Adrenal & Thyroid

Situations of prolonged stress such as those faced by endurance athletes force the adrenal glands to work overtime to meet the metabolic demands. 
These glands, weighing 4-5 grams, are located on top of the kidneys; their cortical part produces especially cortisol and aldosterone, while the medullary produces adrenaline and noradrenaline. 
These last two are involved in acute stress situations, cortisol in cases of chronic stress. Aldosterone regulates the hydrosaline balance (sodium and potassium). 

The thyroid gland, weighing 20-25 grams, is located at the front of the neck below the Adam's apple. 
The thyroid hormones, in particular tri-iodothyronine (T3), facilitate the input of nutrients into the cells and increase the production of energy within mitochondria, allowing to body to meet energy demands. 

Thyroid and adrenal glands work in SYNERGY to respond to and counteract stress, such as repeated and prolonged physical exertion, infectious disease, trauma, nutritional deficiencies, and more. 
"Adrenal fatigue" forces the thyroid to overworking compensation; just like a case of hypothyroidism, even a mild one, particularly stresses the adrenals. 

In order to work well, the thyroid gland requires adequate supply of iodine, proteins rich in the amino acid tyrosine, selenium (essential for the formation of T3), as well as iron, magnesium and zinc. Vitamin C, D, E, A and B complex are also essential. 
To produce its metabolic effect, T3 must be able to adequately bind to cell receptors and then be transported towards the cell nucleus: a deficiency of vitamin D or iron can hinder these processes. For this reason plasma levels of ferritin at around 100 ng/ml and of 25-OH-D3 at 50-80 ng/ml are recommended. 
The recommended daily amount (RDA) of iodine has been set to 150 micrograms, but this amount is insufficient to meet the increased demands of thyroid hormone in endurance athletes, especially when suffering from adrenal fatigue. 
Iodine is found mainly in seaweed (brown algae) and integral sea salt (unrefined), which is also of great support to the adrenal glands. 
The Japanese people take on average 12-14 mg of iodine per day (nearly 100 times the RDA dose) in the form of marine algae and the incidence of thyroid diseases among them is much lower than in Western countries. 

Thyroid infections (thyroiditis) are not at all rare in athletes, frequently caused by bacteria, viruses (mononucleosis, cytomegalovirus), but also by trauma or acute exposure to cold. 
These forms, if ignored, can lead to autoimmune thyroiditis with the subsequent production of antibodies against the thyroid and resulting in permanent damage, which may necessitate a supportive therapy with thyroid hormones. 
An experienced doctor is able to suspect even a mild case of hypothyroidism and should advise body temperature checks, appropriate analyses and possibly the best replacement therapy for the single athlete. 

"Adrenal fatigue", if prolonged, may result in "adrenal exhaustion", which is typical of "overtraining" athletes, resulting in reduced performance, chronic fatigue, low blood pressure, irritability, sleeping issues, frequent respiratory diseases, depression. 
Adrenal exhaustion can be prevented with a reduction of training workloads, as well as with dietary measures: 

- 5-10 g per day of sea salt (preferably North Sea's gray one) 
- limiting simple sugars 
- ensuring a good supply of "good" fats: olives, coconut, butter; avoiding vegetable oil, margarine, hydrogenated fats 
- habitually consuming seeds (pumpkin, sesame, flax, almonds), walnuts, coconut 
- avoiding long hours of fasting: frequent meals should be preferred 
- vitamin C in generous doses: 1-3 g/day 
- vitamin E: 400-800 U/day 
- magnesium: 400-800 mg/day 
- vitamin B complex 
- licorice in the form of root or extract slows the elimination of cortisol. 

If these dietary steps are not enough, a supportive therapy with hydrocortisone in physiological dose may be necessary: 25-50 mg daily divided in 2-3 doses, always under the supervision of an experienced physician, for a total duration of some weeks up to a few months, depending on the severity of the case.