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Old 02-13-2006, 02:15 PM   #3
foxfire4321
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Join Date: Feb 2006
Location: Michigan
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Re: thyroid adrenal?

There is a link between the adrenal and thyroid glands in that they are both part of the endrocine system, but there are distinct differences on how they fail. Many people (estimates are as high as 10% of women over 65) suffer from hypothyroidism (lack of thyroid hormone), most commonly caused by an autoimmune attack on the thyroid gland (Hashimoto's disease). This conidition causes a vast amount of symptoms and the onset is insidious (read as... hard to detect). The lowered thyroid hormone level causes your entire metabolism to slow down which in turn lowers your usage of cortisol (the main "stress" hormone of the adrenals). This typically isn't a problem; but your adrenal function should be tested before you start thyroid meication. If you are one of the small minority (something like 0.33% of hypothyroid patients) who also has adrenal failure (auotimmune attack on the adrenal glands, Addison's disease) the sudden jacking up of your metabolism by exogenous thyroid hormone can deplete your diminished cortisol reserves to dangerous levels (leading to an Addison Crises) through increased use.

Let me emphasize, it is a small percentage of people who suffer from both Hashimoto's and Addison's disease (a condition called Schmidt's disease or Polyglandular autoimmune syndrome type II), somewhere around 14-20 people per million of the general population in the US, while a significant number of people suffer solely from Hashimoto's disease (around 3 per 1000 according to the NIH with overt hypothyroidism). Your doctor will probably test your adrenal function prior to starting thyroid medicine, and either do routine follow-up tests every couple of years or test you for anti-adrenal cortex antibodies (around 1% of Hashimoto's patients have them, and 30% of those progress to Addison's).

This of course brings us to the topic of "adrenal fatigue" and subclinical Addison's disease. There is a body of research to support subclinical Addison's disease, which is where a patient has the autoreactive antibodies to their adrenal glands and they show evidence of damage through skewed biochemistry (i.e. plasma renin activity changes). A significant number of these people over time will continue to progress to Addison's disease and I would think that their doctor would monitor them closely. The "adrenal fatigue" syndrome is a nondistinct syndrome developed in the 80s or 90s to explain people who always "feel bad" but have no evidence of hormonal imbalance. It does not have a lot of support in the established medical community. The syndrome does not show up on normal adrenal function tests and as such has come under fire. I personally don't believe in "adrenal fatigue," but I have never claimed to know everything

There is a documented and significant rise in your chances to develop a second autoimmune disease once you have developed one. So if you have Hashimoto's disease than you are at higher risk to develop such things as Addison's disease (rare), pernicious anemia (fairly common, lack of ability to absorb vitamin B12), vitilogo (fairly common, loss of pigmentation), and diabetes (rare to develop type I later in life, but possible); BUT your chances are still pretty slim. As pertaining to your surgery one of the hallmarks of developing Addison's disease is hyperpigmentation and this is usually evident in recent surgery scars as the stress of the surgery is usually enough to deplete your cortisol levels.