How Drugs and Alcohol Affect Thyroid Function

Substance abuse involving alcohol, opioids and stimulants will cause damage to- and throw of the balance-of nearly every organ and system in the body. The affect that drugs and alcohol cause on the thyroid is especially harmful and opens drug and alcohol users to a host of medical problems on top of their substance abuse issues.

An estimated 27 million adults in the United States are living with thyroid dysfunction, in some form.  Additionally, an estimated 40% of the population has a thyroid that is functioning less than perfect (hypothyroidism or hyperthyroidism).

Hyper- and Hypo-Thyroidism 

Hyperthyroidism is a condition where the thyroid gland is producing too many hormones – the hormone thyroxine, in particular – and can also be called “overactive thyroid.” Symptoms of hyperthyroidism include:

• Rapid Heartbeat (tachycardia, arrhythmia, or heart palpitations)
• Sudden Weight Loss (with no change in appetite or diet)
• Increased appetite (with weight loss, or lack of weight gain)
• Anxiety (Feeling nervous, anxious and irritable)
• Shakiness and/or Tremors (In the extremities, particularly in the hands and fingers)
• Profuse Sweating (hot sweats and cold sweats)
• Changes in Menstruation and Menstrual Patterns (Women)
• Increased Sensitivity to Heat and Temperature Changes
• Difficulty Sleeping (insomnia, inability to fall asleep or stay asleep)
• Fatigue and Muscle Weakness
• Fine, Brittle, or Thinning Hair
• Skin Thinning or Shedding

Hyperthyroidism can be difficult to diagnose, as it mimics other diseases and health issues, and hyperthyroidism can be a symptom of another problem – not always the cause of symptoms.

Hypothyroidism is a condition where the thyroid is producing too few hormones; also called “underactive thyroid.” The symptoms of hypothyroidism are often faint, and it is more difficult to identify hormone deficiency than it is to detect overactive thyroid issues. Women (as they age) and women over 60 are more likely to develop a natural decline in thyroid activity, so it is essential that testing be done to find the source of thyroid deficiency – be it from substance abuse or other factors.

Symptoms of Hypothyroidism include:

• Puffy Face
• Sensitivty to Cold
• Constipation
• Sensitivity to Cold
• Tiredness, Sluggishness and Fatigue
• Memory and Cognitive Impairment/Decline
• Stiff, Swollen, and/or Achy Joints
• Hoarseness in the Voice
• Decreased Libido
• Muscle Aches and Pains
• Thinning or Brittleness of Hair and Nails
• Depression and Feelings of Sadness

In addition to the above, those that are in the advanced stages of hypothyroidism will experience severe dry skin or thickening of the skin, slowed speech, and puffiness of the hands, feet and face.

How Does Alcohol Affect The Thyroid? 

Drugs and alcohol can both affect how the thyroid functions, but alcohol, in particular, can severely impact thyroid function and cause hyper- and hypothyroidism. One of the biggest reasons that alcohol harms thyroid health is that alcohol contains phytoestrogens. So you are adding additional estrogen to your body – which will throw the balance off, and cause the thyroid to alter its hormone products.

In addition to alcohol adding phytoestrogens to your body, alcohol also activates aromatase enzymes, which converts male hormones androgen and testosterone into even more estrogen. This leads to estrogen dominance – which can certainly affect all manners of your body and personality.

It is important to note, however, that these changes in hormonal balance are difficult for the individual to notice, but the moodiness and other symptoms of oversaturation of female hormones in the body of men are easier to spot than in women.

Signs of Estrogen Dominance (Excess Estrogen) in Men 

Men naturally need both male and female hormones in their body, and the presence of estrogen in men is natural and not a worrying occurrence. When the estrogen levels in men increase too much, however, the following signs and symptoms will occur:

• Reduced Libido
• Sexual Arousal Problems and Erectile Dysfunction
• Enlarged Breats or Gynecomastia
• Urinary Tract Issues and Recurrent Urinary Tract Infections
• Increase in Belly Fat
• Fatigue and Chronic Tiredness
• Loss of Muscle Mass
• Anxiety and Panic Disorders
• Depression, Sadness and Loss of Elation
• (Greater Risk of) Developing or Worsening Type 2 Diabetes

How Do Opioids Affect The Thyroid? 

Opioids can affect the thyroid in a number of ways, but the problem is that these issues are not commonly diagnosed, and the symptoms are not easily recognized. One of the prime concerns of how opioid abuse affects thyroid function is the development of opioid-induced endocrinopathy.

Opioid-Induced Endocrinopathy 

Endocrinopathy is any disease of the endocrine gland, and this term is used to describe any type of hormone problem including hyperthyroidism and hypothyroidism. In a study on Opioid-Induced Endocrinopathy by Stephen Colameco, M.D.; Joshua S. Coren, D.O., MBA  the doctors found that long-term opioid use could indeed be connected to hormone deficiencies. In particular, adrenal androgen production decreased, and this – coupled with decreased levels of cortisol – was considered to be the most problematic.

The results of the study showed that sustained-action opioids had the highest effect on DHEAS levels. Sustained-action opioids include oxycodone, morphine (Sustained action), continuous-release fentanyl, and methadone. If these types of sustained action opioids were used for more than a month, it was found that DHEAS levels were below normal in 67% of study patients (Equating to 24.8% of Men and 31.6% of Women).

So what does this all mean?

All in all, this means that patients that have been taking opioids daily for long periods of time, there is likely to be an effect to the Hypothalamic-Pituitary-Gonadal Axis, and you likely have decreased hormone balance. In most cases, this is not too worrisome, and this may be reversible in many cases. However, decreased hormones can cause mood and behavior changes, hypogonadism, and a host of sexual dysfunction issues. Screening and diagnostic testing is recommended if those that have been receiving opioid treatment that is equal to 100mg of morphine daily. This goes for anyone who has been abusing opioids, including heroin, in equivalent dosages.

How Do Adderall and ADHD Medications Affect The Thyroid?

A stern warning with medications for ADHD like Ritalin, Adderall, Focalin, Concerta, Dexedrine, Metadate and Vyvanse is that the medications are not to be taken if you have thyroid issues. These warnings are for very good reasons. Not only do stimulants like ADHD medication and amphetamine now work for treating symptoms of hyperactivity in those with thyroid issues, but increased dosages can worsen behavioral problems.

It is very important to test a patient for thyroid problems before diagnosing ADHD or prescribing medications to treat ADHD. In many cases, treating the thyroid issue alone will take care of hyperactivity, lack of focus, and other symptoms of ADHD.

If you have not been prescribed ADHD medications and are abusing these medications for recreational purposes, they can cause or worsen thyroid problems and worsen behavioral problems.

What To Do If You Suspect Drug and Alcohol Abuse is Causing Thyroid Problems 

Treating a thyroid disorder requires testing first, and a treatment plan to address the issues – usually involving medication and/or hormone therapy. However, before a doctor can effectively treat the thyroid issues, your doctor will require you to stop drinking or using drugs and medication that could be playing a part in the imbalance.

It is at this point that many with substance abuse and thyroid problems find that they simply can’t cut down or quit, and realize they have an addiction. At this point, addiction treatment is needed to get the patient detoxed from the drugs or alcohol causing the chemical dependency, provide for them ongoing addiction treatment, and have a plan for continued addiction recovery that works with the medical and clinical needs for thyroid treatment. Many families don’t know where they need to be to get a loved one help for substance abuse and medical needs, and that is why Intervention Helpline team puts an emphasis on providing families with treatment plans that address all needs – those pertaining to the substance abuse issues, treatment for mental health and emotional problems, and treatment for the medical needs that substance abuse has created.