How To Help Your Adrenals & Thyroid Recover From An Eating Disorder
If you've suffered from anorexia or bulimia in the past, you know recovery can be a long road as you make peace with food, your body, and the very real life triggers that led to your eating disorder in the first place.
What many of the women I see in my medical practice who have struggled with an eating disorder didn't expect was that they'd find themselves facing long-term consequences in the form of a slow-functioning thyroid1 and imbalances in the adrenal stress response, with symptoms like:
- Fatigue, tiredness, sluggishness
- Trouble keeping weight on or off
- Feeling cold all the time
- Trouble sleeping
- Digestive problems including constipation, loose stools, gas, bloating, or IBS
- Anxiety and irritability
- Hormone imbalances including irregular periods, PCOS, or fertility challenges
- Dry skin
- Hair thinning or hair loss
- Frequent colds, herpes outbreaks, and yeast infections
- Thyroid problems, including both autoimmune (Hashimoto's) and non-autoimmune (hypothyroidism.)
Note: Many of the suggestions here are based on my experience, observations, and practice as a medical doctor focusing on women's health, particularly adrenal and thyroid problems. Please consult your doctor before making any lifestyle changes, especially if you have a medical history of eating disorders.
The relationship between disordered eating, your adrenals, and your thyroid.
Eating disorders, particularly anorexia nervosa, can lead to a disruption in the adrenal stress axis2, which leads to increased cortisol and adrenaline production.
When your nutrition levels are low, your energy levels are also low. This sends the body into survival (aka fight-or-flight mode), causing your metabolism and energy expenditure to lower3. Here's why it happens and how it works:
You might feel anxious or have brain fog.
Your brain requires about 20% of the energy you consume from food to do its basic functions4. When it's not receiving enough nourishment, the brain along with other organisms malfunction.
This can lead to nervousness, sweating, cold shakes, brain fog, and other symptoms of anxiety. These side effects are a result of excess adrenaline, which are encouraging you to jump into food-seeking action.
Exhaustion, fatigue, and irritability set in.
Your ancient brain has your entire body hardwired to protect you in the event of famine or starvation. So, when your fuel intake becomes chronically low, not only are you pumping out more adrenaline, but you also start to pump out more cortisol.
This puts you into a state of anxiousness, with symptoms like irritability, increased muscle tension, sleep disruption5, poor digestion, and a weakened immune system6.
Your hormones become imbalanced.
"Thyroid function is usually down-regulated during stressful conditions,7" one study says. This, in turn, slows down metabolic functioning. To preserve energy, attention is also diverted away from tasks you don't need urgently, like regular digestion or making reproductive hormones.
A plan for mind-body-spirit replenishment.
Your brain's perception that you are at risk of starvation puts it into survival mode. To get out of survival mode and allow your adrenals and thyroid to reset to normal, your brain has to realize you're safe. The key is to learn to live a replenished, balanced life, allowing you to restore what has been depleted, mentally and physically.
Here are five ways you can start replenishing your health, starting immediately:
Never get too hungry.
Never let yourself get to the point where you're so hungry that you're shaky, cranky, jittery or unable to concentrate. Going to long in between meals can lead to a dip in blood sugar, which can cause the brain to jump into survival mode. To prevent this from happening:
- Practice intuitive eating by listening to your body.
- Eat a modest sized meal every 3 to 4 hours with a good-quality protein and fat at every meal.
- Have a mid-morning and mid-afternoon snack if needed. Satiating snacks include nuts, a smoothie, a green juice, hard-boiled eggs, or hummus and veggies.
Eat healthy carbs.
Healthy carbohydrates, like whole grains and starchy vegetables can keep your cortisol in a healthy rhythm, especially when you cycle them at the right time of day. Here's how this is done:
- Breakfast: Try to limit carbs—especially sugary, refined carbs—and opt for protein instead.
- Lunch: Eat one portion of a whole grain or a starchy vegetable. Examples include: half a cup of cooked quinoa, black rice, brown rice, millet, sweet potato, winter squash, baked or roasted white potatoes.
- Dinner: Eat one to two portions of whole grains or starchy vegetables.
Eating a healthy carbohydrate about five hours before bed has been shown to normalize cortisol, improve sleep, and help reduce excess weight8.
Get enough sleep.
Sleeping seven to eight hours of sleep each night is essential to replenish our cells9 and restore healthy cortisol rhythm. Try getting to bed at the same time each night and waking up at the same time each day.
Meditation can switch the body from fight or flight mode to rest and digest mode. This is how you feel in savasana at the end of yoga session, during a massage, or when you are deeply at peace.
Practiced for even 15 minutes each day, meditation and deep relaxation can support the adrenal system by creating an inner sense of safety and decreasing cortisol levels.
If meditation is not your thing, try other activities that bring you joy and peace. Dancing, painting, journaling, taking a hot bath, reading a novel, etc. Whatever it is, give yourself permission to pause, replenish your spirit, and relax every day.
You don't have to have a diagnosed eating disorder to notice these adrenal and thyroid affects. Any excessive restricting, including orthorexia (an excessive focus on healthy eating), excessive cleansing, and detoxing that leads to under-eating can have an impact. If you struggle from these issues, always consult with a doctor, nutritionist, or therapist to find support and a plan for healing.
Aviva Romm, M.D. is both a midwife and an Internal Medicine and Board Certified Family Physician with specialties in Integrative Gynecology, Obstetric and Pediatrics, with a focus on women’s endocrinology. She’s also a world renown herbalist, and author of the textbook, Botanical Medicines for Women’s Health, as well as 7 other books, including The Adrenal Thyroid Revolution. A practitioner, teacher, activist and advocate of both environmental health and women’s reproductive rights and health, she has been bridging the best of traditional medicine, total health ecology, and good science for over three decades. She practices medicine in both NY and MA, and lives in the Berkshires of Western MA.