The thyroid is a small butterfly shaped organ located on the front of the throat. Roughly two inches wide, this small gland is responsible for balancing our metabolism and is essential to everyday health. When this teensy tiny organ isn’t functioning correctly however, it can have major consequences on emotions, energy, sleep, appetite and so much more. Furthermore, thyroid disorders are exceedingly common among women. Women are eight times (!) more likely to develop thyroid disease than our male counterparts.
Specific to women’s health; thyroid disease may cause hormone imbalances, infertility and, if left untreated, may cause serious complications during pregnancy and postpartum.
Let’s talk about why women are more susceptible to thyroid disorder and what signs and symptoms to look out for. In this article we’re only addressing and talking about hypothyroidism (under-active thyroid), Hashimoto’s disease (or autoimmune hypothyroidism) and how these two diagnoses may affect female health.
What causes thyroid disease?
Thyroid disease, in the majority of cases is caused by an autoimmune reaction that occurs in the body known as Hashimotos Thyroid Disease. This autoimmune reaction causes the body to mistakenly attack its own thyroid causing such damage and inflammation that the thyroid gland no longer functions properly. This stops the production of the very necessary thyroid stimulating hormone, (TSH), that your body needs to balance your metabolism and function properly as a whole.
There is no absolute understanding as to why women are so much more susceptible to thyroid disorder. Jacqueline Jonklaas, MD, PhD, MPH, associate professor of medicine and endocrinology at Georgetown University School of Medicine in Washington, D.C reports that “we do not fully understand the reason for women being more susceptible to developing hypothyroidism, but it is at least in part due to the fact that Hashimoto’s hypothyroidism — the most common cause of hypothyroidism in the United States — is an autoimmune disease. Autoimmune diseases are, in general, more common in women.”
What are the symptoms of hypothyroidism?
Per the American College of Obstetrics and Gynecologists (ACOG) and WomensHealth.Gov:
“The symptoms of hypothyroidism are slow to develop. Common symptoms of hypothyroidism include the following:
- Feeling very tired or weak
- Decreased appetite
- Change in menstrual periods or very heavy menstrual cycles
- Loss of sex drive
- Feeling cold when others do not
- Constipation
- Muscle aches or weakness
- Puffiness around the eyes or whole face
- Brittle nails
- Pale, dry skin
- Hair loss or dry thinning hair
- Weight gain, even though you are not eating more food
- Feeling sad or depressed
- Slow heart rate
- Less sweating than usual
- A hoarse voice
- You also may have high LDL or “bad” cholesterol, which can raise your risk for heart disease.”
If you feel like you can relate to many of these symptoms – and are wondering if you could have thyroid disease – you’re not alone. Many people find these somewhat vague symptoms familiar in the very busy, hyper-stimulating, non-stop life we live in the US. Concurrently many of these symptoms coincide with high levels of stress, lack of sleep and life balance. The only way to know for sure is to see your family practice or women’s health provider and ask for a lab test. Before you go that route though – if you don’t have a family history of thyroid disease and your symptoms aren’t life rocking or very concerning – I would recommend you attempt good sleep hygiene, healthy diet, create time for self care and begin closely tracking your period to be sure you know what’s up with it. If symptoms persist after you’ve tried these few changes – get in with your doc to check out what’s going on. Also know; women who have been pregnant recently are at an increased risk for developing hypothyroidism due to immune system changes that can take place during pregnancy or shortly after birth, if you’ve recently had a baby and have these symptoms – call your provider ASAP for evaluation.
Why it’s important to be treated.
Protect Your Vitality & Energy: Hypothyroidism makes people feel blah. People often feel their energy is totally drained, have very little motivation to do the things that are normal for them or that they love. It also may cause many of the same symptoms of depression. No one wants to be feel drained and down!
Help Your Hormone Balance and Fertility Flourish: People affected with this disorder also may have difficulty becoming pregnant if and when they so desire. A thyroid that doesn’t function properly may throw off the delicate balance of female hormones that cause regular ovulation. This occurs when the hormone prolactin (the same hormone that helps make breast milk) is out of balance. This same hormone imbalance may also rarely cause a secretion of breast discharge or milk from the breasts when not currently lactating (breastfeeding)…..(whoa).
Be Sure The Health of Your Pregnancy is on Point: Untreated or undiagnosed hypothyroidism may cause major thyroid issues for a baby in utero (in the womb) during pregnancy. It is important to have your thyroid levels checked prior to conceiving if you have any concerns whatsoever as thyroid disease is harder to diagnose once pregnancy has begun. Consider making a pre-conception appointment with your OB or midwife to check in and be sure you’re in tip top shape before trying for a babe.
According to WomensHealth.Gov, Hypothyroidism that is not treated with medicine during pregnancy can cause:
- Anemia (lower than normal number of healthy red blood cells)
- Preeclampsia
- Low birth weight babies (smaller than 5 pounds)
- Miscarriage
- Stillbirth
- Problems with the baby’s growth and brain development
So how is thyroid disorder treated?
The cure for hypothyroidism in the Western medicine world – whether Hashimotos type or not is with a synthetic hormone called Synthroid or Levothyroxine. When your thyroid does not create this hormone on it’s own because of hypothyroidism, you simply substitute it in your body with this medicine. This hormone is taken in the form of a pill. If you have been diagnosed with hypothyroidism you typically must use this medication for the rest of your life. The pill is taken every morning upon waking and you must wait 30 minutes to eat after taking the medicine.
In naturopathic or alternative medicine: ND (naturopathic doctors) treat hypothyroidism by addressing the root cause of the disease; inflammation, diet, etc. and use supportive herbs and lifestyle changes. This works very well for some people. Read more about the ND approach here. Last: Also know there are more natural forms of thyroid medicine that are organically derived from ground and dried pig thyroid. Wait what? Sound weird? Many people, (even Hilary Clinton used this medication) prefer something made by nature rather than made in a lab, and often times those who respond poorly or not at all to synthetic thyroid hormone benefit from adding on this kind of medication in combination with synthetic meds. If this piques your interest read more about it here.
Is hypothyroidism over-treated in the United States?
In Western Medicine in the last 10 years or so, there has been a large cultural shift in the world of primary care, infertility and endocrinology to treat “sub-clinical” hypothyroidism. This is when a patient is treated with synthetic thyroid hormone despite their lab work not technically qualifying for the diagnosis of hypothyroidism. Often times lab test levels may be very close to the diagnosing level. Sometimes the patient has been trying to conceive for a long time or battling with symptoms that are similar to thyroid disease. This “lets see if this works” approach is helpful for some during conception or to quickly relieve symptoms – however know that if you have been diagnosed with subclinical hypothyroidism and don’t want to take medication – it’s reasonable to ask to wait to treat, closely monitor how you’re feeling and have your levels retested in 3 months. Thyroid labs change from day to day and aren’t always the best “snapshot” of what is going on. Multiple tests will help your doc see if this is a long term issue or just an inaccurate picture of what’s going on. If you want more back up and insight on this method of watchful waiting read this article by Harvard Med.
What should I do if I’m concerned about having hypothyroidism ?
Call your provider and make an appointment to discuss your symptoms and concerns and ask for a lab test during your visit. The test that will help to diagnose thyroid disease is called TSH (thyroid stimulating hormone). Your provider may want to do further thyroid studies if your TSH comes back abnormal – however for 96% of the population this simple lab test gives us all the information we need. Best of luck friends – may your metabolic balance never escape you.
