Search Articles

clear search terms

Low Thyroid Function and Estrogen Dominance

Here’s a powerful tip that will help you to support many women who seek help via a functional medicine perspective:  Be on the lookout for symptoms of low thyroid function in those who have an overload of estrogenic effects (what we commonly call “estrogen dominance”).

We talk often in our classes about the epidemic of undiagnosed hypothyroidism.  It stems from many causes…reliance on an overly broad “normal” reference range that includes many hypothyroid individuals, lack of awareness in conventional practices of the full scope of hypothyroid symptoms, and failure to run a full thyroid panel in assessing thyroid function (aka over-reliance on TSH as being accurately indicative of intracellular thyroid hormone function).  As I have shared with you before, we also have an epidemic of estrogen dominance.  And these two dynamics are more interconnected than you might imagine!

High estrogenic action often increases thyroid binding globulin (an example of a study showcasing the effect here) which prevents thyroid hormone from being able to have cellular effects.  This is one (of many) reasons why a person can have “normal” or even optimal thyroid hormone levels and still be suffering (legitimately) from low thyroid function (e.g. constipation, weight gain, fatigue, lethargy, high LDL cholesterol, GI bloating/reflux, foggy thinking).

Keep in mind that estrogen “dominance” doesn’t necessarily mean high estrogen (though it might – especially in the obese); it may also (or instead) involve imbalance with other hormones such as progesterone and testosterone.  Some clinical studies suggest that increasing progesterone when it is suboptimally low (which balances estrogen) can increase Free T4 thyroid hormone.   Other common reasons for estrogen dominance include high exposure to xenoestrogens (endocrine disrupting chemicals) or poor detoxification and clearance of estrogen, both of which may result in excessive estrogenic (and potentially carcinogenic) metabolites.  Unfortunately these types of imbalances are simply not going to show up in conventional labwork, especially typical sex hormone blood markers.  This is yet another reason why I have become such a big fan of urinary hormone metabolite testing in tandem with blood hormone testing.  Common symptoms of estrogenic overload or “dominance” include debilitating PMS, heavy/clotty periods, headache/migraine, anxiety, increased belly fat, tender breasts/fibroids, and infertility.  These patients may need help with reduced synthesis (e.g. body fat), decreased exposure to estrogenic substances (e.g. xenoestrogens), estrogen balancing (e.g. vitex to boost progesterone), estrogen clearance (e.g. methylation, sulfation, constipation), aromatase inhibition (e.g. zinc, ground flaxseed), and/or reduced receptor sensitivity (e.g. magnesium).   These are powerful areas of functional medicine interconnectedness in the body that you can learn to use in your practice with confidence!

Please be on the lookout for women who wrestle with symptoms of both estrogen dominance and low thyroid function (which includes a LOT of longsuffering women who are searching for answers and are frustrated with conventional medicine’s inability to get to the root of their struggles).   Make sure that you fully assess their actual thyroid hormones (a full panel, not just TSH); you will find that many have suboptimal Free T4 (and even*more* will have suboptimal Free T3, often due to nutrient deficiencies – if you’re new to this topic, we can teach you how to do this with confidence).   You may even uncover some chronic autoimmune thyroid dynamics (alas, this empowering Aha happens to our practitioners all the time!).  Then fully assess their sex hormone balance, detox capability, and xenoestrogen exposure.

Interconnected hormonal dis-ease is a great example of the power of functional medicine insight and support.  I hope this quick clinical tip serves you and your patients and clients!

Warmly,

 

 

 

 

 

P.S.  If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.

To receive clinical tips like this one right to your inbox, click here to receive our weekly newsletter.

Like us on Facebook to stay connected to our rich (free!) content and be notified of our popular, monthly Facebook Lives.

Subscribe
Notify of
guest
10 Comments
Inline Feedbacks
View all comments

Jane Roodenburg
Jane Roodenburg

Hi, I am new to functional medicine, but have been a practicing NP for 10 years. If your patients are complaining of fatigue, they are likely to get many of their labs covered by insurance. Since most of the people we see complain of fatigue, I almost always include that code. It is a precursor of so many bad diagnoses, that labs exploring fatigue usually get paid for. So make sure your patients tell their medical provider if they have fatigue. It may grease the wheels for getting those labs ordered!

SAFM Team

Thank you for your comment Jane, and welcome to the SAFM community!

Ann Woelfel
Ann Woelfel

I am so confused about the foods that either is bad for hypothyroidism and good for estrogen dominance. Is there a clear list of foods that are good for the combination of hypothyroidism/estrogen dominance?

SAFM Team
Reply to  Ann Woelfel

I assume that you are referring to the seemingly conflicting information that cruciferous vegetables are good support for estrogen metabolism but they are also a source of goitrogens that may negatively affect the thyroid. It is a valid concern. However, the goitrogens in various splendidly healthy whole foods can be minimized and also their effect on the thyroid will depend on the iodine status. You may appreciate this short review:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740614/
Thus, it is quite possible to adopt a low glycemic diet (very important first step in stopping the estrogen dominance) that is rich in fiber and cruciferous veggies that are prepared in a way to support the liver function in the metabolism of sex hormones AND also support the thyroid health. To take a deeper dive into this high-level interconnectedness I recommend exploring in-depth the SAFM “Adrenal and Thyroid: Myths and Truths” and the “Hormones Demystified” deep dive clinical courses:
https://schoolafm.com/clinical-courses/

Kristina
Kristina

Does estrogen dominance cause Hypothyroidism or does Hypothyroidism cause estrogen dominance? My functional practitioner had me take the DUTCH test and it showed my Progesterone very low, and my estrogen very high. BUT, she said I wasn’t producing an excess of estrogen; rather, I’m just not getting rid of the estrogen and it’s being reabsorbed. She has allowed me to go on progesterone, but didn’t give me direction on how much to use. After about 3 cycles, it has exacerbated my estrogen dominant symptoms. So I am wondering what avenue to take with my Functional Dr.?? Further treat Low Progesterone or more thyroid treatment? I have Hashi’s, but diet has almost brought my antibodies down to 0. My labs indicate my FT4 and FT3 are within range.

Juliana Natividad
Juliana Natividad

Hello, thanks for the refreshing read. I am having a hard time finding a doctor/NP/PA who will order a hormone test for me. Tried my OB as well. I am an RN and I feel like I need to get my hormone levels checked specially because my thyroid, although within normal range, is lower functioning. Is there a reason why providers don’t like to get a pts hormones checked? Any tips on getting them to order it? I’m confused and curious. Thank you.

Paula Youmell
Paula Youmell

A client just asked me about a connection between synthroid and lung cancer. Any thoughts?