Hypothyroid vs. Adrenal Fatigue: Know the Signs and Symptoms

Fatigue is one of the most common concerns among people today. Studies show that 38% of American workers report feeling fatigued.

The thyroid and adrenal glands play a role in regulating energy levels, metabolism, and vitality. Issues with these glands are often linked to feelings of fatigue. In this article, we will explore and differentiate between hypothyroidism and adrenal fatigue.

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Common Adrenal Fatigue Symptoms vs. Hypothyroid Symptoms

Adrenal Fatigue

HPA axis dysregulation is another term for what is often referred to as adrenal fatigue, whereas adrenal insufficiency is a condition like Addison's Disease, an autoimmune condition affecting the adrenal glands. Adrenal insufficiency can occur after prolonged stress or use of certain medications.

Hypothyroidism

Hypothyroidism happens when the thyroid gland does not produce enough thyroid hormone. This hormone is important for metabolism, energy, temperature regulation, and other body functions.

Shared Symptoms of Hypothyroidism & Adrenal Fatigue

Adrenal fatigue and hypothyroidism can share several symptoms. Common signs include:

• Fatigue
• Weight gain
• Depression
• Muscle weakness

What is the Thyroid Gland?

The thyroid gland is located at the front of the neck and is responsible for producing thyroid hormones. It mainly produces thyroxine (T4) and a smaller amount of triiodothyronine (T3), which is the active form of the hormone.

T4 is converted to T3 in the body's tissues. The production of thyroid hormone is stimulated by thyroid-stimulating hormone (TSH), which is released by the brain's pituitary gland. 

Thyroid hormone affects nearly all cells in the body, influencing heart function, metabolism, growth, and reproductive health (4). 

Hypothyroidism

Hypothyroidism can occur for several reasons, including:

• Iodine deficiency
• Autoimmunity (Hashimoto's)
• Issues with the pituitary gland
• Nutritional deficiencies
• Environmental factors
• Problems with how the body uses thyroid hormone 

The most common cause is Hashimoto's thyroiditis, an autoimmune condition where the body's immune system attacks the thyroid gland (41). 

Common Hypothyroidism Signs and Symptoms 

Thyroid hormone helps control metabolism, which provides energy for the body. It also helps regulate body temperature, digestion, heart rate, and brain development. When there is not enough thyroid hormone, symptoms may include:

• Fatigue
• Weight gain
• Constipation
• Dry skin
• Weak nails
• Slower heart rate
• Sensitivity to cold
• Infertility
• Enlarged thyroid
• Stiff or weak muscles and joints
• Higher cholesterol levels

(44)

Testing Thyroid Levels

To check for hypothyroidism, healthcare providers may recommend the following tests:

• Thyroid-Stimulating Hormone (TSH): This hormone prompts the thyroid gland to release T4 and T3. In hypothyroidism due to an underactive thyroid, TSH levels are often high. In central hypothyroidism, TSH levels may be low or normal. 
• Total and free T4: These tests measure the levels of inactive thyroid hormone in the body. Free T4 is usually low in both primary and secondary hypothyroidism. 
• Total & Free T3: These tests measure the levels of active thyroid hormone. T3 levels indicate how well the body is converting T4 to T3. 
• Reverse T3: This is an inactive form of T3. If elevated, it may be associated with symptoms of hypothyroidism.  
• Anti-TPO: This test checks for antibodies against an enzyme in the thyroid gland, which can indicate an autoimmune thyroid condition. 
• Anti-thyroglobulin: This test looks for antibodies against thyroglobulin, which can help detect autoimmune thyroiditis. 

(5, 8, 44)

Our Most Popular Thyroid Tests Ordered on Rupa Health

Thyroid testing can provide insights into the functioning of your thyroid gland. Examples of thyroid panels offered through Rupa Health include:

• Comprehensive Thyroid Panel with Antibodies by Precision Point
• Comprehensive Thyroid Panel by ZRT Laboratory
• Comprehensive Thyroid Assessment by Genova Diagnostics

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What are the Adrenal Glands?

The adrenal glands are located on top of the kidneys and are important for hormone production, managing the stress response, controlling blood pressure, supporting metabolism, and modulating immune function. 

The adrenal gland consists of the outer cortex and inner medulla. The outer cortex produces steroid hormones such as glucocorticoids, mineralocorticoids, and adrenal androgens, while the inner medulla secretes catecholamines, epinephrine, and norepinephrine (48). 

Adrenal Fatigue

The Hypothalamic-Pituitary-Adrenal (HPA) axis is a communication system between the hypothalamus, pituitary, and adrenal glands. When the HPA axis is activated, the adrenal glands secrete cortisol, which plays a role in regulating inflammation, blood sugar, blood pressure, and other important functions. 

The adrenals may become less effective in managing stress over time, leading to HPA axis dysregulation. In this state, the body might not produce enough cortisol to meet daily demands, which can contribute to feelings of fatigue and reduced stamina (30, 58). 

Common Adrenal Fatigue Symptoms 

After prolonged periods of stress, the nervous system can become strained, potentially leading to HPA axis dysregulation. Common symptoms may include: 

• Fatigue
• Decreased stamina and energy
• Feeling "wired but tired"
• Reliance on caffeine or other stimulants throughout the day
• Decreased immune function
• Muscle weakness
• Low blood pressure
• Low blood sugar
• PMS
• Anxiety
• Weight changes

(29)

Testing for Adrenal Fatigue

Adrenal fatigue is not a formal diagnosis but a collection of symptoms that may arise from HPA axis dysregulation. Evaluating this can involve assessing the following hormones and hormone metabolites:

• Morning and evening urine cortisol levels: This test monitors daily cortisol fluctuations.
• ACTH Stimulation Test: This test evaluates the adrenal glands' response to ACTH, a hormone that stimulates the production of cortisol.
• Dehydroepiandrosterone (DHEA): This hormone is produced by the adrenal glands and is a precursor to other hormones. It works closely with cortisol to help manage stress. Measuring DHEA can provide insights into HPA axis function.

Our Most Popular Adrenal Tests Ordered on Rupa Health

The following lab tests offered by Rupa Health can help assess adrenal function: 

• HPA Profile by Sanesco
• Cortisol by Access Med Labs
• Adrenal Function Profile by Doctors Data 

How to Differentiate Between These Two Conditions

Differentiating between hypothyroid and adrenal fatigue can be challenging due to the similarity of symptoms such as fatigue, weight gain, and muscle weakness.

People with hypothyroidism may experience symptoms such as thinning hair, weak nails, constipation, and dry skin, which are less common in adrenal fatigue. For healthcare providers, examining the thyroid gland can help differentiate the two conditions. 

Lab tests examining thyroid function, cortisol, and DHEA levels are needed to distinguish between hypothyroidism and adrenal fatigue for proper assessment and management (44). 

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Key Takeaways

• Adrenal fatigue and hypothyroidism can present with similar symptoms, such as fatigue, weight gain, and muscle weakness.
• Comprehensive lab testing of thyroid and adrenal hormones can help differentiate between the two conditions.
• If you are experiencing symptoms, consult a trusted healthcare provider for an assessment and guidance.