Here’s something you may not have heard: the symptoms of menopause and hypothyroidism (underactive thyroid) are similar. So if you are around perimenopause or menopause age, could the symptoms you are experiencing be about your thyroid or menopause or both? What do you need to know about the presence of hypothyroidism during menopause?

What is hypothyroidism?

The thyroid makes hormones, but when it doesn’t produce enough, hypothyroidism can occur. Inflammation is the most common cause of hypothyroidism, but it also may be due to abnormal levels of iodine in the body or the use of certain medications, such as lithium. This thyroid condition is characterized by fatigue, weight gain, changes in menstruation, mood swings, sleep problems, hair loss, forgetfulness, and dry skin, among others.  

What tests are used to help diagnose hypothyroidism?

A simple blood test is used to check the levels of three thyroid hormones to help determine the presence of hypothyroidism and other thyroid disorders. Optimal levels are guidelines only, as a history of thyroid or pituitary disease or even older age can determine a different range for individual women.

• Thyroid-stimulating hormone (TSH). The optimal range for this hormone is 0.45 to 2.5 mIU/L.
• Thyroxine (free T4). Normal values for free T4 are 0.7 to 1.9 ng/dL. 
• Triiodothyronine (free T3 or total T3). Normal values for total T3 range from 80 ng/dL to 220 ng/dL
• Antibody test. Measures the level of thyroid antibodies in the blood. Thyroid peroxidase antibodies may be a sign of Hashimoto disease, the most common cause of hypothyroidism. The presence of thyroglobulin antibodies also can be a sign of Hashimoto disease. Reference ranges for these antibodies are less than 35 IU/mL and less than 20 IU/mL respectively.

Read about what do menopause and underactive thyroid have in common?

What’s the link between hypothyroidism and menopause?

Some women develop hypothyroidism during perimenopause or menopause. Why? According to Cheryl R. Rosenfeld, DO, a spokesperson for the American Association of Clinical Endocrinologists, “One theory is that fluctuation in estrogen levels may increase inflammation, creating the ideal environment for the development of autoimmune diseases such as Hashimoto’s thyroiditis, which may lead to hypothyroidism.” 

A 2019 report noted that the prevalence of thyroid issues among older adults is nearly 25 percent. Thyroid conditions, including hypothyroidism, are more prevalent among women than men. 

It’s important to get an accurate diagnosis of hypothyroidism as women approach perimenopause and menopause because many of the symptoms are the same and you don’t want to treat your thyroid if nothing is wrong. As noted in the journal Menopause International, correctly treating hypothyroidism is especially important among menopause and postmenopausal women because they are at increased risk of cardiovascular disease and osteoporosis. Untreated thyroid disease can worsen these risks. 

Read about 5 everyday chemicals not doing your thyroid any favors

How do you manage hypothyroidism during menopause?

If you have hypothyroidism during menopause, your symptoms may be worse. Therefore, it’s important to keep up with any treatment for hypothyroidism your healthcare provider has prescribed, because failing to do so may result in high cholesterol, high blood pressure, or osteoporosis.  

Your healthcare provider will likely need to make adjustments to your thyroid treatment as your estrogen levels drop. If you are taking levothyroxine for hypothyroidism when you enter menopause, for example, your doctor may need to reduce your dose. Therefore it’s recommended you work closely with your healthcare provider to determine the optimal treatment course for you.

Which foods support healthy thyroid function?

One way to help keep your thyroid functioning optimally is to nourish it! Let’s look at a few specific minerals and vitamins that are beneficial for your thyroid. Be sure to get plenty of selenium, which is found in great abundance in Brazil nuts—you only need 2 or 3 nuts to get more than you need! Other foods to enjoy include eggs, legumes, and tuna. Zinc helps convert T4 to active T3, so chicken, oysters, beans, and nuts are good sources. 

Vitamin D is important to support hormone production, so strive to get 20 minutes of sunshine four days a week. Both tyrosine and iodine are necessary to produce thyroid hormones: enjoy avocados, bananas, almonds, fish, and pumpkin seeds for tyrosine, while tuna, seaweed, and shrimp are good sources of iodine. 

Overall, plant-based foods are very thyroid-friendly. Choose lots of leafy greens, whole grains, sweet potatoes (great source of vitamin A, which supports thyroid hormones), legumes (e.g., split peas, lentils, beans, chickpeas), nuts, and seeds.  

If you have hypothyroidism and are taking medication, there are some foods that can reduce the effective dosage of thyroid medication if they are consumed within four to five hours of dosing. “These foods are those that are high in fiber, high in calcium, or high in iron,” according to Nicole German Morgan, RDN, LD, CLT, and founder of Your Thyroid Dietitian.

Bottom line

Hypothyroidism and menopause share many of the same symptoms and can occur at the same time. Getting an accurate diagnosis of hypothyroidism or any thyroid condition is important so it can be treated properly and you can help prevent other health issues that may arise.