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Can Stress Cause Thyroid Problems? The Science Between Cortisol & Thyroid

Medically reviewed by

Stefano Guandalini, MD


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Key takeaways

If you have a thyroid condition, you may have heard that there is a link between the thyroid and stress. It turns out that thyroid hormones are connected to the body’s stress system (the hypothalamic-pituitary-adrenal axis) and stress hormones like cortisol. This may make people with thyroid problems more sensitive to stress.

People who have hypothyroidism or hyperthyroidism may also wonder if stress could have caused their illness or if stress makes their symptoms worse. Some studies show that stress is linked to autoimmune diseases in general, such as Graves’ disease and Hashimoto’s thyroiditis. However, there isn’t a lot of evidence that it’s linked to the development of thyroid disease, in particular, due to a lack of research. 

How stress affects your thyroid

There is some evidence that thyroid problems and stress are linked, but the nature of the link is less clear. Some studies discussed further in this article have suggested that stress may cause thyroid issues, and it’s also plausible that thyroid problems can make a person more vulnerable to stress. 

To learn more about the link between thyroid problems and stress, we first spoke with Dr. Stefano Guandalini, MD, Professor Emeritus at the University of Chicago Medicine.

Dr Guandalini tells us that having a thyroid condition does make you more vulnerable to stress:

"When you have either hypothyroidism or hyperthyroidism, you become more sensitive to both mental and physical stresses, as the excessively high or low levels of thyroid hormones affect how the whole body reacts to stress," said Dr Guandalini.
"Stress increases production of the hormone cortisol, which is produced by the adrenal glands. Cortisol can inhibit secretion of TSH (thyroid stimulating hormone) from the pituitary gland, leading to partial suppression of thyroxine, the main hormone produced by the thyroid gland," Dr. Guandalini explains.

To summarize, Dr Guandalini highlights that stress could potentially worsen symptoms of thyroid disease, which, in turn, can cause more stress. This means people with thyroid conditions should take extra care to manage their stress levels.

Does stress cause thyroid disease?

Chronic stress is known to play a role in the development of many diseases, including autoimmune diseases. Autoimmune thyroid diseases, such as Graves’ disease and Hashimoto’s thyroiditis, are by far the most common type of thyroid disease

If you have Graves’ disease or Hashimoto’s thyroiditis, you may be wondering what triggered your illness. Could it have been a stressful time in your life? 

There is not a lot of high-quality evidence for the link between stress and the development of thyroid disease specifically, due to a lack of research. 

A 2005 article published in the journal Thyroid argues that stress may precede the onset of Graves’ and Hashimoto’s diseases. The authors argue that stress may modulate the immune system, which could cause autoimmune disease in those who are genetically predisposed.

A 2013 article also argued that stress plays a role in the pathophysiology of Graves’ disease. The authors suggest that stress management should be part of a patient’s treatment plan. 

Dr. Guandalini is in agreement that there may be a link between stress and the development of autoimmune diseases like Graves’ disease and Hashimoto’s thyroiditis. 

A large retrospective study conducted in Sweden in 2018 showed clearly that subjects that experienced stress-related disorders were about 30% more likely to develop an autoimmune condition, he explained.

Dr Guandalini also mentioned a 2020 study published in BMC Psychiatry, which found that US military personnel who had been diagnosed with PTSD had a 58% higher chance of developing an autoimmune disease. 

"Importantly, we are still far off from understanding the reason for this observed link," Guandalini cautioned.

Because of study design limitations, it’s not possible to determine with certainty whether stress causes autoimmune disease. For example, it’s possible that people who are vulnerable to autoimmune conditions also tend to be more vulnerable to stress. 

Managing stress with thyroid problems

Stress management is important for anyone, whether they’re dealing with a health condition or just trying to stay in good health. But for those with a thyroid condition, it’s clear that extra attention should be paid to stress reduction. Here are six ways to reduce stress, particularly if you have a thyroid condition:

Take your vitamins

Certain vitamins are powerhouses for stress management. The most popular stress-busting vitamins include B-complex, a multivitamin that contains B vitamins and magnesium

For people with thyroid problems, these vitamins are even more important. There is a high prevalence of B12 deficiency among hypothyroid patients, and supplementation may improve symptoms. Magnesium deficiency has also been associated with thyroid dysfunction. 

Get enough sleep

Try to get your 8 hours every night. Research suggests that getting enough sleep is an important aspect of stress management. 

People with thyroid problems can have issues with sleep. Those with hypothyroidism tend to be fatigued and may need more rest, while those with hyperthyroidism may struggle to fall and stay asleep. Prioritizing sleep may reduce the impact of these symptoms. 

Eat whole foods

Whole foods that are as close to their natural state as possible (think fruits, vegetables, fish, nuts, eggs, and whole grains) are the most nutritious. Getting the right nutrition for your body can help build resilience and help you cope with stress.

People with hypothyroidism should be sure to get enough iodine in their diet to support the thyroid. Good dietary sources of iodine include iodized table salt, dairy products, eggs, tuna, cod, and seaweed.

Exercise regularly

Studies have shown that regular exercise may increase a person’s stress tolerance. Plus, it’s got a whole host of other health benefits, too. Exercising with a thyroid condition can be difficult due to the nature of the autoimmune diseases. However, many of the most common symptoms of thyroid problems can be improved with exercise, such as weight gain, depression, and low energy.

Practice relaxation

De-stressing is uniquely personal, and everyone has different activities that help them to relax. Whether it’s rock climbing, meditation, or simply taking a bath, make space in your life to practice relaxation. 

Depending on your symptoms, you may need different de-stress activities on different days – for example, yoga when you’re feeling good and taking an extra nap on a day with more symptoms. 

Make a lifestyle change

For some people, all the yoga in the world won’t change a genuinely stressful situation. People with chronic thyroid conditions need to prioritize their health. So, if a situation under your control is causing you undue stress, consider making a change to support your overall health and well-being. 


There is some evidence that stress is connected to autoimmune disease, and it’s plausible that stress could be linked to autoimmune thyroid disease. However, there isn’t much specific evidence about stress causing thyroid disease in particular.

It’s always a good idea to keep your stress levels in check, whether you’re dealing with a chronic condition or just trying to stay in good health. Because of the link between stress and the thyroid, people who have thyroid disease are encouraged to take extra care to ensure their stress is under control. 

Updated on
February 22, 2024
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