by Dr. Kotb
Your body is talking to you, but you’re not sure how to interpret the message: You’re inexplicably tired all the time, you can’t concentrate, and you’re crankier than usual. Your skin is also dry, your hair seems to be thinning, and you’re gaining weight. What’s going on?
A quick consult with doctor Google will point you toward a number of possible diagnoses, with hypothyroidism and adrenal fatigue likely topping the list. The only way to get to the root of your problem is to see a real live MD, who ought to take a thorough history, do a physical, and perhaps run a few tests. In the meantime, here’s some insight into whether a thyroid or adrenal issue might be to blame.
Think thyroid first.
Thyroid disorders are extremely common, says Antonio Bianco, MD, PhD, professor of internal medicine at Rush University Medical Center and president of the American Thyroid Association. He notes that 11 million people in the US have an underactive thyroid (aka hypothyroidism). Women are more likely than men to develop this problem; the risk also goes up after age 60.
When your thyroid—a small, butterfly-shaped gland that sits at the base of your neck—is functioning properly, it produces hormones that regulate your metabolism and body temperature. If it’s not making enough thyroid hormone, your body’s processes start slowing down. At first, you may not notice anything. But as your metabolism continues to slow, the classic signs of a sluggish thyroid kick in: fatigue, weight gain, constipation, sensitivity to cold, and dry skin. (Here’s how you can get those fat-loss hormones in check using Prevention’s The Hormone Fix.)
Of course, these symptoms can point to other conditions as well, so the only way to be certain you have hypothyroidism is with a TSH (thyroid-stimulating hormone) blood test. “If TSH is high, you have hypothyroidism—simple as that,” says Bianco. Your doc will likely prescribe a daily dose of a synthetic thyroid hormone (thyroxine) to replace what your body is missing.
All about your adrenals
If your thyroid checks out, then maybe it’s time to consider adrenal fatigue.
It’s worth noting that most mainstream physicians don’t think adrenal fatigue exists. But some health care practitioners—mostly naturopathic doctors and some holistic MDs—believe that adrenal fatigue is real and ought to be taken seriously. (Here are 7 other possible reasons you’re tired all the time.)
According to the believers, signs of adrenal fatigue include being both tired and wired, getting lightheaded when you stand up quickly, not being able to shake colds or infections, and feeling anxious, irritable, or moody. The theory is that these symptoms occur because your adrenals—tiny glands that sit on top of your kidneys and secrete stress hormones—burn out. The result is a mild form of cortisol deficiency, which may be called adrenal fatigue or adrenal dysregulation. (This should not be confused with adrenal insufficiency or Addison’s disease.)
Adrenal fatigue happens when “unremitting stress causes your adrenals to pump out more and more stress hormones, and after working overtime for too long, they can’t keep up,” says Sara Gottfried, MD, author of The Hormone Reset Diet. “The adrenal glands sputter, cortisol levels drop, and you feel depleted.”
If you think you might have this issue, Gottfried recommends getting your cortisol levels tested. Cortisol can be measured with blood, urine, saliva, or even hair tests, says Gottfried. “Most [Western] doctors only recognize the merits of blood testing—it’s considered the universal language of conventional medicine,” says Gottfried—but she believes that dried urine testing (it involves peeing on a piece of filter paper) may be a better option for measuring hormones.
Gottfried says it’s smart to consider adrenal fatigue a possibility in a number of cases. “Sometimes it’s felt as anxiety, depression, or PMS,” she says. “Other times, adrenal dysregulation may occur in perimenopause and menopause with worsening hot flashes, night sweats, difficulty sleeping, and low sex drive. When these problems are addressed without consideration of adrenal function, symptom improvement is short-lived or never achieved.” She suggests keeping a log of your symptoms that you can share with your healthcare provider.
If you are diagnosed with adrenal fatigue, lifestyle changes might do the trick. Gottfried says you should cut out sugar (“It acts as an adrenal stimulant”), as well as boost your intake of key vitamins that support this gland, including B vitamins and vitamin C.
Exercise is also important, but make like Goldilocks: “When your adrenals are stressed, you need to be careful not to underdo it or overdo it,” says Gottfried. A 20-minute walk or light jog might be plenty while you’re healing.
Meanwhile, limit your exposure to toxins, such as bisphenol A (BPA), which can mess with your hormones. You’ll find BPA in certain plastic containers, many canned goods (cans are often lined with BPA), and on credit card receipts.
Some practitioners also give cortisol to patients with adrenal fatigue, but this is controversial, as taking too much of this hormone can be dangerous.
Reviewed by Dr. kotb and his team
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