand and felt like I just couldn’t kick the jet-lag… and here we are four months later – still feeling jet-lagged. I thought maybe it was just macros so I tried that, as well as introducing some pretty major weightlifting and neither my weight or energy budged.

    I’m diving in myself now – I read a bit a few years ago and am getting back in since I am desperate. I’ve just eliminated dairy, gluten and soy and am feeling a bit better – it hasn’t even been a week yet but I am so excited to finally figure things out – for myself since there aren’t any doctors who have seemed to help. After much research I decided on what supplements I was going to try – but then I read this and now I’m confused! Does the Adrenal Support have enough of the Benfo-Max? I had one of each in my cart but would taking Benfo-Max in addition to this be too much?

    Reply

  93. could you please remove my last name from the previous comment, if you don’t automatically do so. I looked at other comments and only saw first names, so assumed you did. but it looks like my full name will appear. Thank you.

    Reply

    • Claire – thank you so much for reaching out. Adaptogenic herbs such as ashwaghandha, rhodiola, holy basil, astragalus reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schizandra, spikenard, and suma are examples of herbs that may increase the body’s ability to resist stress, and have been helpful in relieving adrenal dysfunction when used in combination with vitamins and minerals. Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements, and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement, and the book will help uncover your root cause. This will help you figure out your supplementation.

      Hashimoto’s Root Cause
      http://amzn.to/2DoeC80

      Hashimoto’s Protocol
      http://amzn.to/2B5J1mq

      Reply

  95. I have a 15 yr old daughter recently diagnosed with Hoshi. Her symptoms are more hyper than hypo with a resting pulse of 115-125. Her T.Peroxidase is 791.8 Thyroglobulin 18. She definitely needs adrenal support but can’t swallow pills, are there liquid, chew-able or dis-solvable options? I have her on a B-12 and D-3 but the mg are low. After reading and more reading I found liquid selenium and Zinc but now I don’t want to start those until we get new blood work. It kills me to see my daughters world turned upside down and I just want to help her function. Everything I find is in a pill form.

    Reply

  96. I an having excessive sweating on one time or otherwise feeling very cold.I have hashimoto’s for about 6 years and have been taking levothyroxine,but I never feeled good, always depressed, severe weight gain, hair loss,i even stopped going to college. I asked my doctor to check my cortisol but he denied saying that that is not needed. Now I started having severe heart palpitations. Can you tell me which supplements should I start with?

    Reply

    • Saba – thank you for reaching out. I am so sorry you are struggling with all of this. <3 I am not able to advise on what supplements would be appropriate for you and your specific health needs without a comprehensive health assessment. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It's a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.

      CLINICIAN DATABASE
      https://thyroidpharmacist.com/database-recommended-clinicians/

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://ifm.org/find-a-practitioner/

      COMPOUNDING PHARMACIES
      https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/

      Reply

  97. Hello, thank you for an informative article. I wanted to inquire about supplements and safety for breastfeeding. From what I have found ginseng is not recommended to take while breastfeeding. Is it safe to take adrenal supplements while breastfeeding (6 month old baby)? Thank you!!

    Reply

    • C – thank you so much for following! <3 I do not recommend many of the supplements in my program while pregnant or nursing, as these things have the potential to pass through to the baby. That is not to say that they are necessarily unsafe, but I have not specifically researched each of the supplements' effects on pregnancy and nursing, so I am not be able to confirm their safety. I recommend either waiting to use the supplements or working with your practitioner who is more familiar with these things to discuss the safety of the supplements while pregnant or nursing.

      Reply

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