Thyroid problems are affected by many things including low progesterone levels. In today’s article, I will talk about the how female hormone imbalances like low progesterone, affect the thyroid and some of the reasons for low progesterone.
Thyroid problems are one of the most common hormone problems woman experience. In fact, 1 in 4 women in peri-menopause are diagnosed with hypothyroidism. Hypothyroidism (too little thyroid hormone) can cause you to experience fatigue, hair loss, dry skin, constipation, coarse hair, irregular and heavy periods, low libido, cold sensitivity and depression.
About 6 months ago I began working with a woman who was diagnosed with hypothyroidism- (Hashimotos specifically), she was being treated by her primary care doctor with Synthroid but still complained about fatigue, hair loss, and heart palpitations. She described a cognitive decline aka brain fog, she was depressed, and she was gaining weight at an alarming rate.
Essentially, she still experienced all symptoms of hypothyroidism yet she was on medication and her TSH levels were “normal.”
We began to go through her history and being in her 40s (peri menopause) we began to think about some of the other potential causes to these unresolved thyroid symptoms.
She was having regular cycles however she experienced many PMS symptoms. She had breast tenderness, she experienced changes in mood, she had the brain fog, she had menstrual cramps, she had water retention and many of her symptoms intensified- jus flat out got worse just before her period.
Her primary care doctor told her that her thyroid levels were good and so he wanted her to go on antidepressants for the depression, he also thought that a birth control pill would help with the PMS and he said he could prescribe some medications/appetite suppressants to help with the weight.
She didn’t like this idea! she wanted to approach these problems using functional medicine and get to the root cause….. and so this is when she contacted me.
This Is What We Did
- Full Thyroid Panel
- Adrenal Testing
- 28 day Cycling Female Hormone Mapping Test
- FSH and LH testing
We ran a full thyroid panel (which she had never had done) we looked at her TSH levels, Total T3, Free T3, total T4, Free T4, reverse T3, thyroid antibodies and we also looked at her Thyroid binding globulin levels- up to this point, her primary was only running a TSH) While we were waiting for those tests to come ….I also ran testing on her adrenals and we ran a 28 day dynamic hormone mapping test.
This mapping test- essentially maps out the fluctuations in your hormones (estrogen and progesterone) throughout your entire cycle it also gives us an average of the testosterone levels produced in that cycle.
We uncovered that she had low T3 and low free T3 levels, She had elevated reverse T3, she had low DHEA and Cortisol (indicating an adrenal hormone imbalance) and we found she had super high levels of TBG which were binding up her testosterone and thyroid hormones.
If her doctor had put her on any kind of hormone pill that contained estrogen, those TBG would have shot up even higher blocking even more of her thyroid hormones and testosterone levels. In other words, she would have had even more problems with the thyroid because that’s what the pill can do.
She was also low in progesterone. Now….These hormone imbalances (unfortunately) are very common scenarios for woman in their 40s and these imbalances are some of the most common reasons for low progesterone.
If you don’t ovulate, you don’t make progesterone. Now here why progesterone is so important to the thyroid.
Progesterone and thyroid hormones have a reciprocal relationship. What that means is that you need adequate amounts of thyroid hormone for your ovaries to make progesterone and you also need adequate amount of progesterone for optimal thyroid function.
Progesterone Levels Affect Thyroid Hormone Production in Two Very Important Ways.
Research shows us that a progesterone deficiency causing depression of the enzyme called thyroid peroxidase (TPO). Normally progesterone up-regulates TPO function.
Thyroid Peroxidase is an enzyme in your thyroid gland; and it’s one of the enzymes you use to make T4 and T3 thyroid hormones. So, if your TPO enzyme is depressed and is not active, then over time you’re just not going make enough T4 and T3 and you will suffer with symptoms of hypothyroidism.
But that’s not all progesterone does.
Progesterone also affects your Thyroid binding globulin levels (TBG) and this is why measuring your TBG levels is important and why you should have your doctor run this test for you.
Well, it turns out that if you have a Progesterone deficiency like so many woman in their 40,50,60 have you will often have elevated TBG levels in the blood.
So, what that means is that there is less thyroid hormone that can get into the cells where the hormones belong. You don’t want to have high levels of TBG when you are hypothyroid.
So now…. if you have been wondering if your hormones can affect your thyroid gland you now know that low progesterone can cause low thyroid either by affecting TPO levels or by affecting Thyroid binding globulin levels.
What Do You Do About This Low Progesterone-Thyroid problem?
There are a few reasons for low progesterone that need to be understood before resorting to progesterone replacement. I will tell you that I don’t believe in putting every woman who has low progesterone on progesterone replacement and that’s because there are a number of reasons why the progesterone could be low. Let me explain.
Just because a patient has low thyroid hormone does not automatically make them a candidate for thyroid hormone replacement, The same hold true for woman with low progesterone. Just because you are low in progesterone, does not automatically make you a candidate for progesterone.
We need to stop treating patients with this oversimplified approach where if one hormone is low we just give that hormone.
We need to understand WHY the hormone is low in the first place. In some woman the low progesterone can be caused a lack of ovulation. Taking a woman who is not ovulating and putting her on a birth control pill will make that situation worse and create more progesterone deficiency and more thyroid problems.
Remember what I said in the beginning of the video- If a woman doesn’t ovulate, she won’t produce progesterone- she become increasingly estrogen dominant.
Another reason for problems with progesterone production comes down to things that influence luteinizing hormone levels or LH levels. LH is made by your brain and it instructs the ovaries to make progesterone.
Other Reasons for Low LH Levels and Low Progesterone Production
There are many reasons for low LH levels in woman. Sometimes the low progesterone and LH problems is caused by a blood sugar problem such as dysglycemia, sometimes a woman may have high prolactin levels that can affect progesterone levels.
Sometimes its PCOS (Poly-Cystic-Ovarian-Syndrome), sometime its caused by things like anorexia and malnutrition and sometimes its caused by nutritional deficiencies, inflammation and stress (to those adrenal glands)
So these are things worth considering under this umbrella of “I have low progesterone”. To be successful with treatment, you need to know what the cause of the problem is and MOST of the time it is combination of these things that need attention.
My best advice is to work with a Functional Medicine Doctor who understands this, someone who thinks outside the low progesterone/low thyroid replacement box and someone who can properly test you and investigate your Big Picture– (again the reasons for your low progesterone/Low Thyroid)
So, there you go! Hope you enjoyed todays article, hope you learned a few new things and I hope that you subscribe to my YouTube channel.
If you don’t have a functional medicine doctor or you feel your doctor just is not looking at the root cause reach out to my clinic. We work with patients from around the world and we can help provide you with the answers you are searching for.