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How Your Female Hormones Affect Your Thyroid

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How Your Female Hormones Affect Your Thyroid

Do you suspect thyroid issues are behind your health concerns?

You couldn’t survive without your thyroid gland, so it’s worth looking after. It can be affected by many lifestyle factors– nutrient deficiencies, inflammation, stress and lack of sleep, as well as exposure to toxic metals and pollutants. But one unsuspected cause of thyroid issues can be an imbalance in female hormones.

How does your thyroid work?

The thyroid produces thyroxine, literally controlling how quickly your cells produce energy. Not enough thyroxine and the brakes are applied to your metabolism and everything becomes sluggish.

Your thyroid is asked to make thyroxine by your brain’s pituitary gland. This constantly measures the amount of thyroxine in your blood and sends a message to your thyroid to make more when levels drop. It’s a well-ordered system, but it’s not infallible.

Symptoms of low thyroid

  • Tiredness
  • Dry skin
  • Constipation
  • Weight gain
  • Feeling the cold

Because the gland affects every cell in your body, if it is not functioning well, it may cause a huge array of other symptoms. Some of these are very similar to those caused by female hormone imbalances, like irregular or heavy periods.

Oestrogen, Progesterone and Thyroxine

Inside your body, your hormones are constantly talking to and influencing one another, so if something affects one hormone, it will affect the others too.  Your female sex hormones oestrogen and progesterone have a particularly close link with your thyroid, and they all affect each other.

Oestrogen Dominance

Thyroid health can be affected when oestrogen becomes excessively high compared to progesterone. Oestrogen tends to increase the levels of a protein-binding thyroxine, making it less accessible to cells and therefore less able to influence them. High oestrogen levels increase inflammation, impairing thyroid function, encourage antibodies to be produced against your thyroid and block the messages coming from your pituitary gland.

Progesterone on the other hand increases the availability of thyroxine by making sure it’s not bound up with protein.

Too much oestrogen relative to progesterone is called oestrogen dominance. This situation is very widespread, particularly in perimenopause, the period running up to menopause. At this stage in your life, you often won’t ovulate every month. If ovulation doesn’t happen, no progesterone is released in the second half of the month. Because progesterone prevents oestrogen levels from climbing too high, there’s then nothing to oppose oestrogen.

Environmental factors: the environment is awash with synthetic chemicals able to mimic oestrogen by latching onto cells’ oestrogen receptors and fooling them into thinking they’re your body’s oestrogen. These substances, found in plastics, personal care products and pollutants are considerably stronger than your natural oestrogen.

Stress: anxiety and tension can make oestrogen dominance worse because it steals progesterone, dominating oestrogen. An unhealthy gastro microbiome also tends to increase oestrogen levels because good gut bacteria can play an important role in excreting unwanted oestrogen. In a vicious cycle, when your thyroid is struggling you can’t process oestrogen well in your liver and gut, making oestrogen dominance worse.

Even though you don’t make as much oestrogen after menopause, it can still remain high relative to progesterone, especially if you’re stressed. Progesterone is made in your stress glands after menopause, and they won’t prioritise making it if they’re busy making stress hormones.

Functional Testing

Your GP may test your blood thyroid hormones, but these tests don’t always measure how much of the hormones are in an active form. So, it’s impossible to tell whether your hormones are affecting your cells in the way nature intended. Because not all thyroid issues show up on a GP’s blood test, it might look like there’s nothing wrong even though your symptoms shout otherwise.

To look at the whole picture, functional tests examine the levels of both your female hormones and your thyroid hormones and reveal the quantities of active and inactive hormones you’re producing.

Combine these test results with an in-depth consultation examining your nutritional status, lifestyle and health history and it becomes much clearer what’s behind your health issues. Only by understanding the route cause, we can make appropriate strategies to put things right. 

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high-prolactin

High Prolactin

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Symptoms of high prolactin (hyperprolactinemia) include:

  • irregular periods or no periods
  • premenstrual mood symptoms
  • loss of libido
  • headaches
  • breast pain
  • vaginal dryness
  • acne
  • hirsutism or facial hair

High prolactin is one of several causes of androgen excess and can be mistaken for polycystic ovary syndrome (PCOS).

How to diagnose high prolactin

Normal prolactin in a non-lactating woman is less than 500 mIU/L (23 ng/mL). Optimal prolactin is less than 300 mIU/L (14 ng/mL).

If you get a high prolactin result, first consider if it could be temporarily or falsely elevated due to stress, exercise, or eating. To be accurate, prolactin should be tested under the following conditions:

  • early in the follicular phase of the menstrual cycle
  • between 8 a.m. and 12 p.m.
  • fasting
  • hydrated
  • relaxed,
  • not on contraception

If your prolactin is elevated on at least two occasions, the next step is to identify the underlying cause with the help of your doctor. Common causes include:

  • prolactinoma, which is a benign pituitary tumour
  • high oestrogen, either endogenous or from the pill
  • medications such as SSRI antidepressants, anti-psychotics, and stomach acid medication
  • underactive thyroid or hypothyroidism
  • undereating including anorexia nervosa
  • alcohol
  • stress.

Natural treatments to lower prolactin

  • Limit or avoid alcohol, especially beer, because barley stimulates prolactin.
  • Address any underlying issue with thyroid or undereating.
  • Reduce stress with yoga, meditation, and long slow walks.
  • Consider taking vitamin B6 which lowers prolactin levels by increasing the neurotransmitter dopamine.

Note: It is advised that these recommendations are discussed via a one-to-one programme so that it can be tailored to your personal needs – we are all individuals.

birth-control pill with date of calendar background, health care

Is Birth Control Messing with Your Nutrition?

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Oral contraceptives are prescribed beyond preventing pregnancy, for reasons such as
  • To regulate menstrual cycles
  • Provide some relief for pain during menstruation
  • Acne
  • Ovarian cyst prevention.
  • PMS and PMDD relief
  • Endometriosis management
  • Menstrual migraine relief

However, there are many drawbacks of the contraceptive pill which may be affecting your future fertility. In this blog I am going to focus on nutrition depletion.

Research has demonstrated the use of oral contraceptives may be significantly affecting bodily levels of many essential vitamins and minerals. 1-5

Here are 5 essential nutrients commonly depleted by the pill

• Magnesium

• Zinc

• Folic acid

• Vitamin B12

• Vitamin E

Magnesium

The pill and oestrogen therapy has demonstrated a depletion in serum magnesium levels, causing a potential deficiency of this essential mineral. 6,7 This is concerning for most females in where dietary magnesium intake is already low, not to mention a 21st century lifestyle that quickly uses up magnesium stores such as poor sleep, high-intensity exercise, chronic stress, and high intake of caffeine, sugar, and processed foods. 7-12

Magnesium has many benefits which have been supported by research such as supporting energy, sleep, mood, and hormone balance. Given the body’s widespread need for magnesium, low dietary intake in addition to the continual drain on the body’s stores, it is particularly concerning that the contraceptive pill may be depleting levels even further.

Furthermore, magnesium depletion alters the calcium to magnesium ratio which may affect blood coagulation.13 The deficiency in magnesium may contribute to the thromboembolic complications associated with oestrogens.6,7 Therefore, it is worth taking magnesium supplementation in addition to your diet when taking the oral contraceptive pill. 

Zinc

Lower plasma zinc levels have been observed in research dating as far back as 1968 14,15 in addition to more recent studies confirming this finding too. 16-20

Zinc is an essential trace element, used as a cofactor for more than 300 different enzymes, used in every cell, organ, bone, tissue, and fluid of the body.  Zinc is involved in immune and skin health and is important in supporting reproduction. The World Health Organisation (WHO), states the global prevalence of zinc deficiency is a surprising 31%.

The changes which occur as a result of increased oestrogen from the oral contraceptive pill may lower blood zinc levels and also increase the amount of zinc used by bodily tissues. 21-22 When these alterations occur, the need for dietary zinc increases. 20

Although not all research demonstrated a reduced level of zinc, the majority indicated that oral contraceptives, to include lower doses, have a negative effect on the nutritional status of this mineral. 16,20,23-31 Additionally, a decrease in zinc, selenium, phosphorus and magnesium in women taking oral contraceptives was found in a recent systematic review 32 which had been associated to the duration of contraceptive use.

Therefore, when oral contraception is recommended by your health professional, supplementing zinc may be useful and is best supplemented with copper due to both minerals being antagonists, which means they compete for binding sites in the body. Excess zinc can lead to a copper deficiency and vice versa.

Folic acid

Studies have demonstrated a potential reduction in blood folate levels. 33-37. One recent systematic review and meta-analysis concluded, due to reduced blood folate concentrations associated with the use of oral contraceptives, it is necessary that women of a childbearing age to continue the use of folate supplementation whilst using the contraceptive pill. 38

Folic acid is necessary within the first 4 weeks of pregnancy in order to prevent neural tube defects. Due to the folate-depleting effects of the oral contraceptive, in 2012 there was the introduction of contraceptives that were fortified with folate to help reduce the risk of neural tube defects in pregnancies that occurred during use or shortly after the discontinuation of oral contraceptives.39,40

Some evidence has shown an increase in the rate of cervical dysplasia to cervical cancer progression and that folic acid may slow or reverse this dysplasia.41,42

Recent studies recommend all women of childbearing age taking the oral contraceptive pill should supplement with folic acid. It is recommended to take the body-ready form of 5-methyltetrahydrofolate (5-MTHF) of folic acid as some people are genetically less able to convert folic acid into this active form, and therefore is less effective. Supplementing with active 5-MTHF form of folic acid bypasses the need for conversion and therefore reassures folate stores are being replenished.

Vitamin B12

The depletion of vitamin B12 in women using oral contraceptives has been found in many studies, compared to non-users .20, 43-52 In addition to folic acid, low maternal B12 status is also considered to be a standalone risk factor for neural tube defects. 53

Vitamin B12 has many functions, such as

  • Supports the blood to carry oxygen
  • Essential for healthy nerves and DNA synthesis
  • Supports the elimination of toxins   

Animal products are a rich source of vitamin B12 and are the only vitamin that can’t be reliably supplied by a varied wholefood plant-based diet.

one recent systematic review demonstrated oral contraceptives have been found to deplete vitamin B12, therefore vitamin supplements might be beneficial when taking oral contraceptives.54.55

Vitamin E

Vitamin E has many positive health benefits, to include

  • Antioxidant
  • Healthy skin
  • Immune function support
  • Cardiovascular support

Research demonstrated that the oral contraceptive had increased markers of oxidative stress and decreased levels of vitamin E in the blood. A further study found a significant rise in the clotting activity of blood platelets when taking the oral contraceptive pill, naturally accompanying decreased blood levels of vitamin E. 56-58 Research found, supplementing with vitamin E increased vitamin E blood levels and had shown a decrease in the clotting activity of platelets.59

Daily supplementation may help to support improved levels of key nutrients

Research has shown that oral contraceptives can deplete blood levels of many essential vitamins and minerals, in addition to the above, therefore if you are required to take the oral contraceptive pill you may benefit from supplementing your diet with a daily multivitamin & mineral to support these possible negative effects.

References:

1. Theuer RC. Effect of Oral Contraceptive Agents on Vitamin and Mineral Needs: A Review. J Reprod Med. 1972; 8:13-9.

2. Berg G, Kohlmeier L, Brenner H. Effect of Oral Contraceptive Progestins on Serum Copper Concentration. Eur J Clin Nutr. 1998; 52:711-5.

3. Ghayour-Mobarhan M, Taylor A, New SA, Lamb DJ, Ferns GA. Determinants of Serum Copper, Zinc and Selenium in Healthy Subjects. Ann Clin Biochem. 2005; 42:364-75.

4. Tamura T, Picciano MF. Folate and Human Reproduction. Am J Clin Nutr 2006;83: 993-1016.

5. Prevention of Neural Tube Defects: Results of the Medical Research Council Vitamin Study. Mrc Vitamin Study Research Group. Lancet. 1991; 338:131-7.

6. Seelig MS. Increased need for magnesium with the use of combined oestrogen and calcium for osteoporosis treatment. Magnes Res 1990; 3:197-215

7. Seelig MS. Interrelationship of magnesium and estrogen in cardiovascular and bone disorders, eclampsia, migraine, and premenstrual syndrome. J Am Coll Nutr 1993; 12:442-58

8. Stanton MF, Lowenstein FW. Serum magnesium in women during pregnancy, while taking contraceptives, and after menopause. J Am Coll Nutr 1987; 6:313-9

9. Akinloye O, Adebayo T, Oguntibeju O, Oparinde D, Ogunyemi E. Effects of contraceptives on serum trace elements, calcium and phosphorus levels.West Indian Med J 2011; 60: 308-315.

10. Hameed A, Majeed T, Rauf S, Ashraf M, Jalil M, Nasrullah M, Hussan A, Noreen R. Effect of oral and injectable contraceptives on serum calcium, magnesium and phosphorus in women. J Ayub Med Coll Abbottabad 2001; 13: 24-25.

11. Olatunbosun D, Adeniyi F, Adadevoh BK. Effect of oral contraceptives on Serum magnesium levels. Int J Fertil 1974; 19: 224-226.

12. Blum M, Kitai E, Ariel Y, Schnierer M, Bograd H. Oral contraceptive lowers serum magnesium. Harefuah 1991; 121: 363-364.

13. Cowan JA. Introduction to the biological chemistry of magnesium. ed. J.A. Cowan. New York. VCH;1995.

14. Halsted JA, Hackley BM, Smith JC, Jr. Plasma-zinc and copper in pregnancy and after oral contraceptives. Lancet 1968; 2: 278-279

15. King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987; 117: 217- 219

16. Prasad AS, Oberleas D, Moghissi KS, Stryker JC, Lei KY. Effect of Oral Contraceptive Agents on Nutrients: Ii. Vitamins. Am J Clin Nutr. 1975; 28:385-91.

17. Akinloye O, Adebayo T, Oguntibeju O, Oparinde D, Ogunyemi E. Effects of contraceptives on serum trace elements, calcium and phosphorus levels.West Indian Med J 2011; 60: 308-315.18. Briggs Mh, Briggs M, Austin J. Effects of steroid pharmaceuticals on plasma zinc. Nature 1971; 232: 480-481

19. Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980; 33: 267-271.

20. Fallah S, Sani Fv, Firoozrai M. Effect of contraceptive pill on the selenium and zinc status of healthy subjects. Contraception 2009; 80: 40-43.

21. King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987; 117: 217- 219

22. Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985; 17:532-5.

23. Tyrer LB. Nutrition and the pill. J Reprod Med 1984; 29:547-50.

24. Webb JL. Nutritional effects of oral contraceptive use: a review. J Reprod Med 1980; 25: 150-156.

25. Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980; 33: 267-271.

26. Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism – a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45.

27. Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981; 34:1479-83

28. Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983; 36:1016-21.

29. Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987; 69:26-32.

30. Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years’ oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988; 25:113-7.

31. Thane, C W et al : Oral contraceptives and nutritional status in adolescent British girls. Nutrition Research, 2002, 22, 449-462

32. Dante G et al. Vitamin and mineral needs during the oral contraceptive therapy: a systematic review. Int J Reprod Contracept Obstet Gynecol. 2014 Mar;3(1):1-10

33. Trowbridge M, Jr., Wadsworth R, Moffitt E. Malabsorption associated with gluten enteropathy, do oral contraceptives interfere with folate metabolism? J Maine Med Assoc 1968; 59: 240-242.

34. Paton A. Oral contraceptives and folate deficiency. Lancet 1969; 1: 418.

35. Ryser J, Farquet J, Petite J. Megaloblastic anemia due to folic acid deficiency in a young woman on oral contraceptives. Acta Haematol 1971; 45: 319-324.

36. Whitehead N, Reyner F, Lindenbaum J. Megaloblastic changes in the cervical epithelium. Association with oral contraceptive therapy and reversal with folic acid. JAMA 1973; 226: 1421-1424

37. Shojania AM. Oral contraceptives: effect of folate and vitamin B12 metabolism. Can Med Assoc J 1982; 126: 244-247

38. Shere, Mahvash, et al. “Association between use of oral contraceptives and folate status: a systematic review and meta-analysis.” Journal of Obstetrics and Gynaecology Canada 37: 430-438.

39. Castano PM, Aydemir A, Sampson-Landers C, Lynen R. The folate status of reproductive-aged women in a randomised trial of a folate-fortified oral contraceptive: dietary and blood assessments. Public health nutrition. 2014 Jun;17(6):1375-83.

40. Fruzzetti, F. Beyaz P An oral contraceptive fortified with folate Women’s Health1 (Jan 2012): 13-9.

41. Butterworth CE, Hatch KD, Gore H, et al. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr 1982; 35:73-82.

42. Check WA. Folate for oral contraceptive users may reduce cervical cancer risk. J Am Med Assoc 1980; 244:633-4.

43. Wilson SM, Bivins BN, Russell KA, Bailey LB. Oral Contraceptive Use: Impact on Folate, Vitamin B(6), and Vitamin B(1)(2) Status. Nutr Rev. 2011; 69:572-83.

44. Mooij PN, Thomas CM, Doesburg WH, Eskes TK. Multivitamin supplementation in oral contraceptive users. Contraception 1991; 44:277-88.

45. Lussana F, Zighetti Ml, Bucciarelli P, Cugno M, Cattane M. Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users. Thromb Res 2003; 112: 37-41.

46. Shojania AM. Oral contraceptives: effect of folate and vitamin B12 metabolism. Can Med Assoc J 1982; 126: 244-247

47. Wertalik L, Metz E, Lobuglio A, Balcerzak S. Decreased Serum B 12 Levels With Oral Contraceptive Jama 1972; 221: 1371-1374.

48. Sutterlin M, Bussen S, Rieger L, Dietl J, Steck T. Serum Folate And Vitamin B12 Levels In Women Using Modern Oral Contraceptives (Oc) Containing 20 Microg Ethinyl Estradiol. Eur J Obstet Gynecol Reprod Biol 2003; 107: 57-61.

49. Riedel B, Bjorke Monsen A, Ueland P, Schneede J. Effects Of Oral Contraceptives And Hormone Replacement Therapy On Markers Of Cobalamin Status. Clin Chem 2005; 51: 778-781.

50. Shojania Am, Wylie B. The Effect Of Oral Contraceptives On Vitamin B12 Metabolism. Am J Obstet Gynecol 1979; 135: 129-134.

51. Veninga K S. Effects Of Oral Contraceptives On Vitamins B6, B12, C, And Folacin. J Nurse Midwifery 1984; 29: 386-390.

52. Hielt K, Brynskov J, Hippe E, et al. Oral contraceptives and the cobalamin (vitamin B12) metabolism. Acta Obstet Gynecol Scand 1985; 64:59-63.

53. Adams MJ Jr, Khoury MJ, Scanlon KS, Stevenson RE, Knight GJ, Haddow JE et al. Elevated Midtrimester Serum Methylmalonic Acid Levels as a Risk Factor for Neural Tube Defects. Teratology. 1995; 51:311-7.

54. Dante G et al. Vitamin and mineral needs during the oral contraceptive therapy: a systematic review. Int J Reprod Contracept Obstet Gynecol. 2014 Mar;3(1):1-10

55. Basnayake S, de Silva SV, Miller PC, Rogers S. A Trial of Daily Vitamin Supplementation as a Means of Reducing Oral Contraceptive Side Effects and Discontinuation in Sri Lanka. Contraception. 1983; 27:465-72

56. Aftergood L, Alfin-Slater R B. Oral contraceptivealpha- tocopherol interrelationships. Lipids 1974; 9: 91-96.

57. Akinsanya M, Adeniyi T, Ajayi G, Oyedele M. Effects of vitamin E and folic acid on some antioxidant enzymes activities of female Wistar rats administered combined oral contraceptives. African J Biochem Res 2010; 4: 238-242.

58. Brigg M. Letter: vitamin E status and oral contraceptives. Am J Clin Nutr 1975; 28: 436.

59. Renaud S, Ciavatti M, Perrot L, Berthezene F, Dargent D, Condamin P. Influence of vitamin E administration on platelet functions in hormonal contraceptive users. Contraception 1987; 36: 347-358.

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