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  • Writer's pictureDr. Jon Kaiser

Thyroid and Adrenal Abnormalities in Long Covid

Updated: Oct 25, 2022

The word hormone is derived from the Greek word ‘to excite’. While hormones are released in small amounts, they can have wide-ranging and powerful effects.

Many people with Long-haulers Syndrome experience symptoms that can be related to abnormal thyroid and/or adrenal gland functioning.

Covid-19 infection can affect the thyroid and adrenal glands in at least three ways:

· Direct attack - damage by viral particle attachment and infection

· Indirect attack - damage caused by excessive release of cytokines

· Immune-mediated - damage from cross-reacting antibodies

I’d like to discuss the thyroid and adrenal glands separately so you get a sense of which hormones they release, how to evaluate their functioning and how to best intervene in ways that can help you feel better.

The Thyroid Gland

Thyroid hormone helps control your metabolic rate - the rate at which your body generates and uses energy. Thyroid hormone levels can affect your heart rate, blood pressure, muscle strength, energy level and mental alertness. The thyroid gland uses iodine from the food you eat to make its two main hormones:

• Triiodothyronine (T3)

• Thyroxine (T4)

T4 has only a slight effect on your metabolism. The majority of it is converted into T3, which is the active hormone that stimulates metabolism. About 80% of this conversion takes place in the liver and kidneys, while 20% of it takes place within the thyroid gland itself. This conversion process is dependent on healthy mitochondrial function (more info here).

T3 and T4 have similar structures except that T3 contains three iodine molecules while T4 contains four iodine molecules. Up to 99% of thyroid hormones circulating in the bloodstream are bound to transport proteins, such as thyroxine-binding globulin (TBG) or albumen. Only a very small fraction is free (unbound) and biologically active; therefore, when assessing thyroid hormone levels, it is of better diagnostic value to measure the level of free thyroid hormones (free T3 and free T4).

If your thyroid hormone level is low, your TSH level often goes in the opposite direction (up) to stimulate your thyroid gland to make additional hormone.

Many physicians with experience treating patients with brain fog and chronic fatigue believe that the lab’s normal range for TSH is usually too wide. I would recommend targeting a TSH level between 0.05 and 0.2.0 in order to maximize the energy and cognitive benefits provided by an adequate level of thyroid hormone.

Covid-19 can affect the both the pituitary and thyroid glands resulting in thyroid hormone abnormalities. This infection can also stimulate the production of anti-thyroid antibodies that can damage your thyroid gland.

Symptoms associated with too little thyroid hormone include:

· Fatigue

· Dry skin

· Weight gain

· Hair loss

Symptoms associated with too much thyroid hormone include:

· Agitation

· Anxiety

· Insomnia

· Weight loss

The best way to make sure your thyroid hormone levels are in the right range is to consult a physician who has extensive experience treating both post-viral syndrome and hormone abnormalities. This can ensure that your thyroid hormone is at the proper level so your muscles, brain, liver and immune system are optimally supported for you to feel your best.

In next week’s Blog, I will discuss important details on how to assess and support your adrenal gland in order to assist you in recovering from post-viral syndrome.


When it comes to managing your hormones, the two most important words are ‘experience’ and ‘balance’. Since hormones have powerful effects, and they all work together to create a balanced state, it’s best if they are supplemented under the supervision of an experienced physician utilizing regular blood and/or saliva testing.

Recovery from post-viral syndrome requires putting all the right pieces together into a comprehensive treatment program. This includes supporting your body with the proper diet, effective nutrient supplements, hormonal support, microbiome support (more info here) and pharmaceutical medication if and when needed.

Please forward my Blog to your family and friends.

Keep Hope Alive!

Jon D. Kaiser, M.D.

(415) 381-7655

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