Fatigue is a vague symptom description encompassing many possible underlying medical problems leading to hormone imbalance.

Fatigue can reflect any of the following: chronic inflammation, anemia, hematological malignant syndromes, food sensitivities, intestinal permeability, gut dysbiosis, adrenal dysfunction, thyroid dysfunction, blood sugar imbalance and insulin resistance, liver or kidney dysfunction, heavy metal toxicity, estrogen dominance with prolonged or heavy menses, progesterone deficiency, testosterone deficiency, chronic degenerative diseases, immune dysfunction, stress, etc.

Symptoms of thyroid dysfunction for example can overlap with symptoms of other steroid hormone and adrenal imbalance. All hormones need to be in balance for optimal metabolic function and overall relief of bothersome symptomatology.

This is because the hormones’ production and function within the human body is inter-related, and the impairment of one hormone can trigger a cascade of hormone imbalance.

thyroid function

Let’s consider thyroid function for a moment and evaluate all the possible factors that affect it. Cofactors (vitamins and minerals) are needed for production and conversion of thyroid hormones into active ones.

A picture is worth a thousand words. Internal or external factors as illustrated in the picture also play a very important root-cause role. Thyroid hormones also help clear glucose and insulin, so a reduced thyroid function can trigger insulin resistance. Not to mention the other hormones of estrogen, progesterone and cortisol that affect the thyroid health.

Thyroid hormone transport and receptor response require normal cortisol levels, ferritin in optimal levels, and vitamin D in adequate therapeutic levels.

Progesterone is important for thyroid hormone utilization. Deficiency in progesterone reduces the conversion of inactive to active thyroid hormone. One can see how problematic this becomes as women start to experience an age-related decline in progesterone levels from around the age of 35.

Estrogen competes with active thyroid hormone at receptor sites, so a relative estrogen dominance (low progesterone-to-estrogen ratio) will inhibit thyroid hormone function. Oral estrogen supplementation, as with the case of oral contraceptive use, will increase TBG-thyroid binding globulin, a transporter of thyroid hormone, thus binding more thyroid hormone and making less active thyroid hormone available for utilization at cellular and tissue level.

Cortisol makes cells resistant to thyroid hormones and inhibits conversion of inactive to active thyroid hormone, leading to more conversation to reverse T3 (non-functional form of thyroid hormone), but competes with active T3 at the receptor sites.

Low cortisol levels can cause functional thyroid deficiency, meaning that one has enough thyroid hormones, but they don’t function properly at the cellular level. Thyroid hormones help clear cortisol.

If you are given thyroid medication to treat symptoms of fatigue, without checking cortisol levels (and these are already low), the exogenous thyroid hormones will further clear and lower the already low cortisol levels, amplifying the fatigue (fatigue is also a presenting symptom of cortisol deficiency).


Adrenal dysfunction also known as HPA-axis dysfunction (hypothalamic-pituitary-adrenal) plays a major role in the overall hormone balance and must not be overlooked in the presence of fatigue and other symptoms of hormone imbalance.

Do you feel fatigued, or perhaps worn out, feeling like you’re running on empty, have trouble falling or staying asleep, wake up tired and drag through the day and maybe rely on caffeinated stimulants to get you going until you have a second wind of energy after dinner, and if you manage to stay up past 11 pm you could work or stay awake till 2 or 3 in the morning, only to wake up tired again and repeat this cycle? Have you noticed that you’re getting more allergies and sinus-related symptoms more so lately than in previous years?

Have you noticed that your body no longer has that youthful resilience when faced with the common cold and you succumb more often to frequent respiratory infections, while recovery is protracted and end up feeling like you never fully recovered?

Have you developed more food allergies or intolerances that you did not have before? Are you having salt and sugar cravings?

These can be symptoms of adrenal fatigue, which can become life threatening if not addressed promptly. Cortisol is our body’s natural anti-inflammatory. When toxins, injuries, disease, or stress affect us, our body releases cortisol to defend itself from the harmful effects of the above.

However, long-term ongoing stressors can deplete the health of the adrenal glands, thus cortisol is no longer appropriately secreted or released for prompt protection, and when severe, we succumb to disease without possibility of improvement, despite external medical interventions.

If you experience any of the above symptoms, please seek immediate medical attention.

Embrace the principles of Functional Medicine to give you the tools to evaluate the root-causes of your symptoms, so that treatment can be directed at eradication, and not masking of underlying reasons. Stop chasing the TSH levels by adjusting the thyroid medication dose, get a full and comprehensive medical evaluation.

Call now to request your FREE 15-minute discovery call or schedule a comprehensive consultation. I can work with your schedule to meet your health needs.

Optimal health starts with Hormone Balance!