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Menopause And Thyroid Disease

When it comes to menopause, women with thyroid disease have a little more to be concerned about than women without thyroid disease.

All postmenopausal women are at an increased risk of heart disease, which is the leading cause of death for postmenopausal women. But in postmenopausal women with untreated hypothyroidism, hyperthyroidism, or thyrotoxicosis, cardiovascular changes can damage the heart, magnifying the normal risk of heart disease that exists in the general female population. In addition, hyperthyroidism or thyrotoxicosis can speed the process of osteoporosis, which is also a risk for women after menopause.

In women who had normal thyroid function prior to menopause, the signs of thyroid disease can be masked by perimenopausal symptoms. This means that thyroid disease can be missed, aggravating menopausal and postmenopausal risks of other diseases, such as osteoporosis or heart disease. Women might also be mistakenly told they are perimenopausal when they are not. It’s important to note that the incidence of mild hypothyroidism or subclinical hypothyroidism steadily rises with age, increasing from 10 percent in the premenopausal age group to 20 percent in the postmenopausal age group. When you notice signs of perimenopause (changing periods, hot ? ashes, trouble sleeping, etc.), make sure to request a thyroid function test to rule out thyroid disease as the cause of symptoms (e.g., thyrotoxicosis or hyperthyroidism) or to see if you need to alter your current thyroid hormone dosage.

Thyroid Disease and Osteoporosis

Postmenopausal women have the highest risk of developing osteoporosis (bone loss) as a result of estrogen loss, and osteoporosis can be aggravated by thyrotoxicosis. Osteoporosis increases your risk of bone fractures; fully 70 percent of all hip fractures are a direct result of osteoporosis. Maintaining bone mass and good bone health is your best defense against osteoporosis.

Beware of Bioidentical Hormones

If you are considering taking hormone replacement therapy (HRT) for menopausal symptoms, beware of bioidentical hormones; the FDA has determined that this is a marketing term and is not medically meaningful. Bioidentical hormones are unregulated, and many unskilled and unlicensed practitioners are prescribing them, falsely claiming that they protect against breast cancer. They are usually sold by compounding pharmacies as a “natural” form of HRT synthesized from plants, but they frequently contain other hormones, including T3, which can be dangerous if you are already taking thyroid hormone. The truth is, all forms of estrogen and progesterone carry the same risks and bene?ts.

Aim for something that is FDA-approved and regulated, which your doctor can discuss with you.

One of the most common questions that women taking thyroid hormone ask is: What is the link between thyroid disease and osteoporosis?

Contrary to what some women think, the link has nothing to do with calcitonin, which the thyroid also produces.

Thyroid hormone will speed up or slow down bone cells just as it speeds or slows other processes in our bodies, such as our metabolism.

Osteoblasts are the cells responsible for building bone, while osteoclasts are cells that remove old bone so that it can be replaced by new bone.

When you are thyrotoxic, osteoclasts get overstimulated; in short, they go nuts. They begin to remove bone faster than it can be replaced by the osteoblasts, which are not affected by too much thyroid hormone.

The result is too much bone removal and subsequent bone loss.

Women who have had a thyroidectomy to treat thyroid cancer need to be on a slightly higher dosage of thyroid hormone to suppress all thyroid-stimulating hormone activity. Thus, they may live in a state of mild thyrotoxicosis. Postmenopausal women on thyroid hormone should have their levels checked every year to adjust their dosage accordingly.