If you came to me for help with irregular periods, I would think very carefully about your thyroid.
It wouldn’t matter if you already had another diagnosis such as PCOS or hypothalamic amenorrhea. It wouldn’t matter if your doctor had vaguely said at some point that your blood test was normal. I would still think about thyroid. Why? Because underactive thyroid (hypothyroidism) is a common reason for irregular periods.
4 ways underactive thyroid causes irregular periods:
1. It elevates prolactin, which suppresses ovulation.
2. It impairs insulin sensitivity, which increases your risk of PCOS. (See 4 Types of PCOS.)
3. It impedes the detoxification of estrogen and testosterone, which increases your risk of PCOS.
4. It robs your ovaries of the cellular energy they need to ovulate.
⚠ Tip: Cellular energy (ATP) is the energy your cells use to do everything. It’s made by tiny organelles called mitochondria and requires thyroid hormone.
Cellular energy, mitochondria, and thyroid hormone are critically important for ovaries. Why? Because ovaries have a big, big job to do. As we saw in Ode to Ovulation, they have to work hard to bring a healthy follicle (egg) all the 100 days to ovulation. Then they must still have enough energy to grow an amazing 4 cm gland called the corpus luteum, which is how you make progesterone.)
All of that requires energy. Lots and lots of energy. All of that requires thyroid hormone.
Your doctor may have missed a thyroid problem
Your doctor may not have tested for thyroid at all. Or maybe she did test, but only with a blood test called TSH or thyroid stimulating hormone, which not a great test.
Under current guidelines, your doctor cannot diagnose underactive thyroid until your TSH is greater than 4.5 or 5 mIU/L. Yet more than 15 years ago, the American National Academy of Clinical Biochemistry said that underactive thyroid should be diagnosed when TSH is greater than 2.5 mIU/L. This is one of the reasons that borderline thyroid issues continue to be underdiagnosed, having serious repercussions on women’s health.
⚠ Tip: A TSH of less than 2.5 is associated with better outcomes for fertility and pregnancy, and better outcomes for periods.
Ask your doctor to take a second look at your thyroid. For example, ask her to consider your thyroid symptoms such as fatigue, dry skin, depression, hair loss, and elevated cholesterol. Ask her to consider your family history. If you have a direct family member (mother or sister) with thyroid disease, then you may require further investigation. Finally, ask her to test for thyroid antibodies (also called anti-TPO antibodies), which are an important marker of thyroid disease.
Natural treatment for thyroid
- Eliminate wheat gluten from your diet to reduce thyroid autoimmunity.
- Supplement selenium to reduce autoimmunity. A safe dose is 100-150 mcg per day.
- Maintain healthy intestinal bacteria to reduce autoimmunity.
- Supplement iodine to protect your thyroid from toxins such as mercury, perchlorate, plastics, and pesticides. A dose of 500 mcg (0.5 mg) is usually safe but high doses of 5 mg or more can be harmful. Please see my iodine post for more information.
- Supplement magnesium to aid with the production of thyroid hormone
- Take the herbal medicine Ashwagandha (Withania) to aid with the production of thyroid hormone.
- Consider taking thyroid hormone. It’s not always necessary, but it can be helpful. I consider thyroid hormone a natural treatment. You can choose standard T4 medication (thyroxine), or a combination T4 + T3 prescription such as desiccated thyroid.
Yours in health,