Menopause and Thyroid Disease

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.