Why So Many Women Have Thyroid Problems
Thyroid health—we’re hearing a lot about it lately. Is it a fad? Hype? Or is there really something going on that we all need to be aware of?
In fact, the statistics are staggering: One in eight women will develop thyroid disease during her lifetime. The most common form is Hashimoto’s. While men can have thyroid issues, too, women are five to eight times more likely than men to experience thyroid problems.
It’s thought as that as many as 15 million more women have a thyroid problem and don’t know it, tolerating their symptoms or seeking treatments for symptoms and conditions that actually originate in thyroid imbalance, and thus not getting lasting results. And the problem is now starting to affect young girls, largely as a result of one of the same root causes that impacts women: environmental toxins.
It is quite in vogue to talk about the thyroid, and you’ll find a lot of information in the online health space that can be super confusing and make you think everyone has a thyroid problem or that every symptom can be explained by one. It’s even become big business. While some people may be capitalizing on thyroid disease, the fact is that a lot of women feel fatigued, heavy, and brain foggy—symptoms that can be related to the thyroid (and often are), and are developing medical problems as a result of undetected and under-treated thyroid problems.
Is Hypothyroidism (or Hashimoto’s) Really a Big Deal?
The thyroid plays a central role in our total health, and when it slows down, as it does in hypothyroidism (the autoimmune form of which is called Hashimoto’s), it can lead to a host of symptoms—and some serious problems.
Untreated Hashimoto’s and hypothyroidism can cause
- Fatigue and exhaustion
- Weight gain, and with it increased risk of obesity, diabetes, and heart disease
- High cholesterol due to the role of the thyroid in fat metabolism
- Depression—but the thyroid problem hasn’t been diagnosed so they are being misdiagnosed and mistreated. That’s one reason that antidepressants don’t help a subset of women.
- Decreased cognitive function—the thyroid is responsible for helping us maintain brain health, and even slight thyroid dysfunction can impair memory and concentration. Studies of women in their 60s have shown that even marginally slow thyroid function can cause dementia-like symptoms, and that treatment can dramatically improve cognitive function and have a brain-protective effect.
- Increased risk of cardiac arrhythmias and congestive heart failure due to the regulatory control of the thyroid on heart rate and rhythm
Impaired thyroid function can also have a devastating impact on fertility, pregnancy, and motherhood, and is often an undetected source of anguish, loss, and struggle. Women with hypothyroidism
- May contend with fertility problems
- Have an increased risk of miscarriage and preterm birth
- Have a much higher risk of developing prenatal and postpartum depression, making what would otherwise be a beautiful time in their lives potentially traumatic.
Severe hypothyroidism in pregnancy has now been shown to not only increase the risk of developmental problems in the baby but also increase the risk of autism.
And there’s more:
The thyroid impacts bone health and strength. It affects libido—if you have no energy, you’re not going to be in the mood, understandably. It can also lead to all manner of hormonal imbalances. Women with Hashimoto’s are also at risk of developing additional autoimmune conditions—autoimmune disease is a whole-body process, and often more than one system gets attacked. And the hair loss that often accompanies Hashimoto’s can have a tremendous impact on a woman’s self-confidence about her appearance—and is often terribly worrisome.
The impact of hypothyroidism on women’s lives is often dramatic and sometimes devastating, with fatigue and poor concentration, for example, impacting career and financial success, and also affecting personal relationships.
Because the most common symptoms of hypothyroidism—weight gain, depression, anxiety, brain fog, sleep problems, and fatigue—are also among those that are the most likely to be chalked up by doctors (and by us!) to “just stress,” women can go for years with a missed diagnosis—or never get one at all, leaving many feeling confused, blaming themselves, feeling like they’re doing something wrong or aren’t doing enough to have more energy and feel better. They’re driving themselves crazy dieting but can’t lose weight, beating themselves up for not being happier people, and suffering from the grief of fertility problems and miscarriages—all because of a problem for which there’s easy detection and treatment.
Should I Get Tested for a Thyroid Problem?
If you’ve been suspecting that small, subtle symptoms you have might be connected to something bigger, do get appropriate testing. For the estimated 28 million women with known energy and metabolism problems due to hypothyroidism, the trouble usually creeps up. It’s not a flash flood that takes out your whole house—it’s a dripping faucet that might erode the foundation over time.
It’s very important to have an accurate diagnosis before starting any treatment plan for healing your thyroid, and thyroid hormone medication should not be used without a definitive diagnosis. Unnecessary treatment and over-treatment in the integrative and functional medicine practitioners may be as common as missed diagnoses and under-treatment are by conventional doctors.
If you do have a thyroid problem, getting proper treatment can be a total life-changer for you. My patients have described it as having had the lights turned back on, someone flipping the on-switch on their energy, and getting jump-started with jumper cables!
Why Are So Many Women Experiencing Thyroid Problems?
Many factors can interfere with thyroid function, which requires healthy thyroid tissue, the ability to produce adequate amounts of thyroid hormone, conversion of the inactive form of thyroid hormone to its active form (this largely happens in the liver), and the effective binding of thyroid hormone to your cellular receptors—a key-and-lock type of effect that activates all of the thyroid’s activities in your body.
Here are some of the top factors that can interfere with these processes:
Environmental toxin exposure and detoxification overload: We are living in a veritable sea of environmental toxins—from hormones to heavy metals—that can interfere with thyroid function by directly damaging the thyroid, preventing production of thyroid hormone, interfering with thyroid hormone conversion in the liver, or preventing adequate binding of thyroid hormone to the cellular receptors. This toxic burden, which affects us from a very young age and even before we’re born, can cause direct damage and also overload our ability to detoxify fast enough to keep up. The daily and cumulative impact is often overlooked, but it is taking a toll on our thyroid health.
Eating more organic foods, using greener household cleaning products, and using non-toxic cosmetics are great places to start reducing your total toxic body burden, and studies show that we can reduce this toxic load rather quickly, particularly with health dietary changes.
Vitamin and mineral insufficiencies and deficiencies: Many women are low in several nutrients essential to thyroid health, most notably iodine, which keeps the thyroid humming along in its work of making thyroid hormone, but also vitamin D, selenium, zinc, and iron. However, most of us are not deficient enough to develop the most serious symptoms doctors would notice (such as a goiter in the case of iodine deficiency). Instead, we have nutritional insufficiencies, which fly under the radar of a diagnosis but can still cause subtle symptoms.
These “insufficiencies” can be associated with plenty of bigger problems, too: low zinc, vitamin D, vitamin A, and selenium are all associated with Hashimoto’s. Magnesium, vitamin D, and chromium are all needed to regulate blood sugar; low levels are linked to elevated blood glucose, insulin resistance, and diabetes. Low magnesium can cause heart arrhythmias, too, and zinc and vitamin A are essential for the health of the gut lining. In addition, insufficiencies in omega-3 fatty acids and other essential fatty acids can lead to depression and cognitive function issues.
If you suspect an insufficiency or a phytonutrient gap, look deeper. Most doctors get maybe an hour of nutrition training in med school and residency, so we’re not on the lookout for these issues; therefore, you might have to ask for common testing for nutrient status. And make sure to get eight to 10 servings of a variety of veggies and fruits (especially berries) each day, and consider a daily multivitamin, as it’s hard to get everything we need from our diets these days.
Stress overload: The thyroid doesn’t operate in a vacuum. Dysfunction can be a signal of a larger imbalance in your stress response system, which starts in the brain, includes the adrenal glands, and culminates in the production of adrenaline and cortiso, which lead to the familiar fight or flight feelings we get when we’re stressed out (which for a lot of us is a lot of the time). Chronically elevated cortisol levels due to chronic stress inhibit thyroid hormone production and suppress the conversion of the inactive form of thyroid hormone, Free T4, to the active form, Free T3.
Getting out of survival mode (what I call SOS or Survival Overdrive Syndrome) may just help shift your thyroid back into higher gear.
Trouble in the digestive system: Intestinal hyper-permeability (leaky gut) and another problem called dysbiosis (imbalance in your gut microbiome) have been shown to contribute to autoimmune disease through mechanisms that involve the GALT, or gut-associated lymphoid tissue, the immune system located in your gut, as well as translocation of proteins and particles from gut bacteria called LPS (lipopolysaccharide) in the intestines, to trigger the antibodies that can later attack our own tissue.
Common causes of leaky gut and dysbiosis include hidden food intolerances, processed foods, artificial sweeteners, antibiotic overexposure, as well as gluten intolerance, which is now recognized as a major trigger for autoimmune conditions
Hormone imbalances: Though estrogen is a naturally occurring hormone in our body, the synthetic forms of estrogen that we’re exposed to from the environment (called xenoestrogens) are pro-inflammatory and have been found to trigger autoimmune disease by actually changing the shape and functioning of specific immune cells. These xenoestrogens come from sources like plastics in food packaging, cosmetics, and agricultural chemical residues in our food. For women, even our own natural estrogen fluctuations throughout our life cycles have been found to be a trigger for autoimmune disease in susceptible women who are dominant in the more inflammatory estrogen types.
Immune system confusion: Environmental toxins, chronic stress, nutritional insufficiencies, leaky gut, food intolerances, being overweight, and having chronic inflammation are all factors that can lead the immune system to become confused and eventually start to attack our own tissue—which is exactly what is happening in Hashimoto’s.
I Don’t Have Thyroid Symptoms—Should I Still Be Concerned?
The modern thyroid epidemic is symptomatic of deeper problems in our world that I believe we all need to be aware of to protect our health and the health of our children. Given the escalating rates of thyroid problems, the significant role that thyroid function plays in women’s health, and the fact that thyroid problems can be brewing for years before we see the physical signs, we all need to at least be aware of our thyroid health—how to protect it and how to detect problems early.
In days gone by, miners would place a canary in a cage and send it down deep wells before they would dare to descend, to detect the presence of gases that could kill the miners. The birds, more sensitive to lower levels of these gases, would die, thus alerting the miners to the danger.
Women who have thyroid problems are the canaries—those most sensitive and susceptible to the root causes that can affect not only our thyroid health but our collective health as women. These canaries are alerting us to dangers that deserve our greatest attention—and response—even if we are one of the lucky ones who does not have a thyroid condition.
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This article was originally published on Aviva's website.
Aviva Romm, MD, a Yale-trained physician, uses functional medicine to help women heal their bodies and minds, and transform their lives and their families’ health.
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