Adrenal Dysfunction or Hypothyroidism?

Adrenal Dysfunction or Hypothyroidism?

When I met Betty 5 years ago, she was very frustrated with ongoing fatigue. 

She wanted me to do a more thorough thyroid testing – her primary care provider had only ordered a TSH. 

After learning more about Betty’s symptoms, I explained to her that we would run some additional blood work to check for potential causes, but her symptoms sounded more like adrenal dysfunction than hypothyroidism. 

Distinguishing Between Adrenal Dysfunction and Hypothyroidism

It can be difficult to distinguish between adrenal dysfunction and hypothyroidism. 

Both can cause fatigue, depression and weight gain, but there are some notable differences, especially in the pattern of the fatigue.  

I call fatigue due to hypothyroidism a flatline pattern. 

People feel tired all the time; it doesn’t matter the time of the day or the days of the week. Sleeping in doesn’t help much.  People also often feel depressed with hypothyroidism, which exacerbates the fatigue.  

Fatigue from adrenal dysfunction on the other hand is usually more intermittent. 

People usually feel more tired in the early morning or mid-afternoon. Their energy tends to perk up after 6pm, so they may feel tired but also wired at the same time. If they decide to power through the fatigue, they get a second wind of energy, and will have a hard time falling asleep. 

Sleeping in usually helps with their energy level.  They can feel physically drained as there is weakness in their arms and legs, but when they start moving around or exercising, their energy can improve. 

Besides the characteristic fatigue patterns, there are other symptoms that can help distinguish adrenal issues from thyroid. 

People with hypothyroidism tend to crave sugary foods. Eating more protein can help reduce sweet cravings. People with adrenal dysfunction tend to crave fats and proteins. Eating salty foods and caffeine help improve energy. 

People with hypothyroidism experience increased intolerance to cold, hair loss on scalp and eyebrow, dry skin, stubborn constipation, weight gain around hips and thighs and increased difficulty to lose weight despite calorie restriction.

For people with adrenal dysfunction, the cold intolerance is not as pronounced. We see more irritability and anxiety than a depressed mood. We can see hair loss from the scalp but usually not with the eyebrows. Weight distribution is more around the abdomen, and weight is influenced by calorie intake and exercise. 

For women with hypothyroidism, the menstrual cycle is usually heavy and long. For women with adrenal dysfunction, the menstrual cycle often becomes light by the 3rd and 4th day. Some women may skip the 3rd or 4th day and have some spotting on day 5. 

The signs and symptoms I describe above are the general patterns we see. 

Symptoms can change as you move from the early stage of adrenal dysfunction to the later stages. 

Note that there are also many other potential causes that can lead to the same symptoms.  It is important to be thoroughly evaluated by a well trained and knowledgeable health care provider before starting any over-the-counter adrenal or thyroid supports.  

Feel free to schedule a consultation with the providers at Naturopathic Family Health if you have any specific concerns.  

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Dr. Sherry Su, San Jose Naturopath

Dr. Sherry Su, ND, FABNG
Naturopathic Doctor San Jose

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