OptimizingThyroid HealthinWomen
Felice Gersh, MD
Bestselling author of the PCOS SOS series and Menopause: 50 Things You Need to Know
HealthDisclaimer
Thisbookcontainsadviceandinformationrelatingtohealth care.Itshouldbeusedtosupplementratherthanreplace theadviceofyourdoctororanothertrainedhealth professional.Ifyouknoworsuspectyouhaveahealth problem,itisrecommendedthatyouseekyourphysician's advicebeforeembarkingonanymedicalprogramor treatment.Alleffortshavebeenmadetoassurethe accuracyoftheinformationcontainedinthisbookasofthe dateofpublication.Thepublisherandtheauthordisclaim liabilityforanymedicaloutcomethatmayoccurasaresult ofapplyingthemethodssuggestedinthisbook.
Copyright2024byFeliceGersh,M.D.andAlexisPerella
Allrightsreserved.Thisbookoranyportionthereofmaynotbereproduced orusedinanymannerwhatsoeverwithouttheexpresswrittenpermission ofthepublisherexceptfortheuseofbriefquotationsinabookreview.
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Introduction
Theimportanceofthyroid healthinwomen
Thethyroidglandmaybesmall,butitplaysacrucialrolein women’shealth.Locatedinthefrontofyourneck,this butterfly-shapedglandproduceshormonesthatregulate yourmetabolism,energylevels,bodytemperature,andeven mood.Whenitfunctionsproperly,youlikelydon’tevennotice it.Butwhenit’soutofbalance,theeffectscanbefarreaching,touchingnearlyeveryaspectofyourwell-being.
Thyroiddysfunctionissurprisinglycommoninwomenand canoftengoundiagnosedoroverlooked,especiallysinceits symptoms—likefatigue,weightfluctuations,brainfog,and moodchanges—areoftenmistakenforotherconditions. Thesesymptomsmayoverlapwithstress,metabolicissues, polycysticovarysyndrome(PCOS),ormenopause,makingit easytofeelunheardordismissedbydoctorswhomaynot belookingfortherootcause.
Aproactiveapproachtothyroidhealth
Forwomen,particularlyduringlifetransitionssuchas pregnancy,perimenopause,andmenopause,maintaining thyroidhealthisessentialforoverallwell-being.Aproactive approachtomanagingthyroidfunctioncanhelpyoufeel yourbestandpreventlong-termhealthproblems. Understandinghowyourthyroidworks,recognizingthe symptomsofdysfunction,andexploringeffectivetreatments, includinghormonereplacementtherapy(HRT)and integrativestrategieslikefasting,arekeytoachieving optimalhealth.
Inthisguide,we’lldiveintothethyroid’sroleinyourbody, commonthyroidproblems,andhowtheyintersectwith women’shormonalhealth.We’llalsodiscusspracticalways tomanagethyroiddysfunctionandimproveyouroverall vitality.
FeliceGersh,MD Anintegrativeapproach towomen'shealth
Whydoesyour thyroidmatter?
Yourthyroidgland,asmall butterfly-shapedorgan locatedatthebaseofyour neck,mightnotlooklike much,butitisoneofthe mostimportantplayersin maintainingyourbody’s overallbalance.
Thekeytoenergyand metabolism
Thethyroidglandproduces hormones,chemical messengersthattravel throughyourbloodstreamto organsandtissues,directing variousbodilyfunctions. Hormoneshelpregulate everythingfromyourmood toyourimmuneresponse, andinthecaseofthyroid hormones,theyplayakey roleinmaintainingyour body’senergymetabolism.
Yourthyroidproducestwo keyhormones— triiodothyronine(T3)and thyroxine(T4)—thatcontrol yourmetabolism,the processthatconvertsfood intoenergy,whichyourbody cantheneitheruse immediatelyorstorefor later.
FeliceGersh,MD
Theroleofthyroid hormonesinthebody
Thyroidhormones,T3andT4, arereleasedintoyour bloodstreamanddeliveredto tissuesthroughoutyourbody. Theyhelpregulatehow quicklyorslowlyyourbody usesenergy,aprocessknown asmetabolicrate.Whenyour thyroidisbalanced,youfeel energeticandinsync.But whenthere’sanimbalance— whetheryouproducetoo muchortoolittleofthese hormones—everythingfrom yourdigestiontoyour emotionalwell-beingcanbe disrupted.
Awell-functioningthyroid alsoplaysaroleinheart health,brainfunction, temperatureregulation,and reproductivehealth.Thisis whyanydisruptioninthyroid functioncanleadtoawide arrayofsymptoms,someof
whichmaybesubtleatfirst butcanbecomemore seriousifnotaddressed.
Inshort,yourthyroidisthe enginebehindyourbody’s energyproduction,and keepingithealthyisessential forfeelingyourbest.
FeliceGersh,MD Anintegrativeapproach towomen'shealth
Commonthyroid conditionsinwomen 02
Thyroiddysfunctiontypicallyinvolvestheglandproducing eithertoomuchortoolittlehormone.Bothscenarioscan leadtoarangeofhealthissues,butthegoodnewsisthat withmoderntreatments—rangingfromthyroidhormone replacementtosurgicalinterventions—mostwomencan managetheseconditionssuccessfullyandleadhealthy, vibrantlives.
Hypothyroidismandhyperthyroidism
Hypothyroidismoccurswhenthethyroiddoesn’tproduce enoughhormones,whichslowsdownmetabolism.This conditionismorecommoninwomen,particularlyasthey age,andcanleadtosymptomslikefatigue,weightgain,hair thinning,anddepression.Hypothyroidismisoftencausedby anautoimmuneconditionknownasHashimoto’s Thyroiditis,wheretheimmunesystemattacksthethyroid gland.Hashimoto’sistheleadingcauseofhypothyroidismin womenandrequirescarefulmanagement,oftenthrough thyroidhormonereplacementtherapy.
Ontheotherhand,hyperthyroidismoccurswhenthethyroid producestoomuchhormone,speedingupmetabolism.This canresultinsymptomslikeweightloss,anxiety,rapid heartbeat,andheatintolerance.Themostcommoncauseof hyperthyroidismisGraves'Disease,anotherautoimmune
conditionwheretheimmunesystemmistakenlystimulates thethyroidtoproduceexcessiveamountsofhormone.Both Hashimoto’sandGraves’areautoimmunedisorders,with womenbeingdisproportionatelyaffectedduetothecomplex interplaybetweentheirimmuneandhormonalsystems.
Thyroidnodulesandthyroidcancer
Notallthyroidconditionsareautoimmuneconditions. Thyroidnodules,whicharelumpsthatformonthethyroid, arequitecommon,especiallyinwomenover50.Inmost cases,thesenodulesarebenignanddon’tcausesymptoms. However,ifanoduleproduceshormones,itmayleadto hyperthyroidism.Doctorsoftenmonitorthesenoduleswith regularultrasoundsand,ifnecessary,biopsiestoruleout cancer.
Althoughthyroidcancercandevelopinthethyroidgland,it isrelativelyrarecomparedtootherthyroidconditions.Most casesofthyroidcanceraretreatable,especiallywhen caughtearly,andthesurvivalrateisveryhigh.Althoughthe word“cancer”canbealarming,thyroidcancerisoftenslowgrowingandhasexcellenttreatmentoutcomeswhen addressedpromptly.
Riskfactorsforthyroiddysfunction
Severalfactorsincreasethelikelihoodofdevelopingthyroid conditions,andit’simportanttobeawareofthem, particularlyifyou'reexperiencingsymptomsthatmight suggestthyroiddysfunction.
GenderandAge:Womenarefarmorelikelythanmento 1. developthyroiddisorders,andtheriskincreaseswithage. Thyroidproblems,particularlyhypothyroidism,aremore commonaftertheageof60.
2.FamilyHistory:Ifafamilymemberhasathyroiddisorder, especiallyanautoimmunethyroidconditionsuchas Hashimoto’sthyroiditisorGraves’disease,yourriskof developingathyroidproblemishigher.Autoimmune conditionstendtoruninfamilies,soifrelativeshave conditionslikerheumatoidarthritisorlupus,thisalso increasesyourriskofthyroiddysfunction.
3.AutoimmuneDisorders:Ifyouhaveanexisting autoimmunedisorder,suchastype1diabetes,celiac disease,orvitiligo,you’reatagreaterriskfordeveloping anautoimmunethyroidcondition.
4.PregnancyandPostpartum:Hormonalandimmune systemchangesduringpregnancyandthepostpartum periodareknowntriggersforthyroiddysfunction.Some womendeveloptemporarythyroidproblemsduringor afterpregnancy,butthesecansometimesbecomelong termconditionsifleftuntreated.
FeliceGersh,MD
5.RadiationExposure:Radiationtreatmentforcancersin thehead,neck,orchest,aswellasexposuretohigh levelsofenvironmentalradiation,canincreasetheriskof developingthyroidconditions.
6.IodineDeficiencyorExcess:Bothtoolittleandtoomuch iodineinyourdietcanleadtothyroidproblems.Iodineis necessaryforthyroidhormoneproduction,butan imbalancecandisruptthegland’sfunction.
Ifyoufallintooneormoreofthesecategoriesandare experiencingsymptomsofthyroiddysfunction,it’sespecially importanttohaveyourthyroidlevelscheckedregularly.Early detectioniskeytoeffectivemanagement.
FeliceGersh,MD Anintegrativeapproach towomen'shealth
Commonsymptomsof thyroiddysfunction 03
Thyroiddysfunctioncanmanifestinmanyways,andoften, thesymptomsaresubtleatfirst.Oneofthechallengeswith thyroid-relatedsymptomsisthattheyoverlapwithother conditions,includingstress,metabolicdisease,and menopause.It’seasytofeellikesomethingisoff,buthardto pinpointexactlywhat.That’swhyunderstandingthesignsof thyroiddysfunctionissoimportant.
Subtlesymptomsthatareeasytoignore
Whenthethyroidisunderactive,aswithhypothyroidism,your bodyslowsdownandyoumayexperiencesymptomslike persistentfatigue,depression,constipation,unexplained weightgain,coldintolerance,dryskin,hairloss,andbrain fog.Thesesymptomscancreepupgradually,makingiteasy todismissthemaspartofagingortheresultofastressful lifestyle.
Ontheotherhand,anoveractivethyroid,orhyperthyroidism, speedseverythingup.Commonsymptomsinclude unintentionalweightloss,rapidorirregularheartbeat, excessivesweating,andanxietyorrestlessness.Youmay alsonoticesensitivitytoheatordifficultysleeping.These symptomscanbedisruptivebutoftengounrecognized, especiallyiftheyappearalongsideotherlifechangeslike pregnancyormenopause.
Thyroiddisordersinyoungwomen
Thyroiddisorderscanaffectwomenatanyage.Inyounger women,thosediagnosedwithPCOShaveamuchhigher incidenceofautoimmunehypothyroidism,knownas Hashimoto’sThyroiditis.Infact,bothPCOSandthyroid dysfunctionareoftenlinkedtofertilityissues.PCOS, hypothyroidism,andhyperthyroidismcanallinterferewith ovulation,leadingtoirregularmenstrualcyclesordifficulty conceiving,andthyroiddisordersincreasetheriskof miscarriage.Ifyouarestrugglingwithfertility,it’sessentialto haveyourthyroidcheckedaspartofyourevaluation, especiallyifyoualreadyhaveaPCOSdiagnosis.
Thyroidandmenopause
Forolderwomen,thyroiddysfunctionmaybemissed becausemanysymptoms—suchasfatigue,moodswings, andchangesinweight—overlapwithhormonalshiftsrelated tomenopause.That’swhyit’scrucialtolistentoyourbody andtakethesesignsseriouslyatanystageoflife.Ifyou’re experiencingacombinationofthesesymptoms,it’sworth talkingtoahealthcareproviderwhounderstandsthe complexitiesofthyroidhealth.
Rememberthatthyroidconditionsareprimarilydiagnosed throughbloodtests,whichmeasurelevelsofthyroid hormoneslikeTSH,FreeT3,andFreeT4,andnotsimply throughsymptomsandmedicalhistory.Ifyoususpect thyroiddysfunction,makesuretoadvocatefor comprehensivetestingbecauseearlydiagnosiscanprevent moreseriouscomplicationsdowntheroad.
FeliceGersh,MD Anintegrativeapproach
Thyroid,estradiol andprogesterone 04
Thethyroidglanddoesn’t operateinisolation.Like manysystemsinthebody, itiscloselyintertwinedwith otherhormonalprocesses, particularlythoseregulated byestrogenand progesterone.These hormones,whicharekeyto awoman’sreproductive system,haveaprofound impactonhowthethyroid functions.Thisconnection explainswhythyroid disordersaremore commoninwomenand whytheyoftencoincide withreproductive milestonessuchas menstruation,pregnancy, andmenopause.
FeliceGersh,MD
Estrogenandthyroid function
Estrogenplaysavitalrolein regulatingthyroidhormone production.Ithelpsmaintain thesensitivityofthyroid hormonereceptors,which ensuresthatyourbody respondseffectivelytothe thyroidhormonescirculatingin yourblood.Whenestrogen levelsfluctuate—suchasduring themenstrualcycle, pregnancy,ormenopause—it canalterthewayyourthyroid functions.
Foryounger,reproductiveagedwomen,thyroid imbalancescanleadto irregularmenstrualcyclesand fertilitychallenges. Hypothyroidism,forinstance, cancauseheavierorirregular periodsandmayevendisrupt ovulation,makingitharderto conceive.Hyperthyroidism,on theotherhand,canshortenor lightenmenstrualcycles.
Sincethethyroidisso closelytiedtothe reproductivesystem,it’s crucialforwomen experiencingirregular cyclesordifficultywith conceptiontohave theirthyroidfunction evaluated.
FeliceGersh,MD
Menopauseand thyroidhealth
Aswomenapproach menopause,hormonelevels naturallydecline,andthis hasadirectimpacton thyroidfunction.Withthe lossofestradiol,theovarian estrogen,andprogesterone productionduring menopause,thethyroid’s efficiencycanbe compromised.Lower estrogenlevelsreducethe sensitivityofthyroid hormonereceptors, meaningthatevenifyour thyroidisproducingnormal levelsofhormones,your bodymaynotbeutilizing themaseffectively.Thiscan leadtosymptomslike fatigue,weightgain,and cognitivechanges— symptomsthatareoften attributedsolelyto menopausebutmayalso signalthyroiddysfunction.
Inwomenwhoarealready dealingwiththyroidissues, menopausecanexacerbate thesymptoms.Forinstance, womenwithhypothyroidism mayexperienceworsening fatigueormoresignificant weightgainafter menopause.It’sessentialto monitorthyroidhealthclosely duringthistransitionandto workwithahealthcare providerwhounderstands thecomplexinteraction betweenthyroidhormones andreproductivehormones.
Progesterone’srole
Whileestrogenoftengets mostoftheattention, progesteronealsoplaysa criticalroleinthyroidhealth. Progesteronesupports thyroidfunctionbybalancing theeffectsofestrogen.When progesteronelevelsdrop,as theydoduringmenopause orwithcertainconditions
FeliceGersh,MD
suchaspolycysticovary syndrome(PCOS),the thyroidmaybecomeless efficient.Womenwithlow
progesteronemay experiencesymptomsof hypothyroidism,suchas fatigue,moodswings,and weightgain,eveniftheir thyroidhormonelevelsare technicallywithinthenormal range.
Thyroidhealthisdeeply connectedtoreproductive hormoneslikeestrogenand progesterone.Whetheryou’re inyourreproductiveyears, transitioningthrough menopause,orinyour postmenopausalyears, keepingyourthyroidin balanceisessentialfor overallwell-being.Ifyou’re experiencingsymptomsthat couldbelinkedtobothyour thyroidandyour reproductivehormones,it’s importanttotakea comprehensiveapproachto yourhealth,addressingall hormonalfactors.
FeliceGersh,MD Anintegrativeapproach
Thethyroid-menopause connection
Aswomenage,theriskofdevelopingthyroidconditions increases.Menopauseincreasestheriskforseveral autoimmuneconditions,includingHashimoto’sthyroiditis. Additionally,theage-relatedriseinthyroiddisordersisfueled bytheoveralldecliningefficiencyoftheendocrinesystem combinedwiththehormonalshiftsthatoccurastheovaries ceasetoproduceestradiolandprogesteroneduring menopause.Accordingtosomestudies,asmanyas20%of womenovertheageof60mayhavesomeformofthyroid dysfunction,withhypothyroidismbeingthemostcommon condition.
Isitmenopauseoryourthyroid?
Theinterplaybetweenaging,menopause,andthyroid dysfunctionisespeciallysignificantbecauseboth menopauseandthyroidissuescanpresentwithoverlapping symptoms.It’seasyforthyroidissuestobemistakenfor menopausalsymptoms—orviceversa.That’swhyit’scritical forwomentobeespeciallymindfuloftheirsymptomsduring andaftermenopauseandtoadvocateforregularthyroid screeningsaspartoftheirroutinehealthcare.
Menopauseorthyroid?
Youcan’ttellbysymptomsalone
Asyoucansee,becauseoftheoverlapinsymptomsand becausewomencansimultaneouslybeinperi-/menopause ANDhavethyroiddysfunction,testingisessentialtogetan accuratediagnosis.
Regularthyroidscreeningiskey
Giventhecomplexrelationshipbetweenaging,menopause, andthyroidhealth,it’sessentialforwomentomonitortheir thyroidfunctionastheyage.Regularthyroidscreenings— especiallyduringandaftermenopause—arecritical.Evenif you’rebeingtreatedformenopausalsymptoms, undiagnosedthyroiddysfunctioncouldstillbecontributingto yourdiscomfort.Askyourhealthcareprovidertocheckyour thyroidlevelsregularly,includingTSH,FreeT3,andFreeT4,to ensureyourthyroidisfunctioningoptimally.
Althoughagingandmenopauseincreaseawoman’sriskfor thyroiddysfunction,withawarenessandproactivecare, thyroidissuescanbemanagedeffectively.Ifyou’re experiencingsymptomsthatseemmoreseverethantypical menopausalchangesorthatpersistdespitetreatment,don’t hesitatetoaskforathoroughthyroidevaluation.
FeliceGersh,MD Anintegrativeapproach
Testingfor thyroiddisorders 06
Diagnosingthyroiddisorderscanbetrickybecausethe symptomsoftenoverlapwithothercommonhealthissues likestress,aging,andhormonalchanges.That’swhyit’s crucialtorelyoncomprehensivethyroidtestingandan understandingofyouruniquehealthhistorytogetan accuratediagnosis.
Keythyroidteststorequest
Thyroidconditionsareprimarilydiagnosedthroughblood teststhatmeasureyourhormonelevels.Themostimportant teststorequestinclude:
TSH(Thyroid-StimulatingHormone):Thisis typicallythefirsttestusedtoassessthyroidfunction. TSHisproducedbythepituitaryglandandsignals yourthyroidtoproducemoreorlessthyroid hormone.IfTSHlevelsaretoohigh,itindicates hypothyroidism;ifthey’retoolow,itsuggests hyperthyroidism.
FreeT3andFreeT4:Thesetestsmeasurethelevels ofthyroidhormonescirculatinginyourbloodstream. FreeT4(thyroxine)istheprimaryhormone producedbythethyroid,whileFreeT3 (triiodothyronine)isthemoreactiveformthat affectsyourmetabolismandenergylevels.
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Anti-TPOAntibodies:Ifautoimmunethyroiddisease issuspected,thistestlooksforanti-thyroid peroxidaseantibodiesthatindicateyourimmune systemisattackingthethyroidgland.Thisisa commonmarkerforHashimoto’sthyroiditisand Graves’disease.
ThyroglobulinAntibodies:Thistestcanalsohelp diagnoseautoimmunethyroiddiseases.
Whilethesearetheprimarytestsusedindiagnosingthyroid disorders,acomprehensiveevaluationoftenincludes checkingotherfactorsthatinfluencethyroidhealth,suchas adrenalfunction.
Anotherusefulassessmentisamicronutrientpanelto assesskeymicronutrientlevels.Certainnutrients—suchas iodine,selenium,andzinc—areessentialforthyroidhormone productionandutilization.Ifyou’redeficientinanyofthese, yourthyroidmaynotfunctionproperly,evenifyourhormone levelsappearnormalonstandardtests.
Whentoaskfortesting
Givenhowcommonthyroid dysfunctionisinwomen,it’s importanttoknowwhentoask fortesting.Ifyouexperience symptomslikefatigue,weight changes,moodswings,hairloss, ortemperaturesensitivitythat persistdespitelifestyle adjustments,it’stimetogetyour thyroidchecked.Thisis especiallytrueifyou’realso dealingwithirregularmenstrual cyclesorfertilityissues,as thyroidimbalancescanplaya roleinreproductivehealth.
Additionally,womenover40,especiallythoseapproaching menopause,shouldconsiderregularthyroidscreeningsas partoftheirroutinehealthcare.Aswe’vediscussed,thyroid symptomsandmenopausalsymptomsoftenoverlap, makingithardtodistinguishbetweenthetwowithouttesting.
Takechargeofyourthyroidhealth
Gettingacomprehensivediagnosisisthefirststeptoward managingthyroiddysfunctioneffectively.Beproactiveabout yourhealthbyrequestingthesetestsandworkingwitha healthcareproviderwhounderstandsthecomplexitiesof thyroidfunction.Earlydetectioncanmakeabigdifferencein yourtreatmentoptionsandoverallwell-being.
FeliceGersh,MD
Traditionaland integrativetreatments
Whenitcomestotreating thyroiddisorders,thereare severalapproaches available,fromconventional pharmaceuticalsto integrativemethodsthat focusonlifestyle,diet,and hormonebalance.Thekeyis tofindtherighttreatment planthatworksforyou, takingintoaccountyour overallhealth,age,and personalpreferences.
Traditionaltreatment therapies
Forhypothyroidism,the mostcommonandeffective treatmentisthyroidhormone replacementtherapy.This usuallyinvolvestaking levothyroxine,asynthetic formoftheT4hormone. Levothyroxineisdesignedto
replacethethyroidhormone thatyourbodyisnot producingenoughof, helpingtonormalize metabolism,energylevels, andotherbodilyfunctions.
Thyroidhormonetherapyis typicallywell-tolerated,butit cantaketimetofindthe correctdosage.Regular bloodtestsarenecessaryto monitoryourhormone levels.
Althoughmostwomenwith hypothyroidismjusttake levothyroxine,somedo betterwithacomboofT4 (levothyroxine)andT3 (liothyronine),theactive formofthyroidhormone.
Desiccatedthyroidextract (DTE),madefrompig thyroid,isanolderformof thyroidreplacement medication,butitisno longerpreferredbecauseits T4toT3ratioisnotidealfor humansanditisn’ttimereleased.
Forhyperthyroidism, treatmentmayinclude medicationslike methimazoleor propylthiouracil(PTU), whichworktoreducethe productionofthyroid hormones.Insomecases, radioactiveiodineorsurgery mayberecommendedto removeordestroypartofan overactivethyroidgland.
Limitationsof traditionaltreatments
Conventionaltherapiesare highlyeffective,butthere canbechallenges, especiallyinfine-tuningthe treatmenttoyourspecific needsandadjustingitifyour needschange.Some womenmaynotabsorb synthetichormoneswell,or theymayexperienceside effectslikeanxiety,rapid heartbeat,ordifficulty sleepingifthedosageistoo high.
Additionally,mostthyroid conditionswillgetworse overtime.Leftuntreated, nodulesandcancermay grow.Andwithautoimmune thyroidconditions,ifyou don’treduceautoimmunity andlowerinflammation, yourbodywillcontinueto attackthethyroidglandand yourthyroidfunctionwill deteriorate.
Anintegrativeapproachcancomplementtraditional treatmentsbyaddressingunderlyingcauses,optimizing hormonebalance,andsupportingoverallthyroidhealth.
Integrative,whole-personapproaches
Integrativemedicinelooksbeyondtreatingsymptomsand focusesonrestoringbalancetotheentiresystem.Forwomen withthyroiddysfunction,thisapproachincludesaddressing diet,lifestyle,andhormonalhealthtosupportthethyroidand improveoverallwell-being.
Onepowerfullifestylechangethatsupportsthyroidhealthis adoptingfastingmethods,suchastime-restrictedeating, intermittentfasting,andlongerfasts.Thesestrategieshelp improvegutandliverfunction,whichareessentialfor optimalthyroidhormoneproduction.Fastingsupportsbetter digestionandguthealth,whichcanenhancenutrient absorption.Specifically,fastingcanincreasethediversity andbalanceofthegutmicrobiomeandrestoregutbarrier integritytohealleakygut,whichmayhelpreverse autoimmunethyroidconditions.
Forwomeninperimenopauseormenopause,Hormone
ReplacementTherapy(HRT)canalsoplayacriticalrolein supportingthyroidfunction.Estrogenandprogesteroneare keyplayersinregulatingthyroidhormoneactivity,andwhen thesehormonesdecline,thyroiddysfunctioncanworsen.HRT canhelprestorehormonalbalance,whichinturnsupports moreefficientthyroidfunctionandreducessymptomslike fatigue,weightgain,andmoodswings.
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Beyondmedicationsand hormonetherapies,lifestyle changescanhavea significantimpacton managingthyroiddisorders. Eatinganutrient-densediet thatincludeskey micronutrientslikeiodine, selenium,zinc,andironis essentialforthyroidhealth. Regularphysicalactivity, stressmanagement techniqueslikeyogaor meditation,andadequate sleepcanalsoimprove thyroidfunction.
Bycombiningtraditional treatmentswithintegrative strategiessuchasfasting protocols,HRT,andlifestyle modifications,youcancreate amorecomprehensiveplan thataddressesnotjustyour thyroidbutyourentirebody.
FeliceGersh,MD Anintegrativeapproach
Fastingprotocolsand thyroidhealth
Oneofthemostexcitingintegrativeapproachesto managingthyroidhealthistheuseofvariousfasting regimens,includingtime-restrictedeating,alternateday fasting,5:2intermittentfasting,modifiedfasts,andfasting mimickingdiets.Eachvariationhasitsownspecificbenefits andchallenges,buttheyallcanhelpsupportoptimal metabolism,gutfunction,andthyroidhealth.
FeliceGersh,MD
Howfastingsupportsthyroidhealth
Thethyroidglandishighlysensitivetothebody’smetabolic state.Prolongedstress,inflammation,andpoordietcanall negativelyaffectthyroidfunction.Fastingregimensworkby creatingashorttermrejuvenativestatethatpromotes cellularrepair,reducesoxidativestress,andsupportsa healthymetabolism—allofwhichareessentialforoptimal thyroidfunction.
Inwomenwithhypothyroidism,periodsoffastingcanhelp improvethebody’ssensitivitytothyroidhormones.For womenwithautoimmunethyroidconditionslike Hashimoto’sthyroiditis,certainfastingregimensmayhelp resettheimmunesystemtoproducefewerthyroid antibodiesandmaylowerchronicinflammation,thus reducingtheimmunesystem’sattackonthethyroid.
Additionally,fastingregimenscanimproveoverallhormone balance,makingthethyroidmoreefficientatproducingand utilizinghormones.Specifically,bypromotingahealthier metabolicstateandreducinginflammation,periodicfasting helpsimprovethebody’sabilitytoregulateestrogen, progesterone,andthyroidhormones.Forwomenin perimenopauseandmenopause—stagesoflifewhen hormonelevelsfluctuateandthyroiddysfunctionismore common—fastingpracticescanofferaneffectivestrategyto supportbothmetabolicandhormonalhealth.
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Fasting’simpactonweightandmetabolism
Forwomenwiththyroiddysfunction,weightmanagement canbeasignificantchallenge.Anunderactivethyroidoften slowsmetabolism,whichcanpromoteweightgainand makeithardertoloseweightormaintainahealthyweight. Fastinghelpsregulatemetabolismbyshiftingthebodyintoa statewhereitefficientlyburnsfatforenergy.Thismetabolic resetcanbeparticularlybeneficialforwomenwith hypothyroidismwhostrugglewithweightgain.
Implementingfastinginyourthyroidhealthplan
It’simportanttorememberthatwhilefastingcanbea powerfultoolforsupportingthyroidhealth,itshouldbe implementedaspartofabroader,individualizedtreatment plan.Alwaysconsultwithahealthcareproviderbefore startinganyfastingregimen,especiallyifyouhavean existingthyroidcondition,aretakingmedicationsforthyroid management,orifyouhaveapre-existingmetabolic diseasesuchasdiabetes.Yourdoctorcanhelptailoryour fastingpracticetoyourspecifichealthneeds,ensuringthatit complementsyourcurrenttreatments.
Overall,fastingregimensareavaluableadditiontothe treatmentlandscapeforwomenwiththyroiddysfunction.By supportingmetabolichealth,loweringautoimmunity, reducinginflammation,andenhancinghormonebalance, fastingcanimproveoverallwell-beingandmakeiteasierto managethyroid-relatedsymptoms.
FeliceGersh,MD
Hormonereplacement therapyandthyroidhealth
Forwomeninperimenopauseandmenopause,hormone replacementtherapy(HRT)canplayavitalrolein maintainingboththyroidfunctionandoverallwell-being.The hormonalchangesthatcomewithmenopause—particularly thedeclineinestrogenandprogesterone—candirectly impactthyroidfunctionandthyroid-relatedsymptoms.
The
estrogen,progesterone,thyroidconnection
Estrogenandprogesteronearekeyhormonesthatregulate muchmorethanjustthereproductivesystem.Theyalso influencethebody’ssensitivitytothyroidhormones.As estrogenlevelsdeclineduringperimenopauseand menopause,thethyroidreceptorsbecomelesssensitiveto thyroidhormoneslikeT3andT4.Thisreductioninsensitivity canmimicorworsentheeffectsofhypothyroidism,leading tosymptomslikefatigue,weightgain,andcognitiveissues.
Forwomenalreadymanaginghypothyroidism,thedropin estrogencanmakeitharderforthyroidhormone replacementtherapy(suchaslevothyroxine)towork effectively.ThisiswhereHRTcanmakeasignificant difference.Byrestoringhormonalbalancethroughestrogen andprogesteronetherapy,HRThelpsimprovethyroid receptorsensitivity,allowingthethyroidhormonesto functionmoreefficientlyinthebody.
FeliceGersh,MD Anintegrativeapproach
SupportingthyroidhealthwithHRT
Inwomenwithnormalthyroidfunction,thehormonalshiftsof menopausecantriggertheonsetofthyroiddysfunction, particularlyhypothyroidism.HRTcanhelpmitigatethese effectsbymaintainingahealthierbalanceofreproductive hormones,whichinturnsupportsthyroidfunction.Estrogen replacementhelpsthethyroidworkmoreefficiently,while progesteroneaidsinbalancingestrogen’seffectsand maintainingoverallhormonalstability.
HRTmustbeprescribedbyaphysicianorotherhealthcare providerwithprescribingauthority.Bewaryofanyoneinthe wellnessspacewhoencouragesyoutotakesupplements, estriolformulations,orextremelylowdosehormonesinstead oftypicalorphysiologicdosesofestradiolandprogesterone.
It’simportanttoworkwithahealthcareproviderexperienced inmanagingboththyroidandmenopausalhealthtocreate atreatmentplanthataddressesyourspecificneeds.For womenusingboththyroidhormonereplacementtherapy andHRT,carefulmonitoringofthyroidlevelsisessential becauseadjustingonetreatmentcanaffecttheother.
HRTbenefitsbeyond thyroidhealth
Inadditiontosupporting thyroidfunction,HRToffers broaderbenefitsforwomen inmenopause.Ithelps alleviatemanyofthe commonsymptomsof menopause,includinghot flashes,nightsweats,mood changes,andvaginal dryness.HRThasalsobeen showntoimprovebone density,hearthealth,and overallqualityoflife,makingitavaluableoptionforwomen navigatingboththyroidandmenopausalchanges.
Whenusedincombinationwithlifestyleadjustments,diet, andthyroidhormonereplacement,HRTcanbeapowerful toolforwomenlookingtooptimizetheirhealthduring menopauseandbeyond.
FeliceGersh,MD Anintegrativeapproach towomen'shealth
Lifestyleanddietfor thyroidoptimization
Managingthyroidhealthisn’tjustaboutmedicationsand hormonetherapies—yourdailylifestylechoicesanddietplay acriticalroleinoptimizingthyroidfunction.Byadoptingkey habitsandincorporatingthyroid-supportivenutrientsinto yourdiet,youcanhelpyourthyroidfunctionmoreefficiently, supportyouroverallwell-being,andreducetheseverityof thyroid-relatedsymptoms.
Keynutrientsforthyroidhealth
Certainnutrientsareessentialfortheproductionand regulationofthyroidhormones.Withouttheproperintakeof thesenutrients,thyroidfunctioncansuffer,evenifhormone levelsappearnormalinbloodtests.Themostimportant nutrientstofocusoninclude:
Iodine:Thisisakeybuildingblock forthyroidhormones.Without enoughiodine,thethyroidcan’t produceadequateamountsofT3 andT4.Seaweed,iodizedsalt,and seafoodareexcellentsourcesof iodine,buttoomuchiodinecan alsocauseproblems,so moderationisessential.
FeliceGersh,MD Anintegrativeapproach
Selenium:Thismineralplaysavital roleinconvertingT4toT3,the activeformofthyroidhormone. Brazilnuts,sunflowerseeds,and fisharegreatdietarysourcesof selenium.
Zinc:Likeselenium,zincis importantforthyroidhormone conversion.Italsosupportsthe immunesystem,whichisespecially importantforwomenwith autoimmunethyroiddisorders.You canfindzincinshellfish,pumpkin seeds,andlegumes.
Iron:Irondeficiencycanimpair thyroidhormoneproductionand disruptmetabolicfunction.Women, particularlythosewhoare menstruating,shouldensurethey getenoughironthroughfoodslike leanredmeat,spinach,and legumes.
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Theroleofguthealthinthyroidfunction
Guthealthisdeeplyinterconnectedwiththyroidhealth.The gutmicrobiomeplaysaroleintheabsorptionofnutrients thatsupportthyroidfunction,andimbalancesingutbacteria canleadtoinflammationandhormonaldisruptionsthat affectthethyroid.Maintainingahealthygutthroughadiet richinfiber,fermentedfoods,andprobioticsisanimportant partofthyroidoptimization.
Avoidingprocessedfoods,excesssugars,andartificial ingredientscanalsohelpreduceinflammationandimprove thyroidhealth.
Stressmanagementandthyroidhealth
Chronicstresscanwreakhavoconthethyroid.Stress triggersthereleaseofcortisol,ahormonethat,when elevatedoverlongperiods,cansuppressthyroidfunction. Incorporatingstress-reducingactivitiessuchasyoga, meditation,deepbreathingexercises,andregularphysical activitycanhelpbalancecortisollevelsandsupportoverall thyroidfunction.
Exerciseforthyroidsupport
Regularphysicalactivityhelpsmaintainahealthy metabolism,improvesmood,andsupportscardiovascular health—factorsthatareallimportantforthosemanaging thyroiddisorders.However,it’sessentialtolistentoyourbody andavoidoverexercising,especiallyifyou’redealingwith
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fatigueorotherthyroid-relatedsymptoms.Moderate, consistentexercise,likewalking,swimming,oryoga,can improveenergylevelsandboostmetabolicfunctionwithout puttingtoomuchstrainonyoursystem.
Sleepandthyroidhealth
Goodsleepisessentialforhormoneregulation,including thyroidhormones.Poorsleepcanleadtoimbalancesin cortisolandotherhormonesthatimpactthyroidfunction. Aimfor7to9hoursofqualitysleepeachnighttosupport thyroidandoverallhealth.
Makinglifestylechangesworkforyou
Integratingtheselifestylechanges—balancednutrition, regularexercise,stressmanagement,andqualitysleep—into yourdailyroutinecansignificantlyenhanceyourthyroid function.Thesechangesnotonlysupportyourthyroidbut improveyouroverallhealthandvitality,helpingyoufeelyour bestnomatterwhatstageoflifeyou’rein.
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Conclusion Takingchargeof yourthyroidhealth
Yourthyroidhealthisanessentialpartofyouroverallwellbeing,andtakingproactivestepstosupportitcanmakea worldofdifferenceinhowyoufeel.Whetheryou’re navigatingthechallengesofinfertility,approaching menopause,orsimplywanttooptimizeyourhealth,it’s importanttoprioritizeyourthyroidandmakethoughtful, informedchoicesaboutyourhealth.
Diet,lifestyle,andregularcheck-upswithyourhealthcare providerareallcrucialinkeepingyourthyroidfunctioningat itsbest.Eatinganutrient-richdietthatincludesiodine, selenium,andzinc,managingstress,gettingregularexercise, andensuringqualitysleepallcontributetoahealthier thyroid.It’sequallyimportanttoscheduleroutinecheck-ups andrequestthyroid-specificteststostayontopofany potentialissues,especiallyduringlifetransitionslike pregnancyandmenopause.
Aboveall,it’svitaltolistentoyourbody.Ifyoufeeloff— whetherit’spersistentfatigue,unexplainedweightchanges, moodswings,orsimplynotfeelinglikeyourself—don’t dismissitasjustpartofgettingolderorbeingstressed.
Feeling"notquiteright"isn'tsomethingyoushouldsettlefor, andit'snotanormalpartofanylifestages.
Yes,lifestressorsandagingcancauseshiftsinenergy, mood,andweight,butthesechangesstillwarranta thoroughcheck-uptoruleoutanyunderlyingthyroidissues orotherhealthconcerns.
Don’tbeafraidtoadvocateforyourself.Youknowyourbody betterthananyoneelse,andifyoufeellikesomethingis wrong,it’simportanttofindatrustedhealthcareprovider wholistenstoyourconcernsandtakesthemseriously.Your healthisworththeeffort,andyoushouldneversettlefor feelinglessthanyourbest.
Beyourownhealthchampion.Proactivecare,early detection,andacommitmenttoyourwell-beingarethe keystothriving,nomatteryourage.Whenyouunderstand
AboutDr.Gersh
FeliceGersh,M.D.isamulti-awardwinningphysicianwith dualboardcertificationsinOB-GYNandIntegrativeMedicine. SheisthefounderanddirectoroftheIntegrativeMedical GroupofIrvine,apracticethatprovidescomprehensive healthcareforwomenbycombiningthebestevidencebasedtherapiesfromconventional,naturopathic,and holisticmedicine.
For12years,shetaughtobstetricsandgynecologyatKeck USCSchoolofMedicineasanAssistantClinicalProfessor, andshenowservesasanAffiliateFacultyMemberatthe FellowshipinIntegrativeMedicinethroughtheUniversityof ArizonaSchoolofMedicine.Feliceisaprolificwriterand lecturerwhospeaksgloballyonwomen’shealthand regularlypublishesinpeer-reviewedmedicaljournals.
Sheisthebestsellingauthorofthe PCOSSOSseriesandherlatestbook, Menopause:50ThingsYouNeedto Know.
FollowheronYouTube,Instagram, andFacebook.
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