Menopause & Thyroid Function

Overview

Is it hypothyroidism or is it menopause? That can be a difficult question to answer without a blood test, given that the timing and symptoms of both conditions can be quite similar.

All women eventually go through menopause, while roughly one in eight will develop some form of thyroid disease, according to the North American Menopause Society. Most of the time, the problem is low thyroid function (called hypothyroidism).

Hypothyroidism is most common in women, and its prevalence increases around menopause.

A physical exam and a blood test can determine whether a woman is suffering from hypothyroidism or is simply approaching menopause.

Hypothyroidism

The thyroid, a butterfly-shaped gland at the base of the neck, affects almost every cell in the body. It manufactures thyroid hormone, which helps control metabolism.

In hyperthyroidism, the thyroid produces too much hormone. Hypothyroidism is more common, especially in women; it is a result of the thyroid producing too little thyroid hormone.

The likelihood of developing hypothyroidism increases as a woman approaches menopause, according to the American Thyroid Association.

Menopause

Despite the timing, menopause does not increase the risk for thyroid problems, according to the North American Menopause Society.

The timing can be confusing, though, since many symptoms of hypothyroidism may be mistaken for menopause or perimenopause. Such symptoms include irregular periods, mood swings and weight gain.

Menopause, a natural process, generally does not require treatment. Hypothyroidism, in contrast, does. A healthcare professional can determine whether the symptoms are caused by menopause, by reduced thyroid function or a combination of both.

Diagnosis

Because of this potential confusion, hypothyroidism cannot be diagnosed based solely on symptoms.

A physical examination and tests to measure the amount of thyroid-stimulating hormone (TSH) in the blood are essential.

Doctors generally use two basic blood tests to diagnose hypothyroidism, according to the American Thyroid Association.

The TSH test measures how much of the thyroid hormone thyroxin (T4) the thyroid gland is being asked to make. Elevated TSH indicates hypothyroidism.

T4 tests measure how much "unattached" T4 is in the blood and available to the cells. Typically, about 98 percent of the T4 in the blood is attached to a protein and is unavailable to the cells.

Treatment

Synthetic thyroxin is the most common treatment for hypothyroidism. Taken every day at the same time, it's the best treatment for most patients, according to the American Thyroid Association.

Taking the precise dosage is critical. Take too little, and some of the symptoms of hypothyroidism may continue. Too much could lead to the symptoms of an overactive thyroid, such as nervousness, a racing heart, insomnia and shaking.

For that reason, the American Thyroid Association warns against switching brands of synthetic thyroxin.

Misconceptions

Contrary to popular perception, there aren't any "superfoods" to enhance thyroid function at menopause or at any other time. Mayo Clinic endocrinologist Todd B. Nippoldt, M.D., is adamant about this point: "Although claims about hypothyroidism diets abound, there's no evidence that eating or avoiding certain foods will improve thyroid function."

Another popular belief is that body temperature is a way to diagnose hypothyroidism. According to the American Thyroid Association, it isn't a reliable method.