This is a question I have heard many times. Here is an answer that hopefully will deal with this and can be used in response to this in the future: NO!
The language of ‘stress the adrenals’, or ‘adrenal fatigue’ or ‘weak adrenals’ is the language that you see all over the Internet. It is flawed, and out of date. Unfortunately, it is a type of expression that continues to get spread around the Internet.
Thyroid patients get advice like, “You need to take hydrocortisone (HC) to rest your adrenals”, or “You have adrenal fatigue, so use adrenal glandulars until they are less tired” or “You may have weak adrenals, that is why you have low cortisol”, and other such rubbish.
Let me attempt to be very clear:
1) The adrenals do not get ‘stressed’. They are simple, robust organs that rarely have any issues. If they become issues at all, it is usually due to an autoimmune condition that eventually develops into Addison’s disease. All the adrenals need is cholesterol and enough ACTH signal from the pituitary. This is why thyroid patients with low cortisol often pass a Synacthen (ACTH Stim Test) very easily. This brings me to point 2.
2) Hypocortisolism does exist of course. This is usually due to the hypothalamic-pituitary axis not working. Often, this is due to far too little FT3 through the night and in the daytime, as the pituitary effectively ‘runs on’ T3.
3) T3 actually stimulates the pituitary-hypothalamic system more than any other form of thyroid hormone. So, for low cortisol, raising FT3 is a great solution in many cases. T3 therapy does this more effectively than other thyroid treatments.
Note: If T3 is used and the hypothalamic-pituitary system cannot respond, adrenaline can get produced. This feels like a high heart rate and anxiety etc. This can happen in a few situations, e.g. through the use of long-term anti-anxiety drugs, or anti-depressants. Lyme disease also can cause this. But if it does happen, it still is NOT the adrenals getting stressed. They cannot get stressed.
In most thyroid patients, the adrenals are capable of working well. It is simply that the hypothalamic-pituitary system has not responded well. In these cases, persevering with some T3 can sometimes correct this over time. LDN use can sometimes help also. Obviously, addressing any other significant issues is essential.
Here is some further information:
The Thyroid Patient’s Manual Chapter 5 and 7
Recovering with T3 Chapter 16
The CT3M Handbook.
I hope this blog post helps some readers.