Stress (Study) • Holtorf Medical Group
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Stress (Study)

Chronic physiologic stress results in decreased D1 activity  (11,12,13-17,234) and an increase in D3 activity (1,195,196), decreasing  thyroid activity by converting T4 into reverse T3 instead of T3  (1,195,196,216,234). Conversely, D2 is stimulated, which results in  increased T4 to T3 conversion in the pituitary and reduced production of  TSH (11,16,18-22,234). The increased cortisol levels seen with stress  also contribute to physiologic disconnect between the TSH and peripheral  tissue T3 levels (16,18-20). This stress induced reduced tissue T3  level and increased reverse T3 results in tissue hypothyroidism and  potential weight gain, fatigue, and depression (12,13,194,217-219). This  vicious cycle of weight gain, fatigue, and depression that is  associated with stress can be prevented with supplementation with  timed-released T3 (25,26,52,121-124,199,201-215,220,221) but not T4  (52,197-199,201,222,223).

The reduced immunity from chronic stress has been thought to be due  to excess cortisol production; but the associated reduction in tissue  thyroid levels are shown to play a larger role in the decreased immunity  seen with stress, and thyroid supplementation is shown to reverse the  stress induced reduction in immunity (217).

As with stress, treatment with prednisone or other glucocorticoid  will suppress D1 and stimulate D3, reducing T4 to T3 conversion and  increasing T4 to reverse T3, causing a relative tissue hypothyroidism  that is not detected by TSH testing (12,18-21,194,218,224). This low  cellular thyroid level certainly contributes to the weight gain and  other associated side-effects with such treatment. Thus, in stressed  patients or those treated with corticosteroids, there are reduced tissue  T3 levels that are not reflected by the TSH level, making the TSH an  inappropriate marker for tissue levels of T3.