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Why Thyroid Medications May Not

Reverse Subclinical Hypothyroidism

If
you have Adrenal Fatigue Syndrome (AFS), you will experience a range of
physical problems and symptoms. Subclinical hypothyroidism is a very
common problem associated with AFS. Unfortunately, if you go to your
doctor with this problem, they will probably prescribe thyroid medication
to you. Research is starting to show that this may not be the most helpful
strategy as it does not necessarily alleviate all symptoms long term, even
though there may be benefits. And if you have AFS, it may actually
worsen your condition and increase the time before you find a way to
manage and reduce the underlying problems associated with this
disorder.

What is Subclinical Hypothyroidism?

When you have hypothyroidism, your body is not producing enough
thyroid hormones. An early stage of this is known as subclinical
hypothyroidism. Clinical symptoms of hypothyroidism are generally mild

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and often not very significant. At this stage, the serum level of thyroid
stimulating hormone (TSH) may be only a little higher than usual and the
level of thyroid hormones in the blood are still within the normal range or
borderline low. The high TSH levels are a sign that your body is
struggling to keep the thyroid hormones at normal levels and is having to
release more hormones than usual to make this happen.

Even though the thyroid hormones help to regulate your brain, heart, and
metabolic functions, they are also the leading cause of a variety of
diseases and disorders. When the hormone levels start to drop, you may
experience a range of symptoms and issues. Between 3 and 8 percent of
people have subclinical hypothyroidism and in some cases, this can
progress to full hypothyroidism. There are many causes for problems with
thyroid function, including:

Thyroid injury because of an accident or surgery.

Certain medications that affect the thyroid such as iodine or
lithium.
Radioactive iodine therapy.
Certain inheritable diseases such as Hashimoto’s disease.

There are often no apparent symptoms for subclinical hypothyroidism

and they can be vague and non-specific if any. Some of the most common
symptoms are:

Fatigue.
Depression.
Weight gain.
Goiter.
Constipation.
Hair loss.
Memory problems.
Brain fog.
Cold intolerance.

These symptoms are also common in people who have AFS, which is why
people with this disorder are often put on thyroid medications.

Subclinical Hypothyroidism and AFS

Subclinical hypothyroidism is very closely linked to AFS, which is caused
by stress. The NeuroEndoMetabolic (NEM) stress response is
designed to help your body cope with stress. But when this system is
active over a long period of time, it can become fatigued. The NEM stress
response is designed to activate to increase alertness in response to a
threat to your life and then shut down. It is very unhealthy for this stress
response to be active over long periods. This type of prolonged overuse is
just as unhealthy for the NEM stress response itself, because the organs
and systems that are a part of it can become fatigued.

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When the NEM stress response is overused, the adrenal glands will
begin to struggle to keep up with the body’s ongoing demand for cortisol.
Cortisol is a stress hormone that is responsible to make you feel alert and
ready to respond. But if the demand for cortisol is high on an ongoing
basis, the adrenals can start to break down and the hormone levels
become abnormal. As a result of the breakdown of the adrenals, other
systems in the body will naturally become dysregulated as well given that
all the systems in the human body are interconnected. This can lead to a
very damaging and frightening degradation of all the systems in your
body.

AFS and the Hormonal Circuit

The hormonal circuit is often one of the first to be affected when you
have AFS. This circuit plays an important part in maintaining hormone
balance in the body and includes the adrenal glands, the thyroid and the
ovaries or testes. Dysregulation of this circuit has a negative impact on
your body, especially when the adrenals become fatigued because of
overuse that causes AFS. The thyroid is regulated by the Hypothalamus-
Pituitary-Adrenal (HPA) axis, which is an integral part of the NEM stress
response. When this stress response starts to malfunction because of AFS,
it will naturally cause the thyroid to become dysregulated and cause
conditions like subclinical hypothyroidism.

The thyroid gland is also affected by the body’s general poor health and
exhaustion. As your health declines because of AFS, the adrenals start to
focus on survival. Firstly, the adrenal glands down-regulate energy
production, by reducing the production of thyroid hormones. Given that
the body is exhausted and is on the verge of collapse, the adrenals role in
lowering energy output and the body’s workload, helps to cope with this
extreme state of exhaustion. It is also common at this stage for your body
to increase thyroid binding globulin (TBG) levels. This causes low levels

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of T3 and T4 in the blood for measurement, which can confound thyroid

testing. So, your doctor may believe that you have subclinical
hypothyroidism due to your low hormone levels and normal or high TSH
levels when in reality, the reasons behind it are much deeper.

Along with the hormonal imbalance due to your thyroid and adrenal
glands, the balance and the function of the ovaries and testes are affected
as well. These organs are hormonally interconnected and reliant on each
other. So, as the adrenals are increasingly dysregulated because of stress,
the thyroid, as well as the ovaries and testes will continue to malfunction.
These malfunctions will further disturb the hormonal circuit significantly.
The result will be worsening AFS symptoms and increased thyroid
malfunction, adrenal fatigue, and issues related to the ovaries or testes.

How AFS Can Look Like Hypothyroidism

The symptoms and problems caused by AFS are very similar to the
symptoms of subclinical hypothyroidism. In fact, these two conditions are
very commonly mixed up. If you go to your doctor with general fatigue,
cold sensitivity, and inexplicable weight gain, they will very often examine
your thyroid function based on your symptoms. If high TSH levels are
noted, your doctor may decide to address the thyroid problem with
medication. However, this tactic will be ineffective at best or damaging at
worse if you actually have AFS. Unfortunately, many healthcare
professionals are not aware of adrenal function and adrenal fatigue,
which means that adrenal dysregulation is often overlooked by them.

The real issue is about low thyroid gland function or primary

hypothyroidism. In primary hypothyroidism, the condition occurs
when the thyroid is unable to produce the hormones T3 and T4 because
of gland problems. This happens when you have a medical condition such
as Hashimoto’s thyroiditis and your immune system attacks your thyroid
gland. Secondary hypothyroidism occurs as a result of low gland function
when the thyroid is affected by changes in other parts of the body. If you
have AFS or a disorder in the hypothalamus, not enough thyroid
stimulating hormone is released causing secondary hypothyroidism. The
organ system and circuit malfunctions that are characteristic of AFS can
affect the function of the thyroid and cause this type of mix-up. When you
have too much cortisol, it informs the brain to slow down the production
of hormones, thus also decreasing the thyroid function. In addition, when
your body is stressed, the thyroid glands reduces its activity by producing
more inactive reverse T3 hormone rather than its active form, therefore
causing more hypothyroid symptoms.

AFS can cause the same kind of symptoms as subclinical hypothyroidism

as well as an ongoing dysregulation of the thyroid gland, resulting in
impaired thyroid function and high TSH levels. However, if your doctor is
not aware of the underlying problem, they will try to manage only the
thyroid issues. This will not only be ineffective at alleviating your
symptoms, the strong medications will also increase your stress levels

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and worsen the underlying AFS. This kind of situation is a common

experience for people who have AFS and can result of in long term
confusion and ongoing medical interventions without relief from
worsening symptoms and problems.

AFS Versus Hypothyroidism

Whether you have AFS or subclinical hypothyroidism, you will experience
a range of symptoms that appear very similar. Here are some of the most
obvious symptoms and how they differ in these two conditions:

Weight Gain
Hypothyroidism causes general weight gain, people in the early
stages of AFS can experience the same problem.
Body Temperature
Both disorders tend to cause problems with low body temperature.
However, in AFS, temperature regulation tends to fluctuate a little
more than hypothyroidism.

Hair Loss
Both disorders can cause hair loss or a change in hair health.
Mental symptoms
AFS and subclinical hypothyroidism can cause brain fog, slow
thinking and even depression, though depression is more common
with thyroid problems.
Skin and Nails
If you have AFS, your nails may become thin and brittle and your
skin dry and thin. However, people with thyroid problems tend to
have oily or moist skin of normal thickness. Nail thickness is usually
normal as well.
Infections
Frequent infections are common with AFS but not with thyroid
problems.

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Fatigue
This is the most obvious and sometimes troubling symptom of both
disorders.

These symptoms are extremely similar, which is why you need to get
expert help if you are going to improve your health and overcome these
types of problems.

How Thyroid Medications Can Worsen

AFS
There are several ways that your overall condition may be affected if you
take thyroid medications when you have AFS. These include:

Additional physical stress

Taking very strong medications when you are already unwell can
increase your body’s stress levels, particularly if those medications
are not necessary. Your body will need to process the medication
and expel wastes, and if it’s already overloaded with toxins and
struggling, this can add to its stress.
Paradoxical reactions
When you have AFS, your system will already be sensitized by the
overload of toxins and inflammation. As a result, it may have a
paradoxical reaction to any medication you take, which means that
it may cause more damage or harm to your thyroid and other
systems.
Increased emotional stress
If you are taking thyroid medication and yet there is no
improvement of your health, it may cause more emotional stress,
which will worsen your AFS.
Increased financial pressure
Thyroid medications must be taken on an ongoing basis, which may
increase your financial stress and worsen your AFS.

Subclinical hypothyroidism is a serious disorder that can severely affect

your quality of life and your ongoing health and wellbeing. It is important
to seek professional help and see a doctor to find a way of managing it. It
is important to acknowledge and address any disorder such as AFS that
could be underlying the more obvious problem.

Managing Subclinical Hypothyroidism

Current practices claim that thyroid hormones are the best option for
adults with subclinical hypothyroidism. There are two main hormones
produced by the thyroid, known as triiodothyronine (T3) and thyroxine
(T4). These hormones are responsible for regulating many systems and
processes in the body. Current guidelines for managing this problem is to
prescribe thyroid hormones to adults whose TSH levels are over 10
mIU/L. People who are young or have troubling symptoms may be given

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these hormones even when their TSH levels are lower. Normal TSH levels
are between 0.4 and 4.0 milli-international units per liter.

A recent study was performed that included 21 trials and 2192

participants who had subclinical hypothyroidism. The study found that
thyroid hormones produced no clinically relevant benefits. The
participants did not get relief from depressive symptoms, weight gain, or
general fatigue. There were also little effect on mortality or cardiovascular
events. However, further research and follow-ups are needed to confirm
the findings.

These results suggest that changes should be made in the management of

subclinical hypothyroidism. Thyroid medications will probably not
alleviate the symptoms if their adrenals are well optimized. It also adds
lifestyle burdens in terms of lifelong management and financial
considerations. Long term use of these medications may cause
irreversible harm to the body and therefore it is important that there are
alternate strategies in place. These strategies may include long-term
health monitoring and drastic lifestyle changes.

The Takeaway

If
you experience subclinical hypothyroidism as a result of AFS circuit
imbalances, then thyroid medications may not be the solution. In fact, in
certain cases they can do more harm than good. Instead, you need to
work with a trained, experienced medical professional who is aware of
AFS and can help you address the underlying problems and imbalances.
This is the best way to bring your body back into balance, alleviate
adrenal fatigue, and help to correct any problems that are causing your
thyroid dysregulation.

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© Copyright 2020 Michael Lam, M.D. All Rights Reserved.

Dr. Lam's Key Question

What’s the best way to address subclinical
hypothyroidism?
Typically, subclinical hypothyroidism is addressed using thyroid
medication. However, this may not have the desired effect on the quality
of life or thyroid symptoms and may cause more health and lifestyle
problems over time. That’s why monitoring of thyroid function and other
measures may be more effective.

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