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How to Improve Your Stress and Thyroid Feedback Loop

Written by Dr. Michael Ruscio, DC on August 19, 2024

Written by Dr. Michael Ruscio, DC on August 19, 2024 — Reviewed by Kellie Blake

Your Thyroid is Adaptable, But Chronic Stress Leads to Impaired Function

• How Does Stress Impact Thyroid Function?|
• The HPT/HPA Axis Connection|
• How Do Thyroid Issues Affect Stress Levels?|
• Stress Management Techniques for Thyroid Health|
• Other Alternative Therapies to Reduce Stress|
• Stress and Thyroid Health|

Do you have a thyroid condition and worry about how stress could affect your thyroid health? Or, feel like you’re stressed all the time and wondering if your thyroid could be impacted? Whether you have a diagnosed thyroid condition or not, it’s worth knowing how stress can impact your thyroid, from hormone production to autoimmunity. 

Once you know the potential outcomes, you can take precautions to support your thyroid and lower stress levels in a way that works for you. Let’s take a closer look at the effects of stress on thyroid health.

How Does Stress Impact Thyroid Function?

There exists a nuanced and delicate relationship between thyroid health and stress levels. Theoretically, environmental pressures — including stress — trigger genetic, developmental, and short-term adaptations that promote periodic changes in thyroid hormone levels [1].

Using the phrase “periodic changes” is important — for those who have a healthy stress response, this means that thyroid hormones may fluctuate mildly during a stressful period and then return to normal once the stress has passed. However, many people these days are living in an almost constant state of stress, increasing the production of stress hormones (glucocorticoids such as cortisol) and decreasing thyroid hormone production [2]. When the body is chronically stressed, whether from daily social stressors or chronic disease-related inflammation, it can impact the thyroid gland’s ability to make hormones required for metabolism and energy production [2].

We don’t know exactly why this happens, but the best consensus is that higher levels of stress hormones may suppress the thyroid gland and hormone production as a way to help the body conserve energy during stress [2]. 

This could explain what we’ve found in our own research and our experience in the clinic: that subclinical hypothyroidism (an underactive thyroid where thyroid-stimulating hormone levels fall between about 4 and 10) often resolves on its own. Even mild or brief elevations in stress hormones can subtly change your thyroid hormone levels [2] [3]. The times when it doesn’t resolve could reflect the presence of excessive stressors inhibiting the thyroid gland from bouncing back. These cases are then more likely to develop into diagnosable thyroid conditions, such as hypothyroidism. 

The HPT/HPA Axis Connection

The hypothalamic-pituitary-thyroid (HPT) axis is sensitive to stress and interacts with the hypothalamic-pituitary-adrenal (HPA) axis via their shared connection to the hypothalamus and pituitary gland in the brain. If there’s a problem in one axis, it can affect the other. 

For example, a stressor can provoke the HPA axis to produce stress hormones called glucocorticoids (like cortisol), which can lower thyroid hormone levels and inhibit thyroid function [4]. Stress can also tell the adrenal glands to produce catecholamines (such as dopamine, norepinephrine, and epinephrine aka adrenaline), which set off the “fight or flight” response. Both of these actions contribute to what we perceive as higher stress levels. 

Picture this: The HPA and HPT axes are two different railroad tracks. Pulling the lever for the train to take the HPA track automatically blocks access to the HPT track — the train can only access the HPA track. If repeated consistently over time, the HPT track grows rusty with disuse and becomes inefficient. This is analogous to the body constantly prioritizing the HPA axis and producing stress hormones instead of the HPT axis to produce thyroid hormones. 

The HPA axis may essentially suppress the thyroid to tell the body it needs to rest and recover from the damage of prolonged stress. And the longer the stress goes on, the more likely an autoimmune thyroid condition (like Hashimoto’s or Grave’s disease) may develop.

Stress and Thyroid Conditions

Chronic stress has not yet been recognized as a risk factor for Hashimoto’s thyroiditis (autoimmune hypothyroidism), but it likely plays a role [5]. In contrast, research has found that stress does seem to contribute to Graves’ disease (autoimmune hyperthyroidism) in susceptible people [6].

A 2023 meta-analysis of 13 observational studies (2,892 participants, mostly women, from 9 countries) found that stressful life events are strongly associated with the onset of Graves’ disease, especially in younger females. Stress seems to be one of the environmental triggers for the onset of Graves’ disease [6].

Early life stressors (immunological, nutritional, social, or other energetic stressors) may also lead to lower thyroid hormone levels [1].

How Do Thyroid Issues Affect Stress Levels?

Now that we’ve discussed how stress impacts the thyroid, what about the other way around? How can the thyroid impact stress in the body?

The thyroid adapts to stressors, increasing thyroid hormones during conditions (like pregnancy) that require lots of energy use, and decreasing them during times when energy requirements are low, like during fasting. Therefore, it seems that the thyroid gland is flexible and adjusts the body’s metabolism to anticipate energetic stressors [1]. But it’s possible for the thyroid to produce too much or too little thyroid hormone for a long period of time, resulting in an increase in stress and inflammation.

• Conditions of hyperthyroidism (too much thyroid hormone) can provoke the adrenal system to produce stress hormones [4].
• Conditions of hypothyroidism (too little thyroid hormone) may contribute to inflammation, increasing internal stress on the body [7].

So we have a bit of a chicken and egg situation here. Going back to hyperthyroidism, in a cyclic fashion, those stress hormones can trigger various pathways involving the immune system, hormones, and cytokines, which can contribute to Graves’ disease, an autoimmune hyperthyroid condition. And because hyperthyroid can increase stress hormones, we’re back to stress contributing to thyroid dysfunction. 

Stress Management Techniques for Thyroid Health

Based on the research, we can split stress management techniques for thyroid health into two main categories: exercise and holistic stress management. Let’s take a closer look at each of these. 

Exercise

Two high-quality meta-analyses showed exercise has an impact on thyroid function in certain groups of people. 

1. One meta-analysis showed that exercise mildly or moderately improved TSH levels in obese patients with metabolic syndrome [8].
2. The second one found that exercise only trended toward improving thyroid hormone levels in women with subclinical hypothyroidism [9].

This could indicate that exercise affects thyroid function indirectly by improving other conditions, like metabolic syndrome, that may be contributing to poor thyroid function.

For example, a recent small randomized controlled trial (RCT) found that when postmenopausal women with metabolic disease did water aerobics, their TSH and T4 improved along with their insulin resistance [10].

It’s possible that exercise may have a greater effect on thyroid function in people with poorer thyroid health and other conditions that contribute to thyroid dysfunction than in people with milder conditions. That being said, exercise is generally recommended for your overall health, regardless of your thyroid health. 

The cool thing is that the type of exercise required to improve thyroid health seems to be pretty variable as long as you maintain consistency with your sessions. For example, a 2023 RCT compared the effects of aerobic, resistance, and combined exercises on thyroid function, lipid levels, exercise capacity, and quality of life in women with hypothyroidism. The study randomized 60 women (aged 35–45) with clinical hypothyroidism to one of four groups: aerobic exercise, resistance training, combined training, and control. They performed low–moderate intensity exercise three days a week for 12 weeks. 

The study found that, compared to baseline and controls, all exercise groups had significantly improved TSH, T4, lipid levels, VO2 max (exercise capacity), and quality of life. Combined exercise led to the greatest improvement, but all types of exercise had some positive effect [11].

Key Takeaway: If you’re just getting started with exercise to improve your thyroid health, don’t worry too much about what type or trying to balance strength and cardio. Focus on doing an activity you enjoy for three days a week, 30-60 minutes per session, and build on your routine from there. You can start with something as simple as walking or biking.

Holistic Stress Management

A novel RCT was conducted to see if stress management could improve thyroid health in women with Hashimoto’s thyroiditis. A total of 60 women with Hashimoto’s were randomly assigned to undergo eight weeks of stress management or to a control group that only received standard treatment.

Compared to standard care, the stress management protocol was associated with significant improvements in thyroid antibody levels, TSH levels, healthy lifestyle scores, stress, anxiety, and depression. Though decreases in anti-TPO antibodies and TSH were not statistically significant, anti-thyroglobulin antibodies were significantly decreased.

This is very encouraging that lifestyle changes such as breathing exercises, changing thought patterns, and guided meditation could have a significant effect on thyroid function to the point of actually correcting thyroid antibody levels and TSH levels. 

Key Takeaway: Combining and building on a number of stress management techniques can have measurable impacts on thyroid function. You can build your own protocol along these lines, where you practice belly breathing for a week, then move on to progressive relaxation, cognitive reconstruction, and so on. You don’t have to focus an enormous amount of time on learning these techniques; just 10 or 15 minutes a day as a starting commitment is enough. Other techniques, such as EFT tapping, may also be useful for stress reduction. 

Want to learn more about how to improve your thyroid health without prescriptions and specific healthcare providers? Check out our Thyroid Course with a totally self-paced protocol to improve your thyroid health on your own terms. 

Other Alternative Therapies to Reduce Stress

While the following alternative therapies to reduce stress don’t have specific data on thyroid patients or improving thyroid health, they are very effective for managing and reducing the stress that could be contributing to thyroid dysfunction. 

Mindfulness and Meditation Practices

Several studies suggest that meditation and mindfulness practices can help reduce stress markers, inflammation, and cortisol levels, especially in people with higher stress levels or health conditions. Namely, high-quality evidence shows that:

• Meditation can reduce stress markers, including blood pressure, heart rate, CRP (a marker of inflammation), triglycerides, and TNF-alpha (an inflammatory cytokine connected to thyroid dysfunction) in many populations [12].
• Mind-body practices like Tai Chi, Qi Gong, meditation, or yoga, when practiced for 7-16 weeks, significantly reduced CRP and had potential benefits on other immune system markers like IL-6, TNF-alpha, CD4 cell counts, and natural killer cell counts [13].
• Practicing mindfulness or meditation 1-2 times a week may moderately reduce blood cortisol levels in people experiencing a physical illness or stressful life situation [14].
• Stress-reducing techniques, including mindfulness, meditation, or cognitive behavioral therapy, had a small, short-term impact on reducing inflammation, especially in individuals with high psychological distress [15].

Spending Time in Nature

Evidence shows that time in nature can improve adults’ response to stress [16]. 

• A large systematic review found that people who spent time in nature had less anxiety and depression afterward [17].
• Another review found that after time in nature, people said they felt less stressed, and their bodies reflected this perception with reduced amygdala activation, improved cortisol and blood pressure levels, and calmer autonomic nervous systems [18].
• One RCT found that the activated amygdalas of people who did stressful tasks relaxed after a walk in the forest but NOT after a walk along a busy city street [19].
• In older people, walking in urban green areas rather than busy commercial areas appeared to reduce stress and improve emotional well-being [20].

Biofeedback

A 2021 meta-analysis evaluated the effects of heart rate variability (HRV) biofeedback for stress reduction in the treatment of anxiety, depression, and stress-related disorders. HRV biofeedback involves breathing at a pace of 4–7 breaths per minute to balance the autonomic nervous system while an app monitors your progress.

The results showed that HRV biofeedback combined with usual treatment significantly improved stress-related disorders (like PTSD, depression, and panic) compared to usual treatment alone [21]. 

Examples of HRV devices include HeartMath Inner Balance or EmWave 2, Unyte iom2, Muse S Headband, Apollo Neuro, Elite HRV, and Lief. 

Self-Help Virtual Therapy

A 2023 multicenter study in Europe investigated the efficacy of a self-help virtual therapeutic experience for reducing the psychological burden of COVID lockdowns.

Across countries, people who participated in the COVID Feel Good intervention reported significantly less general distress and a greater sense of social connection.

In conclusion, self-help virtual intervention (and potentially others that are similar) was effective in reducing psychological distress. Although I can’t recommend a particular app or website, this contributes to a growing body of research supporting the use of virtual therapies for psychological distress [22].

Stress Is a Significant Indicator of Thyroid Health

The bottom line is that chronic stress can impact many aspects of your health, including thyroid health. Practice stress management techniques, exercise regularly, and adjust your lifestyle wherever possible to reduce overall stress — it’s worth it for your health. 

To learn more about thyroid health, gut health, exciting new research, and more, check out my YouTube channel or find more in-depth protocols and info in my book Healthy Gut, Healthy You. 

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.