Body Temperature – Thyroid, Adrenals, or Something Else?

January 23, 2017 | Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

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 Body Temperature – Thyroid, Adrenals, or Something Else?
Cold hands, cold feet, even the tip of the nose being cold reveal clues about circulation and body temperature. Bundling up with sweaters and layers when others are comfortable is another indicator that something may not be working properly. Impaired thyroid and adrenal function are the two most common endocrine causes of low body temperature. A number of other disorders are linked with low body temperature such as Addison’s disease, blood sugar imbalances, mitochondrial disorders, infections, kidney failure, liver failure, asthma, and anemia, hormone imbalances with low progesterone or estrogen dominance, Chronic Fatigue Syndrome, Fibromyalgia and insomnia. Low body temperature support for one concern may different from that of another concern. Understanding the body temperature picture helps you take charge of your health and comfort level.

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Hypothyroidism versus Adrenal Fatigue with Low Body Temperature



Hypothyroidism is a well-known cause of low body temperature and cold intolerance. Appropriate medical and nutritional management is essential to minimize the impact. Selenium, tyrosine, iodine, zinc, copper, iron, B vitamins, vitamin A and D, magnesium, sulfur rich compounds, fats and protein are integral to the body's natural thyroid management.

But, what happens when thyroid nutritional support is adequate and you still feel cold? This failure to respond to thyroid hormone support may indicate adrenal fatigue. This is known as secondary hypothyroidism and is one of most common overlooked causes of poor functioning thyroid hormone. In secondary hypothyroidism, low body temperature, high TSH, low free T4 and T3, and high levels of thyroid binding globulin occur just like with primary hypothyroidism. Lab tests that measure adrenal hormone levels (cortisol, DHEA, pregnenolone, progesterone, and aldosterone) help discern this differentiation. Symptoms may look similar with fatigue, cold intolerance, dry skin, hair falling out, and weight gain.

Adrenal stress, adrenal fatigue and Addison’s disease all can impact body temperature regulation. Addison’s disease or adrenal failure occurs when the adrenal glands cease to produce adrenal hormones. It is uncommon and is accompanied by other severe symptoms. Replacement adrenal hormone is required. On the other hand, adrenal fatigue and adrenal stress is very common. Adrenal fatigue can lead to imbalanced hormone levels including either low or high cortisol, or low or high DHEA depending on how the body has adapted to acute and chronic stress. In adrenal stress, the glands produce relatively normal levels of hormones, but are under pressure. Adrenal function returns back to homeostasis once the stress is removed and rest has occurred. Imbalance of these adrenal hormones can cause low body temperature and other stress related symptoms.


Body Temperature Chart Differences



Low body temperature in adrenal fatigue has a different pattern than low body temperature related to hypothyroidism. In adrenal fatigue, temperature regulation fluctuates more throughout the day than hypothyroidism. The temperature swings from day to day are also more exaggerated compared to hypothyroidism. Body temperature for adrenal fatigue may be 97.8 F or lower. In hypothyroidism, body temperature is often 97.0 F and much lower, even dropping to 95 F. Interpretation of body temperature and this information is within the context of other symptoms and being indoors at a comfortable room temperature, not affected by climate, exposure, or acute illness.

Do a temperature chart if you are not sure about your body temperature. Measure your body temperature at the same time every day for a month and then chart it on a graph. Ideally it is measured before you get out of bed first thing in the morning. This provides great insight into temperature patterns and helps interpret temperature fluctuation from day to day and your general trend. A day-to-day jagged up-down graph reflects adrenal stress, while staying within the same small temperature range without much variance reflects thyroid concerns.

If you find that your body temperature is low, but erratic or highly variable through the 30 days of measurement, then focus on adrenal health. If the measurements reveal constant, little variation and chronic very low body temperature, then focus on thyroid support. If the primary thyroid or adrenal concern has been fully addressed, yet you still struggle with low body temperature, there may be other factors that need attention.


Body Temperature Impacted by Exercise, Stress, and Autonomic Nervous System Disorders



Body temperature drops after exercise.
This may be related to severe adrenal fatigue. A healthy response to vigorous exercise is the release of cortisol, heat, energy, and endorphins. Individuals with adrenal fatigue and low cortisol levels don’t experience energy and warmth, rather they feel cold, fatigued, and may even shiver after exercise. Stress reduction, reduced exercise load, increased rest, and comprehensive adrenal support is necessary. Many struggling with adrenal fatigue may need DHEA, licorice root, adaptogenic herbs, and mitochondria support to help restore stress tolerance.

Body temperature improves after the stressful event passes.
This response is associated with adrenal gland stress and the autonomic nervous system. High levels of cortisol and adrenalin or epinephrine cause constriction of blood vessels in response to stress. Once the stressor is removed, the relaxation response part of the nervous system usually responds within minutes. Blood flow returns to the extremities and body temperature improves. A common example may be waiting for a worrisome, big meeting with the boss. When the meeting is done and the threat is over, heart rate settles down and body temperature warms up. Focus on stress management nutrients like theanine, magnesium, holy basil, and pantethine.

Body temperature drops with severe stress, cold and shaking.
This is a more disconcerting trend. The body responds with a stress response that reflects significant depletion and severe stress. The sympathetic autonomic nervous system and the adrenal glands shunt blood away from the periphery to keep the internal organs supplied during the severe stress. In traumatic events, this reaction is seen with shock. In chronic stress, this may be related to severe adrenal gland and nervous system stress. Individuals with mitochondria disorders, Postural Orthostatic Tachycardia Syndrome, Chronic Fatigue Syndrome, Fibromyalgia, Lyme or other autonomic nervous system disorders may be more prone to this type of severe response and low body temperature. Any underlying anemia or hypoglycemia will worsen this response. Management of the low temperature situation in this case depends on the underlying issue and may require substantial support.


Other Factors That Affect Body Temperature, Adrenals, and Thyroid



Anemia or oxygenation difficulty (asthma, COPD, heart failure) of the body impacts body temperature regulation and stresses both the thyroid and adrenal glands. Supplementation with thyroid or adrenal support may temporarily improve symptoms, but the low body temperature and thyroid or adrenal symptoms will come back unless the anemia is corrected. Have your health care provider check your serum ferritin, iron panel, and CBC if anemia is suspected. Nutritional support for anemia and low body temperature may include iron, zinc, copper, vitamin C, and several B vitamins. Support for poor oxygenation and low body temperature may include magnesium, squalene, coenzyme Q 10, tocotrienols, and astaxanthin. Support for thyroid or adrenals may be needed if there are still difficulties when oxygenation has improved.

Chronic low grade infections like Epstein Barr Virus or Lyme disease may affect body temperature regulation, in part due to the stress on the brain and the HPA (hypothalamic-pituitary-adrenal) axis or HPT (hypothalamic-pituitary-thyroid) axis. Chronic infections create significant challenges on adrenal and thyroid function and lock in endocrine dysfunction. It is essential to appropriately address the infection first, but in many cases, thyroid and/or adrenal support is needed. Consider olive leaf extract, oregano oil, lauricidin, noni, zinc, and vitamin C to support the immune system.

Low insulin levels may cause low body temperature as insulin is needed for body temperature regulation. Low body temperature is considered an early sign of type 1 diabetes, but both type 1 and 2 diabetics may struggle with body temperature regulation. Insulin resistance is often seen with a mixture of heat and cold intolerance and sweating. Energy crashes after a meal may occur. Thyroid and adrenal function are involved with insulin and blood sugar management, but treatment with thyroid or adrenal hormones does not fully address the blood sugar and insulin distress that strains body temperature regulation. Dietary management with protein, complex carbs, good fats, appropriate meal timing, and blood sugar support like chromium, gymnema syvestre, acetyl-l-carnitine, or R-alpha-lipoic acid may be necessary. Type 1 diabetics may need appropriate medical care and to reduce risk factors to help management.

Low levels of serotonin and dopamine also affect body temperature regulation. Both neurotransmitters are required for thyroid hormone production. Chronic stress depletes serotonin and dopamine. Serotonin controls body heat production because it functions as a signaling molecule in fat tissue and affects blood sugar regulation. Serotonin is needed by the hypothalamus and pituitary gland to signal TSH (thyroid stimulating hormone) production. Low serotonin can lead to low TSH and low body temperature, but the thyroid gland is not the direct cause. Coenzyme/methylated forms B vitamins, magnesium, iron, and SAMe/trimethylglycine, etc. are nutritionally required for serotonin production.

Low dopamine levels in the brain can also cause low TSH production, which leads to low body temperature, poor thyroid function and hypothyroidism. Adrenal fatigue is also linked with low dopamine levels. The body requires tyrosine, B vitamins, copper, iron, and vitamin C for normal dopamine levles.

Hormone imbalances with estrogen or progesterone greatly affect body temperature. Just ask any woman struggling to get through menopause or has PMS. Estrogen dominance blocks the protein, thyroid-binding globulin that carries thyroid hormone in the blood stream. Birth control, estrogen hormone replacement therapy, and xenoestrogenscommonly interfere with this transport. This looks like a thyroid problem, but it is an estrogen dominance issue. The imbalanced estrogen must be dealt with and detoxified. IC3, DIM, fiber, and probiotics help the body's natural detoxification process. Adrenal fatigue worsens estrogen dominance as progesterone levels often decline with challenged adrenal function. Healthy non-stressed adrenal glands are necessary for progesterone production.

The thyroid gland also needs adequate amounts of progesterone and a proper ratio between estrogen and progesterone. Elevated estrogen or inadequate progesterone suppresses activity of the thyroid enzyme TPO which ultimately leads to low T4 levels. Brain support and adrenal stress management are essential. Consider adaptogenic herbs like guggul, holy basil, vitamins A and D, omega-3 fish oil DHA, and phosphatidylserine. Sometimes, short-term progesterone support may be necessary.

Low body temperature is a clue or symptom, just like fatigue or depression. These symptoms have numerous causes. Taking more thyroid hormone may help one feel warmer for a time, but if the problem keeps returning, it may be the wrong tool. A hammer is meant to do a great job hammering in nails. A screwdriver handle can also be used to nail something in a pinch, but won’t be efficient in doing it. The right tool does the best job for the nail as well as for fixing your temperature issues. What is your proper tool – a sweater, more medication, or digging deeper and resolving the underlying issue?

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