In our day-to-day lives, we all experience some level of stress. That, in itself, is not a cause for concern as stress is a natural human response necessary for self-preservation. To properly understand how stress poses a challenge to thyroid health and overall well-being, we first have to contextualize it.
Stress may be acute, episodic, or chronic. Acute stress is the body’s short-term response to immediate or anticipated challenges or threats. It is a normal feeling, and should normally go away in no time once the stressor is eliminated. However, when a person frequently experiences acute stress, it becomes episodic acute stress. This may result in individuals finding themselves in a cycle of frequent stressors and eventually becoming prone to developing a mindset where they perceive everyday events as overwhelming crises. Chronic stress, however, is a prolonged and continuous state of stress that persists over an extended period. Unlike acute stress, which is a short-term and immediate response to a specific situation, chronic stress can linger for weeks, months, or even years. This type of stress can result from ongoing, persistent stressors that may be related to various aspects of life, such as finances, employment, or marriage.
More often than not, when the negative impact of stress is addressed, it has to do with chronic stress. Over the years, much research has been carried out on the apparent link between stress and thyroid disorders. Stress has increasingly been recognized as a factor that impacts thyroid health, although there still are uncertainties regarding the precise ways by which stress may influence the onset of some thyroid disorders.
In the rest of this article, we will focus on:
- What the “stress response” is
- The bidirectional relationship between stress and the thyroid
- General tips on how to manage stress
What is the stress response?
The stress response is quite an interesting physiological survival mechanism that gets activated during moments of perceived threat or danger with the purpose of keeping us safe. When faced with stressors, whether physical or emotional, the body releases hormones such as cortisol and adrenaline, preparing it for a “fight-or-flight” response. The release of these stress hormones is mediated by the hypothalamic-pituitary-adrenal (HPA) axis.
Stressful situations may include financial challenges, having a huge workload with a fast-approaching deadline, grieving the loss of a loved one, moving from one city or country to another, or being late to work and stuck in a traffic jam. Such situations will likely elicit a stress response because the body perceives these stressors as “threats”.
Cortisol, released from the adrenal glands that sit atop the kidneys, increases blood sugar levels as well as the use of sugar (glucose) by the brain. This hormone also slows down certain bodily functions such as digestion and growth processes that the body deems irrelevant in a fight-or-flight response.
Adrenaline, also known as epinephrine, is also quickly released from the adrenal glands in response to stress. When this happens, your palms may get sweaty, and your heart starts racing, as more blood gets to the brain and muscles, thereby increasing blood pressure. Essentially, you become more alert and gain more energy to deal with the stressor (or perceived threat) in the moment.
While the stress response is essential for survival, chronic (long-term) stress can lead to prolonged elevation of these stress hormones, impacting various bodily functions and organs, including the thyroid.
What is the connection between the thyroid and stress?
There is an apparent bidirectional relationship between stress and thyroid health in that stress and thyroid disease can feed into each other. For instance, stress is known to exacerbate hypothyroidism while stress (or stress-like symptoms) can also present as clinical manifestations of hypothyroidism. This can create a vicious cycle, where stress worsens thyroid problems, and thyroid problems make us more sensitive to stress. Research has shown that people with thyroid disorders are often more sensitive to stress and may have difficulty coping with stressful situations.
In this section, we shall briefly explore this bidirectional relationship by addressing the impact of stress on the thyroid and the impact of the thyroid on stress.
Impact of Stress on the Thyroid
Stress can interfere with the hypothalamic-pituitary-thyroid (HPT) axis, a complex feedback system that regulates thyroid hormone production. High cortisol levels, due to chronic stress, can exert an inhibitory effect on the HPT axis, resulting in a decreased production of thyrotropin-releasing hormone (TRH) from the hypothalamus and thyroid-stimulating hormone (TSH) from the pituitary gland, which in turn negatively affects thyroid hormone production from the thyroid gland. Acute stress, however, can cause a short-lasting activation of the HPT axis by cortisol, resulting in an increased level of TSH released into the bloodstream.
- Impaired Conversion of T4 to T3
The thyroid gland produces hormones, primarily thyroxine (T4) and triiodothyronine (T3), which regulate metabolism. These hormones, collectively referred to as the thyroid hormones, help regulate the rate at which the body converts food into energy, affecting essential functions like heart rate, digestion, and body temperature. Although levels of T4 released into the bloodstream are greater than T3 levels, T4 is the inactive form of the thyroid hormone, and hence has to be converted by the body to the metabolically active form T3. Elevated cortisol levels, however, can disrupt the conversion of the inactive thyroid hormone T4 into the active form T3, leading to symptoms of hypothyroidism despite normal T4 levels.
- Autoimmune Response
While stress alone cannot cause an autoimmune thyroid disorder, it can worsen it. Stress has been linked to the exacerbation of autoimmune thyroid conditions, such as Hashimoto’s thyroiditis and Graves’ disease. In these conditions, the immune system mistakenly attacks the thyroid, affecting its ability to function properly.
Impact of the Thyroid on Stress
- Hypothyroidism and Stress-Like Symptoms
Insufficient thyroid hormone levels in hypothyroidism can lead to fatigue, weight gain, and depressive symptoms, often resembling the impact of chronic stress. Individuals with hypothyroidism may find it challenging to cope with stress due to these overlapping symptoms.
- Hyperthyroidism and Increased Stress
Conversely, hyperthyroidism can result in increased anxiety, nervousness, and irritability. The heightened metabolic state associated with an overactive thyroid can mimic the physiological responses to stress, intensifying the overall stress experience.
How can you manage stress?
Considering the relationship between stress and thyroid function, adopting stress management strategies is crucial for maintaining thyroid health. However, before you can effectively manage stress, you need to identify your stressors in a bid to reduce or eliminate them. Here are some effective approaches:
Exercise is a great way to reduce stress and promote overall well-being. Try aiming for at least 30 minutes of moderate-intensity aerobic exercise most days of the week. You can also aim for a mix of the aerobic exercises with strength training and relaxation techniques (such as yoga, mindfulness meditation, and deep breathing).
Prioritize quality sleep, as insufficient or disrupted sleep patterns can contribute to stress and negatively impact thyroid function. When you’re well-rested, you’re better able to cope with stressful situations. Aim for 7-9 hours of sleep each night.
- Balanced Nutrition
Ensure a well-balanced diet with sufficient nutrients, particularly iodine and selenium, essential for thyroid function. You may also consult a healthcare professional for personalized dietary advice.
- Professional Support
If you are struggling to manage stress on your own, you may want to consider seeking professional help from a therapist or counselor. They can provide tailored strategies to manage stress and support thyroid health.
- Social Support
Maintain a strong support network, as social connections can help mitigate the impact of stress. Talking to friends or loved ones about challenges can offer perspective, empathy, and a sense of connection, reducing the impact of stressors. Additionally, the feeling of being understood and supported can enhance your resilience, making it easier to cope with stress.
- Stress, the body’s natural response to challenging situations, is a common aspect of everyday life and has been increasingly recognized as a factor that can impact thyroid health.
- When you experience stress, your body releases a hormone called cortisol. Elevated cortisol levels can interfere with the production of thyroid hormones, which are essential for regulating your metabolism, energy levels, and mood.
- The relationship between thyroid health and stress is complex and bidirectional.
- Conditions such as hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid) can manifest with symptoms that mimic stress, including fatigue, anxiety, and mood swings.
- Recognizing the impact of stress on the thyroid allows individuals to take proactive steps toward stress management.
- Prioritizing a balanced lifestyle with adequate sleep, regular exercise, a nutritious diet, and strong social support can contribute to overall well-being and support thyroid function.
- Always consult with a healthcare professional for personalized advice and treatment options tailored to your specific situation.