Resistance to Hypothyroidism Medication and Adrenal Fatigue


This is Dr. Lam, founder of drlam.com and
the Adrenal Fatigue Center. A lot of people ask me while they’re on
thyroid medication is why the dosage need to be adjusted after a little while. In another words, many people do experience
the necessity to especially increase their thyroid medication for their hypothyroidism
after they’ve been starting on the medication for some time. This can be three months, can be six months,
can be a year, but over time they find that they need the ever-larger dose of thyroid
medication in order to achieve the similar effect that they had when they first started. This is a very interesting question and it
brings up the real underlying problem is that what is really going on in the thyroid gland? Now let’s take a look at physiology here. If you have a primary hypothyroidism, something’s
wrong with the thyroid gland, it’s not making thyroid medication, then you give the body
thyroid medication, you will feel brand new and you will feel significantly better. This is indeed the case for many reasons,
whether you have primary or even secondary hypothyroidism, the fact that you put more
thyroid medications into the body means that the body get increased metabolism and that
leads to increase in energy, reduce in fatigue, reduce in constipation. And it’s a sense of well-being because it’s
almost like you’re stepping on the gasoline pedal of the car, and the car is running a
little faster. So you’re able to do more things during
the day and less problematic. Now as this goes on, most patients who are
on thyroid after initial adjustment will be quite satisfied. But they will find as time goes on their fatigue
tend to return, the constipation tend to get worse. And they go see the doctor, laboratory tests
are usually taken, and it could be normal but they are feeling not as good. So the doctor will invariably raise the thyroid
medication a little bit. And then a few months later another little
bit. Of course if the thyroid test is showing that
it continue to be low then the doctor has more reasons to increase the dosage faster
and stronger, and even including adding other types of hormones, including testosterone
and other types of growth hormone, et cetera. But just on the thyroid alone, if the thyroid
testing does not show any significant change but you still complain of being fatigued,
then increasing thyroid dosage for you is quite common. The question is, why would that happen? And we have many reasons why to consider. First, there could be a resistance issue,
meaning that the body is either getting used to it or it resists for the thyroid to actually
get into the cell. There’s also a problem of conversion, for
example, when thyroid medications need to be converted into different parts in order
to work in the cells, and if there is a defect in this conversion then the body will not
be able to get the thyroid that it needs. Number three, there could be also binding
issues in the sense that thyroid medication could be bounded to certain proteins such
as thyroid-binding globulins and then when it is binded it is not available to the cells. On top of that the body could be getting used
to it. There could be receptor site issues, or simply
adopt the body deteriorate with time. And so there are many, many factors that could
cause this type of issue. The question is, how do you know which one
is which? The laboratory test is usually not very good,
is not sensitive enough to really be able to tell us in great detail which part of the
mechanism may not be working well. So it really all comes down to detailed history,
checking with your doctor on an ongoing basis, and asking the right questions. It is obvious that if you have to keep upping
the dose eventually some people will get into trouble. Symptoms such as wired and tired are quite
frequent, and that is an indication that thyroid medication may have reached a maximum, and
you have to question whether this is even the right thing to do at that point in time. There are many, many possibilities, and we
cannot cover them all here. But the important thing to understand is that
if it is not converting, or your body needs more, there is a reason. The reasons are many including one which is
often overlooked, which is adrenal fatigue. And so, see your doctor. Make sure you discuss these issues. And if there are no answers for you then look
outside the box and look into talking to a adrenal fatigue literate doctor for more explanation,
and to explore. The body reacts logically. If it is not working well there is a reason. So I encourage you to pursue that as the way
to understand the root problem. And the only by solving the root problem will
you get to recover from your illness on a long-term basis.