Ever felt like you were under a lot of stress?

Well, you’ve never seen stress like I’m about to show you in this case study.

That’s right. This is an extreme hypothyroidism case study.

I have all clients fill out our Thyroid Symptom Checklist.

It’s not uncommon for clients to check off 20 to 30 thyroid symptoms on the list.

This young woman checked off 69 of them.

No wonder she feels so horrible.

And it all boils down to stress…

Case Study Background: Hypothyroidism and Stress

I wrote previous about the Thyroid-Adrenal Stress Cycle.

In short, this is a self perpetuating cycle where hypothyroidism increases one’s production of stress hormones while those stress hormones further suppress thyroid function.

Hypothyroidism isn’t the only thing that triggers this stress cycle.

Severe acute stress can trigger it as well.

As it turns out, our case study subject was first diagnosed with hypothyroidism and Hashimoto’s Thyroiditis after receiving a shot of adrenaline (a potent stress hormone).

But that was just the beginning.

A year later, she suffered a broken back in a motorcycle accident causing her thyroid condition and health to spiral out of control.

If that’s not severe acute stress, I don’t know what is.

Her thyroid labs clearly show that she is hypothyroid…

  • Low T4
  • Low T3
  • Elevated reverse T3
  • Suppressed TSH (likely due to the excessive stress hormones)

Now, here’s the clear giveaway that her stress response is overactive and that she’s overproducing stress hormones.

Take a look at her body temperature throughout a given day.

  • Basal Waking Temperature: Commonly elevated.
  • Post Meal Temperatures: Often decline.
  • Afternoon Temperature: Consistently above normal.

(NOTE: It’s essential to account for body temperature and pulse when assessing thyroid function and thyroid labs. Learn how and why in this free thyroid testing training.)

When we see consistently elevated body temperature, it typically points to one of two things.

  1. Hyper-thyroidism (we know from her labs that’s not the case.)
  2. Severely elevated stress hormones.

Severely elevated stress hormones will artificially raise your body temperature.

Plus, our subject exhibited some common symptoms of elevated stress hormone production including:

Now, this is where things get interesting.

The 4 Primary Thyroid-Stress Activators

Whenever excessive stress hormones are produced, we want to figure out what exactly might be triggering it.

We do this by looking at diet/nutrition logs, temperature and pulse logs, labs, symptoms, health history, etc.

This often leads us to one or more of the four primary thyroid-stress activators:

  1. Hypoglycemia
  2. Estrogen Dominance
  3. Excess Serotonin
  4. Excess Endotoxin

All four of these can occur as a result of hypothyroidism, and all four are well known to strongly activate your body’s stress response.

What’s interesting is that we didn’t find just one or two of these thyroid-stress activators in our case study subject.

We found all four.

Let’s take a quick look at how we came to this conclusion…

Thyroid-Stress Activators #1: Hypoglycemia (including poor blood sugar handling and insulin resistance)

When you become hypothyroid, you’re liver can’t store and release sugar efficiently.

So, you become prone to hypoglycemia and poor blood sugar handling.

When blood sugar drops, stress hormones are produced to help regulate your blood sugar by stimulating your liver to release sugar and by breaking down muscle tissue in your body to convert into sugar.

When this hypoglycemia-stress hormone cycle continues long term, it triggers the onset of insulin resistance and diabetes.

(NOTE: Want to learn more about how hypothyroidism leads to insulin resistance and diabetes? Take a look at this article on “Hypothyroidism and Diabetes: How to Reverse It and Why Sugar Is NOT the Problem”.)

Our subject shows some common symptoms of poor blood sugar handling and insulin resistance:

  • Mood Swings
  • Blurry Vision
  • Poor Cognitive Function
  • Fatty Liver (diagnosis)
  • Elevated Insulin (lab)
  • Low Carbon Dioxide (lab)

Thyroid-Stress Activators #2: Estrogen Dominance

Estrogen dominance (excess estrogen and/or progesterone deficiency) is well known to activate your body’s stress response.

Excess estrogen activates your adrenal glands both directly and by increasing adrenocorticotropic hormone (ACTH).

In our subject’s case there were many signs of excess estrogen including:

  • Heavy Periods
  • Edema
  • Hashimoto’s Thyroiditis (diagnosis)
  • Pelvic Inflammation (diagnosis)
  • Elevated Estradiol (lab)
  • Elevated Prolactin (lab)
  • Elevated Luteinizing Hormone (lab)

Thyroid-Stress Activators #3: Excess Serotonin

Serotonin wasn’t measured, but I’m certain if it was, it would be elevated too.

This is because excess serotonin goes hand-in-hand with excess estrogen by way of the Hypothyroidism–Estrogen–Prolactin Cycle.

hypothyroidism and stress

We’ve already verified elevated estrogen and prolactin. Labs also verified elevated parathyroid hormone (PTH), all of which implicate serotonin.

Our subject also showed many other symptoms of excess serotonin including:

  • Food Sensitivities
  • Skin Rashes
  • Itching
  • Irritable Bowel Syndrome (diagnosed)
  • Pelvic Inflammation (diagnosed)
  • Elevated estrogen, prolactin, and parathyroid hormone (labs)

Thyroid-Stress Activators #4: Excess Endotoxin

Last, but not least, we have endotoxin.

Endotoxin is a byproduct produced by bacterial overgrowth in your intestines.

Studies show that hypothyroidism makes you more susceptible to small intestine bacterial overgrowth (SIBO).

It just so happens that our subject was also diagnosed with SIBO, making endotoxin a problem too.

Hypothyroidism and Stress Case Study Recommendations

As you can see, there is a lot going on with this case study subject.

She is stuck in the Hypothyroidism-Adrenal-Stress Cycle with her stress response being activated by all four primary thyroid-stress activators.

Plus, she’s showing signs of insulin resistance and severe liver dysfunction.

Two things are for certain…

  1. This isn’t going to be a quick and easy recovery.
  2. With so many complications, it’s going to require some experimentation to determine the most effective path to healing.

But here’s a good place to start…

1. Fix the Fatty Liver First

Without a healthy liver, you’re odds of restoring thyroid function are nil.

You simply won’t be able to get stress hormones under control.

There are a number of things that can help with this:

2. Focus on the 3 Anti-Stress Hormones

Since hypothyroidism (or lack of thyroid hormone) contributes to all four primary thyroid-stress activators, then it should make sense that restoring thyroid hormone levels is essential to suppressing the stress response once and for all.

However, thyroid hormone often needs to be introduced and increased in small amounts (to toleration) when stress hormones are extremely elevated.

This process is necessary, but can take some time.

The next anti-stress hormone is progesterone.

Progesterone strongly suppresses the body’s stress response in large part by its opposing effects on estrogen, while also helping to restore proper function of the thyroid gland.

Due to the subject’s significant estrogen excess, a larger dose of progesterone will likely be needed.

Since the subject is still menstruating, we can also use Vitamin E to further suppress estrogen during times of the menstrual cycle when progesterone isn’t used.

Studies show that Vitamin E can lower estrogen by up to 55% in 10 weeks.

The third and final anti-stress hormone is pregnenolone.

Pregnenolone has many similar effects as progesterone and has been shown to lower cortisol levels by up to 60%.

3. Ditch the Starch and Focus on Fruits and Shoots

Limiting dietary starch can help with a number of the subject’s underlying issues.

It can help decrease fatty liver, improves insulin resistance, and helps to lower endotoxin.

Instead of getting carbohydrates from starch, the subject should focus on higher fructose sources of carbohydrates such as fruits, keeping carbohydrate intake in moderation until the insulin resistance is corrected.

In insulin resistance, you can’t delivery sugar to your cells, so consuming large amounts of sugar can lead to a significant rise in blood sugar.

Instead, focusing on slow yet frequent intake of fruit (combined with collagen protein) can help keep blood sugar elevated enough to prevent activating the stress response, without blood sugar rising too high.

The endotoxin issue should also be addressed by the use of bamboo shoots and/or cascara.

4. Get More Salt

In hypothyroidism and chronic stress, sodium is wasted rapidly.

So, it wasn’t surprising to see the subject’s labs indicate low sodium levels.

Sodium is essential for keeping stress hormones low (adrenaline in particular) and regulating blood sugar.

5. Restoring Insulin Sensitivity

Suppressing the body’s stress response is essential to restoring insulin sensitivity.

For many, it’s best to focus on restoring liver function first.

Aside from what has been mentioned thus far, using therapeutic doses of Vitamin B3 (niacinamide) and/or aspirin is where we start.

As you can see, this turned out to be a more complicated case study.

But, by using the tools and resources we have at our disposal (diet/nutrition logs, temperature and pulse logs, labs, symptoms, health history, etc.), we’re able to make some sense out it all.

It’s also important to understand that the more stress we are under, the more thyroid hormone we need to compensate for that stress.

If our case study subject was properly treated from the beginning with thyroid hormone, when her hormones began to spiral out of control, it could have prevented many of these unnecessary health complications and now severe symptoms.

And of course, the more hypothyroid you become and the more complications you develop, the longer the road to recovery.