Thyroid Thursday Episode 18: Why Women Have More Thyroid Problems
Today we want to talk about why it seems that women have more thyroid disorders – hypothyroid symptoms and more autoimmunity issues – especially Hashimoto’s. Is it by chance or is there some science behind this?
What research is starting to show is that women definitely do have a greater propensity for developing hypothyroid symptoms and autoimmune issues. One of the big things that’s being talked about in the literature is something called leptin. Women have a tendency to have a higher level of circulating leptin. The reason for that is, as young girls move into puberty and estrogen levels rise, leptin has a tendency to rise with estrogen. Women carry more estrogen, therefore they carry higher levels of leptin than men do.
What’s the big deal?
Leptin creates a chronic low grade inflammatory response which means women are walking around with a chronic state of low grade inflammation. Is that a problem? Well, yes, it can be because inflammation triggers changes in our physiology. Low grade inflammation from leptin on it’s own may not be such a big deal, but when you add the inflammation from other factors in life, it really can become a bigger deal.
Inflammation will decrease thyroid hormone transport into the peripheral cells of the body. When I say peripheral cells I means away from essentially the brain and the thyroid gland. So, when you decrease thyroid transport to the peripheral tissues, at the same time we are increasing thyroid transport to the pituitary gland.
So, what happens? When this is occurring, if you have decreased thyroid hormone to the peripheral tissues, you’ll have all the symptoms of low thyroid function or hypothyroidism; constipation, fatigue, tiredness, weight gain, dry skin, hair thinning. You’ll have all of those symptoms. The problem is that we have decreased thyroid hormone to the peripheral cells so we get symptoms, but at the same time thyroid hormone transport to the pituitary becomes upregulated in inflammatory states. So, the pituitary gland becomes saturated with T3 and the saturation of T3 causes the TSH levels to stay normal or actually go low towards a more hyperthyroid state.
You’ll go to your primary carer or the endocrinologist pretty sure that you have a hypothyroid condition based on what you’ve read on the internet, and they’ll run the TSH test, and that’s usually all that’s run, and your TSH will be normal or low and they’ll say you don’t have a thyroid issue and that your symptoms are caused probably by something else; you are eating too much, you are not exercising enough, you are not sleeping enough, you are stressed out. There are multiple excuses that you’ll be given, but this is probably what’s really going on.
This low grade inflammation is also unique to the thyroid gland because the thyroid gland has a unique immune system. It is way more sensitive to the inflammatory response. So, inflammation in the thyroid creates more cell damage, the increased cell damage drives more inflammation and then the process just keeps feeding on itself. Eventually, the immune system of the thyroid gland loses what is called self-tolerance. It loses its ability to differentiate damage tissue and pathogens from good healthy tissue. The immune system starts creating an immune attack against thyroglobulin and thyroid peroxidase, producing antibodies. This is the situation when someone develops Hashimoto’s. They may also start to attack thyroid stimulating hormone receptors which is associated with Graves’ Disease.
All of this stuff starts to occur and that’s what drives increased autoimmunity, or increased susceptibility to autoimmunity. If autoimmunity is going to occur, the thyroid gland is thought to be one of the most sensitive tissues, if not the most sensitive tissue to autoimmunity, based on its unique immune system.
It also sets the stage for increased susceptibility to molecular mimicry, meaning other things that look very similar to the immune system to the thyroid tissue that its attacking, can also increase the autoimmune response; things like yeast, bacteria, gluten and environmental toxins. All can exacerbate this whole situation. So, one of the number one reasons why women have a tendency to develop more hypothyroid symptoms, more autoimmune attack on their thyroid, is the result of leptin.
The number one thing I said that can drive leptin levels up, that differentiates why more women than men develop thyroid problems, is estrogen levels. There are some other things that can drive up leptin as well; a diet high in carbohydrates can drive up leptin levels. That’s for men or women, but women are going to be at a greater disadvantage. Decrease physical activity, because if you decrease your physical activity there is a lesser need for excess carbohydrates, excess sugar, so more of those glucose molecules are going to get stored as fat, which means you are going to drive more leptin. Stress of any type; physical, chemical, emotional, microbial… can increase cortisol, which can increase inflammation, which can increase leptin and drive this whole scenario.
Lastly, there are a whole bunch more things that can drive leptin levels to go up. I don’t think we need to get into it, you just need to know that there is a reason why more women have hypothyroid symptoms, have more hypothyroid conditions and develop more autoimmune thyroid conditions. Next time, I’ll probably talk to you about what you can do naturally to lower your leptin levels.
Alright, hope that helps. If you have any questions, put it in the comment area below or give the office a call if you have any questions. Have a great day.
