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 byadjusting 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 we return to a recurrent theme in our 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 article revealing that as many 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...
Karilee & Richard Shames