If you are hypothyroid, you likely already know this:
It’s rarely “just the thyroid.”
Through the teachings of the Nutritional Therapy Association, we’re trained to look upstream. To ask:
- Is the body safe?
- Is blood sugar stable?
- Are the foundations in place?
Because cortisol and thyroid are dance partners. And if one is off rhythm, the other compensates.
Let’s unpack this in a grounded, practical way.
The Cortisol–Thyroid Connection
Cortisol isn’t the villain. It’s your survival hormone. It regulates:
- Blood sugar
- Inflammation
- Blood pressure
- Circadian rhythm
- Thyroid hormone conversion (T4 → T3)
But here’s where things get tricky in hypothyroidism:
When Cortisol Is Too High
Chronic stress → elevated cortisol →
- Suppressed TSH
- Reduced T4 to T3 conversion
- Increased reverse T3
- Increased blood sugar swings
Clients may present with:
- Wired but tired
- 3 AM wakeups
- Anxiety with fatigue
- Cold hands + high stress tolerance… until they crash
When Cortisol Is Too Low
Long-term stress depletion → blunted cortisol response →
- Fatigue in the morning
- Reliance on caffeine
- Salt cravings
- Poor resilience to stress
- Thyroid medication “not working”
Low cortisol = thyroid hormones can’t adequately signal cells.
This is why some clients increase T3… and labs barely budge. The terrain isn’t ready.
The NTA Foundations First (Always)
Before supplements. Before protocol stacking. Before chasing lab tweaks.
The NTA teaches us to prioritize foundations:
- Blood Sugar Regulation
Unstable blood sugar = cortisol rollercoaster.
Start here:
- 20–30g protein per meal
- Fat paired with every carbohydrate
- No naked carbs
- Eat within 60 minutes of waking
- Avoid fasting in dysregulated clients
A hypothyroid client skipping breakfast?
That’s a cortisol spike waiting to happen.
- Mineral Balance
Adrenal function is mineral-dependent.
Key players:
- Sodium
- Potassium
- Magnesium, you should also add some potassium rich foods or potassium supplements when taking magnesium
- Iodine (and the co-factors), I like Biotics Research Thyrostim for this.
- Selenium, I like Biotics Research Thyrostim for this.
Low sodium diets can worsen low cortisol symptoms.
Practical supports:
- Unrefined sea salt in water upon waking
- Mineral-rich broths
- Magnesium glycinate in the evening, you should also add some potassium rich foods or potassium supplements when taking magnesium
- Whole food selenium (2 Brazil nuts daily)
- Circadian Rhythm Repair
Cortisol should:
- Rise in the morning
- Gradually taper
- Be lowest at night
Support this by:
- Morning sunlight within 15 minutes of waking
- No screens 60 minutes before bed
- Consistent sleep schedule
- Protein-rich breakfast
Blue light at 10 PM? That’s synthetic cortisol stimulation.
- Nervous System Regulation
The thyroid thrives in safety.
From an NTA lens, digestion and stress are inseparable. If a client is in sympathetic dominance:
- Nutrients aren’t absorbed well
- Thyroid conversion suffers
- Cortisol stays elevated
Tools:
- 5 minutes of diaphragmatic breathing before meals
- Slow eating
- Walking after meals
- Gentle strength training (not chronic HIIT)
What About Adrenal Glandulars & Adaptogens?
They can be helpful. But timing and context matter.
For high cortisol:
- Phosphatidylserine
- Magnesium
- Ashwagandha (if tolerated)
For low cortisol:
- Adrenal cortex extract (I like Biotics Research Cytozyme AD, 1 at waking and 1 at Noon)
- Vitamin C (food based)
- Licorice root (short-term support only)
But here’s the key:
If blood sugar and sleep are unstable, supplements become expensive band-aids.
Thyroid Medication & Cortisol
Some patterns seen clinically:
- Adding T3 without stabilizing cortisol can increase anxiety.
- Clients with low cortisol may not “feel” thyroid medication.
- Labs drawn 12–14 hours after T3 dosing may look unchanged if cortisol rhythm is impaired.
We must prepare the terrain.
Red Flags That Cortisol Needs Addressing in Hypothyroidism
- 3 AM waking consistently
- Afternoon crash (1–3 PM)
- Coffee dependence
- Cold intolerance despite T3
- Low blood pressure
- Salt cravings
- “I can push through stress… until I can’t.”
Sound familiar?
A Foundational Daily Framework
Morning
- Sunlight
- Salted water
- Protein-rich breakfast
- Gentle movement
Midday
- Balanced lunch
- Outdoor light exposure
- Avoid caffeine after 12 PM
Evening
- Mineral support
- Protein + fat dinner
- Dim lights
- In bed before 10:00 PM
Consistency beats complexity.
The Big NTA Takeaway
The thyroid doesn’t operate in isolation.
Cortisol is not the enemy. It is the messenger.
When we:
- Stabilize blood sugar
- Replenish minerals
- Repair circadian rhythm
- Regulate the nervous system
We often see:
- Improved T3 conversion
- Better medication tolerance
- Reduced anxiety
- More sustainable energy
Optimization isn’t about pushing harder.
It’s about restoring safety and rhythm.
And that is very much in alignment with the Nutritional Therapy Association philosophy:
Support the foundations. Trust the body. Work upstream.
A quick and easy recipe that is perfect for these cold winter days! This was one my Grandmother made. Look at your own family recipes for ideas, those made a couple of generations ago and further back, are made of all the healthy foods you were meant to eat, not any of it is processed!
Mothers Potted Chicken
Ingredients
Serves 2-3 people
- 4-5 slices of bacon, cubed
- 2 bone in chicken breasts, or legs, thighs etc. (or 3 boneless breasts)
- 1 large onion, cubed
- 1 large clove of garlic, diced
- 4 organic red potatoes, quartered (if small, use more and only cut them in half)
- 4-5 basil leaves (a handful, the more the merrier!)
- salt and pepper to taste
Directions
Cube 4-5 pieces of bacon and cook in Iron Dutch oven, remove to bowl
Add to brown, bone in chicken pieces or boneless chicken breasts,
Place on top of chicken pieces:
Cubed onion, diced garlic and as many organic red potatoes halved or quartered as you need.
Sprinkle with salt, pepper and a handful of fresh organic basil (tear in pieces if large leaves)
Put in oven at 325 degrees for 1 hour for bone in chicken breasts or 40 minutes if boneless chicken breasts.
Hint, the little bit of bacon grease/sauce in the bottom, is delicious over the potatoes with a dollop of grass fed butter (or ghee if dairy is an issue).
So simple and so true. Focus on the good, the love, the happiness
and let THOSE grow.
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adrenals and hormones,
so that they too, can have endless energy
and truly love and live life again.
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