- What doctors don’t say about the birth control and thyroid connection
- The birth control and thyroid connection
- Is the pill the cause of your thyroid problems?
- Non-Hormonal Alternatives to The Pill
- How to Make the Most of Your Hypothyroidism Treatment
- Finding the Right Dose of Thyroid Medication
- Following Your Thyroid Treatment Instructions
- Watching for Interactions With Levothyroxine
- Monitoring Potential Side Effects of Thyroid Medication
- Thyroid Hormone Replacement Drugs and Birth Control Pills: A Safe Combo?
- Hormonal Contraceptives & Your Thyroid
- Two main ways hormonal birth control interferes with thyroid function.
- How Birth Control Affects Thyroid Function
- Endocrine Abstracts
What doctors don’t say about the birth control and thyroid connection
I was 17 years old. I went to my doctor about my painful, irregular, extremely heavy menstrual cycles. I was not sexually active. The answer. Birth control. No thyroid test, by the way these symptoms are typical in hypothyroidism, which would have saved me from decades of undiagnosed hypothyroidism.
Written by Jolene Brighten, ND
Worldwide, 100 million use some form of birth control…without knowing how it actually works and the possible damage it can do to their bodies. I’m talking the pill, the patch, the ring, the IUD, the depo shot, the implant, the “fill-in-the-blank”. Women are being put on birth control to manage their symptoms without any discussion of what that’s doing to their body now and what it could be doing to their body in the future.
Are you aware that most women, at some point in their life, have been recommended the birth control pill by their doctor? The CDC estimates 10.6 million women use oral contraception in the U.S. alone.
Doctors often offer up the pill in response to common complaints, such as acne, heavy menses, PMS symptoms, or irregular periods. And yes, the pill can help with all of those symptoms for some women, but this approach certainly doesn’t address the underlying cause, including in many cases thyroid disease.
What most doctors don’t share with women is that the birth control pill has its own share of side effects. Some of which are irreversible.
The birth control and thyroid connection
The birth control and thyroid connection is real! And many women have written to me questioning if the birth control pill could be sabotaging their thyroid health. The common story I hear from these women and the women in my practice is that most of their problems started when they committed to that daily pill consumption.
This has been a question on my mind too, after all I did my time with The Pill and was diagnosed as hypothyroid later in life. After I was diagnosed with Hashimoto’s hypothyroidism, I knew I had some work to do if I was going to get my health back on track and that this was definitely not the time to get pregnant. After having over a ten year relationship with birth control pills I knew I didn’t want to go back, but it did make me curious about what effects the birth control pill could have on thyroid health.
So I dug into the research and found that the pill does more than prevent pregnancy – it sabotages your thyroid health.
Is the pill the cause of your thyroid problems?
Birth control pills deplete vital nutrients your thyroid requires and can interfere with thyroid hormone on multiple levels. For example, selenium and zinc are needed to produce thyroid hormone and to convert it to its active form, T3. Zinc is also required for getting the thyroid hormone and cell receptor talking.
Just by depleting zinc alone, the pill can prevent you from making, activating and using thyroid hormones. But the pill affects more than just your minerals.
Crucial B vitamins are also depleted by the pill. Without these key vitamins, you can not synthesize thyroid hormone…not to mention the hundreds of other uses for them in the body.
So, let’s recap where these nutrient depletions are impacting your thyroid:
- Interferes with synthesis of thyroid hormone
- Interferes with conversion from T4 (inactive) to T3 (active)
- Interferes with using thyroid hormone at the cellular level
The pill affects just about every level of thyroid hormone synthesis and utilization. You make less, you convert less and you use less…this alone is enough to advise against taking the pill if you have a thyroid condition.
But there’s more…
The Pill Increases Thyroid Binding Globulin
On top of interfering every which way it can with your thyroid hormone, the pill also elevates Thyroid Binding Globulin (TBG) and as you can probably guess, it binds thyroid hormone.
Once thyroid hormone is bound to TBG it is not available for use by the cell. This means that even if you manage to overcome the nutrient depletions and make enough thyroid hormone, much of it will be bound and therefore, not available to your cells. Keep in mind, every cell in your body requires thyroid hormone.
So, in addition to depleting nutrients needed to make and use thyroid hormone — the pill also causes your body to bind up any thyroid hormone you actually manage to make.
The Pill is Inflammatory
You know what else is inflammatory? Autoimmune disease. And it is the number one cause of thyroid disease in the United States.
Why is this important? Well, there are 3 big reasons.
ONE: Inflammation is at the root of all chronic disease.
If you already have an autoimmune condition then you probably already understand that more inflammation is bad. Like, can’t get out of bed, or move, or even think bad.
TWO: Inflammation will take your T4 and convert it right into Reverse T3 (RT3).
And when RT3 is up, you are beyond tired. I call it the hibernation hormone because it is designed to make you store calories (aka fat) and go to sleep…you know, hibernate.
THREE: Inflammation makes your cells walls less responsive to ALL OF YOUR HORMONES.
This includes insulin…and we all know where insulin resistance leads to. Actually, let me tell you that it is not just diabetes, but also neurological issues and heart disease that you have to worry about.
Think inflammation as fire and the pill as gasoline.
C-Reactive Protein (CRP) is a common inflammatory marker that is measured with via a blood test. With the pill, women not only experience an elevation in the CRP (the lower the better), as well as other acute phase proteins, including fibrinogen and ceruloplasmin.
Ok, so we’ve established the pill isn’t great for thyroid health, but what choice do we have?
Non-Hormonal Alternatives to The Pill
Your choice for a contraceptive should be made after doing your research and having a conversation with your doctor. This is an individualized decision and as such, there is no one-size-fits-all answer. Talk to your doctor about non-hormonal options and ask for the pros and cons of these methods as they relate to your health and needs.
For my high-tech gals, check out Daysy Fertility Monitor. Actually, you don’t have to be high-tech at all. Daysy makes it so easy and has so much data that she can help get your cycle dialed in quickly. This is the method I use because “green light go” and “red light stop” work really well when my mind is on pregnancy prevention.
About Jolene Brighten, ND
Dr. Jolene Brighten is a licensed Functional Medicine Naturopathic Doctor and best selling author of the book Beyond the Pill. Dr. Brighten specializes in women’s health, from fertility to postpartum care, adrenal and thyroid support, autoimmune conditions, and digestive disorders. In her innovative women’s medicine clinic, Rubus Health in Portland, Oregon, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness.
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How to Make the Most of Your Hypothyroidism Treatment
For people with hypothyroidism, the most common medication is levothyroxine, a synthetic form of thyroid hormone that’s identical to the one made by your own thyroid gland. It’s an effective hypothyroidism treatment, but it’s also a very tricky one because the absorption from the gut is affected by food and other medication, and it can take weeks or even months to figure out the daily dosage that works best for you. Even then, if you don’t follow your doctor’s instructions closely and take your medication properly, you could throw your hormone levels out of whack.
Finding the Right Dose of Thyroid Medication
To determine your levothyroxine dosage, your doctor will draw your blood to test for thyroid-stimulating hormone (TSH). The pituitary, which is a part of your brain, makes TSH in response to how much thyroid hormone is in your blood. The higher your TSH level, the more starved your brain and body are for thyroid hormone — a sign that your doctor needs to increase your dose of the synthetic replacement hormone.
Unless your TSH levels are unusually high or you have a known cardiac condition, such as a rapid heartbeat or angina, your doctor typically will start you out at a low dose of about 50 micrograms a day. Because of the very long half-life of the hormone, it will take a least three to four weeks for the blood levels of thyroid hormone to stabilize. Then you’ll probably have a TSH test every four to eight weeks, and the readings from those tests will be used to determine your precise hypothyroidism treatment. Based on the test results, your doctor may increase or decrease the dose until your thyroid hormone levels stabilize.
“You’ll likely get to a steady level in around a month, and then four to six weeks is the rule of thumb to recheck your levels again,” says Stephanie Lee, MD, PhD, director of the thyroid health center in the section of endocrinology, nutrition, and diabetes at Boston Medical Center and an associate professor at the Boston University School of Medicine in Massachusetts.
If you find that your levels are not stabilizing, you and your doctor will need to discuss alternatives. Your doctor might prescribe another type of levothyroxine or see if you respond better to a combination of different thyroid hormones.
RELATED: How Is Hypothyroidism Treated? Medications and Supplements to Consider and Avoid
Following Your Thyroid Treatment Instructions
It’s very important to follow your doctor’s instructions when taking medication as part of your hypothyroidism treatment. If you don’t, your body may not be able to fully absorb the levothyroxine and your hormone levels could fluctuate.
“This hormone is potent in very small amounts, so any little change in your routine can change your hormone levels,” says Laura Pizzi, PharmD, a professor at Rutgers’ Ernesto Mario School of Pharmacy in Piscataway, New Jersey.
For the best levothyroxine absorption, Hossein Gharib, MD, a professor of endocrinology at the Mayo Clinic in Rochester, Minnesota, recommends that it be taken in a fasting state, just after you wake up. “If you can’t take it in a fasting state, they you should take it in the evening, two to three hours after your evening meal,” Dr. Gharib says.
Taking the medication on an empty stomach, and then switching to taking it with food, can influence the effect of thyroid medication on your body — as can taking your medication within two to three hours of supplements such as iron and calcium, high fiber foods, and certain medication for gastric ulcers or cholesterol. Taking your medication with coffee can also have a negative effect; always take it with at least one-half cup of water. And taking your medication at the same time each day can help you remember to be consistent.
Different brands of levothyroxine can vary in their preparations. Don’t switch brands without consulting your doctor, advises the American Thyroid Association.
RELATED: Life Hacks to Manage Hypothyroidism Symptoms
Watching for Interactions With Levothyroxine
Other drugs and some dietary supplements can interact with levothyroxine. As noted above, iron and calcium supplements can interfere with the absorption of levothyroxine. The iron or calcium can bind with the synthetic hormone, preventing your body from using it. “You’re basically snatching away some of the levothyroxine that otherwise would’ve been absorbed into the body,” Dr. Pizzi says.
The hormone estrogen also can interfere with the body’s ability to use levothyroxine. That means women taking birth control pills may need an increased dose of thyroid medication, Pizzi says. Hormonal changes caused by menopause can also affect how the body uses levothyroxine.
According to Dr. Lee, other medication and physical conditions that can change the daily requirement of levothyroxine include:
- Being elderly
- Nephrotic syndrome or protein-losing enteropathies (kidney disorders)
- 5-fluorouracil (a drug used to treat certain cancers)
- Resin-binding drugs, such as cholestyramine (for cholesterol)
- High-dose intravenous heparin and furosemide (used in hospitals)
- Dopamine agonists (also for hospital use)
RELATED: 7 Things Your Pharmacist Wants You to Know About Hypothyroidism Medication
Monitoring Potential Side Effects of Thyroid Medication
Not taking levothyroxine the right way or experiencing drug interactions can make your thyroid hormone levels swing high or low and cause side effects. Elevated hormone levels can make you feel shaky, jittery, and jumpy, Pizzi says. You might notice your heart racing or have trouble sleeping at night. You might even lose some weight.
Hormone levels that are too low can cause fatigue and sluggishness. You might experience a slow heart rate, have constipation, lose some of your hair, feel depressed, or gain weight.
RELATED: 6 Things You Can Do Today to Better Manage Your Hypothyroidism Symptoms
If you experience any of these problems, call your doctor. “Your doctor will likely ask you to come in and get your blood checked,” Pizzi says. Based on the results, he or she will probably change your thyroid medication dosage to address the side effect.
Overall, if you establish and maintain a regular routine with your hypothyroidism treatment, the condition should have little effect on your long-term health and well-being, Pizzi says.
Additional reporting by Jennifer Geddes.
Published January 29 2018
Birth control is a very important and sometimes hot-button topic today. Between legislative changes in birth control and insurance coverage from presidency to presidency, to the risks involved in medical birth control options, this is definitely a widespread topic with a lot of implications for women’s health overall. There is so much information to cover that I decided to split this up into two separate parts. Between both parts I’ll be discussing both hormonal and non-hormonal options, although in this first part I will be focusing on oral contraceptives. In part two, I will talk about IUDs and other birth control options, including what I prefer for my patients with thyroid and autoimmune thyroid conditions.
Before discussing oral contraceptives, I’d like to briefly explain what ovulation is. Ovulation involves the release of eggs from the ovaries, and it is triggered by a peak in estrogen in a woman’s body around 14 days into a woman’s cycle. This peak causes a release of luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the pituitary gland, which prompts the ovaries to release an egg.
So how does this relate to oral contraceptives? When a woman is on hormonal birth control, steady levels of estrogens and progestins trick the pituitary gland into thinking a woman is already pregnant, which stops the pituitary gland from releasing hormones that stimulate ovulation.
By the way, the reason why I’m focusing this entire first part on oral contraceptives is because in the Unites States, the birth control pill is the most commonly used contraceptive today (1), followed closely by female sterilization (i.e. tubal ligation).
Different Types of Oral Contraceptives
There are three main types of oral contraceptive pills (2):
1. Combined estrogen-progesterone. This is the most commonly prescribed combined oral contraceptive. Progesterone is the primary hormone that prevents pregnancy, while estrogen will control the menstrual bleeding, although it will also play a role in inhibiting follicular development due to its negative feedback on the anterior pituitary.
2. Progesterone only. This can be a good choice for women who can’t take estrogen (or choose not to take it). One way that progesterone can prevent pregnancy is by preventing ovulation. The negative feedback mechanism I mentioned earlier takes place in the hypothalamus, as the pulse frequency of gonadotropin releasing hormone is decreased, which in turn decreases the secretion of follicle-stimulating hormone (FSH), and also decreases the secretion of luteinizing hormone (LH).
3. The continuous or extended use pill. Oral contraceptives are classically given in a cyclic manner with 21 days of active pills followed by 7 days of placebo (3). However, other oral contraceptives are available which either shorten the placebo time, lengthen the active pills (extended cycle), or provide active pills every day (continuous) (3). Extended use contraceptive pills delay menstruation, whereas continuous use contraceptive pills eliminate menstruation. The main reason these oral contraceptives were developed was to reduce the frequency of menstruation, although just as is the case with the other two forms, the continuous or extended use pills can also help to reduce PMS symptoms.
Earlier I mentioned that progesterone can prevent pregnancy by preventing ovulation. In addition to preventing ovulation, the progesterone in birth control also causes the body to form a thick layer of cervical mucus. This makes it difficult for a sperm to reach the egg, and it also affects the uterine lining, which makes it hard for an egg to attach.
We know that birth control pills work, and now you know how they work. Let’s talk about the consequences of these synthetic estrogens and progestins. They can’t be doing anything good for anyone aside from preventing pregnancy, right? Well, that’s not necessarily true.
Other Health Benefits of Oral Contraceptives
There are plenty of women who take the pill for health reasons other than avoiding pregnancy. Here are some of the conditions that commonly result in medical doctors recommending the pill to their patients (4):
- Severe menstrual cramps/irregular cycles
- Severe acne
- Polycystic ovarian syndrome (PCOS)
- Ovarian cysts
The pill also has a benefit of decreased risk of endometrial and ovarian cancer (5). As a result, if you have a family history of endometrial or ovarian cancer, the pill might decrease your risk of developing these conditions. However, there seems to be a small increased risk of breast, cervical, and liver cancer (5). And so if you have a family history of these types of cancers, hormonal birth control might not be the best option for you.
The majority of women who take the pill for non-contraceptive purposes take it for the benefits of an improvement of acne, improving their cycle regularity, and reducing menstrual cramps. Being a functional medicine practitioner, the problem I have with this approach is that severe acne and irregular menstrual cycles are often symptoms of a bigger problem. I’m always looking for the underlying causes of conditions, so I stand to argue that the pill is merely masking the symptoms of the condition, while leaving the root causes and underlying imbalances unaddressed. So not only are patients not addressing the underlying causes of their imbalances, they are taking some risks with their health by taking the pill every day.
Risks of Oral Contraceptives
1. Increased risk of certain types of cancers. I just mentioned how oral contraceptives can cause a small increased risk of breast, cervical and liver cancer. Some may wonder if this is due to the estrogen in the combined oral contraceptives, and this does seem to be a factor. That being said, progestin-only oral contraceptives also can cause an increase in breast cancer, although the risk is higher with the combined pill (6).
2. Cardiovascular risks. There are cardiovascular risks associated with taking oral contraceptives. In fact, some of the most well known risks of the pill are the increased risk of heart attack and stroke (7) and the increased risk of blood clots (8). Once again, this isn’t to suggest that most women who take the pill will suffer from a heart attack, stroke, and/or develop blood clots, but only that it will increase the risk.
3. Nutrient deficiencies. A few studies show that oral contraceptives can result in multiple nutritional deficiencies (9) (10). Some of the key nutrient depletions involve folate, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc (9). This not can only have negative health consequences on women who take oral contraceptives, but if they discontinue the pill and then become pregnant this of course can affect the health of the baby.
4. Depression. According to the research, the most commonly stated reason for discontinuation of oral contraceptives is depression (11). A pilot study showed that women on the pill were significantly more depressed than a control group (11). It’s important to mention that this involved the combined oral contraceptive pill.
Why Did Women Start Taking The Pill?
When the pill was introduced it was seen as a form of sexual empowerment for women. The pill allowed for the reliable separation of sex and reproduction, and gave women the opportunity to plan when to have children. After all, with the pill, women can have sex without the consequence of an unwanted pregnancy. This opened up a whole new kind of sexual freedom that wasn’t currently available to women. As great as this all may sound, those constant levels of synthetic estrogens and progestins can wreak havoc on your female sexual function.
Fluctuations in hormones on a cycle not adulterated by synthetic hormones provide drive and pleasure in sex. By taking the pill, sure, you can have sex whenever you want and not worry about getting pregnant. But chances are, you would enjoy having sex more if you were not on hormonal contraception.
Another factor to consider is a woman who doesn’t want to become pregnant now, but does want to have children in the future. When a woman stops taking the pill, there is typically a delay in the resumption of ovulation and conception, and so after stopping the pill it can take awhile before she becomes pregnant (12). This would be particularly important for those women who are older, and time is of-the-essence in getting and maintaining a healthy pregnancy.
The Case Against The Pill In Those With Graves’ Disease and Hashimoto’s
For women with Graves’ Disease or Hashimoto’s, there is even more evidence that taking the pill is a bad idea. For example, I find compromised adrenals to be a common problem in the majority of my patients, and so it’s important to point out that the pill decreases the cortisol response to stressors (13). While we don’t want cortisol to be too high, we also don’t want cortisol to be too low, as healthy cortisol levels are important for controlling inflammation, which is a factor in autoimmunity. As a result, if you are trying to reverse your autoimmune thyroid condition, the pill isn’t going to get you any closer to that goal.
Another common factor for autoimmune thyroid conditions is gut dysbiosis and an increase in intestinal permeability (a leaky gut). Synthetic hormones disrupt the gut’s natural microbiome, and they can increase the risk of inflammatory bowel disease (Crohn’s disease and ulcerative colitis) (14). I spend a good amount of my time with patients trying to heal their gut, and hormonal contraception can potentially hinder this process.
I’ve also had numerous patients with gallstones and bile metabolism issues. Many of them are surprised to find out that the pill increases the risk of the formation of gallstones, as this isn’t one of the more well-known side effects. My assistant Kate had been plagued with years of gallbladder attacks, and she was also on the pill for the majority of her reproductive years starting at a young age. Coincidence? Perhaps. But the research suggests that maybe it’s not a coincidence either (15) (16).
Does it make a difference what type of oral contraceptive is used? Unfortunately, both estrogen and progesterone have been shown to increase the risk of gallstones (17). The way that estrogen can cause gallstones is by increasing cholesterol production in the liver, with excess amounts precipitating in bile and leading to the formation of gallstones (18). Progesterone can also cause gallstones by decreasing gallbladder motility, which in turn impedes bile flow, and leads to the formation of gallstones (17).
On the other hand, the increased cardiovascular risk I mentioned earlier is more commonly associated with combined oral contraceptives, and not with progesterone-only contraceptives (19). While I’m not a fan of oral contraceptives in general, if someone does choose to take them I would recommend to take the progesterone-only form. But as you have learned, even these come with risks.
What Can Women Do About Menstrual Pain, Bleeding, and Irregular Cycles?
As I mentioned earlier, many women don’t take the pill to prevent pregnancy, but instead to help with symptoms such as menstrual pain, bleeding, and irregular cycles. I realize that the pill can greatly help with these symptoms, which in some cases can be extreme. Just remember that the pill isn’t correcting the cause of the problem, and so what I would recommend is to work with a natural healthcare professional who will test the adrenals and sex hormones, and then do what is necessary to correct any imbalances that are present.
Many women have an estrogen dominant state that can be the primary cause, or at least a contributing factor. This doesn’t necessarily mean an excess of estrogen, as it commonly is related to an imbalance of the estrogen/progesterone ratio, with progesterone commonly low. In other words, low progesterone in the presence of normal estrogen is considered to be a state of estrogen dominance.
Also, you need to have healthy adrenals in order to have healthy sex hormones. Because of this, in most cases you want to focus on improving your adrenal health before taking any type of oral contraceptive or bioidentical hormone. And even if you choose to take either one of these, you still want to focus on improving the health of your adrenals.
So hopefully you understand how incredibly important it is to weigh the benefits of hormonal contraception with the risks. Are the risks worth it? If you are thinking they may not be, you might now be wondering, what birth control options are left? I’ll be discussing this in Part 2, as I’ll talk about IUDs, skin patches, vaginal rings, along with natural options.
Thyroid Hormone Replacement Drugs and Birth Control Pills: A Safe Combo?
What’s the thyroid?
Yes, it can make you bloat up and shrink down faster than a breakup. But your thyroid can also do so much more. It produces thyroid hormones, which control your body’s use of vitamins, proteins, carbohydrates, fats, electrolytes and water, according to the American Thyroid Association. These hormones also regulate the body’s immune response and how your body reacts to other hormones and drugs.
The thyroid gland is controlled by thyroid-stimulating hormone (TSH) and thyrotropin-releasing hormone (TRH).
What’s thyroid hormone replacement therapy (THRT)?
If you suffer from a thyroid hormone deficiency, or hypothyroidism, you can encounter symptoms as varied as lack of energy, depression, constipation, weight gain, hair loss, dry skin, dry coarse hair, muscle cramps, decreased concentration, aches and pains, swelling of the legs and increased sensitivity to cold. Possible causes of hypothyroidism include a non-functioning thyroid gland, thyroid-gland damage due to surgery or radiation treatment, or a non-functioning pituitary gland.
If you suspect your thyroid isn’t working as it should, your doctor can test your thyroid levels using a TSH test or T4 test, says Kent Holtorf, M.D., Medical Director of Holtorf Medical Group, which studies women’s health and endocrinology. A TSH test measures your body’s levels of thyroid-stimulating hormone, which helps control the thyroid gland. Your doctor may also order a T4 test, which measures the levels of the T4 hormone in the body. T4 is one of two types of thyroid hormones. The other, T3, comes from T4, so it’s not commonly measured.
These tests will let your doctor know if your thyroid isn’t working properly. If you do suffer from hypothyroidism, your doctor will likely put you on thyroid hormone replacement therapy (THRT), which is basically extra T4 hormones. You’ve got to bump those babies up.
Common synthetic THRT medications include Synthroid, Levoxyl, Levothyroid, Unithroid. The most common natural THRT medication is Armour Thyroid and is made from porcine (pig) thyroid glands.
Image zoom Blaine Moats
Can birth control pills and THRT medications affect each other?
If you’re taking an estrogen medication (like birth control pills or hormone replacements) during THRT, you may have to adjust your dosage of T4 hormones, according to the American Thyroid Association.
Why? Ninety-nine percent of T4 (one of the two thyroid hormones) should bind to little proteins called thyroxine-binding globulins (TBG) in the bloodstream, making it pretty much useless. Estrogen in oral contraceptives causes TBG to hang out in the body longer, increasing your body’s level of TBG — and a percentage of all T4 stuck to it, says Wendy C. Wilcox, M.D., Vice Chairperson of the North Bronx Healthcare Network Department of Obstetrics and Gynecology.
Since the remaining 1 percent of “free” T4 is what affects your body, your thyroid gland should work to produce more T4 to keep enough of the hormone gallivanting around your body free from TBG, according to the American Thyroid Association. But sometimes (especially in patients who already have a thyroid condition) the thyroid can slack off, meaning you have to up your dosage of T4.
Whether or not you have to change your dose, the estrogen will throw off your levels of T4, since an absurd amount of T4 will be hanging out with TBG, Dr. Wilcox says. For that reason, when having your thyroid levels checked, your doctor should opt for the THS test, not the T4 test. Your high T4 levels will give the false impression your thyroid is putting in double time.
The good news is that THRT should not affect the effectiveness of birth control medication, Dr. Holtorf says. But thyroid disease can decrease fertility by affecting ovulation.
What Can I Do?
Get yourself a knowledgeable physician who understands the complex relationship between estrogen and thyroid hormones. Your physician should monitor your thyroid levels and how any medications, including oral contraceptives, are affecting them, and adjust your dosage accordingly.
All of your doctors must know all of the medications you are taking — no “ifs, ands, or buts” about it, says Dr. Holtorf . Your doctors don’t exchange all of their medical records about you each time there’s an update, so unless you tell them your current list of medications, your physicians don’t know what drug interactions to look out for.
Although changes in T4 hormones from estrogen-containing oral contraceptives are not dangerous, you may want to avoid them altogether by using a birth control pill that doesn’t contain estrogen, Dr. Wilcox says. Keep in mind, however, that progesterone-only birth control pills are not as effective as those that contain estrogen and progesterone, and have to be taken at the same time every day. Alternatively, you can use a different form of birth control altogether.
Copyright & copy 2011 Meredith Corporation.?
- Decoding Thyroid Problems
- Pregnancy’s Effect on Other Health Conditions
- Factors that Affect Fertility
- By : K. Aleisha Fetters
Hormonal Contraceptives & Your Thyroid
If you’ve been with me for any length of time, you’ve probably heard me talk about the fact that your thyroid relates to EVERY other system in your body, and every other system can be affected by thyroid dysfunction — even your reproductive system.
That’s because our hormones are always in a delicate balance with one another; a change in one hormone changes the dance. When we introduce hormones artificially, as with hormonal contraceptives, it throws everything out of balance, and our body doesn’t know how to react.
I was on the pill from age 15–33 — almost half my life before I finally went off it. What I didn’t realize until I went off it was how much the pill had affected my mood, body and personality. It wasn’t until after it cleared my body that I realized I was actually a “normal” person and not bat guano crazy as I had felt almost my entire life because of my polarizing mood swings.
As I explored the research for healing my own thyroid and Hashimoto’s condition, I learned the role that hormonal birth control can have on thyroid conditions, and it’s not pretty.
Two main ways hormonal birth control interferes with thyroid function.
There are two main ways that the pill and other hormone birth control can interfere with your thyroid function:
1. Estrogen Dominance
Generally, the pill works by suppressing our natural hormonal cycle by flooding the body with doses of estrogen and progesterone. The drugs trick the body into believing it doesn’t need to produce progesterone, which thereby never allows ovulation or pregnancy.
The problem is that this constant imbalance of hormones can result in a condition called estrogen dominance — which can be caused by too much estrogen, or too little progesterone.
Either way, excess estrogen affects your TBG (Thyroxine Binding Globulin), which binds thyroid hormone, leaving less free thyroid hormone available to your system. If your thyroid hormones are already low, it can cause them to go even lower, exacerbating your condition.
2. Damages Gut Health
As you know, your gut health is intimately linked with your thyroid health (and health overall) and the pill can wreak havoc with your gut health.
- Birth control pills deplete the body of selenium, zinc and the amino acid tyrosine, all of which are vital for thyroid health
They can cause a shift in your immune system that can lead to autoimmune disorders.
The pill changes our natural gut flora, and can allow yeast and other bad organisms to thrive.
They suppress testosterone production, further imbalancing our endocrine systems.
And many contain lactose as a filler, which can be especially problematic for women with gluten and dairy intolerances.
In addition to these thyroid-specific risks, birth control pills are associated with long-term increased risk of blood clots and stroke, osteoporosis, and breast, ovarian and liver cancers.
Overall, many women are realizing that the risks are not worth it. Many other non-hormonal forms of birth control exist, including male and female condoms, fertility tracking and more, that in no way endanger your overall health for the sake of family planning.
For even more information, check out Sweetening The Pill by my friends Abby Epstein and Ricki Lake — and consider making a donation. Every dollar counts!
In addition to the article you just read, I provide a ton of resources on healing your thyroid naturally, including:
- Our totally free Thyroid Healing Type Assessment, Report and Coaching Sessions
- Right here on my blog, where I talk about what’s worked best for me and my clients, as well as the latest research and resources I come across. You can subscribe to get new blog posts delivered right to your email by signing up on the righthand side of the page.
- My book, Healing Hashimoto’s Naturally — part memoir, part instruction manual for how I personally healed my Hashimoto’s disease.
- My exclusive free 6 Thyroid Myths That Can Keep You From Healing workshop — with info on the comprehensive Thyroid Fix in 6 program, which walks you through, step-by-step, the exact actions you need to take to heal your thyroid and get your life back! We’ve seen hundreds of participants in the Thyroid Fix in 6 avoid, decrease, or even eliminate the need need for thyroid medications.
- The incredible Your Best Thyroid Life Video Bundle, in which I personally invited 27 of the world’s top health experts to share their best tips for living with and healing thyroid disease.
Remember, no matter what diagnosis or symptoms you’re facing, you always have a choice about your own body.
Jen Wittman is a Certified Holistic Health Expert, Chef, Author & Vitality Coach, who teaches women how to reverse thyroid and autoimmune conditions naturally. She’s helped hundreds of women decrease (or even eliminate) their thyroid medications and has helped others stay off thyroid medication entirely.
Through her free Thyroid Healing Type Assessment, Jen teaches easy and simple steps to thyroid healing that can fit into your busy day. She also provides print outs to bring to your next doctor’s appointment so you can get the support and respect you deserve.
If you or anyone you know currently takes oral contraceptives, or has taken them in the past, then you’ll want to read this article carefully. Millions of women take “the Pill”, which is a highly effective form of birth control, and can also help to minimize many different symptoms in which cycling women commonly experience. But while there are numerous benefits with oral contraceptives, there are also a number of risks you need to be aware of. Not all of these directly relate to thyroid health, but taking “the Pill” can definitely have an impact, and can affect the recovery for anyone looking to restore their health through a natural thyroid treatment protocol.
With regards to thyroid health, taking “the Pill” will suppress the production of progesterone, which does a great job of preventing a woman from becoming pregnant, but also will create chaos with the endocrine system. I’ve mentioned in the past how many people with thyroid conditions have the condition estrogen dominance, which can be caused by an excess in estrogen, but is more commonly caused by a progesterone deficiency. And so a person who is taking oral contraceptives will frequently develop this condition, which not only can affect their thyroid health, but their overall health as well.
Other Risks In Addition To Affecting Thyroid Health
In addition to potentially affecting thyroid health, what are some of the other risks of taking “the Pill”? Well, even though it is a small risk, there still is the risk of getting pregnant while taking oral contraceptives. While many doctors will tell you the risk of getting pregnant is less than 1%, some sources show that the risk is actually closer to 6%, which is still low, but obviously a bit higher than 1%. And for women who get pregnant while taking “the Pill”, continously taking this drug could have severe risks with regards to the baby. And many women don’t discover that they’re pregnant while taking “the Pill” until many weeks later.
In addition to this risk, some potential symptoms include weight gain, a decrease in sex drive, depression, fatigue, and headaches. And while these are definitely symptoms to be concerned about, the primary health concern is the effects that oral contraceptives have on the endocrine system. Many medical doctors recommend “the Pill” in order to “regulate” the menstral cycle. And while it can do a good job of symptom management, it does this by suppressing the endocrine system, which has its own set of consequences. And the long term consequences are worse for someone who took “the Pill” at an earlier age. One of these risks is an increased incidence in breast cancer. This is once again due to the effect that oral contraceptives have on the hormones of the endocrine system. Some studies also show an increased incidence of heart attacks and strokes for women who are taking oral contraceptives, or have taken them in the past.
What Other Options Are There Besides “The Pill”?
If you’re taking oral contraceptives to prevent pregnancy, then there are of course other birth control options out there. However, many of them come with other risks. For example, many women choose an IUD as a form of birth control, which also comes with risks. Obviously having the male wear a condom is an option, although many women choose oral contraceptives to avoid their partners using condoms. I recommend reading the book “The Pill, Are You Sure It’s For You?”, which was written by Jane Bennett and Alexandra Pope, as they talk about natural forms of contraception (and not just the rhythm method). This book also goes into greater detail about some of the risks associated with “the Pill”.
On the other hand, if you are taking oral contraceptives because you have severe symptoms during PMS, acne, or other symptoms, then this frequently can be corrected by following a natural treatment protocol. Such a protocol involves changes in lifestyle, support with nutritional supplements and/or herbs, and other factors that address the actual cause of a disorder. For example, many women who experience severe PMS symptoms can have these symptoms reduced dramatically by following a natural treatment protocol.
Is It Possible To Restore Thyroid Health While Taking The Pill?
For someone who is taking the pill and wants to restore their thyroid health back to normal, it admittedly will be more challenging to accomplish this. However, if the women is taking oral contraceptives on a regular basis and is still having her monthly cycles, then this is still possible by following a certain protocol. On the other hand, a women who is taking an aggressive form of birth control which suppresses her menstrual cycle will have just about no chance of completely restoring her health back to normal.
In summary, taking oral contraceptives can definitely affect your thyroid health, and also lead to many other health risks as well. And while it still is possible for women currently taking “the Pill” to restore their thyroid health through a natural thyroid treatment protocol, it’s definitely more challenging when compared with someone who isn’t taking oral contraceptives. For those no longer taking “the Pill”, there is still a good chance you have a hormonal imbalance, which once again can be contributing to your thyroid condition, and leave you at risk for developing other conditions in the future. As a result, whether you are currently taking oral contraceptives, or have in the past, it’s a good idea to consult with a natural endocrine doctor to achieve optimal health, and reduce the risks of any future problems.
Other Articles You Might Like To Read:
3 Common Causes of Estrogen Dominance
Should Natural Progesterone Be Used To Help Restore Thyroid Health?
4 Bodily Systems To Address With Most Thyroid Conditions
Using Bioidentical Hormones To Restore Thyroid Health
3 Reasons Why Natural Thyroid Treatments Might Not Work
How Birth Control Affects Thyroid Function
The thyroid is a small gland located in the neck that influences nearly all bodily functions. Many factors are involved in proper thyroid activity and malfunction in one area can result in significant dysfunction.
Hypothyroidism is a common thyroid disorder, most often seen in women, that limits thyroid function and causes an array of symptoms. Although there are many possible causes of hypothyroidism, there is one prominent yet often-overlooked contributor…
The Prolific Use of Birth Control
At some point during their life, most women will have a doctor recommend that they take birth control. This is supported by CDC data suggesting that oral contraception, commonly known as “the pill,” is used by over 10 million women in the U.S. alone. Even though estrogenic birth control medications are primarily used to prevent pregnancy, doctors often prescribe them to aid in other areas. It is common practice for doctors to recommend birth control medications to treat symptoms of PMS, acne, heavy menstruation, irregular periods, and other hormone-related issues. Sadly, these recommendations are made, and birth control used without proper understanding of the impact it has on other systems such as the thyroid.
The Impact of Birth Control on the Thyroid
The primary influence of birth control over thyroid function involves an increase in estrogen. Birth control medications typically contain a high volume of estrogen that can skew hormone balance resulting in dysfunction. In addition to disrupting hormone balance, birth control negatively influences specific aspects of thyroid function including nutrient availability and hormone transport while also increasing the risk of autoimmune dysfunction.
Birth Control Depletes Important Thyroid Nutrients
To function properly, the thyroid requires a regular supply of various vitamins, minerals, and nutrients – learn about the most common nutrient deficiencies in thyroid patients here. For example, the thyroid uses selenium and zinc to produce thyroid hormones and convert the inactive form of thyroid hormone T4 (thyroxine) into the active form T3 (triiodothyronine). In addition to these processes, zinc in particular is necessary for communication between thyroid hormones and cell receptors. Therefore, a deficiency of influential substances such as these can result in a major thyroid malfunction.
B Vitamins, particularly B6, B9 (Folic Acid), and B12, are also an important component of thyroid hormone activity. A deficiency of B Vitamins can cause the body to become incapable of producing thyroid hormone and may also prompt the development of symptoms including anemia, depression, and fatigue.
Birth control medications can sap the body’s supply of essential nutrients including selenium, zinc, and B Vitamins. This means that improper use of birth control can interfere with nearly every stage of thyroid hormone activity including synthesis, signaling, transport, and usage.
Birth Control Impedes Thyroid Hormone Activity
Thyroid Binding Globulin (TBG) is an important component of thyroid function. TBG joins thyroid hormones T4 and T3 allowing for easier transport through the bloodstream and improving cellular utilization of thyroid hormone. Therefore, maintaining an appropriate level of TBG is important.
Birth control medications containing high doses of estrogen promote TBG production to a potentially harmful degree. Research shows that after only six weeks of estrogen-based therapies, levels of TBG increase significantly in hypothyroid women. Elevated TBG levels triggers greater thyroid hormone binding, which reduces hormone availability. A lack of circulating thyroid hormone in the form of Free T4 and Free T3 can cause symptoms of hypothyroidism even though tests may suggest normal levels in the bloodstream.
Reduce thyroid hormone availability due to increased TBG also prompts an increase of TSH. An elevated TSH level may result in unnecessary production of thyroid hormone. Such action can impede thyroid hormone activity and contribute further to symptoms of hypothyroidism.
Birth Control Promotes Inflammation and Autoimmune Dysfunction
Most birth control medications cause a notable degree of inflammation. Oral contraceptives in particular can trigger a shift from Th1 immunity to Th2, which is associated with a greater degree of inflammation with an extended duration. Sustained inflammation, such as that triggered by the Th2 immune response, significantly increases the risk of developing chronic disease such as the autoimmune thyroid disorders Hashimoto’s thyroiditis and Graves’ disease.
Inflammation caused by birth control also has a direct impact on hormone activity. Highly estrogenic birth control medications can instigate inflammation that promotes conversion of T4 into the inhibitory mirrored version of active form of thyroid hormone Reverse T3 (RT3). If levels of RT3 are increased to an inappropriate level, thyroid hormone activity can be severely inhibited and cause a patient to suffer from symptoms of hypothyroidism. Increased inflammatory activity also limits cellular receptivity to hormones, meaning that thyroid hormones are less capable of regulating overall bodily function.
Stay Informed About the Effects of Birth Control
Even though birth control provides some benefits there are potentially harmful effects that should be considered. The significant hormonal impact of birth control medications can greatly disrupt thyroid function. Multiple effects of birth control such as nutrient depletion, increased TBG production, and greater inflammatory activity all contribute to thyroid dysfunction. Women taking birth control who are suffering from hypothyroidism or other thyroid related dysfunction should speak with a doctor about other contraceptive options or methods to improve hormone balance. Birth control is a powerful tool when used in the appropriate circumstances. However, before using them, patients should always consider what effect birth control medications will have on important systems such as the thyroid.
1. Jolene Brighten, ND. “What doctors don’t say about the birth control and thyroid connection.” Hypothyroid Mom.
3. Agren, U et al. “Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol in comparison to one containing levonorgestrel and ethinylestradiol on markers of endocrine function.” Eur J Contracept Reprod Health Care. 2011 Dec;16(6):458-67.
5. Santin, A et al. “Role of Estrogen in Thyroid Function and Growth Regulation.” J Thyroid Res. 2011; 2011: 875125.
6. Izabella Wentz, Pharm D. “14 Ways Birth Control Pills Rob Us of Our Health.” Thyroid Pharmacist.
7. Jolene Brighten, ND. “Is The Pill At The Root Of Your Thyroid Problem?” MindBodyGreen.
Introduction: Graves disease is an autoimmune disorder which may lead to thyroid overactivity and eye disease. Oestrogen and progesterone are thought to be immunomodulatory and have been postulated to play an important role in the difference in prevalence of autoimmune disorders between men and women. Autoimmune disorders, including autoimmune thyroid disease, are often quiescent during pregnancy with an increased prevalence postpartum. The increase in immune mediated thyroid disease postpartum has been associated with alterations in oestradiol and progesterone levels.
Case: A 27-year-old lady with a 2-month history of fatigue, tremor, sweating, pruritus, and weight loss. She had been taking the oral combined contraceptive pill (Yasmin) for 3 years, which she stopped just prior to the onset of her symptoms. Examination revealed a diffuse, smooth goitre although no evidence of thyroid eye disease. Thyroid function tests revealed a suppressed TSH at 0.01 mIU/l, free T4 41.9 pmol/l, and free T3 >46.1 pmol/l. TSH receptor antibodies were elevated at 2.2 U/l confirming a diagnosis of Graves disease. She was treated with anti-thyroid medication and B-blockade with full resolution of her symptoms.
Conclusion: There are no previously reported cases of autoimmune thyroid disease occurring following cessation of the combined oral contraceptive pill. Graves disease often affects young women, who are most likely to be treated with oral contraceptive agents. In a cross sectional study looking at risk factors for autoimmune thyroid disease, Strieder et al. have reported that oestrogen use was associated with a lower rate of hyperthyroidism (RR 0·169) and furthermore oestrogen use was negatively correlated with the presence of TPO antibodies. Thus it seems feasible that the withdrawal of oral contraceptive use may have precipitated the onset of autoimmune thyroid disease in this young woman.