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Why Do Thyroid Disorders Affect Women More Often Than Men?

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Here’s what to know about thyroid dysfunction — and how to get tested.

Although millions of men experience thyroid dysfunction, women are 10 times more likely to have a thyroid imbalance.

The reasons are uncertain, but according to integrative physician and gynecologist Sara Gottfried, MD, the phenomenon is linked to female hormones, since estrogen dominance (a condition in which estrogen levels are high relative to progesterone) has been implicated as a contributing factor.

The interaction between the thyroid and a woman’s reproductive hormones is significant: Hypothyroidism can lead to infertility, miscarriage, premenstrual syndrome (PMS), osteoporosis, endometriosis, polycystic ovary syndrome (PCOS), irregular cycles, uterine fibroids, low libido, and difficulty in menopause.

For many women, thyroid problems first arise during times of hormonal unrest, such as childbearing and periods of prolonged or intense emotional, physical, and mental stress. According to Gottfried, “Women are most vulnerable after pregnancy and during perimenopause and menopause. Thyropause — a drop in reproductive hormones that often triggers hypothyroidism — is the main cause of fatigue, weight gain, and depression.”

A woman’s hormonal matrix is a bit of a chicken-and-egg scenario. Boosting thyroid function has a beneficial effect on ovaries and adrenals, but the opposite is also true: Resolving estrogen dominance, low progesterone, and adrenal fatigue can help rebalance thyroid hormones, too. All the organs and glands talk to each other; they also compensate for each other, explains family nutritionist and naturopathic endocrinologist Laura Thompson, PhD.

“All of these systems need to be aligned,” says Gottfried. “Otherwise, the thyroid can be sidetracked by the ovaries and adrenals, especially in the presence of estrogen dominance and adrenal burnout.”

Thompson agrees: “Estrogen dominance can contribute to hypothyroid conditions, especially in menopause. The use of high estradiol birth-control pills can also contribute to low thyroid conditions.”

But men aren’t entirely immune to hormonally triggered hypothyroidism, she notes: “Low testosterone often accompanies low thyroid in both men and women.”

Getting Tested

Many doctors don’t test for thyroid dysfunction at all, and even when they do, they rely on only one blood test (for thyroid stimulating hormone, TSH) that reveals little about overall thyroid function. As a result, millions of people suffering from thyroid dysfunction are left undiagnosed.

If you do go to the doctor for thyroid testing, be sure to be tested for Free T3 (FT3), Reverse T3 (RT3), and the presence of two thyroid antibodies, TPOAb and TgAb. The “Free” in front of T3 discloses what is unbound and usable by the body. Reverse T3 is just that — the opposite of T3 — and it blocks thyroid receptors and can cause patients to be unresponsive to any thyroid hormone.

There is some disagreement about what constitutes acceptable lab values, depending on the doctor and the lab. As a result of outdated ranges, borderline hypothyroid patients are often overlooked. Thompson uses functional medicine thyroid-reference ranges. Optimal ranges for FT3 is 2.0–3.0 pg/ml; for RT3, it’s 90–350 pg/ml.

It’s also a good idea to get tested for celiac disease, as Hashimoto’s and celiac are often in cahoots, and to be on the lookout for gluten sensitivity. If your healthcare provider scoffs or tells you that these tests are unnecessary, consider finding a new doctor. In the meantime, you could also seek out comprehensive thyroid-panel testing through direct-to-consumer lab services, like HealthCheckUSA.com or DirectLabs.com.

This originally appeared in “Repair Your Thyroid” in the November 2012 issue of Experience Life.

Illustration by Gracia Lam

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