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Hi Dr. C, I’m excited to start the Thyroid Reset Diet, but my functional medicine practitioner said I have to treat adrenals before thyroid. I thought it was the other way around? Which should I heal first, my adrenal or my thyroid?
Perennial question – I have Hashimoto’s, which should I treat first, my adrenals or my thyroid?
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Many adults with thyroid disease have or suspect abnormal adrenal function. There is a vague warning that bad things will happen if one treats these issues in the wrong order. I imagine a password entry page that threatens to lock your account with one more failed attempt.
There are so many uncertainties people face when dealing with these issues. This one is especially thorny. People are often left feeling worried that they can’t do anything without risk. The fear is that diet, lifestyle, supplements, or medications – all could be harmful if they are done out of order.
Let’s talk through this fear so that you know what is safe.
Where Did it Come From?
The kernel of truth is from the package inserts on thyroid medication. The wording below is from synthroid, but all thyroid medications give the same warning:
What Does This Mean?
If someone has a severe lack of both thyroid and adrenal hormones, it can be better to treat with adrenal hormones first.
Thyroid hormones and adrenal hormones interact with one another. A lack of thyroid hormones can make adrenal hormones remain in circulation longer than normal. If someone lacks both hormones, adding thyroid hormones could compound the lack of adrenal hormones. The opposite risk is less relevant. Adding adrenal hormones, when needed, will not worsen a lack of thyroid hormones.
Here is where it got out of control – the risk is for those with adrenal insufficiency who may start thyroid medication. It is not for adrenal fatigue or adrenal stress. The difference is that with adrenal insufficiency, the adrenals are unable to make adequate amounts of hormone. In cases of ‘adrenal fatigue’ or adrenal stress, the adrenals are capable of making hormones, but the body is limiting how much they make.
Adrenal Stress or Adrenal Insufficiency?
Are you not sure if you have adrenal stress or adrenal insufficiency? Adrenal insufficiency is rare. The most common cause is Addison’s Disease and it only affects about 5 people per every million.
This risk is real, but the circumstances in which it applies are rare.
You know how a message gets distorted over the course of a game of telephone? That has happened in functional medicine.
If a patient has untreated Addison’s Disease and untreated hypothyroidism, they need to first stabilize their glucocorticoid levels with replacement medication. Once having done so, they may then proceed with thyroid medications as are appropriate.
This almost never happens. Both issues cause significant symptoms. Both can be missed at early stages but this concern does not apply to early stages. To have someone let both go unchecked for some length of time is nearly impossible.
The idea has expanded to include anyone with any concerns regarding their thyroid or adrenal health.
A large percentage of adults have suboptimal or subclinical hypothyroidism. Many of them are put on thyroid medications, even though they don’t help in these situations. Nearly all of these same people have symptoms that can be ascribed to ‘adrenal fatigue’.
The risk is that a well-meaning practitioner can tell someone like that about the order – you must treat the adrenals first!
The popular idea is that ‘adrenal fatigue’ is a root cause of thyroid issues. If one fails to treat this root cause the disease will only progress.
What Should You Do?
If your adrenals and your thyroid are not right, please don’t be afraid to take action. Nothing you do to help one will harm the other.
If you have abnormal thyroid levels, diet alone can help for about 80% of people. You can learn about this approach and the proof behind it in my latest book, the Thyroid Reset Diet.
If your adrenals are not right, diet can also help. The Adrenal Reset Diet spells out 4 distinct plans and has a quiz to help you find which is best.
If both are a problem, follow the right adrenal plan and stick with the green light foods in the Thyroid Reset Diet. It is no more work to do both!
Take Good Care Today
Now that we know a bit more about cardio, physical exercise, and why you shouldn’t be afraid of a little endurance exercise, let’s focus on other areas of your health. Try the Thyroid Quiz today (Click Here: Take the quiz) to learn more about your thyroid and the impact it may be having on your overall health.
P.S. Whenever you are ready, here is how I can help you now:
1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet, The Metabolism Reset Diet and The Thyroid Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.