Adrenals or Thyroid: Which One to Support First?

If you suspect you have an adrenal and a thyroid problem, which one should you address first?  Some people notice they feel worse if they support their thyroid before their adrenals.  Let’s discuss why this is.

If you need help with your adrenals or thyroid, click here

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Adrenals or Thyroid: Which One to Support First?

Dr. Michael Ruscio: Adrenals or thyroid—which one should you support first?

If you’re looking into your adrenal and thyroid health, you may have heard the recommendation that it’s important to support your adrenals first, and let’s talk about why that is.

Now, the adrenals are two glands that are located on top of your kidneys, that produce a number of hormones that help with things like sleep, energy, sex drive, mood, and the thyroid, of course, is a gland in your throat that produces a hormone called thyroid hormone, which is very important for metabolism and preventing things like feeling cold, high cholesterol levels, fatigue, and weight gain. There’s a lot of overlap between these two, of course.

People oftentimes may think or have laboratory evidence that shows that they have a problem with both, so what would be the most intelligent way to start supporting these if you find a problem with both or you suspect a problem with both? It’s likely a good idea to support the adrenals first, and the reason for that is because thyroid hormone increases your metabolism, and that includes the metabolism of cortisol. If you have low cortisol, which is your adrenal hormone, which you need enough of to feel good—it’s often vilified as being a stress hormone and that we have too much of it, but if you run labs on people, you oftentimes will see most people come back with a little bit too low of a cortisol level. Most people who are a little bit tired tend to have low cortisol, and again, you need a proper amount to have adequate energy.

So if someone has low cortisol and you give them thyroid hormone and the thyroid hormone helps detoxify or clear out or metabolize this cortisol, it can make the cortisol levels even lower and make the underlying low cortisol, adrenal fatigue-type problem even worse. This is why some people—not all, but some people—may feel no difference or even worse when going on a thyroid hormone because the adrenals may be severely deficient. So what to do in this case would be to start with supporting the adrenals and then or shortly after support the thyroid. Now, it also depends on the extent of the hypothyroidism or the thyroid dysfunction, but this is a good general concept.

Now, when it comes to supporting the adrenals, there are a number of compounds that can be used. There are herbs, there are glandulars, and there are hormone precursors like pregnenolone and DHEA. All of these can work, but it’s very important to mention that none of these will work ultimately if the underlying cause of the adrenal fatigue is not addressed. Sometimes it’s diet, sometimes it’s lifestyle. For people that have addressed their diet and their lifestyle and are still exhibiting chronic signs of adrenal fatigue, it’s more often than not another issue in the body, a chronic inflammatory issue—oftentimes in the gut, in my experience—that’s causing this chronic adrenal stress and thwarting the ability of the adrenals to respond fully to adrenal support and to come back online fully.

Again, in reiteration, thyroid and adrenals have a relationship to one another. Because increasing thyroid levels through thyroid hormone can decrease levels of cortisol, one should be careful about taking thyroid hormone if they suspect or they know they have very low cortisol levels because that may worsen the issue. Support the adrenals first in most cases and then the thyroid, but of course, you want to check in with your doctor because the patient context is going to be an important determinant for exactly how and what you do in this regard.

This is Dr. Ruscio, and I hope this helps you get healthy and get back to your life. Thanks.

If you need help with your adrenals or thyroid, click here

What do you think? I would like to hear your thoughts or experience with this.

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

18 thoughts on “Adrenals or Thyroid: Which One to Support First?

  1. Hello Dr. Ruscio,

    I just read the article on treating the adrenal vs. the thyroid first, interesting and informative, as are your many articles. I did notice however, that your closing remark, “This is Dr. Ruscio, and I hope this helps you get healthy and get back to your life. Thanks” made me pause to consider, when do we ever get to go back in time? Never. Though that is not what you were meaning it sounds backwards. How about, ‘get on with your life;. I’m a big fan of NLP, as always much to learn, but, to me it sounds more positive to move on. vs. get back. Something to consider.

    Be well and enjoy the journey!

    Andrea

    1. I don’t think he meant for us to literally “go back in time’. He meant for us to use the information to get healthy and get back to living a healthy life again. A lot of people who are dealing with these issues absolutely want to get back the life they had before the malaise set in. Their life is basically “on hold”.

  2. Hello Dr. Ruscio,

    I just read the article on treating the adrenal vs. the thyroid first, interesting and informative, as are your many articles. I did notice however, that your closing remark, “This is Dr. Ruscio, and I hope this helps you get healthy and get back to your life. Thanks” made me pause to consider, when do we ever get to go back in time? Never. Though that is not what you were meaning it sounds backwards. How about, ‘get on with your life;. I’m a big fan of NLP, as always much to learn, but, to me it sounds more positive to move on. vs. get back. Something to consider.

    Be well and enjoy the journey!

    Andrea

    1. I don’t think he meant for us to literally “go back in time’. He meant for us to use the information to get healthy and get back to living a healthy life again. A lot of people who are dealing with these issues absolutely want to get back the life they had before the malaise set in. Their life is basically “on hold”.

    1. Hi Rick,

      An adrenal saliva panel that measures cortisol at 4 times throughout the day is a great way to test adrenal function. You simply provide a saliva sample in the morning, noon, afternoon, and night.

    2. Hi Rick,
      That being said, I no longer test adrenals because they can fix themselves rather quickly once the cause of adrenal stress has been addressed. I did used to use BioHealth however. Hope this helps.

    1. Hi Rick,

      An adrenal saliva panel that measures cortisol at 4 times throughout the day is a great way to test adrenal function. You simply provide a saliva sample in the morning, noon, afternoon, and night.

    2. Hi Rick,
      That being said, I no longer test adrenals because they can fix themselves rather quickly once the cause of adrenal stress has been addressed. I did used to use BioHealth however. Hope this helps.

  3. If you support your adrenals due to low cortisol.. Would it be bad to use bovine brain supp in conjunction to the adrenal glandular? or would it assist the pituitary and tsh and in turn… T4/t3 and you’re back to lowering cortisol?

    1. Hi May,

      I’ll pass this question along to Dr Ruscio to hopefully answer in an upcoming listener Q+A episode of the podcast. Stay tuned!

  4. If you support your adrenals due to low cortisol.. Would it be bad to use bovine brain supp in conjunction to the adrenal glandular? or would it assist the pituitary and tsh and in turn… T4/t3 and you’re back to lowering cortisol?

    1. Hi May,

      I’ll pass this question along to Dr Ruscio to hopefully answer in an upcoming listener Q+A episode of the podcast. Stay tuned!

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