What Is Thyropause?

Menopause brings a range of physical and emotional changes, and one lesser-known condition that complicates this transition is thyropause. This condition occurs when menopause-related hormonal shifts impact thyroid function.¹ Symptoms like weight gain, fatigue, and mood swings can overlap with those of menopause, making thyropause easy to overlook.²

During menopause, changes in estrogen and progesterone levels can affect your thyroid function, leading to symptoms similar to thyropause.³ This overlap can complicate diagnosis and management, but understanding how menopause affects your thyroid can help you and your healthcare practitioner manage these symptoms more effectively.

The Thyroid and Menopause: A Crucial Connection

Your thyroid gland is a small, butterfly-shaped organ at the base of your neck that plays essential roles in controlling metabolism, producing energy, and regulating hormones. These functions are vital for maintaining overall health.⁴

During menopause, hormonal changes can affect your thyroid gland and lead to symptoms like fatigue, weight gain, and mood swings, significantly impacting daily life and long-term health.⁵

A major reason for thyroid changes during menopause is the drop in estrogen levels. This decrease reduces the proteins in your blood that carry thyroid hormones, affecting their function. As a result, thyroid symptoms can worsen, making them harder to diagnose and manage.⁶

Progesterone, another hormone that decreases during menopause, also plays a role in regulating thyroid function. Changes in estrogen and progesterone levels during menopause can lead to thyroid hormone imbalances, which can cause symptoms of hypothyroidism like tiredness and weight gain, or hyperthyroidism symptoms like anxiety and weight loss.⁷

Common Thyroid Disorders in Menopausal Women

Hypothyroidism and hyperthyroidism are common thyroid disorders; however, the way they present may look different during menopause than at other times.

Hypothyroidism occurs when the thyroid gland produces too little thyroid hormone, leading to symptoms such as:

Fatigue: Feeling extremely tired even after adequate rest.
Weight gain: Unexplained weight gain despite a balanced diet and the right exercise.
Depression: Persistent feelings of sadness or a lack of interest in activities.⁸

Hyperthyroidism results from an overactive thyroid gland, causing symptoms such as:

Weight loss: Unintended weight loss despite normal eating habits.
Anxiety: Increased feelings of anxiety and nervousness.
Irritability: Heightened irritability and mood swings.⁹

Menopausal hormonal fluctuations can worsen these symptoms, making them more intense and challenging to distinguish from typical menopausal symptoms.

Studies show that thyroid disorders are common among menopausal women. In one study, researchers divided 150 women over 40 into premenopausal (61 women) and postmenopausal (89 women) groups. They found:

53.3% had normal thyroid function
13.3% had hypothyroidism
3.4% had hyperthyroidism
23.3% had mild hypothyroidism
6.7% had mild hyperthyroidism

The study also revealed that depressive mood was more common among women with menopause-related thyroid disorders.¹⁰ These findings highlight a strong connection between menopause and the onset or worsening of thyroid conditions.

What Causes Thyroid Changes During Menopause?

Hormonal fluctuations during menopause, particularly a drop in estrogen, can trigger or worsen thyroid conditions. However, other factors also impact thyroid health during this life stage, including:

Autoimmune factors: During menopause, you can become more susceptible to autoimmune conditions like Hashimoto’s thyroiditis. This disorder causes the immune system to attack your thyroid gland, reducing thyroid hormone production and leading to hypothyroidism. Symptoms include fatigue, depression, and cold intolerance.¹¹
Diet: Dietary choices have a big impact on thyropause. Eating processed foods, sugary snacks, and unhealthy fats can harm your thyroid. A high-sugar, low-protein diet is particularly detrimental because your body needs protein for hormone production, and excessive sugar causes inflammation and hormone imbalances.^{12, 13}
Chronic stress: Stress affects your thyroid health by increasing the stress hormone cortisol, which disrupts hormone balance. Stress weakens the immune system, increasing the likelihood of developing autoimmune thyroid conditions like Hashimoto’s or Graves’ disease, and worsens symptoms such as fatigue, anxiety, and mood swings.¹⁴
Other factors: Regular exercise helps regulate hormones, improves metabolism, and reduces stress. Being inactive can negatively affect your thyroid by slowing metabolism and reducing thyroid hormone production, leading to weight gain and fatigue.¹⁵ Similarly, poor sleep disrupts hormone balance and adds to chronic stress.¹⁶

Distinguishing Thyropause Symptoms from Menopausal Symptoms

While menopause and thyroid issues share overlapping symptoms, key distinctions can help you tell them apart. Identifying these differences is vital because thyroid problems can worsen menopausal symptoms and vice versa. Understanding the root cause of your symptoms can help you make a more informed decision about effective treatment.

Fatigue

Thyropause: Fatigue from thyroid issues often comes with feelings of sluggishness and a lack of energy that persists throughout the day, regardless of sleep quality.¹⁷
Menopause: Fatigue is often linked to poor sleep quality caused by night sweats or insomnia. You might feel more tired during the day due to disrupted sleep.¹⁸

Weight Changes

Thyropause: Weight gain is usually generalized and can occur despite no changes in diet or exercise. It’s often accompanied by a slowed metabolism, making it hard to lose weight.¹⁹
Menopause: Weight gain tends to concentrate around the abdomen. It might be more noticeable if your diet and exercise habits have not changed.²⁰

Mood Swings

Thyropause: Mood changes such as irritability, anxiety, or depression can be more constant and severe, often accompanied by other thyroid symptoms like dry skin and hair loss.²¹
Menopause: Mood swings are more likely to be sporadic, aligning with hormonal fluctuations, and might come and go with hot flashes or menstrual changes.²²

Temperature Sensitivity

Thyropause: You might experience a consistent sensitivity to cold (feeling cold all the time) or heat, not just during specific times.²³
Menopause: Hot flashes and night sweats are more intense and sudden, often happening without warning and usually associated with specific times, like at night.²⁴

Changes in Hair and Skin

Thyropause: Dry skin, thinning hair, or hair loss are common and might be accompanied by other signs like brittle nails and a puffy face.²⁵
Menopause: Skin and hair changes are more gradual, with skin losing elasticity and hair thinning due to the overall aging process and reduced estrogen levels.²⁶

Digestive Issues

Thyropause: You might experience persistent constipation or slower digestion that doesn’t fluctuate much day-to-day.²⁷
Menopause: Digestive changes can be more variable, related to dietary changes, stress, or other aging-related factors.²⁸

Cognitive Difficulties

Thyropause: Brain fog, memory problems, and difficulty concentrating can be more severe and persistent.²⁹
Menopause: Cognitive difficulties often come in waves, correlating with periods of intense hormonal change.³⁰

Muscle and Joint Pain

Thyropause: Muscle weakness, aches, and stiffness are consistent and might worsen over time.³¹
Menopause: Joint stiffness and muscle pain might vary, often linked to physical activity levels or hormonal cycles.³²

Menstrual Changes

Thyropause: Periods can become heavier or lighter unpredictably, and may be accompanied by other thyroid symptoms.³³
Menopause: Menstrual changes are more predictable, typically becoming irregular and eventually stopping.³⁴

Sleep Disturbances

Thyropause: Sleep issues such as trouble falling asleep or staying asleep can be constant, regardless of other symptoms.³⁵
Menopause: Sleep disturbances are often tied to night sweats or hot flashes, disrupting sleep patterns.³⁶

Heart Palpitations

Thyropause: Irregular heartbeats or a pounding heart can occur frequently and may be accompanied by anxiety or restlessness.³⁷
Menopause: Palpitations are often associated with hot flashes or anxiety during hormonal fluctuations.³⁸

Swelling

Thyropause: Puffiness, especially in the face or around the eyes, is more common and persistent.³⁹
Menopause: Swelling can occur but is usually less pronounced and may fluctuate with other symptoms.⁴⁰

Elevated Cholesterol Levels

Thyropause: High cholesterol can be more persistent and resistant to diet and exercise changes.⁴¹
Menopause: High cholesterol may develop gradually with aging and hormonal changes.⁴²

It can sometimes be confusing to differentiate between menopause and thyroid issues, even with their distinct symptoms. A detailed symptom diary can help identify patterns specific to thyroid dysfunction or hormonal changes. Talk with your functional-medicine doctor about thyroid function tests and hormone level assessments. By understanding these differences and working with healthcare professionals, you can achieve the correct diagnosis and appropriate treatment.

Testing for Thyroid Issues During Menopause

Once you identify your symptoms, work with your functional-medicine doctor and ask for the correct tests for an accurate diagnosis. Relying solely on the TSH test can be misleading, as it does not provide a complete picture of thyroid health.⁴³

A comprehensive thyroid panel is essential for accurately diagnosing and managing thyroid disorders, especially during menopause when hormonal changes complicate thyroid function. This test includes:

TSH (Thyroid Stimulating Hormone): This test measures the level of TSH in the blood, indicating how well the thyroid functions. High TSH levels typically suggest hypothyroidism (underactive thyroid), as the body is trying to stimulate the thyroid to produce more hormones. Low TSH levels indicate hyperthyroidism (overactive thyroid), where the thyroid produces too many hormones, and your body reduces TSH production to compensate.
T4 (Thyroxine): The T4 test measures the blood’s total or free (unbound) T4 hormone. This test helps evaluate thyroid function and diagnose thyroid disorders. Low T4 levels often indicate hypothyroidism, which means the thyroid is not producing enough hormones. High T4 levels suggest hyperthyroidism, which means the thyroid produces excessive hormones.
T3 (Triiodothyronine): This test measures total or free T3 hormone. It is particularly useful when TSH and T4 results are inconclusive. Elevated T3 levels can indicate hyperthyroidism, even when T4 levels are normal, providing additional insight into thyroid function that T4 alone may not reveal.
Thyroid Antibodies: These tests detect thyroid antibodies, which are proteins made by your immune system that target thyroid proteins. They include Thyroid Peroxidase Antibodies (TPOAb), Thyroglobulin Antibodies (TgAb), and Thyroid Stimulating Immunoglobulin (TSI). By identifying the presence of antibodies that attack the thyroid gland, these tests can help diagnose autoimmune thyroid conditions, such as Hashimoto’s thyroiditis (hypothyroidism) and Graves’ disease (hyperthyroidism).⁴⁴

Regular thyroid function tests help you keep track of any changes in your thyroid. Talking with your healthcare practitioner about how often to test can help you catch and manage thyroid problems early. This can improve your overall health and well-being during menopause.

Ways to Manage Thyropause

Thyropause management often includes synthetic thyroid hormones such as levothyroxine to regulate hormone levels. Levothyroxine, a synthetic form of thyroxine (T4), is designed to replace or supplement the T4 hormone that the thyroid is not making adequately.

Your healthcare provider can tailor dosages for your condition, and they must regularly monitor hormone levels to ensure they remain within the target range. While generally well-tolerated, levothyroxine can cause side effects if the dosage is too high or too low.^{45, 46}

While other medications (such as liothyronine/T3 and combination therapies) may be considered based on specific symptoms and hormone levels, you can also manage your thyroid health through diet and lifestyle modifications. These approaches can complement your treatment and enhance your overall well-being during menopause.

Eat By the Plate

Eating a balanced diet with the trifecta of protein, healthy fats, and fiber can significantly support thyroid health:

Optimal protein helps maintain thyroid function by providing essential amino acids for hormone production and overall gland health.
Omega-3 fatty acids in wild-caught seafood, walnuts, chia, and flax seeds help reduce inflammation and support overall thyroid health.
Plant-based foods are rich in fiber. Fiber helps with thyroid health by aiding digestion and maintaining hormone balance. It supports your gut, which activates some thyroid hormones. Fiber also helps regulate blood-sugar levels, which can impact thyroid function. ^{47 – 50}

Nutrient-wise, a few key minerals can optimize thyroid function:

Iodine supports the production of thyroid hormones. Wild-caught seafood is an excellent source of this mineral.
Selenium is another vital thyroid nutrient. This mineral helps make thyroid hormones and protects the gland from damage. You’ll find selenium in foods like Brazil nuts and sunflower seeds.
Zinc is important for thyroid function because it helps the thyroid gland produce hormones. This mineral also plays a role in converting inactive thyroid hormone (T4) into its active form (T3), which is crucial for the body’s metabolism and energy levels. Without enough zinc, thyroid function can be impaired, leading to imbalances and related symptoms. You can get enough zinc by including meat, poultry, nuts, and seeds.^{51 – 53}

Certain foods can impair thyroid function when consumed in large amount, which would be more than 2-3 servings per day, especially raw). To minimize these effects, vary your diet with a wide range of plant foods and cook vegetables by steaming or sautéing to break down goitrogens. Additionally, blanching and freezing greens like spinach or kale before adding them to smoothies can help reduce their impact on thyroid health. ^{54, 55}

Likewise, some experts believe soy can interfere with thyroid function by inhibiting iodine absorption.⁵⁶ Soy can create food intolerances for many people, so I recommend people avoid it in The Virgin Diet.

Manage Stress

Chronic stress raises cortisol levels. Elevated levels of this stress hormone can interfere with how your thyroid makes and uses hormones, causing imbalances. High cortisol levels can stop T4 from turning into T3, the active thyroid hormone, and can lower the production of thyroid-stimulating hormone (TSH).⁵⁷ To manage stress, practice stress-reducing activities such as meditation, yoga, and deep breathing exercises. I’ve found Dr. Joe Dispenza’s meditations especially helpful for managing stress and being at my best.*

Lift Heavy

Regular resistance training supports metabolism and thyroid health during menopause. Lifting heavy things helps maintain muscle mass, which supports hormonal balance for managing thyroid function effectively.⁵⁷

My FREE Resistance Training Cheat Sheet provides everything you need to build and maintain muscle, including home gym essentials, an 8-week workout plan, and a progress tracker to monitor your sets, reps, and weights with each workout.

Avoid Smoking and Excessive Alcohol

Both can negatively affect thyroid function. Smoking introduces harmful chemicals into your body that can interfere with thyroid hormone production, while excessive alcohol consumption can impair your liver’s ability to process these hormones.^{59, 60}

Get Support

Stay informed about menopause and thyroid health to recognize symptoms early and seek appropriate help. Functional-medicine practitioners are more apt to perform comprehensive testing, including a full thyroid panel, to provide a detailed understanding of your thyroid health. Regardless of who you work with, schedule regular check-ups to monitor thyroid hormone levels and adjust treatment as needed. Follow your prescribed thyroid medication regimen closely and consult your doctor before making any changes.

Supporting a Healthy Thyroid with Optimal Protein Intake

As you enter menopause, maintaining a healthy thyroid becomes even more critical, and optimal protein intake plays a key role. Protein supports thyroid function by providing essential amino acids for hormone production and metabolic processes. However, there’s a challenge: many of us aren’t consuming enough protein to meet our increased needs as we age. One simple dietary change can make a significant difference: eat protein first.

My 7-Day Eat Protein First Challenge provides everything you need to optimize protein intake. Use the protein calculator to help you determine your ideal protein intake—the results may surprise you! Plus, you’ll receive a guide with tips, tricks, and a protein-first meal plan to help you successfully move to a higher-protein meal plan.

Claim your FREE 7-Day Eat Protein First Challenge here.

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These statements have not been evaluated by the Food & Drug Administration. Products mentioned are not intended to diagnose, treat, cure, or prevent any disease. The views in this blog by JJ Virgin should never be used as a substitute for professional medical advice. Please work with a healthcare practitioner concerning any medical problem or concern.