It usually starts quietly. Maybe you wake up tired, no matter how early you went to bed. You grab a coffee (or three) just to get moving. By 3pm you crash (yes, the tea and biscuits which we call the afternoon ‘adrenal binge’), brain fog rolls in, and all you want is sugar. Yet, somehow, at 10pm you come alive again. You are scrolling, Netflixing, buzzing with energy.
Sound familiar? Or is this your partner? Or even your best friend who calls herself a ‘night owl’ but secretly wishes mornings didn’t feel like climbing Everest.
This is the story of adrenal dysfunction. And it’s far more common and more measurable than you may think.
Stress and the adrenals
The adrenal glands
Your adrenal glands are two tiny ‘hats’ sitting on top of your kidneys, but they are in charge of some of your body’s biggest jobs. Hormones produced by your adrenals include:
- Cortisol: your daily ‘battery charge’ hormone that should rise in the morning and gently fall by night.
- Adrenaline and noradrenaline: quick burst hormones for acute stress (like slamming the brakes to avoid a crash).
- DHEA: your resilience and repair hormone, also a backup source of sex hormones during perimenopause and beyond.
- Mineralocorticoids: keep your salt and fluid balance steady and even your blood pressure too.
Ever been told your blood pressure is on the lower side and told it’s good? It may be your adrenals asking for respite.
Adrenals the pension plan every woman needs to invest in
Something most women are never told, is that once you reach menopauseMenopause is often described as the point at which a woman has gone twelve consecutive months without a menstrual period. Whilst technically correct, it does not provide the bigger ‘picture’. Menopause is a transition, more than an event. For many women, the journey begins years earlier during perimenopause, when hormones start to fluctuate and symptoms such as hot flushes, sleep disturbances, anxiety, brain fog, mood changes, joint pain, weight gain, and irregular periods may begin to appear. It can feel as though the body has decided to ‘pack up and go home’., your adrenal glands are meant to become your‘backup ovaries’. Your adrenals take over a significant share of oestrogen, progesterone, and testosterone production. It is nature’s way of softening the hormonal changes. However, if your adrenals are already ‘burned out’ from decades of stress, they don’t have much capacity left to produce those sex hormones.
And remember, all of these hormones, stress and sex alike, come from the same raw material, cholesterol.
- Cholesterol is converted into pregnenolone (the ‘mother hormone’), which then branches into cortisol or progesterone, DHEA, oestrogen, and testosterone.
- Under chronic stress, the body doesn’t ‘steal’ from sex hormones but it can prioritise cortisol pathways over reproductive ones. In other words, survival trumps reproduction. Always!
This is why women with adrenal dysfunction often feel perimenopause and menopause symptoms more intensely, as hot flushes, night sweats, anxiety, low libido, mood swings, brain fog, and weight gain.
Let’s talk protein
…Before we get carried away with the adrenals and thyroid connection.
Have you made proteinProtein is one of the three main macronutrients, alongside fats and carbohydrates, yet for many years it was often the forgotten member of the trio. More recently, protein has become something of a celebrity in the nutrition world, appearing in everything from snack bars and cereals to coffee and desserts. Whilst the marketing can sometimes get a little carried away, the truth is that protein is essential for human health. Every cell in the body relies on it. Protein helps build and repair tissues, supports immune function, forms enzymes and hormones, transports nutrients, and helps maintain muscle mass, particularly as we age. your best friend?
Most people believe that protein is for the gym bros, or it is for those who workout hard, but have we got news for you?
When stress is high, your body shifts into catabolism, breaking down muscle for fuel, a state where muscle tissue is broken down to keep blood sugar stable. Cortisol makes sure you have quick fuel to ‘fight or flee’ but over time this constant breakdown leaves you depleted.
We need protein to rebuild health.
Protein needs go up when your adrenals are under strain. Without enough protein:
- Blood sugar crashes harder, leaving you craving sugar and caffeine.
- The immune system struggles to repair tissues and antibodies.
- The liver can’t detox hormones properly (Phase II detox is amino-acid dependent).
- Muscle mass and resilience decline, worsening fatigue.
Aim for 1.0–1.6 g protein per kg body weight daily (yes, you read that correctly). Start the day with a protein-rich breakfast to anchor blood sugar and cortisol. Choose clean sources: eggs, fish, poultry, grass-fed meat, lentils, hemp etc. Especially in times of stress, illness, and the ‘pauses’ of life example, perimenopause. Protein can make a ‘massive’ difference.
If you fancy a meal plan with a ‘decent’ amount of protein, then pop on over to our blog on MetabolicMetabolism is not a calorie-burning furnace that sits somewhere near your belly button, deciding whether you can fit into last year's jeans. Metabolism is the set of chemical processes taking place inside your body every second of every day, keeping you alive. Syndrome….
Let’s talk exercise
When your body is already under stress, the type of exercise you choose matters. Endless cardio can worsen ‘adrenal fatigue’, but strength training, done wisely builds resilience.
The gold standard? Compound weight-bearing movements performed to muscle fatigue. These exercises work multiple large muscle groups, improve insulin sensitivity (and boy oh boy, women do with a helping hand of being more insulin sensitive when the peri-menopause comes along), and stimulate anabolic (building) pathways that counteract the catabolism of stress.
Examples include:
- Deadlifts: train the entire posterior chain, improving posture and metabolism
- Squats: build glutes, quads, and core strength
- Bench press: engages chest, shoulders, and triceps
- Pull-ups or lat pulldowns: strengthen the back and grip
- Overhead press: stabilises shoulders and spine
- Rows (barbell or dumbbell): support back and posture
The key is progression and form. Training to near-muscular failure (with proper rest between sessions) signals the body to repair, grow, and adapt, the opposite of the ‘breakdown’ seen in chronic stress.
Strength training also:
- Boosts bone density (vital post-menopause)
- Improves metabolic flexibility
- Enhances mood through endorphins and dopamine regulation
Pair protein with progressive strength training because together they shift the body out of survival mode and back into growth mode.
Check out our syllabus for more topics covered in
our Diploma course …save it, as you may want to join
us sometime
Back to the adrenal hormone cortisol
Cortisol is not the villain! Cortisol gets blamed for belly fat and ‘burnout’. Without cortisol, you wouldn’t survive. It wakes you up, fuels your brain, tames inflammation, and sharpens focus when you need it. The problem isn’t cortisol itself, but when the rhythm is off, too much, too little, upside down, or even chaotic. These can all be picked up in a functional testIf you have ever been told, ‘your blood tests are normal’, not ‘normal’ or not yourself, then you have already discovered one of the reasons functional testing has become so popular. Functional tests are designed to provide additional information about how the body is functioning. They may explore areas such as hormones, digestion, nutrient status, fatty acids, the microbiome, genetics, metabolism, or stress physiology. Think of them as gathering more pieces of the health puzzle, ideally before a dis-ease ‘shows up’. Sadly, most people turn to functional tests, once they have a dis-ease. that looks at adrenals.
The cross-talk between the adrenals, thyroid and gonads
The cortisol curves we see:
- Stage 1: high and wired: You wake up buzzing, multitask like a pro, but can’t switch off at night. Sleep is light, fragmented, or elusive.
- Stage 2: the flip: Mornings are brutal, as you drag yourself out of bed, feel sluggish until afternoon…then suddenly you find your second wind at 10 pm. You call it being a ‘night owl’ but really it’s cortisol showing up at the wrong time.
- Stage 3: flatlined: This is the ‘spoonie’ stage (silica cell salt can come in handy here). Fatigue is constant, socialising or exercise leaves you wiped for days. You need caffeine just to function, but even then you never feel fully ‘switched on’.
Find out more about the functional tests that we cover at the New School:
So that was a little on the adrenals, now let’s move onto the thyroid…
The thyroid and adrenal ‘bond’
Adrenal dysfunction and thyroid health are intimately linked.
- High cortisol can impact thyroid hormone as reverse T3 is made instead of T3 (the active hormone)
- Low or high cortisol can make thyroid meds feel ineffective. You know when the thyroid medication dose is increased and increased and increased? And you notice no change, maybe even experience a flare-up if you have Hashimoto’s form of under-active thyroid.
- Around perimenopause, the adrenals pick up 70% of sex hormone production, if they’re exhausted, symptoms hit harder.
At the New School, we are not gland-centric; we never look at the thyroid without checking the adrenals, liver, bile, sleep, food, nervous system, etc.
Molecular mimicry is when the immune system mistakes thyroid tissue for gluten proteins because of their similar amino acid sequences, leading antibodies against gluten to also attack the thyroid.
Autoimmune thyroid is more than just a ‘slow’ thyroid or hypothyroid.
Most people don’t realise that over 90% of under-active thyroid conditions are actually autoimmune in nature. This means the immune system is ‘attacking’ the thyroid gland itself, not just a thyroid that decided to ‘slow down’ or not enough iodine or selenium etc.
The two main autoimmune thyroid conditions are:
- Hashimoto’s thyroiditis – the most common cause of hypothyroidism worldwide.
- Graves’ disease – usually associated with hyperthyroidism (overactive thyroid), but it can sometimes swing into under-active phases.
Symptoms of autoimmune thyroid dysfunction
Think beyond just tiredness as autoimmunity often creates a cluster of symptoms, which includes:
- Fatigue that doesn’t resolve with rest
- Weight gain (despite no big changes in diet or exercise)
- Cold hands and feet, feeling chilled easily
- Hair thinning or hair loss (especially outer third of eyebrows)
- Dry skin, brittle nails
- Constipation or sluggish digestion
- Puffy face or swelling around the eyes
- Depression, anxiety, or brain fog
- Hoarseness or a feeling of “lump in the throat”
- Irregular or heavy menstrual cycles
- Joint stiffness or muscle aches
The 5 stages of autoimmune thyroid progression
Autoimmune thyroid disease develops gradually. Conventional medicine often only catches it at stage 3 or later, but functional testing helps us see the earlier stages. And sadly, conventional medicine does not always test for the presence of antibodies.
Stage 1: silent autoimmunity
- Genetic predisposition or family history.
- Thyroid antibodies (TPO, Tg) show up on labs, but TSH, free T3, and free T4 remain in the optimal range.
- No obvious symptoms yet but prevention opportunities are enormous here.
Stage 2: subclinical hypothyroidism
- Antibodies remain positive.
- TSH begins to climb above 2.0.
- Free T3 and free T4 drift out of optimal ranges.
- Subtle symptoms (fatigue, weight changes, feeling cold) may appear, but often brushed off.
Stage 3: overt hypothyroidism
- Classic symptoms: fatigue, hair loss, constipation, depression, weight gain, cold intolerance.
- TSH elevated, free T3 and free T4 low.
- Antibodies remain high.
- This is typically when conventional medicine steps in with thyroid medication.
Stage 4: thyroid gland damage
- The gland becomes scarred or nodular, less able to produce hormones.
- Symptoms worsen and become chronic.
- TSH high, free T3/T4 very low.
- Antibodies may remain elevated or begin to fall as thyroid tissue is destroyed.
Stage 5: atrophic thyroid / end-stage
- Thyroid gland is essentially non-functional.
- Antibodies may even appear low (because there’s no tissue left to attack).
- Lifelong thyroid hormone replacement is required.
- Often accompanied by other autoimmune conditions such as rheumatoid arthritis, celiac disease, lupus, or Crohn’s.
Full thyroid profile panel
At the New School, we believe in preventative medicine first and foremost, but we know that as human beings, it is pain that usually creates change, if any, in most people. We implement functional tests to identify and educate people and students about the underlying root causes of symptoms.
Functional testing guides us to ensure we are personalising the plan and not missing the root causes, such as…
- where is the stress showing up in the body,
- how the thyroid and adrenals are actually performing (beyond ‘normal’ lab ranges),
- whether autoimmunity is brewing silently
- how the gut, liver and nervous system are shaping the bigger picture
By showing people the physiology behind their fatigue, brain fog, or mood swings, the tests don’t just guide treatment, they create the ‘aha moment’ where clients finally understand why they feel the way they do. That is the moment when prevention becomes vital and change can be more lifestyle-based.
Functional tests
We don’t guess as we have the tools:
- Adrenal Saliva Test
- Maps cortisol across the day.
- Shows the classic 3pm crash, evening spike, or flatlined pattern.
- DUTCH Complete
- Tracks cortisol + metabolites + DHEA.
- Adds neurotransmitter insights such as noradrenaline and adrenaline, even dopamine
- Can be helpful if saliva collection is tricky (dry mouth, kids, etc.).
- Continuous glucose monitor (CGM)
- Shows blood sugar swings tied to cortisol.
- “Muffin-top” belly fat, pre-diabetes, and energy crashes often trace back to stress chemistry.
- Full thyroid panel with antibodies
- Because adrenal stress often reveals thyroid dysfunction.
If your TSH looks ‘normal’ but you still feel awful, functional testing often reveals the deeper root causes.
Real life case of Sarah who thought she was a night owl, but was not.
Sarah, swore she was just a ‘night person’. She would crash every morning but hit her stride at midnight. Her GP told her nothing was wrong, her blood tests were within normal range. When we ran a saliva cortisol panel and urine test, her cortisol curve was flipped, almost no cortisol in the morning, a rise at 10pm. Add to that a free T3 on the low end and elevated TPO antibodies, classic early Hashimoto’s triggered by stress.
With morning light exposure, adrenal support nutrition (protein-rich breakfasts with vitamin C and electrolytes), and thyroid antibody monitoring, she shifted her rhythm in six months. She no longer calls herself a ‘night owl’ either.
Real life case where the gut drives the thyroid
One of our students worked with a client, we will call her Seema, who came convinced her thyroid medication had ‘stopped working’ and the root cause was high reverse T3 (social media does that). She was exhausted, her hair was thinning and falling out, and she had gained weight despite eating carefully. Her labs showed fluctuating thyroid hormones and rising antibodies, but nothing his GP could explain.
H.Pylori can present with very mild symptoms, even auto-immune conditions
When we ran functional tests, the picture became clear:
- She was positive for H. pyloriHelicobacter pylori is a bacterium that has lived alongside humans for thousands of years. In fact, many people carry it without ever knowing it is there. Like many microbes, it is not always a villain. Sometimes it is simply part of the ecosystem. It is just that when it decide sto get a tad ‘loud’ that it becomes an issue., a stomach infection known to inflame the gut lining
- Her intestinal barrier markers pointed to leaky gut, allowing inflammatory molecules to leak into circulation
- Her cortisol curve was elevated, a sign indicating that the infection was driving her stress chemistry.
In Seema’s case, it wasn’t simply a ‘thyroid problem’ as her thyroid flares were downstream of gut-driven inflammation and cortisol dysregulation. Once the infection was addressed, the gut lining was supported with nutrients, and stress pathways were addressed, protein was added, and exercise to boot! Her thyroid antibodies dropped, and her energy returned. Within 6 months, her hair stopped falling out, and she lost weight.
This is what we mean at the New School when we say, we teach nutrition medicine through a systems biology lens. The thyroid does not sit in isolation. It dances with the gut, nervous system, adrenals, immune system, nutrition and even the liver’s detox capacity. Healing becomes possible when the individual and the mind-body are understood.
Remember to check out our YouTube Channel, we have a couple of videos on the thyroid.
Come and train with us in London, one weekend a month for two years….We start in just under two weeks …
To health!
From the team at the New School Of Nutritional Medicine
Learn about the Founder & Principal of the New School of Nutritional Medicine, Dr Khush Mark PhD, HERE.
