Dr. Taz MD, Solutions for Living Healthy, Naturally: Thyroid Health and the OAT axis

4.6% of Americans over the age of 12 have hypothyroidism. Hypothyroidism can be caused by a number of factors such as Hashimoto’s disease, some medications, radiation, or a congenital disorder . Hypothyroidism is usually treated with a synthetic version of the thyroid hormone T4 and many patients respond well to this treatment. However, a small percentage of female patients have a difficult time getting their thyroid to respond to therapy or even if their thyroid levels are normal, they still do not feel like their old selves. These patients could be suffering from an imbalance rarely recognized or treated in conventional medicine.

The OAT axis is the Ovarian-Adrenal-Thyroid axis. These three endocrine organs play critical roles in regulating one another; so when one of the three is stressed, it affects the whole system. Symptoms of OAT axis imbalance commonly include insomnia, fatigue, chronic fatigue, joint pain, exercise intolerance, brain fog, sugar intolerance, diabetes, dry skin, feeling cold, slow metabolism, inability to lose weight, PMS, endometriosis, irregular menstrual cycle, fibrocystic breast disease, anxiety, depression, and accumulation of fat at the waist line . You might notice that these are all symptoms of dysfunction in the adrenals, ovaries or thyroid. That is because in OAT axis imbalance, every system is negatively affected.

The OAT axis is complicated, below is simplified diagram of the axis to help you understand the connections.
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When the adrenals are stressed, the body makes less progesterone because the increased production of cortisol effectively “uses up” the materials for making progesterone. Constant adrenal stress can result in what we call “adrenal fatigue.” Adrenal fatigue causes the adrenals to down regulate many processes because they cannot keep up with the body’s demand for

cortisol. This is important to know in the case of treating hypothyroidism because in this down regulation, the adrenals also down regulate thyroid function. The adrenals can inhibit the production of T3 from T4 as well as redirect T3 production to reverse-T3 production. Reverse- T3 opposes the effects of T3. This process therefore negates any treatment of hypothyroidism with replacement T4. Supplemental T4 can actually make an OAT axis imbalance worse .

Progesterone is necessary to counter estrogen in the female body. Without progesterone, estrogen dominates and can cause irregular periods, depression, fatigue and foggy thinking. This is known as “estrogen dominance.” Estrogen dominance causes low cortisol levels by blocking the signals from the brain to the adrenal glands that tell the adrenals to make cortisol. Low cortisol causes the down-regulation discussed earlier which leads to thyroid resistance. The thyroid dysfunction causes low progesterone which starts the vicious cycle all over again.

The key to addressing hyperthyroidism due to OAT axis imbalance is the adrenals . Adrenal fatigue is caused by excessive exercising, toxic relationships, chronic stress, etc. Addressing these factors in your life that are taxing your adrenals should be your first step. Adrenal recovery is necessary because without it, your adrenals will continue to work against any treatment aimed at fixing hypothyroidism or estrogen dominance.

1.”National Endocrine and Metabolic Diseases Information Service (NEMDIS).”Hypothyroidism. Ed. Leonard Wartofsky, MD. The National Endocrine and Metabolic Diseases Information Service, 13 Mar. 2013. Web. 21 Jan. 2014. <http://www.endocrine.niddk.nih.gov/pubs/hypothyroidism/>.

2.Lam, Micheal, MD. “OAT Axis Imbalance – DrLam® – Body. Mind. Nutrition®.” OAT Axis Imbalance. DrLam® – Body. Mind. Nutrition®, n.d. Web. 23 Jan. 2014. <http://www.drlam.com/articles/ovarian_adrenal_thyroid.asp>.