If you’re experiencing symptoms such as unexplained weight gain, depression, amenorrhea, low sex drive, PMS, excessive menstrual bleeding, aches and pains, chronic colds and illnesses, hair loss, brittle hair, dry skin, and even trouble getting pregnant—you could be dealing with thyroid issues.
Interesting fact: 15-20% of people with depression have low thyroid hormones!
Hypothyroid vs. Hyperthyroid
Hypo means too little, whereas hyper means too much. Basically, if you’re hypothyroid, you’re not making enough (of either or both) T3 and T4. When you’re hyperthyroid, you’re making too much thyroid hormone. Hyperthyroidism only affects about 2% of the US population, whereas hypothyroidism affects many more of us, so I’m going to make it my fun focus today! You can read this post to learn more about hyperthyroidism.
Players in the Thyroid World:
- Thyroid Stimulating Hormone (TSH): Produced by the pituitary gland to stimulate the thyroid to produce T3 and T4.
- Thyroxine (T4): The inactive version of thyroid hormone and a precursor to T3.
- Triiodothyronine (T3): The active version of thyroid hormone which is converted from T4.
- Reverse T3 (rT3): Slows down metabolism to save energy during times of stress. Illness, trauma and calorie-restriction will raise Reverse T3 and slow down metabolism.
- T2, T1: They play pretty minor roles so we won’t worry about them for now.
If your thyroid is functioning correctly, it produces these hormones in the right amounts. Unfortunately, this is not the case for many of us. Millions of women around the world live in a state of subclinical hypothyroidism for years before being properly diagnosed.
This is usually because even though their test numbers are low, they still fall within the normal range on their test results. If you are dealing with any of the symptoms above and your test results are “normal,” or your symptoms have been dismissed by your current doctor, then you should find a functional medicine doctor to get more proactive care.
Menstrual/Hormonal/Fertility Issues? Your thyroid could be the culprit!
Our thyroids play a huge role in regulating not only our energy and metabolism but also our reproductive health. When a woman goes to her doctor about menstrual/hormonal/fertility issues, the thyroid is not often checked—but it should be! This is because there is a special conversation happening between the hypothalamus, pituitary, and the endocrine glands (the adrenals, thyroid, and ovaries)
They all work in a series of axes—the HPA Axis (Hypothalamic Pituitary Adrenal Axis), the OAT (Ovarian Adrenal Thyroid Axis) and the HPO (Hypothalamic Pituitary Ovarian Axis)—which means that when one gland isn’t functioning the way it’s supposed to, the other glands will feel the heat.
Over time, this leads to a domino-effect breakdown in overall endocrine function! Think of it as the hormone superhighway: If there’s traffic or an accident, things slow down on the highway, and eventually everything comes to a screeching halt. Ideally, we want 70 mph all day every day! 🙂
Potential causes of hypothyroid (low functioning thyroid) for women:
- Birth control pills – (I know, I’ve been on a bit of a BCP rampage recently, but for good reason!) BCPs increase thyroglobulin, a protein that binds with thyroid hormone and prevents it from being free to be used by the body. This slows down your thyroid function. In addition, the BCP weakens your gut’s ability to absorb certain key minerals that are vital to a healthy functioning thyroid.
- Goiter and lack of iodine – Lack of iodine is the leading reason of hypothyroidism around the world. Thyroid cells are the only ones in the body that can absorb iodine, so if we lack this vital mineral, our thyroid can become enlarged (a goiter) in order to absorb as much iodine as possible.
- Stress – (You knew that was coming too, right?) When we’re stressed, as in the shitty boss breathing down our necks or the venti latte we drank hurriedly this morning, our adrenals pump out a bunch of cortisol to help us deal with that stress. Unfortunately, high cortisol affects your hypothalamus and pituitary glands (the thyroid bosses). This causes you to make less free T3 and more reverse T3, which blocks thyroid receptors. Boo.
- Endocrine disrupting chemicals – In particular, Bisphenol-A (BPA). This is a known endocrine disrupting hormone found in canned food linings and some plastic water bottles. It slows down your thyroid function by blocking thyroid receptors.
- Chronic dieting/eating low fat foods – This is somewhat complicated because it involves the hormone leptin, a regulator of body weight and thyroid function. Chronic dieting and lots of low-fat foods can cause leptin resistance, which means leptin is no longer communicating with the hypothalamus correctly. Without proper communication from leptin, the hypothalamus thinks that you are in starvation mode. This slows down thyroid hormone production AND causes you to retain body fat (at all costs!). Double whammy!
- Hashimoto’s thyroiditis – This is when your immune system develops antibodies against the cells in your thyroid that produce thyroid hormones, causing the cells to destruct (i.e., it attacks your thyroid). Over time, this process destroys your thyroid tissue, which leads to less thyroid hormone production. When your hypothalamus gets the message that your thyroid is slacking on the job, it tells the pituitary to produce more TSH to stimulate the thyroid. This is why TSH is high with hypothyroidism. Eventually, your thyroid can’t keep up with demand and you start to become fatigued, you put on weight and you lose your cool way more often. To assess for this condition, a doctor must run the TPO antibody test to measure the level of antibodies in the thyroid tissue.
Thyroid’s Connection to Our Menstrual Cycles
Okay, now I’m sure you’re really wondering how the heck these two are connected.
It all starts with pregnenolone, the mother hormone (or precursor) of our sex hormones. This is where the feedback loop comes into play. We actually need adequate thyroid hormone so that pregnenolone can be made from cholesterol. Pregnenolone then makes progesterone (the hormone that is secreted after ovulation). We need a certain amount of progesterone for our thyroid to function optimally. Can you see the circle here:
Thyroid (T3 & T4) –> Pregnenolone –> Progesterone –> Thyroid (T3 & T4)
As you can see, it’s just one big feedback loop!
Low thyroid hormone could lead to low pregnenolone and ultimately low progesterone. Low progesterone is one of the main causes of luteal phase defect and estrogen dominance. These of course are linked to lack of ovulation and infertility, PCOS, fibroids, endometriosis and a wide range of other menstrual issues.
Best Testing for Your Thyroid
You want to get the following tests:
- TSH (Thyroid stimulating hormone): Should be between 0.3 – 2.5 mIU/L. If it is above 2.5, you are hypothyroid.
- Free T4: Should be in the top half of the normal range on your test results.
- Free T3: Should also be in the top half of the normal range on your test results.
- Reverse T3: Should be in the bottom half of the normal range on your test results.
- Thyroid peroxidase antibody, or TPO antibody and thyroglobulin antibody tests: These help your practitioner to evaluate whether there is an autoimmune issue causing the thyroid dysfunction like Hashimoto’s or Graves Disease.
This will give you a complete picture of what’s going on in thyroid land. TSH and T4 alone are certainly not sufficient enough to determine thyroid issues. Don’t let your doctor tell you that it is.
What can I do now?
If you are experiencing symptoms of hypothyroidism, you don’t need to wait for tests to start taking action. Here are a couple of things to get you started.
- Get off gluten. Gluten sensitivity or celiac disease (a full blown gluten allergy!) can cause serious intestinal issues like leaky gut syndrome. This causes undigested food particles to “leak” out of the gut lining and allows them to wreak havoc on the immune system. It appears that celiac sufferers are much more likely to have Hashimoto’s, the autoimmune condition where the immune system attacks the thyroid. Get tested for gluten sensitivity and remove gluten from your diet if you have a sensitivity or allergy.
- Check your Vitamin D levels. Don’t underestimate the power of vitamin D. Lack of vitamin D actually blocks T3 production. You should test your D levels at least once a year to make sure you are not deficient. Your levels should be 75-90 mg/mL, but I am finding many women test in the 20-30 range (myself included!). Expose your arms and legs to sun for 20 minutes a day and supplement with 2000 IU per day if you feel you need additional support.
- Increase your intake of good fat and cut out this low-fat nonsense. As you now know, starvation diets wreak havoc on leptin levels and thyroid function. We need adequate fat and cholesterol in order to make pregnenolone, which makes our sex hormones—in particular, progesterone. As I described above, we need adequate progesterone for optimal thyroid function.
- Reduce goitrogenic foods. Weird word, isn’t it? Goitrogens are compounds found in many foods, in particular the Brassica family of vegetables, that can cause the thyroid to malfunction. Think kale, cabbage, broccoli, brussel sprouts, mustard greens, etc. Cruciferous vegetables have gotten a bad rap for people with thyroid issues. What we’ve since learned is that, as long as iodine levels in the body are adequate, the benefits far outweigh the harm. The thing is, iodine levels tend to be low in people who have low thyroid function. Lightly cooking these vegetables reduces their goitrogenic effect by about a third. You may even want to limit them to 2-3 times a week if you are diagnosed as hypothyroid, or you notice your symptoms becoming worse in conjunction with eating these foods.
- Have some Brazil nuts. Three Brazil nuts a day is enough to get the recommended amount of selenium, a trace mineral that the body needs to convert T4 to T3, the active form of thyroid hormone. Selenium is also needed to increase glutathione, an antioxidant made by the body that keeps the immune system, and particularly the thyroid antibodies, under control. For maximum benefits, always buy organic Brazil nuts and soak them overnight in spring water.
- Stop exercising so hard. This relates back to the stress factor. If we are working out too hard/too much, our adrenals might interpret this as a sign of stress or danger. When our adrenals sense danger, they automatically go into cortisol production overdrive. Remember, cortisol inhibits the production of valuable thyroid hormone. So we end up having the opposite effect than we thought: We don’t lose weight as easily or we put on weight (aarrgh!).
- Seriously reduce your exposure to chemicals by using a water filter (shower, kitchen or whole house), natural body care, and home care products. You’d be surprised how many chemical-laden products you are exposed to on a daily basis. These include the chlorinated chemical compounds, such as PCBs, dioxins, and flame retardants, as well as xenoestrogens like BPA and phthalates. All of these chemicals bind to cells in our immune and endocrine systems, as well as the delicate tissue in our thyroid glands, damaging their function. Radiation and electromagnetic frequency (or EMF) are also just as harmful. The most studied thyroid disrupting heavy metals include mercury, cadmium, and lead. Heavy metals disrupt thyroid function in a number of ways: They interfere with iodine uptake into the thyroid, they mess with the conversion of T4 to T3, and they block thyroid receptors from receiving thyroid hormone.
If you want even more solid solutions to address your thyroid/adrenal/reproductive issues, take my quiz to determine which of my programs is right for you. Each of my programs has a module that breaks down how your thyroid functions, the causes of thyroid problems, as well as my thyroid healing protocol to help you get your thyroid humming along again! 🙂