June 5, 2013

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:

  • Fatigue
  • Weight gain
  • Hair loss on the scalp or eyebrow
  • High Cholesterol
  • Infertility
  • Brain Fog
  • Depression
  • Constipation
  • Joint and muscle pain

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. 

  • This surge of progesterone causes an uptick in the activity of TPO so that you make more T4 and T3.
  • This is why a woman has an increase in her body temperature when she ovulates because there’s a surge of progesterone.
  • That progesterone affects TPO in the thyroid gland, and that ultimately increases her metabolic rate and the temperature increases.

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:

  • irregular menstrual cycles and periods
  • menstrual cramping.  water retention before your period begins.
  • heavy menstrual bleeding
  • migraines in the second half of the menstrual cycle
  • early miscarriage
  • infertility
  • depression.
  • breast tenderness

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.

  • Low thyroid hormones (hypothyroidism) is a known cause of Infertility, miscarriage and depression. 
  • Low Progesterone is a known cause of Infertility, miscarriage and depression.

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.

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© 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.

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