The Menopause Thyroid Solution

Overcome Menopause by Solving Your Hidden Thyroid Problems

Mary J. Shomon

• Publisher: William Morrow Paperbacks
• Year: 2009
• Print ISBN: 9780061582646
• eBook ISBN: 9780061898976
• Topic: Medicina
• Subtopic: Successo personale

chapter 1

Menopause and Thyroid
AN INTRODUCTION

After thirty, a body has a mind of its own.

—Bette Midler

As a woman born in 1961, I’m lucky to be part of the generation of baby boomers who are likely to live well into our seventies or eighties. All of us want to get to that age feeling as healthy and energetic as possible. After all, we’re the generation that has come up with the popular mantras “Fifty is the new forty,” “Sixty is the new fifty,” and so on.

So here we are, living longer than ever. For many of us, our forties and fifties are a time when we are hitting our professional stride, our children are growing up and leaving home, and we can turn our attention to taking care of ourselves.

Why is it that just when you’re coming into your own, it seems as if your body is falling apart?

You start gaining weight and feeling bloated. You find it harder to remember things and nearly impossible to concentrate. You notice your cholesterol level is going up, even though you haven’t changed your diet. Your moods shift quickly: sometimes you’re anxious; other times you feel blue and depressed. You’re exhausted, but at bedtime, you feel restless and find it hard to sleep. You feel hot, then cold—the temperature is never right. Every time you shampoo or run a brush through your hair, a handful of hair comes out. Periods? They’re erratic and unpredictable, and when they do come, they’re sometimes so heavy you can’t even leave the house. And sex? What’s that?

So you jump to what seems like a logical conclusion: “Menopause!” (And if you don’t assume it, your doctor will happily assume it for you.)

By menopause, I’m actually taking some liberties with the term and talking about the whole perimenopause-into-menopause transition, a process that can sometimes take as long as eight to ten years. Many people use the terms menopause and perimenopause interchangeably to refer to the entire transition process. In this book, I actually do this too at times, even in the title, because, let’s face it, we’re more likely to connect hot flashes, night sweats, erratic periods, and such with the idea of menopause. But apparently, 90 percent of us go through four to eight years of fluctuating hormones, erratic periods, and then, finally, that last menstrual period. Officially, the entire process is known as perimenopause or, less commonly, “premenopause.” Officially, menopause is confirmed when it’s been a year since your last period. After that last period, it’s “postmenopause.”

If you say “I’m going through menopause,” and you are still having periods, then you are actually going through perimenopause. If you’ve stopped having periods for at least a year, you are technically postmenopausal.

You may not realize that by the time you are one year past your last menstrual period (again, menopause) your symptoms usually have improved and often have disappeared. That’s because it’s not the lack of hormones that causes symptoms in most women. It’s actually the up-and-down fluctuations in hormones, as well as imbalances in the ratio of hormones, that take place in the months and years before that last period that cause the most troublesome symptoms.

Anyway, back to the symptoms. You start feeling exhausted, gain weight, become overheated, lose your hair, develop a low sex drive, and notice assorted aches and pains, so you assume you’re in menopause. And off you go, to try to deal with it all.

You may start drinking soy smoothies, munching on soy burgers and edamame, and popping every menopause-manipulating herb available, from black cohosh to dong quai to chasteberry. Or you smear yourself with wild yam cream. Or you end up taking out a second mortgage to pay for complicated, compounded bioidentical hormone regimens. Or you head to the doctor, who sends you off with Premarin or Prempro—the prescription conjugated estrogen drugs made from horse urine—then every time you take a pill, you’re worried that you’re increasing your risk for breast cancer or stroke.

And the saddest part of all? For some of you, none of this will help.

Why? Because it’s missing the point.

You’re forgetting what may be the most important hormone of all: thyroid hormone.

By age sixty, as many as half of all women have a slowdown in the thyroid, the master gland of metabolism and energy. And guess what the most common symptoms are? Fatigue, weight gain, depression, anxiety, menstrual irregularities, low sex drive, hair loss, and brain fog/memory problems.

So when you and your doctor assume that your symptoms are “hormonal,” you may be partially right, but the critical hormone you’re overlooking may be thyroid hormone.

The natural decline of estrogen and progesterone that occurs in women starting in our late thirties—and which is happening now to millions of American women—is one of the most common triggers of a thyroid slowdown. The shocker is that the millions of baby boomers who are in thyroid slowdown are not even diagnosed.

Instead, these women—and their doctors—are assuming they are menopausal. These women then spend thousands of dollars a year on appointments, pills, and potions to try to stave off menopausal symptoms and never get thyroid tests.

A near epidemic is being overlooked in this, an otherwise empowered, informed generation of women.

That’s why we need a solution: The Menopause Thyroid Solution.

Why are baby boomer and menopausal women at such a risk for thyroid problems? There are actually several key reasons.

• - First, thyroid problems are simply more prevalent as we age. Like many organs, the thyroid tends to slow down as we get older. So, as we age, we are generally at greater risk of developing thyroid problems.
• - Second, busy baby boomer women frequently face a high degree of physical stress—improper diet, lack of exercise, not enough sleep, exposures to toxins—as well as emotional and life stresses. Chronic stress causes the adrenal glands to ramp up production of stress hormones. There are limited raw materials to produce hormones, and the body considers survival more important than thyroid function, so chronic stress shifts production away from making thyroid hormone and toward making stress hormones. Eventually, if you push the adrenals long enough, adrenal fatigue sets in, which puts even more strain on the thyroid.
• - Third, hormone fluctuations during this period can affect the thyroid. When the ratio of estrogen to progesterone becomes imbalanced, even if both hormones are declining, a situation known as estrogen dominance can develop. Estrogen dominance can prevent thyroid hormone molecules from properly binding with receptors, making thyroid hormone unavailable to your cells, and leaves you functionally hypothyroid at the cellular level.
• - Fourth, thyroid hormone has some chemical similarities to estrogen. The various receptor sites for thyroid, found throughout the body, can, therefore, be blocked by the presence of estrogen. Taking supplemental estrogen, as some women do when they are experiencing what they think are menopausal symptoms, can prevent thyroid hormone molecules from properly binding with the receptors, which makes the thyroid hormone unavailable to the cells.
• - Finally, as progesterone levels drop, which is characteristic in perimenopause and menopause, thyroid hormone requirements typically increase. Sufficient progesterone is actually necessary to ensure adequate binding of T3 (triiodothyronine), the active thyroid hormone.

Thyroid problems also worsen perimenopausal/menopausal symptoms. This means that women who don’t know they have a thyroid problem and go into this period of hormonal flux may suffer more than other women. Women who know they have a thyroid problem but who aren’t being properly or effectively treated may also suffer more.

How do thyroid problems trigger or worsen perimenopausal/menopausal symptoms? There are four key ways.

• - First, as noted, the thyroid slows as we age. As the thyroid becomes less functional, it is less able to perform its job of delivering energy to organs and glands. Reproductive organs like the ovaries are no exception.
• - Second, when chronic stress causes a hormone shift toward adrenal/stress hormones and away from thyroid hormone, it also shifts away from reproductive hormone production. Over time, in addition to causing thyroid conditions, stress-triggered adrenal fatigue can cause reductions in estrogen and progesterone.
• - Third, thyroid imbalances can disrupt the hormone production pathway. Thyroid hormone is essential to the process of converting cholesterol into pregnenolone, which is then converted into progesterone, DHEA (dehydroepiandrosterone), estrogen, and testosterone. So any deficiency of thyroid hormone can disrupt the entire hormone production process.
• - Finally, anovulatory cycles (cycles where you don’t ovulate) are more common in thyroid patients. These can contribute to a deficiency in progesterone, which can affect perimenopause.

If we have what some practitioners consider an epidemic of undiagnosed thyroid problems in American women, and these problems may be the cause of symptoms in a substantial number of women in perimenopause/menopause, why isn’t it standard for women to get tested and treated?

The problem is that perimenopause/menopause is a confusing time. Because thyroid problems often develop in women at the same age as perimenopausal or menopausal symptoms, and they share many symptoms, it can be difficult to figure out the real problem.

Except for traditional hot flashes and night sweats that last a few minutes, vaginal/bladder problems, and sagging/tender breasts, the symptoms of perimenopause and menopause are exactly the same as the symptoms of a thyroid problem. Still, doctors—and women—are far more familiar with sex hormone imbalances than they are with thyroid problems.

Unfortunately, according to a survey conducted by the American Association of Clinical Endocrinologists, only one in four women who have discussed menopause with their physician actually receive a recommendation to be tested for thyroid disease. Doctors are assuming that perimenopause/menopause is the one and only issue at hand. Or, in some cases, there’s an assumption that symptoms may be due to the stage in life. Says patient advocate and physician Marie Savard, MD:

All too often doctors attribute these symptoms to stress and women becoming “empty nesters.” I’ll never forget my GYN textbook in medical school that described menopause symptoms of depression, fatigue, etc., and clearly said they were due to “empty nest syndrome” and not hormonal changes.

Thyroid testing is also not part of any standard screening, nor are thyroid tests part of most annual physicals—no matter what your age.

Another challenge to getting diagnosed is that it’s difficult to find doctors who will listen to and explore our symptoms. We’re a generation of women who are being faced with shorter than ever appointments with doctors and revolving-door HMOs.

It’s also a challenge because there’s sometimes the assumption that it’s normal to not feel well as we age. Hormonal expert David Brownstein, MD, explains:

Women need to be aware that if they are feeling tired, brain fogged, and not thinking clearly, these sorts of symptoms are not “a normal part of aging.” You don’t have to feel like all of a sudden you’ve aged fifteen years overnight. If that happens, something is wrong. And one of those things that frequently show up is thyroid problems. When they’re rectified, you can feel back to normal. You don’t have to feel like you’re eighteen, but brain-wise, you should feel as good. If you’re not, that’s something that needs to be brought forward. Investigating the thyroid at the time of hormonal change is appropriate.

Another challenge is that hormones are a big business. There’s far more profit to be made in selling you Premarin and Prempro, bioidentical hormones, and herbal menopause remedies than in diagnosing and treating a thyroid condition. Take a look in any women’s magazine, and count up the number of ads and articles about menopause treatments. Then look for ads and articles about thyroid treatments. You’ll see what I mean.

Tieraona Low Dog, MD, says that medicine has made menopause an “estrogen deficiency disease.” She says:

There’s a societal attitude promoting menopause as something to be treated because there’s a huge business around menopause, and to sell a drug, you have to convince people that there’s something they need to take it for.

According to research company Datamonitor, sales of hormone replacement drugs in the United States alone topped $2 billion in 2008. If you were to pay out of pocket, a typical monthly supply of thyroid medication costs from around $15 to $23. The least expensive combination estrogen/progesterone therapy, Premphase, will run you more than $60 a month. A brand name combination regimen of an estradiol patch like Climara plus Prometrium progesterone costs more than $150 a month. “Follow the money,” as they say.

Could you be one of the millions of women suffering what you think are perimenopausal/men...

Table of contents

• Cover
• Title Page
• Epigraph
• Contents
• 1
• 2
• 3
• 4
• 5
• 6
• 7
• 8
• 9
• 10
• 11
• Appendix A
• Appendix B
• Appendix C
• Searchable Terms
• Acknowledgments
• About the Author
• Books by Mary J. Shomon
• Credits
• Copyright
• About the Publisher