Dr. David Clark, DC- Center for Low Thyroid Solutions Raleigh-Durham-Chapel Hill, NC – explains how low levels of progesterone can cause low thyroid symptoms.
Hidden Cause #11 why you still have low thyroid symptom–even though you’re taking medication and even though your lab tests are “normal”– is:
A progesterone deficiency causing depression of the enzyme thyroid peroxidase (TPO).
Thyroid Peroxidase is an enzyme in your thyroid gland; and it’s one of the enzymes you use to manufacture T4 and T3. So, if you don’t have good activity of this enzyme, then over time you’re just not going make enough T4 and T3. At some point, you’ll start suffering low thyroid symptoms such as:
How does progesterone play into this scenario? Well, normally, progesterone up-regulates TPO function.
Here’s what normally happens ( a bit of physiology, here):
In the second half of the menstrual cycle, when she ovulates, there’s s surge of progesterone.
What happens when you don’t have enough progesterone?
Well, when you don’t have enough progesterone, it’s pretty simple…TPO activity goes down and therefore, the amount of T4 and T3 you make goes down.
Here’s the key thing I want you to know about all this:
When a woman doesn’t have enough progesterone, she can have symptoms related to that progesterone deficiency (I’ll explain them in a second)–BUT, the progesterone deficiency may never cause the thyroid lab numbers to look “abnormal.”
This is why a lot of times a women will go to her doctor and be suffeirng low thyroid symptoms such as depression, hair loss, weight gain, high cholesterol, infertility, constipation, brain fog…
The doctor will run some kind of thyroid blood tests (usually woefully insufficient such as only a TSH and T4). The doctor says, “Looks pretty normal to me.” And if you have Low progesterone as your hidden cause for your low thyroid symptoms…there’s not much the tests could pick up on lab work. Why?
Because when a woman is not making sufficient progesterone for her needs, it may not necessarily be reflected in an abnormal T4 or T3 or TSH that’s below or above the lab range on blood work.
That’s why low progesterone is definitely a hidden cause because the doctor that you’re working with has to be able to recognize that you’ve got progesterone symptoms AND low thyroid symptoms.
What are the typical low progesterone symptoms?
Many of these have to do with the menstrual cycle and getting pregnant so here they go:
If you have three or four of these symptoms…AND… and you’ve also got low thyroid symptoms, then low progesterone affeccting thyroid peroxidase in your thyroid gland could be a HUGE factor for you.
What do you do about this progesterone-thyroid problem?
The most common cause that I see for low progesterone is a depressed level of luteinizing hormone (LH) in the brain caused by a stress response or a blood sugar problem.
If you want to boil it down, you can have low thyroid symptoms and low progesterone symptoms that are ultimately being caused by unstable blood sugar levels. Blood sugar levels should be very stead…NOT up and down…peaks and valleys.
That’s a little bit beyond what we want to talk about today, but here’s the takeaway:
Whomever you’re working with…an MD, DC, ND, LAc…whomever… that person needs to be able to recognize if you’ve got low progesterone symptoms AND low thyroid symptoms.
What makes this more complex and difficult for many doctors is the fact that some of these symptoms overlap.
Your doctor must able to ask the right questions…do the right detective work and determine if Low Progestorone is a hidden factor your symptoms.
What do you about low progesterone? What’s the next step?
I’m not a big fan of people taking hormones unless, of course, they absolutely need them. And I’ve got to tell you that most women that I’ve seen they didn’t need to actually take progesterone in a prescription, nor progesterone in a supplement. What they needed to do was work on fixing their blood sugar—and that’s a whole other topic for another day.
If you have progesterone deficiency…or just low, non-optimal levels of progesterone causing a down-regulation of thyroid peroxidase (TPO)…this can cause low levels of thyroid hormones.
So you need to find someone that understands this relationship and knows how to look for both low progesterone AND low thyroid at the same time.
© 2013 David Clark. All Rights Reserved.Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.
Dr. David Clark, DC – Center for Low Thyroid Solutions Durham, NC – educates women with low thyroid on the potential dangers of iodine supplements.
Are iodine supplements safe for low thyroid? Listen very closely to what I’m about to tell you.
Iodine is important for thyroid hormone metabolism. You must have iodine to make T4 and T3. T4 (inactive) is converted into T3, the active form of thyroid hormone.
There is one….ONE kind of hypothyroidism in which iodine works very well…
…and that’s called Primary Hypothyroidism. (There are about 24 different ways that thyroid hormone chemistry can go wrong).
In Primary Hypothyroidism, the thyroid gland is not excreting and not manufacturing sufficient T4. This is the type of hypothyroidism that responds very well to drugs such as Synthroid®, Levothyroxine®, and Armour®.
But—Primary Hypothyroidism not the most common cause of hypothyroid. The most common cause of hypothyroid in America (and the world), is called Hashimoto’s Autoimmune Thyroiditis.
In Hashimoto’s, your immune system is attacking and trying to kill your thyroid gland. Specifically, your immune system targets:
1. Thyroid Peroxidase (TPO) -an enzyme used to make T4 and T3.
2. Thyroglobulin (TGB) -a protein used to make T4 and T3.
Here’s where we talk about two issues with Iodine…
Issue #1 with Iodine:
Iodine stimulates the manufacture of TPO inside the thyroid gland. If you are already attacking TPO (have Hashimoto’s) then increasing levels of TPO is like throwing wood on the fire.
Issue #2 with Iodine:
If you don’t have Hashimoto’s, taking Iodine can cause Hashimoto’s autoimmune thyroiditis. Iodine triggers Hashimoto’s. This is without a doubt, there’s no question. There’s a ton of research studies on this topic that prove that iodine is a trigger for Hashimoto’s.
How do they know? In many countries around the world they’ve given people prophylactic iodine, meaning, “Hey, we think our citizens in this area don’t have enough iodine in their blood. Their TSH levels look weird, they have goiters. Let’s give them all iodine and correct that.”
In almost 100% of the cases, when they give iodine, they also cause Hashimoto’s in all of those people.
That is a horrible thing to do to someone because once you have one autoimmune attack, the chances are you’re going get another one. In Hashimoto’s, the autoimmune attack can move very quickly into the parietal cells of the stomach, casing pernicious anemia….into the pancreas causing blood sugar problem…and intp the cerebellum, causing dizziness, vertigo, balance problems.
So please read this next part very closely…
There’s thousands of people on Yahoo! Groups and chat groups saying, “I’ve treated my hypothyroidism with iodine, therefore iodine is good for low thyroid symptoms.”
No, Iodine is not. You must to get tested first to make sure you do not have Hashimoto’s. A very simple test to do. You get what’s called a TPO antibody test and you get a TGB antibody test.
If either one or both of those antibody tests come back positive, DO NOT TAKE IODINE. It’s very simple.
When a person has Hashimoto’s and they take iodine, their symptoms get worse. I’ve lost count how many times I’ve read this in a patient’s history.
I get called a murderer and all kinds of whacko things when I talk about iodine, but it’s true.
I’m not telling you that iodine doesn’t work on some people because clearly, it does. It works on those people that have Primary Hypothyroidism, but that’s not the most common kind of Hypothyroidism.
Do yourself a favor and be safe. If you’ve got classic low thyroid symptoms like
Don’t try to supplement yourself, which is the same as medicating yourself. Find someone that understands these things I’m talking about. Find someone who understands a functional perspective, a functional way of looking at hypothyroidism. Hopefully will be a good detective and will find out what is actually causing those low thyroid symptoms (because maybe they’re not even low thyroid symptoms. They might be adrenal gland symptoms or brain symptoms.)
That person is going to have to do some tests. There’s over 24 different ways your thyroid hormones can go wrong and iodine only really helps one of those Yes, probably 20 of those are fairly rare, but the most common is Hashimoto’s.
In the scientific journals Iodine + Hashimoto’s has been called “an explosive mix”.
I’ve seen too many people get into trouble over the last four years trying to self supplement and using iodine. Women come in and I find out they’ve taken iodine and felt awfula and smartly stopped it. Or, worse they’ve never really recovered from it.
This is serious business were talking about here. You can make yourself worse.
Iodine is not safe for low thyroid symptoms until you find out if you’ve got Hashimoto’s or not…and it might not even be safe then because iodine can trigger Hashimoto’s.
© 2012 David Clark.
Dr. David Clark, DC – Center for Low Thyroid Solutions Durham, NC -explains the 3 surprising reasons why your doctor isn’t doing anything for the autoimmune part of Hashimoto’s.
Every day I get asked the question, “Why isn’t my doctor doing anything about the autoimmune part of my low thyroid problem?” There are three reasons why your doctor isn’t doing anything about it…
1. Your doctor may not know that you have autoimmune problem. If they have not tested you for Hashimoto’s, then they don’t know you have an autoimmune thyroid problem.
2. What you have to understand is if that even if your doctors knows for sure that you’ve got Hashimoto’s autoimmune hypothyroidism— the only treatment your doctor has for you replacement thyroid hormones. They don’t have any other tool to offer you.
3. The more sinister reason–your doctor doesn’t really understand Hashimoto’s in the first place. They haven’t read an scientific article about Hashimoto’s in years. They’re out of touch with current science. (The current record for admitted out-of-touchness by my patients former doctors is TEN years.)
I see a lot of people in my practice that have Hashimoto’s, which is an autoimmune attack on the thyroid gland. And most of these people have already been taking thyroid hormones for a year or two years or three years, but they still feel bad.
They still have:
The reason why they still have theses low thyroid symptoms?
When you have Hashimoto’s and all you do is give the person replacement thyroid hormones like Synthroid®, Levoxyl® or Armour® — it does very little for what’s actually happening in Hashimoto’s.
In Hashimoto’s your immune system is destroying your thyroid gland. The replacement hormones don’t stop that.
It’s the same as if I were to come home and my house is on fire, but the firefighters give me a key to a hotel room…but NEVER try to put out the fire. What are we going to do to put out the fire? Ignore it. Let it burn and hope everything works out OK?
To me, that’s asinine. I’m shocked that more physicians aren’t trying to do something more.
You can’t tell me that all these doctors don’t know something’s not working when their patients are coming back every six months saying, “I still feel awful.” I mean what are the doctors doing? In their mind, what are they thinking?
Well, I’ll tell you what they might be thinking.
I’ve come to the conclusion that a lot of the doctors that treat these women suffering with Hashimoto’s think that you go home and eat ice cream & bonbons while sipping a milkshake. And that’s why you’re still gaining weight.
Seriously, I think that’s what some of them think. But I don’t understand why they don’t try to do something about it.
If your the doctor, I just don’t understand how someone can show up to your office and say, “I still feel bad.”
And you say, “Well, time to give you more of the same thing I already gave you that didn’t work.”
That just doesn’t make any sense to me. But that’s what a lot of these doctors are doing; and I think it’s because they don’t understand Hashimoto’s. They don’t understand that it’s an autoimmune condition.
A lot of doctors have stopped reading. When they got their diploma and they got their degree, they stopped reading medical journals. They certainly stopped reading about anything that has to do with natural management or non-drug methods. They’re not reading any of that.
It just saddens me.
I see hundreds of these people – thousands of these people that are taking thyroid medication just like they’re supposed to. Their labs are normal, but they still have low thyroid symptoms while they’re taking that medication. And it’s because the medication not helping their underlying problem.
Many times, when I’m here in my office talking to people, I get really angry at what doctors are telling people….
“That can’t have anything to do with it,”
“Gluten can’t have anything to do with your Hashimoto. There’s nothing you can do for this, you just have to live with it.”
Trash that doctors spit out as a defense mechanism. But they’re really not getting you better in the process.
And that’s why your doctor’s not doing anything about the autoimmune part of your thyroid problem. They either
A. Don’t know you’ve got it, so then you’ve got to get tested for it.
B. Even if you did get tested for it, they’re the hammer and you’re the nail.
They only have one tool and their hammer is thyroid replacement hormones. Most of them don’t have any training in what to do with autoimmunity. They have no idea about what modulates it, what makes it better. And they’re terrified, terrified that they’re ignorance is going to be exposed. Most of these people are just terrified that you’re gonna ask them some question that they don’t know the answer to, which is why they say, “Oh, you can’t do that.” They’re gonna poo-poo things they don’t understand.
If you’ve found a doctor that can tell you, “Look, I don’t know about that, It’s not my field.” That I can accept. It’s the doctors that act like they do know what they’re talking about but really have no basis for their opinion… that infuriates me.
There is help. You have to find a doctor who understands all these things I’m just telling you.
Someone who understands and has been trained on how to functionally deal with this autoimmune problem and get it calmed down and get your immune system under control.
If you don’t get the right help, that autoimmune problem can expand into more tissues, more organs, and cause more problems that are ten times worse than the awful thyroid symptoms you’re suffering right now.
©2012 David Clark.
I’m going explain why iodine supplementation is still a bad idea if you have low thyroid symptoms.
After a few years of salt iodination, the government assessed the results and were unhappy. They passed a rule to increase the amount of iodine put in the salt–a mandatory increase in iodine.
Well, some sharp researchers though..
“Let’s see if there’s a relationship between iodine and antibody production against the thyroid.”
To put it another way:
Does iodine cause Hashimoto’s Thyroiditis?
So let me back up and explain that.
For years, well-established, credible scientific data have shown that when you give people supplemental iodine —and this may be in a frankly iodine deficient area—you cause an autoimmune attack against the thyroid.
TPO antibodies and thyroglobulin antibodies are how you determine if there is an autoimmune attack on the thyroid gland.
The researchers from Denmark ran these exact tests in their quest to determine if iodine caused an autoimmune attack on the thyroid gland.
Here’s the citation so you so you can take a look at it.
Clinical Endocrinology (2011) 75, 120–126
(You would be shocked at the hate mail I get when I talk about iodine and it’s possible negative effects. It’s clear by their comments that they are either not actually reading, or they simply dont’ understand my point.)
This is my point about iodine, low thyroid symptoms and Hashimoto’s…
if you have low thyroid symptoms, you need to find out if you have Hashimoto’s or not. Because if you have Hashimoto’s, taking iodine is like taking toxic waste.
Iodine will make you worse.
Let me tell you a quick real life story about iodine…
Recently I had a patient, Kim. She’s 36 years old and she had been taking iodine for seven years – for seven years—because some well-meaning but totally wrong alternative practitioner told her to take iodine for her low thyroid symptoms.
Quick Review of Low Thyroid Symptoms
Turns out, that in all these years of suffering low thyroid symptoms…and after all these years of seeing doctor after doctor… Kim had never been tested for Hashimoto’s.
For seven years Kim has felt bad. In the last year and a half she’s got worse and worse. Her hair’s been falling out, she’s gaining weight.
And all I did was say, “You know what? Why don’t we just find out for sure if you’ve got Hashimoto’s? Let’s find out if you’ve got these antibodies.”
Sure as heck, she’s got them. It explains why she feels so bad.
Iodine is a huge risk factor for Hashimoto’s.
In Denmark, where larger amounts of iodine have been put in the salt by law, the researchers discoverd a shocking increase in elevated thyroid antibodies in the youngest age group of women – 18 to 45.
Denmark passed a law that’s given a huge part of their population Hashimoto’s Autoimmune Hypothyroidism.
This might sound strange, but…
Hashimoto’s is actually the least of your worries. Why?
Because once you have one tissue under attack from your immune system–pay close attention—your entire body is now on the menu.
You can now attack your cartilage and develop rheumatoid arthritis…
…Or attack myelin and develop multiple sclerosis symptoms.
…Or attack your ovaries and develop infertility and various other polyglandular endocrine symptoms.
This is the new, real information about iodine and Hashimoto’s.
But I will probably still get flooded with hate mail or have people threatening to kill me and calling me a “murderer” because they don’t like what the research shows. This is the truth, folks.
If you’ve got lot thyroid symptoms such as hair loss, weight gain, constipation…
If you’re taking thyroid medication like Synthroid®, Armour®, Naturethroid®, Levoxyl® or Cytomel® — and you STILL feel bad…
Then, you’ve got to find somebody to do these simple, non-exotic tests for TPO antibodies and thyroglobulin antibodies.
But here’s the catch…
If the results show you do have those elevate antibodies…you have a Hashimoto’s autoimmune attack on your thyroid….
Taking replacement thyroid hormones is only one tiny piece of the solution.
You need to find someone that understands the autoimmune situation. Someone who can help you get your immune system back into balance and slow down the autoimmune process (this can be done).
So to go back where I was at the beginning….low thyroid and iodine is a bad idea.
Until you know whether you’ve got an autoimmune situation, I suggest you do NOT take iodine.
If someone is telling you to take iodine for low thyroid symptoms (no matter who they are), it’s time they read a recent article with recent information.
© 2011 Dr David Clark, DC
Dr. David Clark, DC -Center for Low Thyroid Solutions in Durham, NC-helps women suffering with low thyroid symptoms avoid the huge mistake of taking tyrosine supplements.
Low thyroid mistake number three is–taking broad spectrum immune system support.
Now you need to pay close attention. Here’s what you have to understand about this risky and potentially catastrophic mistake….
Botanicals, herbs, plants—they all effect your immune system. Some plants make your immune system go one way, some things will stimulate your immune system to go another.
So I’ll explain it like this. There are two sides to your immune system—TH1 (that stands for T Helper 1) and TH2 (T Helper 2.)
Well each of these is stimulated by different plants. Some things stimulate T Helper 1; some things stimulate T Helper 2.
Here’s why this matters and why we’re talking about low thyroid. The reason it matters in low thyroid is the number one cause of low thyroid in America is an autoimmune disease called Hashimoto’s. In this condition called Hashimoto’s, there’s an imbalance between T Helper 1 and T Helper 2– it’s skewed one way or the other (TH1 is dominant, or TH2 is dominant).
If you take an herb or supplement that makes your immune system more unbalanced, you’ll feel worse. You’ll make your autoimmune attack worse.
How could you avoid this problem?
Don’t take herbs or supplements that are supposed to boost your immune system.There’s plenty of things out there. You can look on the Internet, or go to a health food store (where the employee simply looks in a nutritional “cookbook”) and you’ll find a ton of herbs and supplements that claim to “be for low thyroid.”
Or they are supposed to “balance the immune system.” That’s bogus.
Don’t take these herbs and supplements if you have not had the proper testing to find out if you’re TH-1 is high or TH-2 is high.
When you take these supplements without the proper testing you are playing Russian roulette with a bullet in all six barrels.
Those aren’t good odds.
You may know someone or see someone in a forum or a message board someplace that says hey, I took this thing, it was an immune system product and I felt so much better. Well all that means is she got lucky. She took something that maybe, temporarily shifted her back towards a balance.
But if you take it….or another Hashimoto’s sufferer takes it….or another low thyroid patient takes it…
The results could be disastrous and I mean dis-astrous. You could trigger an attack on a NEW tissue, like cartilage, or myelin in the brain, or the cerebellum.
So instead of just having low thyroid symptoms, you could take one of these immune system products and now you end up with a condition that looks like Multiple Sclerosis. Or worse, you would never even know this was happening until the damage was severe and advanced. You could take one of these immune system support formulas that skews your immune system and it could actually cause an attack on a heart valve, it could cause an attack on the lining of your stomach and you wouldn’t even know it but it would be happening beneath the surface. ( I hope I’m driving this home to you.)
Taking broad spectrum immune support without the proper evaluation is a massive mistake.
I see this mistake in 9 out of 10 women that come into my office with low thyroid symptoms.Many of them have Hashimoto’s and they’re taking (or have taken) some of these immune system products…. or they’re taking some botanicals and the story is always the same.
These formulas never helped at all….or, the supplements “helped” for a day or two and then stopped…or the supplements made them worse. And without fail, with almost every single one of these women, when you take them off all those things, even if I did nothing else and just took them off those things, they start to stabilize and feel better.
We’ve talked about iodine, we’ve talked about tyrosine and now we’re talking about broad immune system support. You’ve got to get the right testing to find out what the heck you even need.
If you’re taking immune system support herbs or supplements without the proper testing, you are counting the days while you wait for a NEW horrible symptom to show up.
© 2010 Dr. David Clark, DC DACNB DCCN FACFN FABVR
Dr. David Clark, DC -Center for Low Thyroid Solutions in Durham, NC-helps women suffering with low thyroid symptoms avoid the huge mistake of taking tyrosine supplements.
Huge Mistake #2 Made by Women Suffering with Low Thyroid
A long time ago someone mis-interpreted some research and they concluded that tyrosine would be good for thyroid metabolism.
There’s never been a single study to show that tyrosine improves thyroid hormone metabolism.
In fact, what really happens is tyrosine gets converted into catecholamines such as epinephrine and norepinephrine and these compounds actually suppress thyroid function and worsen her symtpoms. You can look it up.
This shines a real bright light on something I was just talking about on another post..
The problem is that this realm of “alternative” medicine, in a lot of ways is not so alternative.
They have their conventional standard way of doing things that have been going on for 30 or 40 years and they’re doing it blindly…. and they’re doing it without even referencing or thinking about new scientific findings.
Tyrosine in fact doesn’t do anything good for improving thyroid metabolism.
What it does more often than not is actually suppress thyroid metabolism by converting into sympathetic nervous system chemicals, adrenaline and noradrenaline, epinephrine and norepinephrine. These will slow down thyroid function.
So here’s a common scenario… a woman starts feeling low thyroid symptoms like
And she seeks help at her local health food store or she goes to the mall, or she even sees a well-meaning alternative medicine practitioner. And that person, since they don’t understand the full spectrum of what can be causing low thyroid, suggests tyrosine–which will probably only make her symptoms worse.
Side note: Often the NON-effectiveness of tyrosine gets missed because the woman will take the tyrosine as part of a supplement with MANY ingredients, some that might actually help. So it’s a two steps forward, three steps back situation.
But because it’s kind of a tradition, the well-meaning health food store or practitioner looks in one of these books that you can get for $10 or $15. It’s like a recipe book for all sorts of ‘common” problems. (You know what I’m talking about.)
They flip it open; say oh, the person needs tyrosine and iodine. Iodine I already talked about, and they give the woman tyrosine and what usually happens is…nothing happens. Or they give her tyrosine and because tyrosine is converted into chemicals that will further squash her pituitary and thyroid…she feels worse. Yuck!
So the second mistake I see, the first one was iodine and please go back and look at that post. The second mistake is tyrosine support.
Tyrosine support should not be used with someone with low thyroid.
It just shouldn’t. There are formulas available that do not contain tyrosine–But better yet, don’t even try to supplement yourself. Find someone that understands the complex nature of thyroid hormones. And it is more complicated than iodine and tyrosine.
The thing you’ve gotta remember and I’m gonna say this a million times if you listen to me very often…
The number one cause of low thyroid in America is an autoimmune disease called Hashimoto’s.
If you have Hashimoto’s autoimmune thyroiditis, it needs to be controlled right now.
Because if you don’t get it under control, that autoimmune process is going to march through your body and find other things to kill…such as your pancreas, brain, cartilage. I think understand how these could ruin your life.
So it’s time to do your homework. If you’ve got low thyroid problems, please, don’t take tyrosine. Find a doctor that can actually do the detective work and find out what’s wrong.
© 2010 Dr. David Clark, DC DACNB DCCN FACFN FABVR