Part 1 of 3
No, not the T and A of the B movies -- this is about your thyroid and adrenals. You hear so much about DNA and genes determining your health. Genes are important, but they are not destiny. They can serve you or work against you, based on the status of your thyroid and your adrenals.
When these glands are out of sync, you struggle just to get through the day, everyone seems to drive you crazy, and no matter what you cut from your diet, the muffin top keeps growing.
This first installment in this three-part series will give you an overview of these glands and how central they are to your sanity. The second installment will allow you to understand the connections between them and your DNA, and the third installment will give you some guidelines to get them firing on all cylinders, so you can rock your mission.
Meet Your T and A
These glands work side by side with your ovaries or testicles or both, if you're so blessed.
Top symptoms for thyroid disease include:
- Weight gain
- Hair loss
- Dry skin
- Intolerance of cold temperatures
- Irregular menstrual cycles
Top symptoms of adrenal dysfunction include:
- Weight gain
- Sugar cravings
- Salt cravings
- Poor stress tolerance
- Muscle cramps and weakness
- Low or erratic blood pressure
Where is your thyroid, and what does it look like? Imagine a bow tie. The size of it, the shape of it, and where it sits on the neck are all good approximations of your thyroid. Your adrenals are a little more hidden. They live inside your back, on top of each of your kidneys, and each is a lump of tissue about the size of a large blueberry.
Your thyroid gland makes three active thyroid hormones, called T4, T3 and T2. These hormones control how quickly your body converts food to energy and how quickly you repair your hair, skin, nails, cartilage and intestinal lining. 
The adrenals make over 50 hormones with the top billing going to cortisol, DHEA, and aldosterone.  These hormones control lots of important things, including your:
- Stress response
- Blood sugar
- Blood pressure
- Immune system
- Fluid balance
- Reproductive hormones
- Cycle of waking and sleeping
- Body weight
As important as these glands are, why would anything ever go wrong with them? This is an area where the two differ greatly. Your thyroid's kryptonite is your own immune system, and the adrenals' main problem is they try too hard to keep up.
Your immune system tries to guard you from dangerous things, like streptococcus bacteria or influenza viruses. If your immune system is not sure if something is a friend or foe, its usual response is to attack rather than ignore. When your immune system attacks something from outside of you that is harmless, you have an allergy. Some allergies are a minor nuisance, like seasonal allergies; others are life threatening, like peanut reactions. The immune system can also be driven to attack something harmless that belongs inside you. This is called autoimmune disease, and that is how most thyroid disease starts.
Our current understanding is that a perfect storm occurs involving genes, the environment and the immune system. Thyroid disease clusters in families, and everyone has some level of exposure to chemicals that could trigger thyroid disease. The genes determine whether or not these chemicals will build up in the thyroid. The last piece is immune stress. If someone has an ongoing infection, bad allergies or unhealthy digestive flora, that can trigger the immune attack against the chemical-laden thyroid. When this attack damages the gland, it becomes unable to provide enough hormones to meet the body's needs. The most common version of this is called Hashimoto's Thyroiditis. Healing Hashimoto's involves two things: 1) undoing the steps that gave rise to it (as much as possible) and 2) helping the body regulate the amount of thyroid hormones present, since the thyroid is not doing a great job at it.
So, since thyroid disease is driven by a mistaken immune system, what goes wrong with the adrenals? The exact same thing can happen in the cases of Addison disease or Cushing syndrome, but these are both rare, affecting only a few people per million.
Since the adrenals manage stress, they prepare your body to perform harder in life or death situations. We call this the "fight or flight response" or the "stress response." If this happens every now and then, it is likely good for us. The problem is that modern life is fraught with things that don't really endanger us, but trick the adrenals into turning on the fight or flight switch. Not only is staying in the stress state dangerous, but there is a vicious cycle: The more we are in it, the easier it is triggered.
This triggering involves the adrenal glands, as well as the adrenal-regulating glands in the brain, the pituitary and the hypothalamus. This system is referred to as the Hypothalamic Pituitary Adrenal axis (HPA axis for short). When the HPA axis has gone into stress mode so much that it only takes the slightest provocation to set it off, we call this HPA dysfunction or adrenal dysfunction.
Mind you, adrenal dysfunction is not a disease, like thyroid disease. It is an exaggerated and unhealthy adaptation to stress. This distinction is important because correcting adrenal dysfunction is less about manipulating the amount of adrenal hormones in the body and more about lowering the number of stress triggers and raising the body's resilience.
If you are wondering about the health of your T and A, below are some free symptom quizzes you can take, some personalized recommendations, as well as lab tests you can do in conjunction with your doctor.
Thyroid -- www.thethyroidquiz.com
Adrenal -- www.adrenalquiz.com
- Basic screen - TSH, free T3, free T4, thyroid antibody panel
- Thorough check -- This includes the basic screen above, plus a thyroid ultrasound, reverse T3, thyroglobulin, basal metabolic rate.
- Basic screen -- 4-point salivary cortisol panel
- Thorough check -- This includes the basic screen above plus blood levels of AM and PM Cortisol, DHEA, Pregnenolone, ACTH, and adrenal antibody panel.
In the next issue, I'll tell you how these glands jointly determine whether your DNA is serving you or not.
 Kirsten D.The thyroid gland: physiology and pathophysiology. Neonatal Netw. 2000 Dec;19(8):11-26. Review.
 Kemppainen RJ1, Behrend EN. Adrenal physiology. Vet Clin North Am Small Anim Pract. 1997 Mar;27(2):173-86.