Treating Adrenal Dysfunction with Cortisol
By Kent Holtorf, M.D. on Oct 17, 2019
Originally Posted November 2012
Many people report feeling under constant pressure and stress which causes them to feel sluggish, irritable and fatigued. They are desperately trying to clear up that mental fogginess with coffee or other stimulants, just to crash worse afterwards. Does this sound like you?
Although it’s been widely accepted as the “common way of living in a working, modern society”, it is not normal.
Understanding Adrenal Fatigue
The adrenals are small glands that sit on the kidneys. They regulate many bodily processes through the production of hormones. The hormones produced by the adrenal glands help regulate blood sugar, immune function, and stress response. A disruption in the excretion of these hormones can lead to malfunction in these bodily processes and others.
Adrenal fatigue is a chronic condition wherein the adrenals are incapable of supplying the hormones needed for healthy bodily function. There are a number of potential causes for this dysfunction including physical trauma, a stressful professional or personal life, hormone imbalances, chronic illnesses, chronic infections, and sleep deficits. These and other physiological stressors trigger adrenal activity. If the adrenals continue to experience an increased demand, they will eventually become exhausted and incapable of sustaining healthy function.
The Symptoms of Adrenal Fatigue
Low levels of adrenal hormones, specifically cortisol, can result in symptoms such as:
- Muscle aches
- Sugar or salt craving
- Shakiness relieved with eating
- Food sensitivities
- Recurrent infections
- Dizzy when standing
- Low blood pressure
- Decreased ability to handle stress
- “Brain fog”
- Swollen ankles that are worse at night
- Muscular weakness
- Difficulty getting out of bed
- Wiped out with exercise
- Inability to tolerate thyroid replacement
The Role of Cortisol in Adrenal Function
The most important anti-stress hormone in the body is cortisol. It protects the body from excessive adrenal fatigue by:
- normalizing blood sugar: cortisol increases the blood sugar level in the body, thus providing the energy needed for the body to physically escape threat or injury in order to survive. Cortisol works in tandem with insulin from the pancreas to provide adequate glucose for energy.
- anti-inflammatory response: cortisol is a powerful anti-inflammatory agent. It is secreted as part of the anti-inflammatory response. Its objective is to remove and prevent swelling and redness of nearly all tissues.
- immune system suppression: cortisol influences most cells that participate in the immune reaction, especially white blood cells. It suppresses white blood cells, natural killer cells, monocytes, macrophages and mast cells. It also suppresses adrenal fatigue.
- vaso-constriction: people with low cortisol have low blood pressure and reduced activity to other body agents that constrict blood vessels.
- physiology of stress: people with adrenal fatigue can not tolerate stress and will then succumb to severe stress. As their stress increases, progressively higher levels of cortisol are required. When the cortisol level cannot rise in response to stress, it is impossible to maintain the body in optimum stress response.
Cortisol sustains life via two opposite, but related, kinds of regulatory actions: releasing and activating the existing defense mechanisms of the body, while shutting down and modifying the same mechanisms to prevent them.
Using Cortisol to Safely and Effectively Treat Adrenal Fatigue
In the right situation and using the right dose, hormone replacement can be of great benefit for people with adrenal dysfunction. Medical science is just beginning to find out that a person can feel horrible and function poorly even with a minimal to moderate hormone deficiency that is clinically undetected by routine blood tests. This is evident in the case of adrenal fatigue.
Some physicians, notably Dr. Jefferies in the mid 1980s, have advocated low dose cortisol as safe for long-term use. Dr. Jefferies found that as long as the adrenal hormone level is kept within the normal range, the main toxicity that a patient might experience was a slight upset stomach, due to the body not being used to having the hormone come in through the stomach.
In an article published by Dr. Kent Holtorf in the Journal of Chronic Fatigue Syndrome about therapeutic doses of cortisol for patients with fibromyalgia and chronic fatigue syndrome, he states:
“Because treatment with low physiologic doses of cortisol (< 15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not appear to have significant diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure, or have baseline cortisol levels in the low or low-normal range. (…) Physiologic replacement of cortisol at doses of 5 mg to 15 mg a day are safe, with little or no associated risk. Such physiologic doses don’t carry the risk of adrenal and immune suppression or bone loss, which are well known risks of pharmacological doses of corticosteroids. Cortisol treatment carries significantly less risk and a greater potential for benefit than standard treatments, such as antidepressants, muscle relaxants, anticonvulsants and narcotics.”
Finding a Doctor that Understands Adrenal Fatigue
The adrenals are a critical component of healthy bodily function. Adrenal fatigue result in dramatic repercussions on your physical, emotional, and mental health. Treatment of adrenal fatigue should be tailored to you and your specific needs and can include low dose cortisol, adrenal glandulars, vitamin C, Pantothenic acid, licorice, and chromium.
At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan that is personalized to you. If you are experiencing symptoms of adrenal fatigue, give us a call at 877-508-1177 to see how we can help you!
1. Kent Holtorf, MD. “Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Diagnosis_and_Treatment_of_HPA_Axis_Dysfunction.pdf
2. Kent Holtorf, MD. “Adrenal Fatigue Testing.” https://www.holtorfmed.com/download/other/Adrenal-Testing.pdf
3. Kent Holtorf, MD. “Adrenal Fatigue Treatment Options.” https://www.holtorfmed.com/download/other/Adrenal-Treatments.pdf.
4. William McK. Jefferies. “Safe Uses of Cortisol.” Book.
How the Adrenals and Thyroid Are Connected
By Holtorf Medical Group on Oct 15, 2019 11:40 am
Hormones are one of the most influential elements of wellness. These chemical structures relay messages throughout the body to regulate numerous functions. There are multiple systems responsible for production and regulation of hormones. Two of the most important being the adrenals and the thyroid. In addition to be essential for healthy bodily function, these two systems have a significant degree of influence on one another. Therefore, to better maintain wellness it is important to understand the role of the adrenals, the thyroid, and their mutual impact over each other.
What are the Adrenals?
The adrenals are small but highly influential organs located just above both kidneys. These are the glands responsible for controlling the body’s stress response as well as producing hormones essential for healthy bodily function. Some of the most notable adrenal hormones include pregnenolone, adrenaline, estrogen, progesterone, testosterone, DHEA, and cortisol – learn more about the adrenal hormones here. These and other adrenal hormones regulate areas such as metabolism, physical ability, libido, energy level, stress response, and much more.
What is the Thyroid?
The thyroid gland is located at the base of the neck. Like the adrenals, the thyroid regulates important areas of health including metabolism, mood, weight, neurological function, energy level, and more. The thyroid completes this complex task through the secretion of thyroid hormones. The most well-recognized thyroid hormones are thyroxine (T4) and triiodothyronine (T3). These hormones help to determine the activity level of virtually every cell and tissue in the body. It is for this reason that some refer to the thyroid as the body’s gas pedal.
Identifying Arenal and Thyroid Imbalances
Disruption of either the thyroid or the adrenals can result in a cascade of dysfunction throughout the body. There are several ways in which the adrenals and the thyroid may become dysfunctional including physical damage or trauma, chronic mental or physical stress, and chronic illness. These factors can contribute to hormonal imbalances that encourage the development of serious dysfunction such as adrenal fatigue and hypothyroidism.
Many symptoms of adrenal fatigue and hypothyroidism are shared. Because of this, it is common for patients to be misdiagnosed. Fatigue, poor sleep quality or insomnia, depression, PMS, brain fog, sensitivity to cold, weight gain, forgetfulness, and loss of libido are just some of the shared symptoms of adrenal dysfunction and hypothyroidism. If you experience some, or all, of these symptoms, it is important to assess both adrenal and thyroid function.
The Shared Influence of the Adrenals and the Thyroid
Although they are two different systems, the adrenals and the thyroid have a great deal of overlap. Typically, this is beneficial as both systems can support each other. However, because they are so closely related, if one system fails or malfunctions it often leads to disruption of the other.
The adrenal glands are responsible for regulating the body’s stress response. When we experience stress the adrenals release cortisol. The increase in cortisol triggers elevated immune activity, increased inflammatory response, heightened physical ability, and greater alertness. These are all beneficial qualities when handling stress in the short term. However, constant activation of the adrenals encourages further release of cortisol. Excess cortisol can negatively affect thyroid function and contribute to hypothyroidism. In part, this is why many individuals suffering from chronic stress also experience a decline in thyroid function.
For the thyroid to effectively regulate bodily function, T4 must be converted to T3 and interact with tissues throughout the body. Studies show that certain adrenal hormones play an important role in the conversion process of thyroid hormones. Additionally, some experts suggest that adrenal hormones are needed to effectively deliver T3 into cells and tissues. Therefore, poor adrenal function and a lack of adrenal hormones may inhibit thyroid activity resulting in symptoms of hypothyroidism.
Both systems play a significant role in maintaining healthy metabolic activity. If either system faulters, the other must work harder to make up the difference. For example, if metabolic activity is failing due to an underactive thyroid, the adrenals must work harder to maintain proper metabolic function. If thyroid function remains defunct, the adrenals will ultimately become exhausted resulting in adrenal fatigue. With these two systems exhausted, the body is almost certain to experience a significant and long-lasting decline in functionality.
The Importance of Treating Both Thyroid and Adrenal Dysfunction
Because hypothyroidism and adrenal fatigue both involve hormone deficiency, the conditions are treated in a similar fashion. The most common approach is to administer hormone therapy based on the individual needs of the patient. For example, if thyroid dysfunction is suspected, a patient may be given thyroid hormone supplements to increase their hormone values. Similarly, if adrenal signs point to adrenal fatigue, a doctor may recommend cortisol or other adrenal hormone supplements.
When treating the adrenals or the thyroid it is critical that diagnosis is accurate. For example, in the presence of adrenal malfunction, thyroid hormone therapies may actually cause greater disruption. This is because thyroid medication accelerates metabolic activity, which can place greater stress on the adrenals thereby contributing further to adrenal fatigue . Ideally, if a patient is presenting symptoms of either adrenal dysfunction or thyroid disease, both systems are evaluated, and a full gamut of tests are run to assess relevant hormone values.
Finding a Doctor That Understands the Adrenal-Thyroid Connection
The body is composed of an intricate web of interlocking systems, many of which have direct influence on one other. An excellent example of this is the relationship between the adrenals and the thyroid. Both systems are integral to overall bodily function and exert their influence through the production of hormones. Due to their high degree of interconnectivity, dysfunction of one can have a dramatic negative impact on the other. Therefore, if symptoms of either adrenal or thyroid dysfunction develop, it is important to consider and assess both systems. Being aware of the close relationship between the adrenals and the thyroid and their important role in bodily function can help you better preserve their function and maintain greater wellness.
At Holtorf Medical Group, our physicians are knowledgeable in both thyroid and adrenal dysfunction, and how the two are connected. Because of this, they are able to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan that is personalized to you. If you are experiencing symptoms of thyroid or adrenal dysfunction, give us a call at 877-508-1177!
1. Victor Parsons, DM and Ian Ramsay, MD. “Thyroid and adrenal relationships.” Postgrad. med. J. (May 1968) 44, 377-384.
2. Seck-Gassama et al. “Serum cortisol level variations in thyroid diseases.” Dakar Med. 2000;45(1):30-3.
3. Amy Myers, MD. “The Adrenal-Thyroid Connection.” Amy Myers.