Hormonal shift number three involves your thyroid system, which controls metabolism, energy production, and cellular function throughout your body. Chronic stress from narcissistic abuse creates a cascade of thyroid dysfunction that doctors struggle to identify and treat. Your thyroid system operates on a feedback loop between your hypothalamus, pituitary gland, and thyroid gland. The hypothalamus releases TRH, which signals the pituitary to release TSH, which then tells your thyroid to produce T4 and T3 hormones.
Narcissistic abuse disrupts this entire system. Chronic cortisol elevation suppresses TSH production, leading to functional hypothyroidism—even when your TSH levels appear normal on standard tests. Additionally, stress hormones interfere with the conversion of T4 to T3, the active form of thyroid hormone your cells actually use. The chronic inflammation caused by narcissistic abuse can trigger autoimmune responses against your own thyroid tissue, leading many survivors to develop Hashimoto’s or Graves’ disease months or years after their abusive relationship ends.
The symptoms of thyroid dysfunction mirror many effects of narcissistic abuse: fatigue, brain fog, weight changes, depression, anxiety, hair loss, and temperature sensitivity. This is why many survivors feel like they are going crazy. Their symptoms are real and biological, but standard thyroid tests come back normal because doctors are not looking at the complete picture.
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