Is The Pill At The Root Of Your Thyroid Problem?
Dr. Jolene Brighten, NMD, is one of the leading experts in women’s medicine and is a pioneer in her exploration of the far-reaching impact of hormonal birth control and the little known side effects that impact health in a large way. A trained nutritional biochemist and Naturopathic Physician, Dr. Brighten is the founder and Clinic Director at Rubus Health, an integrative women’s medicine clinic
"I knew something was wrong one humid June morning when the rest of the office was sweltering—our AC had gone out the night before—yet I was freezing," my 33-year-old patient Brenda told me during our initial consultation. Brenda had all the telltale hypothyroidism signs, including mental fogginess, fatigue, muscle pain, feeling cold, and unexplainable weight gain. Her former doctor had run some tests and found that, indeed, she had trouble converting the inactive thyroid hormone T4 into active T3. Rather than stay on prescription drugs, Brenda wanted to uncover why she had hypothyroidism and heal it naturally, which is why she visited me.
The birth control-thyroid connection.
As a doctor who helps women treat autoimmune disease and balance their hormones naturally, I’ve witnessed how hypothyroidism and other thyroid conditions wreak massive havoc including weight gain, depression, and heart disease. And in my practice, I’ve learned that the pill—and equally important, going off the pill and experiencing subsequent post-birth-control syndrome (PCBS)—can really mess with your hormones. And when one hormone gets out of whack, a domino effect occurs, and other imbalances result. As I frequently see among patients, birth control can take a massive toll on your thyroid, leading to hypothyroidism and other issues that affect your entire body. Because although your thyroid weighs less than an ounce, this butterfly-shaped organ affects everything from your immune system to your metabolism; an out-of-whack thyroid can affect energy levels, sex drive, and your ability to lose weight.
Brenda’s former doctor ran standardized thyroid tests, but he overlooked one common culprit: Because of excess estrogen, birth control pills can lower thyroid function and even contribute to autoimmune disease. Brenda had gone off the pill several months ago, but she still struggled with hormonal imbalances, which studies show can linger for up to a year after women stop using oral contraceptives. High-dose estrogen increases thyroxine-binding globulin (TBG), which binds thyroid hormone. So when you’ve got higher levels of circulating TGB, you’ve got less free thyroid hormone available.
Nutrient deficiencies and your thyroid.
Birth control also depletes thyroid-supporting nutrients. Your thyroid needs iodine, selenium, chromium, tyrosine, and zinc to make T4. For example, it requires selenium and zinc to convert inactive T4 into active T3. When you have insufficient amounts of any of those nutrients, your thyroid can’t function optimally.
The pill also increases inflammation. Never mind that chronic inflammation plays a role in nearly every disease on the planet. It also converts T4 into reverse T3 (RT3), a form your body can’t use that just makes you tired and stores fat like crazy. That’s why I call RT3 the hibernation hormone: You gain weight and want to sleep all the time. Over subsequent consultations I addressed Brenda’s thyroid issues by providing the right nutrients to support adrenal health, thyroid health, and post-birth control:
1. Ask for the right tests.
Many conventional doctors only look at thyroid stimulating hormone (TSH), but your TSH can read as "normal" while hypothyroidism or even autoimmunity lurk underneath. I recommend a complete thyroid panel that includes TSH, total T4, free T4, total T3, free T3, reverse T3, anti-TPO antibodies, and anti-thyroglobulin antibodies.
2. See the bigger picture.
Brenda’s thyroid problem affected nearly every system in her body, which is why I took a big-picture approach to treating it. During our consultations, we focused on things like nutrient depletion, gut health, reducing inflammation, reversing metabolic conditions, and brain health (since your brain is loaded with thyroid hormone receptor sites, which explains why low thyroid creates mental fogginess). I recommend working with an integrative practitioner for these and other issues.
3. Get a good night's sleep.
In my practice, I’ve repeatedly seen how insomnia and other sleep impediments can crash my patients’ thyroid and adrenals. Getting eight hours of solid, uninterrupted sleep every night—even though it took a few months to happen—played a dramatic role in healing Brenda’s hypothyroidism.
4. Focus on the right foods.
Grass-fed meats, wild-caught seafood, leafy greens, mushrooms, and other nutrient-loaded foods help you replenish nutrients the pill depletes. Make every meal a colorful array of nutrient-dense, low-sugar plant foods along with quality protein and healthy fats.
5. Get optimal nutrients.
While eating a nutrient-dense diet is essential in keeping your thyroid functioning, I find many women in my practice require supplementation to regain thyroid function and eliminate symptoms like fatigue, brain fog, weight gain, and period-related symptoms. For Brenda, I initially recommended a professional-quality multivitamin along with anti-inflammatory fish oil plus extra vitamin D and magnesium.
6. Get moving.
Exercise helps lower inflammation and supports the conversion of T4 to T3. Because she often felt sluggish, Brenda had long been inactive. To start I asked her to walk a total of 30 minutes every day, and eventually she was able to incorporate high-intensity interval training (HIIT) and yoga.
7. Love your liver.
The pill can directly affect liver function, which detoxifies metabolic waste, environmental toxins, and hormones. Among its workhorse duties, your liver converts most of your inactive T4 to active T3, which is why liver support becomes crucial whether you’re on or off the pill. I asked Brenda to lay off alcohol for three weeks (just three weeks!), and eventually we did a professionally supervised detoxification plan.
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