Heat Up, Speed Up: Thyroid & Adrenals in Lyme

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"I updated this article on 4/1/19 to include updated treatment options. The original video from 2013 is still relevant." Marty Ross MD

Cytokines May Suppress Hormones in Lyme

Low hormones occur often in chronic Lyme disease. If you have symptoms of low hormones the supplements and drugs I discuss in this article may help. Blood testing is not always reliable to decide if a person should treat.

Inflammatory cytokines made by white blood cells to fight Lyme decrease the effective functioning of an area of the brain called the hypothalamus and pituitary. This part of the brain produces chemicals that induce sleep and that regulate hormonal systems. It also releases messengers such as thyroid stimulating hormone (TSH), adrenocorticotropin hormone (ACTH), and follicle stimulating hormone (FSH) to stimulate the thyroid, adrenal glands, and sex hormone organs respectively. Because of the dysfunction caused by the cytokines, these regulatory messengers are released based on an incorrect interpretation by the brain of the hormone environment. Thus measurements of these messengers are an unreliable way to determine the hormone status.

Marty Ross MD Discusses Low Thyroid & Adrenals 

The video is a Lyme Byte from our webinar Conversations with Marty Ross MD recorded on 12/03/2013 when Dr. Ross practiced in Seattle, Washington.

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Another way to check hormone status is to measure the actual hormone levels like T4/T3 (thyroid), or cortisol/dhea (adrenals), or estrogen/progesterone/testosterone (sex hormones). These tests give a broad range of normal however. A person could have normal range testing for each of the hormones but still have clinically low hormones. Because of the unreliability of testing, treat for low hormones if there are clinical symptoms of low hormones as long as treatment does not increase hormone levels above the upper end of normal. Hormones provide many functions in the body. Proper levels improve energy and help the immune system to work more effectively.


  • Low thyroid: fatigue, achiness, low body temperatures, cold intolerance, weight gain, constipation, changes in menstrual periods.
  • Adrenal Insufficiency: fatigue, recurrent infections, poor recovery from infections, low blood sugar with shakiness and irritability relieved by eating, low blood pressure and dizziness on standing, afternoon crashing, and sugar cravings.


The hormonal systems require essential micro­nutrients found in a high quality multivitaminto work best. Curcumin, a part of the seasoning turmeric, may lower cytokines that interfere with the functioning of the hormone control centers in the brain. Thyroid glandulars like desiccated thyroid and armour thyroid are available by prescription. Based on my experience, these often work better than synthetic thyroid products like synthroid. The adrenals can be supported to work better. Ashwagandha, an Ayurvedic and Chinese medicinal herb, is an adaptogen that supports adrenal function and can improve cortisol and dhea levels. It also lowers inflammatory cytokines that cause many Lyme symptoms. As a neutral herb it tends not to cause the caffeine­ like jitteriness that can occur with other herbs that support the adrenals like ginseng or rhodiola. Adrenal glandulars are the cortex of the adrenal gland and thus contain cortisol and dhea.

For Any Hormone Problem

Take a multivitamin that supports all the the hormonal systems and curcumin that may lower cytokines.

(Warning: Before beginning any glandular treatment have blood testing done with your healthcare practitioner to ensure that your hormone levels do not exceed the top end of normal range. Only use glandulars at a level that removes the low hormone symptoms and do not exceed the upper limit of normal on laboratory testing.)

  • Multivitamin. Take one scoop daily of a powered multi-vitamin preferably by Thorne or Integrative Therapeutics or use a capsule like Physician's daily from Researched Nutritionals.
  • Curcumin 500mg 1 pill 3 times a day.

Adrenal Insufficiency

Start with the natural medicine or prescription medicine. It is possible to use both together if the symptoms of low adrenals persist.

Natural medicine:

  • Ashwagandha 400 mg 1-2 pills in the morning and 1 to 2 pills between 1-2 pm. Taking late in the day may disturb sleep.

Prescription medicine:

In my Seattle practice, I rarely used this because there is a very small risk of immune suppression using prescription hydrocortisone. However, the doses I recommend are the normal amounts the adrenal glands should make. I prefer ashwagandha because it is a supportive herb that does not suppress the immune system.

  • Cortef 5 mg 1 to 2 pills in the morning and 1 to 2 pills between 12 pm. Taking late in the day may disturb sleep.

Low Thyroid

Natural medicines:

  • Ashwagandha 400 mg 1 to 2 pills in the morning and 1 to 2 pills between 1-2 pm. Taking late in the day may disturb sleep. Also use with
  • Zinc 20 mg, Selenium 100 to 200 mcg, and Iodine 200 to 300 mcg 1 time a day. (These are often found in multivitamins or you can supplement them individually.)

Use these natural medicines first for one to two months before adding or trying the prescription medicine option below. Often, working with these supplements corrects the thyroid so you do not need to take thyroid prescription medicines.

Prescription medicines:

  • Desiccated Thyroid 1⁄2 grain or Armour Thyroid 1⁄2 grain 1 pill in the morning 30 minutes before anything else and on an empty stomach with water only. Increase every 3 to 4 weeks by 1⁄2 grain if low thyroid symptoms persist.

For more information about how to manage thyroid, even if your tests are normal, read my comprehensive article: Hypothyroidism. The Best Tests, Meds, & Vitamins. This article also includes more information about how to manage the immune system using Low Dose Naltrexone (LDN) in Hashimoto's Thyroiditis.


The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.


View Citations

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About The Author

Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State (License: MD00033296) where he has treated thousands of Lyme disease patients in his Seattle practice.

Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS) and The Institute for Functional Medicine.

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