Dr. Sara Gottfried is a Harvard-trained OB-GYN who runs The Gottfried Center in the San Francisco Bay Area. Dr. Gottfried specializes in female hormone balance including developing thyroid optimal function. This is latest in a series of interviews with Dr. Gottfried on various wellness concerns specific to women. In this article she shares her advice on women and thyroid health which affects vitality, libido, and overall energy levels.
1. What is the connection between thyroid dysfunction and low energy, libido, fatigue, etc?
If your thyroid is not working properly, you’ll feel it. Maybe you’re sluggish or stressed out. Most women notice low energy and weight gain because their metabolism is slower. Other women have hair loss or lose their libido. Today I was on a call with Baywatch actress Gena Lee Nolin, who asked, “Dr. Sara – what is sex?” She was joking that her problems with her thyroid turned her husband into a martyr, but seriously, life at age 35-55 shouldn’t be so hard. Between 10 and 20 million women in the US with thyroid problems are undiagnosed – don’t be one of these statistics. Get tested.
2. How does the thyroid begin to stop functioning properly?
There are many reasons for why the thyroid gets wonky. The most common reason in the US is Hashimoto’s thyroiditis, which is an autoimmune condition where your body attacks the thyroid via your immune system. Grave’s Disease is another common autoimmune condition of the thyroid. Here’s the scary part: Autoimmune conditions have been dramatically increasing in recent years. More than 50 million Americans have an autoimmune condition and we don’t understand fully the root causes. One possibility is nutrition and food allergies; another is the environment. For instance, Bis-Phenol A and flame retardants are both proven to disrupt the thyroid and most of us are exposed to these endocrine disruptors daily. Another common reason for the thyroid to hit the skids is stress. While we don’t have great data on this, we know that both high and low stress hormones, particularly cortisol, can cause you to make less active thyroid hormone, or T3. Finally, low vitamin D is an epidemic in the US – and this keeps your thyroid hormone from doing its job in the nucleus of your cells.
3. Describe the disruption of a hypothyroid state and a woman’s hormones?
The vast majority of people with hypothyroidism are women, so it makes sense that the main female hormones of estrogen and progesterone have a lot to do with thyroid problems. In fact, there’s a bit of a sea-saw effect with women’s hormones: When estrogen is high, thyroid function tends to be low, and vice versa. Fluctuations in estrogen also impact autoimmune conditions such as Hashimoto’s — women have the wildest fluctuations at two times in their lives: right after giving birth and again at perimenopause, and these are the most common times for autoimmune thyroiditis flare ups.
4. What are the particular disruptions that hyperthyroidism causes women?
When your immune system attacks your thyroid, too much thyroid hormone can enter the blood and make you feel anxious, irritable and make it tough to sleep. If you have any of these symptoms, you can ask your doctor for a blood test to check not just your TSH (Thyroid Stimulating Hormone), but also your antibody levels (Thyroid Peroxidase Antibodies and Anti-Thyroglobulin).
5. Do you have any recommendations on the use of progesterone cream?
Over the past 10 years, I’ve taken care of 10,000 women and estrogen dominance is one of the most common problems I see. Starting around age 35-40, your ovary just doesn’t make as much progesterone to balance your estrogen, and this shows up at Premenstrual Syndrome (PMS), depression, weight gain, and sometimes endometriosis and fibroids. Progesterone cream helps to settle the balance. I like most of Dr. John Lee’s suggestions on progesterone cream, although I disagree with his rather long list of proven benefits. I encourage women to try progesterone cream if they have these symptoms. You can get progesterone cream online or at your local health-food store, and follow the directions on the tube. It’s over-the-counter, so the FDA does not believe it is risky for you to try this. I suggest starting at half dose and see if that helps your system over one cycle (or 28-30 days). If you don’t notice a difference, try a higher dose but don’t exceed what’s on the tube. Sometimes it can take a full 3 months to see a benefit.
6. Tell me about the easy and effective changes women can make to restart their vitality in the wake of thyroid problems?
With women in my integrative medicine practice, we customize a protocol to get you feeling like a thyroid superhero. I’m now offering those details in an online course called Mission Ignition Secrets of a Harvard Gynecologist on How to Double Libido and Vitality. Link here for more info: http://www.saragottfriedmd.com/mission. Over the next 3 days I have a special offer that you can see on the page.
There’s not a quick fix here, but I highly recommend getting your free T3 and reverse T3 measured as most doctor don’t check them and I find the ratio to be extremely helpful at getting your thyroid optimized. I also recommend getting your stress hormones under control, and eating the right foods are key – limit goitrogens such as kale and spinach, limit sugar, and make sure you get enough protein. Eat anti-inflammatory. Get an oil change – I like for my patients with thyroid problems to use coconut oil for cooking.
7. What is involved in a thyroid restart program?
I have another Mission Ignition Series in January, 2012 that is designed to reset your thyroid in 30 days, and uses targeted nutrition, nutraceuticals such as selenium and copper, botanicals and Ayurvedic therapies along with bioidentical thyroid hormones. There’s more info coming soon on my website at http://www.saragottfriedmd.com/missionignition
8. Can certain yoga poses stimulate a low thyroid?
Yogis believe that certain poses, where you clamp your chin toward your chest and “squeeze” the old, stagnant blood out of your thyroid gland is good for all of us, not just those with a low thyroid. I haven’t seen randomized trials to prove it but if you have correct form, you are unlike to hurt yourself. The best pose is shoulder stand, but I highly recommend doing shoulder stand only with the instruction of an experienced yoga teacher because it’s a lot of pressure – your entire body weight- on the tiny vertebra of your neck.
9. What is your position on adding Cytomel to improve energy and libido for a woman?
I’m a big fan of Cytomel in a woman with low free T3, the active thyroid hormone. Cytomel definitely helps with energy in most women but I haven’t seen data showing that it improves energy levels. Recently, psychiatrists are prescribing it more in women with depression which I think is great. However, some women feel anxious on it, so you need to advance “low and slow” when it comes to Cytomel.
10. Are there top 5 tips you advocate to manage menopause and its impact on overall energy levels?
Sure, I’d love to!
- First, thyroid and low libido are more prevalent as you age, so watch your numbers as closely as your 401K. Track TSH, free T3, reverse T3, cortisol and estrogen.
- Second, how are you handling stress, really? Do you have a good program in place or does it deserve revisiting? Yoga and meditation are very helpful to vitality and have been shown to reduce hot flashes by 46%.
- Third, maca – as a capsule or tincture – is an herb proven to help increase libido, and reduce anxiety and depression.
- Fourth, fight the slow slide into low libido. What are your issues? Dry vagina? Angry at your husband or partner? The sooner you address these issues, the faster you’ll get back to your baseline.
- Fifth, join my ecourse. I struggled personally with low libido myself, and consolidated 5 years of self-experiment, research and 23 years of clinical practice into an info-packed 30 days for you beginning October 25. Here’s the link: http://www.saragottfriedmd.com/mission/