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Can Perimenopause Cause Hypothyroidism?

You’ve no doubt heard horror stories about the symptoms that may come with perimenopause, the transitional period leading to menopause. But the problems can be far more complex. As if hot flushes, night sweats, insomnia, loss of libido, weight gain and brain fog weren’t enough, you can also develop hypothyroidism ― that is, an underactive thyroid.

It happens to around 26% of women undergoing perimenopause.

Why is hypothyroidism so bad?

For starters, if you have low thyroid function, there’s a good chance you will also find yourself battling depression.

Not only that, but when this little butterfly-shaped gland at the base of your throat malfunctions, it can have huge repercussions for your entire body.

The thyroid produces triiodothyronine (T3) and a larger amount of thyroxine (T4), which is converted to T3. These two hormones affect metabolism. That means they control how your body uses food to produce energy and determine the rate at which your heart, liver, muscles and other organs, including your brain, work. In short, they affect about all your body’s working parts.

One of the most common effects of low thyroid ― when not enough thyroid hormones are being produced or when they’re not working at the cellular level ― is depression.

Why Do Perimenopausal Women Get Hypothyroidism?

Perimenopause occurs in mid-life, normally beginning between your mid-30s and late 40s. That’s the same time when your risk for hypothyroidism greatly increases, so it’s entirely possible that the two simply occur coincidentally.

But it’s equally true that perimenopause and hypothyroidism are often related. As your egg supply diminishes with the onset of perimenopause, your ovaries begin to produce less oestrogen. However, your progesterone level can fall far faster than that of oestrogen, throwing these two hormones out of balance. In other words, your optimal oestrogen/progesterone ratio is disrupted.

This imbalance often results in oestrogen dominance ― a condition when progesterone falls to a level so low that it’s unable to limit the action of oestrogen. When this happens, you can experience symptoms exactly like those caused by low thyroid, including depression, along with weight gain and brain fog.

But it can get worse . . . .

All that low but excessive oestrogen can actually sabotage your thyroid hormones. Even if your thyroid is pumping out sufficient T3 and T4, oestrogen dominance can make them ineffective. And if they can’t do their job, you will develop hypothyroidism.

It can also work the other way. A pre-existing low-functioning thyroid can cause your progesterone levels to plummet. Even if your oestrogen/progesterone balance was initially optimal, the ultimate result can be oestrogen dominance, which further impairs the thyroid and worsens depression.

How Hypothyroidism Leads to Depression

The T3 thyroid hormone acts in the brain to govern three neurotransmitters important to your emotions:

  • Serotonin: Optimal levels of serotonin (called the “feel-good” neurotransmitter) make you feel happy and relaxed
  • Norepinephrine: Improves mood, helps you deal with stress and acts like a natural anti-depressant
  • GABA (gamma aminobutyric acid): Improves mood and relieves anxiety

When the action of the T3 hormone is impeded by hypothyroidism, these mood-stabilising neurotransmitters are effectively taken ‘off-line.’ When that happens, depression gets worse.

Serotonin seems particularly important for maintaining an ‘up’ attitude and good mood, but it can drop precipitously following an abrupt decrease in oestrogen, which can occur in the mid-30s. Shortages of serotonin can worsen symptoms associated with menopause ― hot flushes, insomnia and mood changes ― that can add significantly to depression.

How You Can Relieve Thyroid Dysfunction and Depression in Perimenopause

Diagnosing low thyroid can be tricky. Even though your oestrogen/progesterone levels are unbalanced and affecting your thyroid hormones’ action, a routine thyroid test may show your thyroid hormones are at perfectly normal levels. That’s because your thyroid is putting out hormones that can be measured ― they just can’t do what they’re supposed to do.

Generally speaking, adequate thyroid treatment will reverse thyroid hormone insufficiency and depression. It’s important to be aware, however, that people with hypothyroidism-induced depression are often misdiagnosed and treated as having a psychiatric illness. As a result, they are frequently prescribed antidepressants.

Unfortunately, antidepressants can be addictive. Also, they can have dangerous side effects. They can, in fact, actually worsen depression ― even trigger homicidal or suicidal impulses ― and they won’t fix an oestrogen-dominance problem or a low-thyroid problem.

To reverse low thyroid and depression during perimenopause, you will need thyroid testing, but the standard TSH test doesn’t detect most cases of low thyroid and won’t give you the answers you need.

You need a restorative medicine physician skilled in bioidentical hormone restorative therapy (BHRT) who offers comprehensive, full-panel thyroid testing. That includes total T3 (TT3) and total T4 (TT4) tests, along with a TSH test. He or she will also do full testing of your sex hormones (oestrogen, progesterone and testosterone) in order to assess their status.

With that knowledge, your doctor will prescribe the appropriate treatment to restore optimal balance to your hormones, proper functioning to your thyroid, and a life free of perimenopausal-related depression, as well as other troubling menopausal symptoms.

SOURCES:

Depression: Common Symptom of Hypothyroidism. Hotze Health.
Dowling, C. Menopausal Depression Is Common and Treatable. Women’s Wellbeing and Mental Health.
Kellman, R. Menopause or Low Thyroid ― Is It One, The Other or Both? Huffington Post, THE BLOG. Oct. 30, 2015.
Magnolia. 35 Symptoms of Perimenopause ― Hypothyroidism. The Perimenopause Blog. Oct. 10, 2016.
Northrup, C. Thyroid Disease. DrNorthrup.com.
Perimenopause and Thyroid Problems ― common and confusing. CEMCOR.

Perimenopause: What Every Woman Should Know

It is important that every woman in their 40’s is aware of the perimenopause and the changes it will bring. Even if you feel you are way too young to be thinking about the dreaded M word, learning about the P word will stand you in good stead.

If you understand the vital role hormones have in your health, emotions and overall wellbeing you will be much better prepared to deal with the perimenopause, menopause and ageing process in general.

So in the spirit of forewarned is forearmed, here are 5 things I wish someone had told me when I hit 40!

1. It starts at 40 not 50

Sorry, you probably didn’t want to read that. However, I cannot over emphasise enough how important it is to listen to your body in your 40’s when changes in your hormone levels begin to occur.

You probably know that menopause is when you have not had a period for 12 months. But… you may not know that the six to thirteen years leading up to the menopause are when some of the most difficult symptoms kick in. I’m talking; hot flushes, insomnia, bone loss, mood swings, brain fog, irregular periods, diminished sex drive, breast cancer and unexplained weight gain. This is called the perimenopause. It usually starts in your 40s, but can start as early as your 30s.

Although most women experience the menopause at around the age of 51, it’s very likely you will have suffered some perimenopause symptoms from your 40s onwards.

2. It’s your hormones

Menopause symptoms are your body’s way of signalling that something is wrong, that you have a hormonal imbalance. Hormones regulate every bodily function, from your heartbeat to weight gain. Without them we would slowly but surely fade away and die! Perimenopause is in fact, the earliest stage of this fading process.

In menopause, oestrogen(s) and progesterone levels decline drastically. These female hormones, that are so famous for fertility in our younger days, should not to be ‘left out in the cold’ once we reach menopause, as they are key hormones and play a vital role in bone health; protecting against osteoporosis. They protect our skin, keeping it healthy and glowing; brain function, protecting against dementia; heart health, protecting against heart attack; vaginal and urethral tissues, keeping our sex drive in ‘top’ form!

When there is an imbalance of even just one hormone, it will adversely affect the others and may result in any of several menopausal symptoms.

3. Test your thyroid

After your fortieth birthday, it is important to recognise the symptoms of low thyroid (hypothyroidism). Low thyroid complaints include; joint pain, allergies, carpal tunnel syndrome, high insulin, unexplained weight gain, fibrocystic breast tissue, hair loss, loss of libido, dry skin and headaches to name just a few.

In perimenopause, declining levels of oestradiol (a type of oestrogen) and progesterone (both known as female sex hormones), along with testosterone from our ovaries, may leave a woman with a ‘go-slow’ (underactive) thyroid. Declining levels of female sex hormones may cause thyroid issues such as hypothyroidism. However, these are not true thyroid problems, they occur because female sex hormones are low. When oestrogens and progesterone are restored to optimal levels, in the majority of cases, thyroid issues will be rectified, thus, there would be no need to supplement with thyroid hormones.

However, about 25 per cent of perimenopausal women have some kind of thyroid problem. In the majority of cases it is due to subclinical hypothyroidism which may progress into overt hypothyroidism. Both subclinical and overt hypothyroidism should be treated.

4. There is an alternative to conventional HRT

There is not a one-size-fits-all woman. Therefore, there cannot be a one-size-fits-all pill. We are all different, we all metabolise hormones differently, and our hormonal decline varies from woman to woman. Therefore, we need an individualised treatment. HRT is a one-size-fits-all treatment. Bioidentical hormone restorative therapy (BHRT) is tailored to the patient’s requirements. We are all different – would you go out and buy a size 14 dress just because your friend did, when you’re actually a size 12?

5. Don’t dread the ‘M’ word

Contrary to the conventional menopause stereotypes that we often see in the media, you can have a happy, healthy, strong and sexually vibrant life, well into your forties, fifties and even beyond. The key is to get the right information early on.

 

The Menopause Cure: Hormonal Health. The book is available in good book stores and online at Amazon.

Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an inflammation of the thyroid gland and is the most common form of thyroiditis. It is much more prevalent in women than men. It is an autoimmune disease.

The major role of the thyroid is to regulate growth and metabolism – in Hashimoto’s thyroiditis the immune system attacks the thyroid gland, which causes it to dysfunction, therefore growth and metabolism will be slowed.

Common symptoms are:

  • weight gain,
  • cramps,
  • depression,
  • fatigue,
  • goiter,
  • muscle weakness,
  • constipation and sensitivity to cold.

However, some people with Hashimoto’s thyroiditis display no symptoms.

If you suspect you have Hashimoto’s thyroiditis check in with your restorative medicine doctor and do the appropriate blood tests (full thyroid panel). If you do have Hashimoto’s thyroiditis your doctor will restore thyroid hormones to alleviate your hormone deficiency. It is extremely important that the dosage is correct – when hypothyroidism is diagnosed, both T4 and T3 pathways should be restored. If you only restore T4 pathways, then you could still have low thyroid symptoms because of problems with the conversion of T4 to T3.

Conventional doctors usually only prescribe T4 (in the synthetic form). Restorative doctors prescribe T4 and T3 (in the natural form). T4 is the inactive form and needs to be converted in the bloodstream into T3, before it becomes the active form. There are no receptors in the body for T4 only T3.

Medicine prescribed by conventional doctors (Synthroid – synthetic) only contain T4. Armour Thyroid prescribed by restorative doctors are natural and made up of T4, T3 and other substances that assist the body in converting T4 to T3, such as calcitonin and selenium. Of course, it is important to get other hormones checked as thyroid dysfunction rarely happens alone. When basic hormones are low or imbalanced the immune system is weak, which may actually provoke autoimmune diseases including Hashimoto’s Thyroiditis. Hormones are crucial in keeping our immune system in order. It is important to get it right if you want to be healthy!

As well as taking thyroid hormones, there are also certain supplements that can help discourage the immune system attacking the thyroid gland.

  • EPA/DHA (fish oil), omega-3 – when taking fish oils also take vitamin E to prevent oxidation or choose a source that contains vitamin E.
  • Gamma-linolenic acid (GLA), omega-6 – it is important to maintain the correct ratios of omega-6 to omega-3 fatty acids, between 3:1 to 6:1, or it can lead to chronic inflammation and many other health problems. The diet today is very high in omega-6 and low in omega-3.
  • Magnesium – if you find it causes diarrhea take a lower dose.
  • Olive leaf extract – to be taken with food.
  • Probiotics – if taking any antibiotics make sure to wait 3 hours before taking probiotics.
  • Selenium – to be taken once a day.
  • Vitamin C – do not take a high dose if you are subject to kidney stones or gout.
  • Vitamin E – make sure to take mixed tocopherols, which is the more active form of vitamin E. Please first consult with your healthcare provider if you are taking blood thinners.

The Effects of Yo-Yo Dieting

yoyo-diet-thyroid-weight

The thyroid is our metabolic motor, and controls our metabolism (metabolic rate), when we ‘crash diet‘ a biologically-programmed interruption in its function is created, which actually results in weight gain – the opposite to what you are looking to achieve. As the thyroid talks to all the other hormones, this interruption disrupts the hormonal flow, and consequently, other metabolic processes along the way.

The thyroid gland secretes its hormones in the following proportions: 80 percent of T4, the inactive form, which is ultimately converted to T3 in the bloodstream to become the active form, and 20 percent of T3. When we crash diet a physiological response in the body takes place, which most likely dates back to Paleolithic man and the risk of starvation. T4 is then converted into reverse T3 (RT3), instead of T3. Reverse T3 is not metabolically active, and will result in the ‘shutting down‘ of our basal metabolic rate (metabolism).

When there is a lot of crash dieting going on the body sees this as a sign of famine and slows everything down, so whatever we are doing we will not lose weight. With persistent yo-yo dieting we are technically lowering our basal metabolic rate. Our metabolism will get stuck on neutral and we will gain weight on fewer calories whatever programme we are following, be it a high protein, low-carb, high vegetable, or whatever – the results are always the same; metabolic ‘shut down’.

Yo-yo dieting has gained its name because it truly is a yo-yo effect; as soon as we stop the severe food restrictions, the weigh piles back on and at a greater rate. This short-term solution does not work. If we restore our body with bioidentical hormones, adapt healthy eating habits and include exercise, the weight will come off and stay off!

Note: The same mechanism occurs in people under intense and increased stress. Stress raises the hormone, cortisol, which interferes with the conversion of T4 to the active form T3, this results in more reverse T3 being made, and again, it slows down the metabolism. This is known as stress-induced weight gain.

Balance your hormones, your systems, your body. Restore your body!