Menopause and Thyroid Disease

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You have to wonder how a small (2 inches long), butterfly-shaped thyroid gland weighing in at 1 ounce, located in the front of your neck can affect everything you do and are! This gland has two lobes that pump out thyroid hormones which are powerful chemicals that work with just about every system in your body.  They work to keep your brain sharp, your energy levels up, your reproductive system churning, and your skin, nails, and hair beautiful.

This little gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4) which impact our metabolism, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. For us women, thyroid disease can have negative effects on puberty, pregnancy, menopause, and fertility.

According to the University of Maryland Medical Center, women over 50 are at the greatest risk of thyroid disorders. Sadly, according to the American Thyroid Association up to 60 percent of those with thyroid disease are unaware of their condition.

So when it goes on the fritz—and it has for 20 million Americans—everything suffers, and get this; most of those victims are women, according to Dr. Daniel Einhorn, M.D., an endocrinologist at Scripps Memorial Hospital La Jolla.

Thyroid disease, generally, comes in two flavors: over- active(hyperthyroidism) and under-active (hypothyroidism).

If your thyroid is out of control, all of your efforts to curb perimenopause and menopausal symptoms and achieve hormone happiness will be for naught. What’s more, your symptoms might not be perimenopause or menopausal at all. Or, if you are like moi, you could be in perimenopause and find out you are hypo, as well.  I call that, a perfect storm!

Be sure to ask your menopause specialist to check your thyroid function when you have your menopausal evaluation! Before your appointment, chart your symptoms to keep track of what you’re experiencing. Remember, the blood work is half of the story, the other half is how you feel.  This chart will help you communicate this to your doctor. After all, in the end, the only surefire way to tell if your symptoms come from a lack of thyroid hormone or a lack of estrogen is to get your hormones tested, Einhorn indicated.

According to Dr. Einhorn, the most common test to ID a thyroid gland gone haywire is a TSH test, which measures your blood’s levels of thyroid stimulating hormone, a hormone that tells your thyroid to get to work. In the case of an underactive thyroid (hypothyroidism), TSH levels will be markedly elevated, while low levels can be caused by several conditions, meaning that more testing will be needed to determine if the cause is an overactive thyroid (hyperthyroidism).

Are you hyper or hypo???

There is an increase of hormones in hyperthyroidism, which causes metabolism and other bodily functions to speed up. Symptoms of hyperthyroidism which may include weight loss, rapid heartbeat, insomnia, irritability, trembling hands, heat intolerance and a constantly “wired” feeling—generally catch women’s attention sooner than those of hypothyroidism. A common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder of the thyroid.

An underactive thyroid, called hypothyroidism, however, is a whole different story. In hypothyroidism, there is not enough hormone being produced, so the metabolism and the body slow down.

“The symptoms are usually mild and non-specific, so it’s easy to attribute them to many other things… like menopause, for instance,” Einhorn says. According to the U.S. National Library of Medicine, an underactive thyroid can lead to fatigue, brain fog, irregular menstrual periods, weight gain, depression,  constipation,  muscle aches, infertility, goiter, constantly feeling cold, and even hair loss—all of which also can occur during perimenopause and into menopause. Five to eight times as many women have hypothyroidism than hyperthyroidism. A common cause of hypothyroidism is Hashimoto’s disease.

There’s really not much you can do to prevent hypothyroidism. “For better or for worse, hypothyroidism is largely not under our control,” says Einhorn, who notes the disease is primarily genetic. Family history may be the greatest indicator of troubles ahead, but since so many people are undiagnosed, you could have a family history of thyroid disease and have no clue about it – like me.  My Mom was not aware that she should tell her children that she was hypo. Thank goodness, I was aware of the importance of sharing this information with my children.  My daughter is hypo, my son is not. Had my daughter not been aware of this important information,  she might have been undiagnosed.  This could have affected her fertility.

Pregnancy increases the risk of hypothyroidism both through altering iodine requirements and through reproductive hormones altering thyroid hormone levels, according to the University of Maryland Medical Center.  (BTW my daughter needed to change her thyroid meds during her pregnancy.)What’s more, some women develop antibodies to their own thyroid during pregnancy, so if you had postpartum thyroiditis, your chances of developing permanent hypothyroidism are also increased. Polycystic ovary syndrome also increases your risk.

Luckily, in most cases, simply taking thyroid meds can result in complete symptom resolution. It sure did for me!

If you have any of these risk factors or are experiencing symptoms that might or might not be due to menopause, your health can benefit from checking in with your doctor. The signs of a thyroid disorder are easy to dismiss.

Don’t! Ladies, for the sake of your health and happiness, ask your doctor to take a serious look at what’s going on in that second brain of yours: your thyroid. Unlike so many of life’s problems in today’s crazy world, your thyroid is one thing you can take care of relatively easily.

Suffering in silence is OUT! Reaching out is IN!

Click here to download my free eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • Great advice Ellen! I was diagnosed with hypothyroid condition after it appeared I was growing a goiter! I was just recovering from breast cancer treatments so I wasn’t feeling well but that didn’t help. Now I am on medication that is easy to take, no interactions or side effects and inexpensive.

    • Yep…………me too, Haralee. I do have to tweak my meds once in awhile. I am hypo!

  • Sadly just taking medication isn’t handling it for me. I have Hashimoto’s and my thyroid cycles between hypo and hyper, wrecking havoc on my body. It was controlled for 15 years, but just this year has become a nightmare of constant RX readjustments.

    • Oh dear, Jennifer. I am so sorry you are going through so much. Are you going to an endocrinologist? I ask because many women have their Gyno’s treat them. but I think it is best to go to a specialist.

    • cis

      I don’t think taking thyroxine is a “fix” for Hashimotos. It certainly helps with the thyroid levels, but fails to address the root issue of the autoimmune component. Unfortunately, I see Italian doctors have been medicating my friend’s 18 year old daughter with just thyroxine for 10 years, totally ignoring the problem of identifying the root cause as needed to prevent autoimmunity from going out of control in the future.

      • I hope your friend’s daughter finds a good Endocrinologist to help her. I was happy to interview Dr. Einhorn for this blog. He is a very well respected Endocrinologist her in the U.S.

  • I know quite a few women with this problem. Thankfully, I am not one of them. Thanks for raising awareness of it.

    • Yep………so many menopausal women are hypo and don’t even know it!

  • Great article! It amazes me that something that small can wreak that much havoc. Thanks for spreading awareness.

  • Rosemond

    I have several friends who’ve had thyroid diseases but it seems like it wasn’t really something that most people know about and so few actually know the symptoms so that they can be proactive.

    • I totally agree! Proactive is the best way to go when it comes to our health.

  • CathyLynchLawdanski

    I’m HYPO and never thought to share this with my daughters. Thanks for a very informative post!

    • I am so glad your read the blog! This is important information for your children..especially our daughters as it can be hereditary and affect their fertility if they are hypo, too!

  • Ruth

    I have read more and more about the inaccuracy of the standard blood tests and that proved absolutely true in my case. Thankfully I was able to do the home saliva collection (4 different times in one day) and blood stick test which I then sent to a lab to be analyzed (Comes with a prepaid UPS envelope) I got the kit from the compounding pharmacy.The kit picked up the serious thyroid issues I had been feeling all along. A standard thyroid blood test came back just fine. So thankful for Integrative Medicine Doctors who look further than standard tests and catch one before one is in total crisis. Happily on the road to better health. Thanks for raising awareness!

    • Happy to hear you got the help you needed. The normal range is so huge…that is why the tests are only half of the story. The other important side for our specialist to consider is how you feel.

  • Cheryl Nicholl

    Mine went kaput early on so I have never had any symptoms because I’ve replaced the hormone for years, BUT, I’m always amazed at the number of people and physicians that NEVER consider this! Very informative post.

    • Yep, that is why we have to be our own best health advocates and push to get the help we need and deserve.

  • sue

    I’ve been so fortunate with menopause Ellen, however I’m going to share your post on my Sizzling Towards 60 facebook page. So informative and I think we all feel so much easier and better about things when they are explained to us. Thank you!

    • Thanks so much, Sue. Love Sizzling Towards 60!

  • Alana Mautone

    I’m hypo, and I suffered for several years before I saw a different doctor in the practice I go to (my regular provider is a man) and guess what – she picked it right away when she saw me shivering away in the exam room. One blood test later, I was on Synthroid. Still, I have days when I am so tired and cold, but the doctor says my TSH tests are normal, so no problem. It really makes me wonder.

    • Alana, I always recommend going to an endocrinologist. They are up on the latest info. If you are still tired and cold….you probably need your Synthroid tweaked. The ranges of normal are huge. But if you are tired and cold…your levels are not normal for you. Most doctors keep the TSH at 2 or under.

  • Linda

    Hi Ellen:) so thankful your bringing one of the most underdiagnosed diseases that is only in the past few years coming up for serious discussion! When I think about how much my poor Mom suffered. Plus so many women of her generation. Thankfully with people like you, we can get proper diagnosis! I was diagnosed with hashimotos 4 years ago. I’ve learned how to deal with it; blood work up every 3 months, gluten free diet which brought my thyroid to a clean bill of health, bio identical t4 t3, and natural desicated thyroid. Like everything else in hormone land everyone is different. There is no one size fits all, but if you stay on top of it you WILL start feeling better. It is very hard at first because your brain is so foggy and the fatigue… Terrible! However, the fog and the fatigue will lift! If it did for me it will for anybody! Never ever ever give up! There’s always HOPE!

    • Thanks for sharing your story with us, Linda! I have Hashimotos, too. I have been on Synthroid for years (which is identical to what my body makes)…..I have a wonderful Endocrinologist that checks me often and has tweaked my medication many times to ensure that I feel great!

  • cis

    I disagree about there being two different types of thyroid issues. It is not quite like that. Very often people can have a hyper period (or more than one) followed by a (longer or permanent) hypo period. I see these fluctuations as part of the same pattern, not as having two distinct diseases one after the other.

    • It does make sense that one’s thyroid numbers could possibly fluctuate throughout our lives. One could be Hypo and then at another point experience symptoms of Hyper. I had a thyroidectomy, so, I am on thyroid medicine every day. As I age, I seem to need more medicine…..but if I take too much I can become hyper. It is a balance. I am lucky I have a great Endocrinologist who looks at the bloodwork, but really listens to how I feel. There is no one-size-fits-all approach to this. Thanks for sharing!