Why are so many Thyroid and Menopause symptoms the same?

Hi everyone, Dr. Dana Gibbs here!

Today, we'll delve into a topic relevant to many women: the potential link between Hashimoto's thyroiditis and menopause. Both conditions can significantly impact a woman's health, and their symptoms overlap in many ways, causing confusion. Let's break down what each one is and how they might interact.

Hashimoto's disease

This common condition is present, and frequently undiagnosed, in 10-15% of the US population. In Hashimoto's thyroiditis, your own immune system attacks the thyroid gland and disrupts the production of thyroid hormones, which is vital for regulating metabolism, energy levels, and overall body function. Think of it this way, imagine your thyroid as the main engine of your body, and the one  responsible for controlling your body’s energy output. In Hashimoto's, the engine sputters, leading to symptoms like fatigue, weight gain, and feeling down. You can read more about this disease on this blog post: What is Hashimoto's Disease?

Menopause: The Hormonal Shift

Perimenopause and menopause, the natural cessation of menstruation, is eventually experienced by every woman as she gets older. It is accompanied by fluctuations and then a profound decline in estrogen and progesterone production. These sex hormones influence many body processes, including metabolism and mood. Symptoms of menopause can be similar to hypothyroidism, such as fatigue, weight changes, mood swings and depression, hair and skin changes. More recently it has been rediscovered that estrogen loss without hormone replenishment is a huge driver of bone loss, muscle mass, heart and vascular disease, and dementia. If you are interested to learn more on how hormones affect your overall health, you can read my blogs regarding menopause and other effects of hormone imbalances. 

The Overlapping Signs and Symptoms

Because both Hashimoto's and menopause can cause similar symptoms, it can be tricky to tell them apart. They can also frequently coexist, one exacerbating the other.  Here's what they share:

• Fatigue: Feeling drained? Due to the underproduction of thyroid hormones, both conditions can make you feel exhausted and low on energy. Menopause can also lead to fatigue due to changes in sleep patterns and hormonal fluctuations.
• Weight Woes: Changes in metabolism due to hormonal fluctuations can contribute to weight gain in both scenarios. Hashimoto's, a slowed metabolism due to low active thyroid hormone levels can make it harder to burn calories. Menopause can also lead to changes in body composition, with increased fat storage around the abdomen, because loss of estrogen increases Insulin Resistance.
• Mood Swings: Feeling irritable, anxious, or down can be symptoms of both Hashimoto's and menopause. In Hashimoto's, these mood changes may be linked to hormonal imbalances and the body's inflammatory response. Menopause can cause similar mood swings due to fluctuations in estrogen and progesterone levels.
• Period Problems: Irregular periods are a hallmark of menopause, but thyroid dysfunction can also disrupt your menstrual cycle. Thyroid dysfunction can disrupt the delicate hormonal balance needed for regular ovulation and menstruation, and lead not only to infertility, but also recurring miscarriages.
• Joint pain: While more common in menopause, some women with low thyroid function may also experience joint pain and stiffness. The exact reason for joint pain in Hashimoto's is not fully understood, but it may be linked to inflammation or autoimmune processes.

How They Might Interact

Inadequate levels of Thyroid hormones affect the ovaries directly, and indirectly by interacting with sex hormone-binding globulin. An underactive thyroid gland (hypothyroidism) can cause missed ovulations, heavy menstrual bleeding, increased frequency of periods, longer bleeding, more PMS symptoms, missed periods. People with untreated hypothyroidism may also have trouble conceiving and are more likely to experience miscarriage and pregnancy complications.

Researchers are still exploring the exact way Hashimoto's and menopause interact, but some interesting possibilities exist:

• Estrogen's Influence on the Thyroid: The thyroid gland has receptors for estrogen. Studies suggest declining estrogen levels during menopause might affect thyroid function in women with Hashimoto's. A 2014 review by Prelevic et al. delves deeper into this potential connection. Here's the interesting part: estrogen receptors seem to influence the activity of immune cells in the thyroid gland. With less estrogen, these immune cells might become more active, potentially worsening Hashimoto's inflammation.
• Autoimmune Activity: Menopause can lead to a general rise in autoimmune activity of the body, potentially worsening Hashimoto's symptoms for some women. Arias et al. explored this concept in their 2013 study,which shows increase in general autoimmune activity might further target the thyroid gland in women with Hashimoto's.

It's important to note that these are potential interactions, and more research is needed to fully understand the complex interplay between Hashimoto's and menopause. However, being aware of this connection can empower you to advocate for your health.

Finding Health Again: Management Strategies

If you're experiencing symptoms suggestive of either Hashimoto's or menopause, it's crucial to see a doctor. Early diagnosis and appropriate treatment are key for managing both conditions effectively. These are the ways I recommend on how to approach your management:

• Thyroid Hormone Replacement Therapy: For Hashimoto's, synthetic thyroid hormone medication in the proper ratio of T3 to T4  can help regulate hormone levels and alleviate symptoms
• Hormone Replacement Therapy (HRT): For menopausal women, HRT can help manage symptoms and improve overall well-being. However, the decision for HRT can be nuanced, so discuss the options with a doctor who is up to date on the latest sexual/menopausal health research and recommendations
• Lifestyle Changes: Maintaining a healthy weight, eating a diet low in processed food, and getting regular exercise are crucial for managing both conditions.

Remember: Knowledge is Power!

By understanding the connection between Hashimoto's and menopause, you can take charge of your health. Working with your doctor, you can develop a personalized plan to manage this complex situation and regain control of your well-being.

So, there you have it! I hope this explanation helps you navigate the potential overlap between Hashimoto's and menopause. I'm Dana Gibbs MD. I'm an integrative physician in North Texas. I help people address fatigue and loss of vitality resulting from thyroid and other hormone imbalances. If you are in North Texas and you want a caring doctor to help you resolve your exhaustion, joint and muscle aches, poor sleep issues and weight gain, come sign up for a discovery call with me now.

Stay healthy everyone!