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Case Study: Is Thyroid Dysfunction Stressing You Out?

The patient, a 34 year old female, presented to the Health World Clinic with a ten year history of fatigue, and severe stress and anxiety. She worried incessantly and had an overactive mind. She experienced general muscle tension and aches, with headaches every 2 to 3 days. She was often restless and irritable and had rapid mood swings, particularly premenstrually.

Many of her signs and symptoms indicated reduced thyroid function, including fatigue, sluggishness, cold hands and feet, difficult infrequent bowel movements, and dry skin and hair. She gained weight easily and had symptoms of Irritable Bowel Syndrome (IBS), along with belching, and bloating after meals, and constipation.

Salivary hormone testing indicated low cortisol levels, consistent with adrenal exhaustion after an extended period of stress. Cortisol levels will initially rise with stress, but may later fall after long-term stress as the HPA system becomes ineffective and is no longer able to produce high levels of stress hormones.

Treatment Protocol

Treatment priorities included supporting adrenal and thyroid function, and restoring healthy nervous system function.

Results of Treatment

After 6 weeks of this simple treatment, the patient had a dramatic reduction in anxiety levels and many of her stress symptoms had improved. Many of her hypothyroid symptoms had also improved, with her energy improving significantly and her hands and feet no longer being perpetually cold. The patients’ digestive function normalized as well, with regular bowel movements, no post-meal bloating or belching and no IBS symptoms. The patient was also sleeping better and walking refreshed. The patient was amazed at how well she was able to function when not clouded by stress and fatigue. She found herself more motivated with her work, and had improved brain function, memory and concentration.


Thyrobalance – A blend of herbs and nutrients to assist with the symptoms of hypothyroidism, by supporting healthy thyroid hormone production and peripheral conversion of thyroid hormone, as well as reducing oxidative stress within the thyroid.

Dose: 2 tablets twice daily.

Adaptan – Herbal combination to restore healthy adrenal and nervous system function during times of stress, anxiety and exhaustion. Contains restorative herbs such as withania and American ginseng for enhancing adrenal output.

Dose: 2 tablets twice daily.

Relaxan – A blend of herbs and nutrients to support healthy moods in patients with mood swings and emotional instability, particularly where there is a hormonal component.

Thyroid at the Mercy of Stress

As this case demonstrates, excessive stress has a huge impact on many body systems – the thyroid is no exception. Healthy cortisol levels are required for healthy thyroid function. Excessively high cortisol levels and very low cortisol levels can impact negatively on thyroid function.

An imbalanced stress response can affect thyroid function by:

  • Reducing TSH production.
  • Reducing the conversion of T4 to T3 in peripheral tissues.
  • Increasing conversion of T4 into its inactive metabolite, reverse T3 (rT3).
  • Reducing the binding of T3 at tissue level.
  • Stress may also suppress thyroid function by increasing oxidative stress, which can damage thyrocytes and reduce production of thyroid hormones.

It is no surprise, therefore, that when these patients’ adrenal ad thyroid functions were supported, she had such dramatic improvements in symptoms.

Re-energise yourself

Are you feeling tired, stressed and exhausted more often than not? Maybe you need an energy boost to reinvigorate you as you face the challenges of the New Year!
Signs of adrenal exhaustion

  • Excessive fatigue
  • Non-refreshing sleep
  • Feeling rundown or overwhelmed
  • Feel most energetic in the evening
  • Difficulty concentrating
  • Prone to illness
  • Slow to recover from injury/illness

Numerous surveys on health issues frequently rank lack of energy and exhaustion among the top five concerns of Australian adults, and even teenagers report being regularly tired and stressed. There is no doubt that resolving to eat a healthier diet, exercising regularly and adopting a positive outlook on life all improve energy levels and your perception of wellbeing. However there are a number of nutrients and herbs that can create a noticeable difference in your energy levels, without the need to rely on stimulants such as coffee or cola!
Start with the basics
It’s important to start with the basics and a good quality vitamin B complex with vitamin C is a must as it will support the nervous system and adrenal glands. You will also need the much under-rated mineral, magnesium, which is essential for the transmission of nerve impulses. A high percentage of people are deficient in magnesium and prolonged stress causes further depletion. So make sure these vitamins and minerals are addressed first and then there are a number of energy nutrients and herbs that should be considered.
Coenzyme Q10 – your natural spark plug
Coenzyme Q10 (CoQ10) is a powerful antioxidant and is vital in powering the body’s cellular energy production cycle (ATP). The most commonly used analogy of CoQ10 compares it to the spark plugs in your car and just as a car can’t start without that initial spark, your body can’t function without CoQ10. If the body’s level of CoQ10 starts dropping, so does your general health. Scientists investigating the role of CoQ10 in human biochemistry have estimated that once the body’s levels of CoQ10 becomes more than 25 per cent deficient we become more susceptible to disease. It has been shown that your ability to produce CoQ10 decreases with age, production peaking at around age 20 and then declining. By age 77 you already have 57 per cent less CoQ10 in your heart muscle than a 20 year old.1 This Nobel Prize winning nutrient was discovered 40 years ago and since this time numerous research studies have shown that
CoQ10 is intrinsic to health. CoQ10 not only improves energy production levels, research has shown there are a number of other conditions that it can benefit.
Ageing: CoQ10 interacts directly with free radicals, inactivating them so cellular damage, which causes the visible signs of ageing, is reduced.
Heart health: CoQ10 has received particular attention for its benefits for heart health. It assists to reduce the oxidation of LDL cholesterol that is involved in atherosclerosis. CoQ10 is required for healthy heart beat and rhythm and normal blood pressure. Many studies support its beneficial effects for cardiovascular health.
Oral health: CoQ10 slows the progression of periodontal disease and can help maintain healthy gums.
Brain health: Research carried out at the Institute of Neurosciences in Argentina has shown that brain activity and alertness is enhanced in patients with high blood pressure, within one hour of oral administration of 100 mg of CoQ10.2 Studies have also suggested that supplemental CoQ10 slows functional decline in Parkinson’s disease by helping to reduce the amount of free radical damage in nerve cells.3
Energy: A favourite of athletes, CoQ10 increases stamina and reduces the shortness of breath that is associated with fatigue – particularly after exercising.

Fertility: CoQ10 increases sperm motility leading to enhanced fertility.
Interactions: Statin drugs, used to lower cholesterol levels, also lower your body’s own natural production of CoQ10. In a double blind study there was a 50-54 per cent decrease of CoQ10 levels in statin treatment groups.4 In order to gain a therapeutic effect, the suggested dose of CoQ10 is 75 mg twice daily.
Withania – your vitality tonic
Withania somnifera (also known as Ashwaghanda or Indian Ginseng) is considered by many natural healthcare practitioners to be a first class adaptogenic tonic. Adaptogens as their name suggests, facilitate the ability to adapt to a variety of heightened stressful experiences (whether physical, mental or emotional). The use of this herb in India dates back over 3,000 years and is considered a major rejuvenative tonic to promote healthy ageing and longevity. Withania may be the best herb to take for the support of adrenal exhaustion. Stress, caffeine, nicotine and a nutrient-deficient diet can all take their toll and leave you exhausted and feeling like you have ‘no petrol in your tank’.

Making changes to your lifestyle and supplementing with Withania can help your adrenals recover quickly. Withania is also considered one of the most potent aphrodisiac tonics of all and is considered in the Ayurvedic tradition to be specific for low masculine libido. An added bonus for women is that Withania is rich in iron, so you can boost your iron levels with this herb as low iron levels are a known cause of fatigue. Withania is also held in high regard for both men and women for its ability to: increase vitality, energy, endurance and stamina, strengthen the immune system nurture the nervous system, counteract anxiety and stress to promote a calm state of mind. The recommended dosage of Withania for a therapeutic effect is approx 3,000 mg daily.
Cordyceps for endurance
Cordyceps sinensis, a less familiar herb, has been used extensively in China for stamina and endurance. The traditional use is for aiding respiratory health, increasing energy, assisting vitality as well as improving sexual energy and desire. If you find you get tired easily, Cordyceps is helpful for fatigue and it is often used to restore energy after illness and strengthen your general resistance. When the immune system becomes weakened due to prolonged stress, you are much more susceptible to illness and infection. This highly valued medicinal fungi, has been shown in clinical trials to build and support the immune system.5 In the 1993 World Outdoor Track and Field Championships in Germany a group of Chinese runners broke nine world records. Afterwards the coach attributed those results to the athletes’ regular use of a Cordyceps tonic which helped to increase their stamina, energy levels and recuperative powers. To help increase energy, endurance and fight fatigue, take 2 to 3 g a day with meals. You need to take Cordyceps regularly to get results, and benefits should start to be seen in one to two months.
References: 1 & 2 Marincola et al; JOM; 1997; 87-95. 3 Shults et al; Archives of Neurology; 2002; 1541-1550. 4 Langsjoen PH, Langsjoen AM; Biofactors; 2003;18(1-4):101-11. 5 Zhu et al; J Alt Comp Med; 1998; 429-57

How to solve Adrenal Gland Fatigue

Q. I have severe Adrenal Gland fatigue with the most severe problem being Fatigue (also have hypothyroidism, sensitivity to chemicals and perfumes, insomnia etc). However, I am particularly interested in American Ginseng for my Fatigue problem.

A. The adrenal glands produce a large number of hormones. The cortex (outer part) produces corticosteroids that include cortisol, dehydroepiandrosterone (DHEA), aldosterone and the sex hormones, testosterone and oestrogen. Cortisol is the major hormone involved in the stress response. Under prolonged stress cortisol levels are elevated, which increases blood pressure and blood sugar levels thereby suppressing the inflammatory response of the immune system.

In early humans there were long periods of time between exposures to stressful situations in which the body could recover, but in today’s busy world the ‘fight-or-flight’ response is activated many times a day for most people so the body never gets the chance to recover and levels of stress hormones may be chronically raised.

With adrenal fatigue or adrenal exhaustion, over time the adrenal glands may be unable to keep up the pace of hormone production due to exhaustion of nutritional reserves or damage to the gland itself and the result is low production of adrenal hormones and resulting symptoms of illness such as fatigue. Environmental illness sufferers usually have low corticotropin-releasing hormone (CRH) (1). This is a hormone produced by the hypothalamus in the brain that signals the release of another hormone, ACTH, which tells the adrenal glands to increase their hormone output. If CRH is low then adrenal hormones will also be low.

Whether it is low CRH levels causing under stimulation of the adrenal glands or adrenal exhaustion, usually people suffering from CFS, fibromyalgia and other environmental illnesses have low output of the adrenal hormones cortisol and DHEA (2, 3, 4). DHEA is thought to counteract the negative effects of prolonged high cortisol levels such as immune suppression and damage to brain cells through over stimulation. DHEA has been shown to increase energy and feelings of well being.

In the early stages of adrenal exhaustion cortisol levels become chronically elevated and DHEA levels start to decline. This has a negative impact upon thyroid function since cortisol is directly antagonistic to thyroid function.

Cortisol reduces thyroid activity by reducing stimulation of the thyroid gland through decreased output of Thyroid Stimulating Hormone (TSH) from the pituitary gland. It also acts to stop the conversion of the thyroid hormone T4 (thyroxine) into the active form, T3. Low thyroid function has many health consequences.

The most widely used herbs to treat this condition include Ginseng, Licorice and Echinacea. Asian Ginseng (Panax Ginseng) improves adrenal function and increases blood pressure and energy. Panax ginseng has a strong anti-stress effect, reducing high cortisol levels and bringing the ratio of cortisol to DHEA into balance.

Licorice contains a compound, glycyrrhizin, which raises the body’s level of cortisol by inhibiting its breakdown. Only use licorice only for a maximum of 8 weeks as it can raise cortisol levels too high and cause high blood pressure as well as interfere with fluid balance, due to its effect on mineralcorticoid hormones.

Echinacea has immune stimulating activity, including an adrenal stimulating action so may benefit people with low adrenal function. If using Echinacea, supplement with vitamin C as adrenal levels can decrease as the glands requirement increases due to the stimulation produced by the herb. 500-2000mg of vitamin C daily is a suggested dosage.