At various stages of life, and after major physical events, like child birth and menopause, many women notice a shift in things like energy level, sleep patterns and weight. Angela LaSalle, MD, Parkview Physicians Group – Integrative Medicine, shares how a thyroid condition could be at play and why it can be hard to diagnose.
The rapid hormonal changes of pregnancy and menopause can cause major shifts in our immune system, making a woman’s immune system more likely than a man’s to attack her own tissues. Because thyroid hormone levels also shift with changes in estrogen and progesterone, the thyroid gland can be misidentified as a foreign invader and is prone for attack by the immune system. The result may be thyroiditis, or inflammation of the thyroid gland, and may present with symptoms of either hypothyroidism (low function) or hyperthyroidism (high function).
Such inflammation may be transient and resolve on its own, as in the case of post-partum thyroiditis, or may be chronic in nature, and require long term medical treatment. Many patients have presented with complaints of not returning to their normal energy levels after pregnancy or issues during menopause such as hot flashes, insomnia, or hair loss. Since the symptoms of thyroid disease overlap with hormonal changes, it may be easy to miss a developing thyroid problem without proper testing.
Every tissue in the body has receptors for thyroid hormone, making it a critical player in your overall health and well-being. Hypothyroidism can present with weight gain, constipation, dry skin, depression, cholesterol issues or menstrual abnormalities. Hyperthyroidism is associated with weight loss, fast heart rate, feeling jittery, and diarrhea. It is important to note that both conditions can cause menstrual abnormalities, fatigue, hair loss, skin changes, palpitations, and mood issues. For a new mom, issues with milk production, not restarting menstrual cycles after stopping breast feeding, continued hair loss, rapid weight changes, depression, palpitations and insomnia may be additional red flags to a possible thyroid issue.
Perimenopause is another vulnerable time for the development of thyroid issues. Decreases in progesterone and fluctuating estrogen levels both affect the thyroid levels. Symptoms like hot flashes, insomnia, palpitations, foggy thinking and weight gain are common in menopause, and are easily blamed on “getting older” or “going through the change”. Nutritional and other hormonal influences can affect the thyroid gland as well, such as insulin resistance or vitamin D deficiency.
If you suspect a thyroid problem, ask your doctor to check the level of a signal hormone from the pituitary called TSH, or thyroid stimulating hormone. Its level runs opposite of the thyroid function and will be elevated if the thyroid is under functioning and low if the gland is too active. Checking free levels of thyroid hormones (T4 and T3) measures the amount of thyroid hormone available to the cells, and anti-thyroid antibody levels like thyroid peroxidase antibody and anti-thyroglobulin antibody which can indicate an immune system attack on the thyroid gland. Symptoms of fullness in the throat, hoarseness, or discomfort when you touch the front of your neck may be signs of an enlarged or inflamed thyroid. Your physician can order a thyroid ultrasound to look at the structure of the gland to rule out nodules or enlargement of the gland.
Thyroid issues can present in both men and women at any time of life. But in women, hormonal swings can often overlap or trigger the symptoms of thyroid disease, and complicate the diagnosis. Talk with your doctor about testing and treatments to help you find your hormonal balance.
Still have questions?
For more information regarding Parkview Physicians Group – Integrative Medicine, call (260) 672-6590, or join Dr. LaSalle this Friday, January 27, 10:30 – 11:30 a.m. at the Parkview Center for Healthy Living – Warsaw for her presentation, “My Thyroid Test Is Normal But I still Don’t Feel Well.” Seats are still available!