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An Update On The Thyroid - Gynecology
Connection
By Richard Shames, M.D. & Karilee Shames,
Ph.D, R.N.
Here is the first and introductory installment
for a series of art icles
on the
thyroid - female hormone connection.
In recent weeks, it has
come to my attention that a great many women are still confused
about the interactions between their thyroid hormone and their
female hormone balance. The good news is that the estrogen panacea
is winding down. The bad news is that a great many women don't
know how to proceed with female hormone balance.
The more progressive gynecologists are using bio-identical
hormones instead of Premarin & Provera. Nevertheless, estriol and micronized
progesterone may still not be yielding the results you would like, unless potential
thyroid situations are taken into account. This can be difficult if your gynecologist
- like many - is still not using the new TSH guidelines (remember that a TSH
level over 2.0 is suspicious for low thyroid, and above 3.0 is diagnostic for
it).
When we first wrote our book THYROID POWER, we took the position
(for simplicity) that an additional thyroid balance would be available by adjusting
female hormones, if needed, then adjusting adrenal hormones, if needed. The reverse
of this posture is also quite valid. Further adjustments of thyroid (whether
you are being treated for a diagnosed thyroid problem or not) can be of great
benefit in your reproductive hormone balance. The interaction between these two
hormonal systems is extremely significant. Anyone who has taken birth control
pills, or estrogen, needs to keep in mind that one additional effect of that
maneuver is to increase thyroid-binding proteins in the blood.
This means that almost any thyroid blood test result
is quite suspect, because the regular tests will show plenty of thyroid hormone
in the bloodstream, but you may still not have sufficient thyroid hormone in
the tissues. In other words, estrogens will make thyroid blood tests even more
unreliable than they already are.
What this means is that you can be told you don't have
a thyroid problem when you really do. In addition, if you are taking thyroid
medicine, you could be told that you're taking plenty, when in the reality of
your tissue levels (not measured on blood tests) you need more.
This is not a minor subtlety. It is of critical importance
to you. A lack of proper thyroid hormone levels has been implicated in everything
from bad PMS to irregular cycles, low libido, infertility, miscarriage, endometriosis,
polycystic ovary, uterine fibroids, dysfunctional bleeding, severe menopause,
and osteoporosis. With a long list of possible gynecological problems such as
this, you are well advised to optimize your thyroid function as much as possible.
So once again I return to a recurrent theme in my office & coaching
practice: if there has been any thyroid, diabetes, migraine, colitis, rheumatoid
or other autoimmune problems in your family, then you are likely to have some
degree of thyroid involvement yourself. This is especially true approaching and
during menopause years. The Journal of Epidemiology in 2001 had a compelling
art icle revealing that as much as 26% of menopausal women were hypothyroid,
making their menopause years worse.
Therefore, you owe it to yourself to do extra diagnostic maneuvers
for revealing low thyroid, such as obtaining thyroid antibody testing in addition
the routine T3, T4, and TSH. In addition, make sure the T4 determination is the
Free T4, and your T3 testing is for both Free T3 and Total T3. Consider asking
for a clinical trial of thyroid medicine if you are in the low normal area on
these results.
Perhaps even more important is for the person who is
already diagnosed and being treated for low thyroid to make sure that your treatment
protocol is optimal. In my coaching practice, where I speak with women from all
over the country, I frequently find someone who is experiencing uncomfortable
symptoms of female hormone imbalance due to an inadequate dose of thyroid medicine.
Often these symptoms completely disappear without further female hormone intervention
simply through the proper thyroid care alone.
Keep in mind there are at least five (5) different kinds
of synthetic thyroid, and five (5) different kinds of natural thyroid, in addition
to Armour. Sometimes it's not just the dose of your medicine, it's the type or
brand - and don't forget that many women need a mix of thyroids rather than just
one type.
We'll share more on each of these topics in our next installments! Stay tuned...
This art icle appears
on the Mary Shomon 's
website About Thyroid
http://www.thyroid.about.com
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