Women suffer from hypothyroid disease at a rate of almost ten times that of men. Though reasons remain unclear, the close link between estrogen and the thyroid is considered a factor. Some doctors suggest many hypothyroid cases are actually the consequence of “estrogen dominance”; a term which implies low progesterone. The estrogen/progesterone hormone imbalance directly affects thyroid function. The prevalence of estrogen dominance is higher than ever before and the causative factors are many. Environment, diet, and lifestyle are all contributors, as is chronic stress. Hypothyroidism itself can also lead to estrogen related issues, i.e. infertility, miscarriage, PMS, polycystic ovarian syndrome (PCOS), fibroids and cancer. The key is to look at the big picture and an individual’s unique case. Once estrogen, thyroid and stress are considered together, one can map out a customized action plan towards improved overall health.
Hormones: The Importance of Balance
Balance is the most important thing to keep in mind when it comes to hormones. Hormones are part of the endocrine system, which is a complex network of checks and balances. They regulate metabolism, energy, growth, temperature, and reproduction. Considered to be the “master regulator” is the thyroid. When the thyroid is sluggish, a variety of symptoms can ensue, including weight gain, moodiness, memory problems, hair loss, and dry skin. The connection between the symptoms and the thyroid often goes unrecognized. Other areas of the hormone network affect the thyroid too (i.e. blood sugar), but the focus of this discussion is the Hypothalamus-Pituitary-and Ovaries, (HPO-axis). Simply put, this translates to the thyroid, estrogen and the adrenals.
Estrogen’s Role in Thyroid Function
The link between estrogen and hypothyroidism is hard to miss, considering the high rate of disparity between the sexes. It’s also noted that during transitory times in women’s reproductive status is when the risk of hypothyroidism is highest. Thyroid expert Dr. Sara Gottfried explains, it is the change in reproductive hormones that triggers hypothyroidism and the symptoms of fatigue, weight gain and depression. Since many of the symptoms overlap with imbalanced reproductive hormones, practitioners have nicknamed the condition “thyropause”.
Symptoms of estrogen dominance include:
- Cervical dysplasia
- Breast cancer
- Uterine fibroids
Estrogen Dominance and Thyroid
It is important to note, estrogen levels are balanced proportionate to progesterone. This means, one can have estrogen dominance when estrogen levels are low if progesterone is deficient. The effect of having this hormone imbalance has the potential of causing hypothyroid in those susceptible. In many cases, hypothyroidism manifests as the autoimmune disease, Hashimoto’s thyroiditis. In order for Hashimoto’s to occur other factors must also be in place, namely genetic predisposition, a trigger, and “leaky gut” (intestinal hyperpermeability). The problem many patients have is ongoing symptoms despite treatment, which is typically Synthroid, levothyroxine or Armour Thyroid. Thyroid hormone replacement drugs are ranked the third most common prescribed in the county and yet many users continue to suffer. With the strong connection between the thyroid and estrogen, and the amount of hormone disrupting factors listed below, it is easy to see why the affected population is so high. Contributing factors include:
- Poor diet, high in meat and dairy, low in fiber
- Liver and bilary congestion
- Synthetic hormone replacement therapy (HRT) and oral contraceptives
- Xenohormones which are in foods, plastics, personal care items, air pollution, pesticides, etc.
*Xenohormones interfere with estrogen and they are everywhere: hormones in meats, pesticides on foods and in our yards, household products, and the polluted air that we breathe.
The causative factors listed impact every aspect of our daily lives. The degree to which these estrogen disruptors exist has increased in recent decades, which is of great concern to scientists who recognize the effects. Produce has more pesticides, livestock are injected with hormones, obesity is on the rise, and being “really busy” is the accepted norm. People are so busy they often don’t realize they are stressed, much less hurting their health. The good news is there is a lot one can do.
How to Avoid Excess Estrogen
- Avoid diet high in meat and dairy, low in fiber. Eat fiber to flush out excess estrogen.
- Minimize exposure to hormone disruptors, i.e. plastic water bottles, Styrofoam, pesticides, cosmetic products, and cadmium.
- Avoid cigarettes.
- Avoid oral contraceptives.
- Avoid chronic stress.
Why Stress is so Important
When a person is stressed, it means the adrenals are secreting excess cortisol. When this becomes chronic, it disrupts the normal circadian rhythm and the stress response of the (HPA) Hypothalamus-Pituitary-Adrenal axis. When the body is so busy trying to keep up with cortisol production it takes priority over the sex hormones. Since estrogen and progesterone are made from the same chemical (pregnenolone) as cortisol, it becomes depleted affecting production. Other ways chronic stress impacts estrogen dominance and the thyroid include:
- Reduces the liver’s ability to process and eliminate excess estrogen.
- Increases thyroid binding globulin (TBG), which keeps it bound and inactive.
- Hinders the function of the hypothalamus and pituitary reducing thyroid hormone production.
- Interferes with T4 to active T3 production.
- Weakens the intestinal lining causing leaky gut.
What Else Should I Do?
- Have a full thyroid panel that includes TSH, freeT3, T3, T4, rT3, TPOAb and TgAb antibodies.
- Check for iron deficiency with iron panel including ferritin.
- Maintain vitamin D levels in the range of 50-70ug/dl.
- Avoid gluten when a hypothyroid condition exists.
- Eat organic foods.
- Maintain healthy body weight.
- Minimize and manage stress.
Note: It’s important to have sufficient iron, zinc, iodine and selenium for thyroid support. However, since the threshold is low it is important to be informed of dosing and not to overdo it.
It’s impossible to avoid all the causes of estrogen dominance yet with proper maintenance, the body is equipped to handle much of it. When problems do occur seeing a health provider who recognizes symptoms in the context of the body as a whole, rather than segregating symptoms, can offer improved outcomes.
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6. Educational Resources: Xenohormones and xenoestrogens. Women Living Naturally. http://www.womenlivingnaturally.com/articlepage.php?id=73