iThei mdcdaelcinfd o c elllllrllll ThofthThseThyroid Supplements
Once thyroid activity increases (such as with thyroid supplements or life-
style interventions), additional stress is placed on the adrenals, resulting
in a worsening of symptoms. This can make most people feel they are
suffering a huge setback, despite making gains. When attempting to im-
prove thyroid function, adrenals should always be considered in conjunc-
tion with restoring nutritional deficiencies.
Addison’s Disease
Known as Addison’s disease, full-blown adrenal insufficiency is usual-
ly not diagnosed until someone is going through an adrenal crisis (an
emergency situation). Addison’s disease used to be historically associated
with tuberculosis and other types of infections that destroy the adrenal
glands. Today, autoimmunity is the leading cause of Addison’s, respon-
sible for 70–90 percent of cases. Just as anti-thyroid antibodies are found
in Hashimoto’s patients, corresponding anti-adrenal antibodies are found
in people with Addison’s disease. The most common antibody is formed
to one of the adrenal enzymes, 21-hydroxylase; up to 86 percent of pa-
tients with autoimmune adrenal insufficiency will test positive for these
antibodies.
Symptoms of full-blown Addison’s include weakness, fatigue, loss of ap-
petite, weight loss, darkening of the skin, nausea, vomiting, low blood
pressure with orthostatic hypotension (dizziness when standing), muscle
and joint pain, salt cravings, decreased hair growth in underarms and pu-
bic area, and diminished sex drive in women. These symptoms are similar
to those of adrenal fatigue but are more severe in most cases, sometimes
requiring hospitalization. Physicians screen for adrenal fatigue by check-
ing to see if there is an elevation of ACTH or measuring blood levels
of cortisol or DHEA. Adrenal insufficiency becomes clinically manifest
only after at least 90 percent of the adrenal cortex has been destroyed.
Subclinical Addison’s
People with Hashimoto’s and other autoimmune conditions are more
likely to develop Addison’s.
Co-occurring Addison’s and Hashimoto’s is known as Schmidt’s disease,
and any person with Hashimoto’s who has anti-adrenal antibodies should
be considered to have both conditions.
People with anti-adrenal antibodies go on to develop adrenal insufficien-
cy at a rate of 19 percent a year. Some people with the antibodies were