The new study came out of beautiful Nepal – not a country that I would associate with changing thyroid function in some of the population, but apparently so. The study’s purpose was to evaluate whether blood levels of calcium, magnesium and phosphorus were out of balance in hypothyroid cases. (Dhungana et al, 2022).
With a wide range of ages of subjects between 20 and 50+ years, and with it including women, I read it with interest.
The outcome was intriguing. The results led the authors to conclude that a significant change in the levels of serum calcium, phosphorous and magnesium was connected with thyroid dysfunction of the study subjects. As such, this might affect bone loss and osteoporosis, including fractures.
My interest in this study was also piqued for another reason.
It backed up another study that I had been reading about the connection between low magnesium levels with thyroid dysfunction. I had been preparing for a zoom session with Health Professionals on my CPD course – and was interested as the study was conducted exclusively on women transitioning menopause. [Kolanu et al, 2020].
Thyroid problems predominantly affect women. The incidence is 5-20 times higher in women than in men and are more prevalent as women age. (Gietka-Czernel, 2017).
And whilst many of us know that iodine is a nutrient that is needed for optimal thyroid function, apparently, optimal levels of magnesium are needed for this iodine to be effective – I wish I knew this years ago when doing a lot of exercise!
Thyroid hormones play a vital role in both metabolic and physiologic balance in the body. They perform numerous roles including helping to regulate cardiac output, heart rate, resting metabolism, temperature, brain and endometrium function as well as helping to regulate the stress hormones.
Magnesium is involved in helping to make (synthesize) thyroid hormones. It’s an important mineral that helps with the uptake of iodine.
Numerous women on the MyMT™ programmes mention that they are on thyroid medication and I wonder now, that perhaps as they’ve moved into menopause, whether their magnesium levels may have been an issue too. Who knows!
The symptoms of thyroid disease might sound familiar to you –
anxiety, heart palpitations, sweating, gaining or losing weight and insomnia are common symptoms for both thyroid and ovarian dysfunction in menopause.
Your symptoms in menopause are closely related to the health and function of your thyroid gland, and yes, as your thyroid gland ages, then some lowered function is normal. (Gesing, 2015; Gietka-Czernel, 2017; Slopien,Owecki et al., 2020).
But your thyroid hormones can also get out of balance if you aren’t sleeping, or you are doing too much exercise, or you are overweight (or underweight) or you feel stressed and if your diet isn’t as healthy as it should be during this stage of your life.
You may feel cold or tired, sluggish, your hair and skin might become dry or you may gain weight or for some of you, your hot flushes and brain fog may worsen as does your anxiety levels.
Normal thyroid function is dependent on several nutrients to regulate the production of thyroid hormones.
Iodine, iron, tyrosine, selenium, and zinc are needed to facilitate the conversion of T4 to T3 A deficiency of any one of these nutrients could result in reduced T3 production, causing you to experience hypothyroid symptoms.
Vitamin A and D also play important roles in cell receptor behaviour to regulate thyroid hormone metabolism and more recent research suggests that magnesium is important too.
The role of magnesium matters to numerous hormones as you can see from the diagram below (Kolanu et al, 2020).
This is why, if your menopause symptoms are frustrating you, then perhaps you need to look at your magnesium intake (around 400mg daily) and your iodine intake (unless you have had a thyroidectomy) and of course, also understand the other lifestyle factors that you may need to put into place to help your thyroid cope with your hormonal changes during and after menopause.
Physiological Changes to your Thyroid in Menopause and as you Age:
As those of you who have been reading my posts for a while may have gathered, I’m always going on about the fact that our menopause transition is the biological gateway to our ageing. In my 2 hr online Masterclass on Menopause I also talk about this.
Natural menopause, when periods end, occurs around 51-52 years old and is a natural biological event that heralds in our ageing.
For too long our symptoms in menopause have been looked at through the lens of ‘sickness’ but when you look at the ageing science, then everything makes so much sense. Including symptoms that are the result of an ageing thyroid gland.
As I often say to women, your declining reproductive hormones are not the problem. This is natural. The ‘problem’ is that our organs are ageing and therefore, we need to change how we look after ourselves at this stage of life, especially if we already have health changes.
In other words, it’s time to reverse the damage that the years have thrown at us and ‘get back on track’ with our health – looking after our thyroid, including exploring your magnesium and iodine intake, is one such lifestyle factor that you have control over.
The thyroid’s main job is to regulate your metabolism.
Located in your neck, the thyroid is a butterfly-shaped gland that wraps around your windpipe and sits just below your Adam’s apple. If you look in the mirror, you might see that it looks bigger – is so, then get it checked out .. . you might have Goitre.
Your thyroid produces hormones (chemical messengers) that help to control your body’s metabolism – how you burn calories and use energy. This means that the thyroid gland has a direct effect on your weight, energy levels and your ability to absorb nutrients from food as well as your sleep and hot flushes.
When your thyroid produces the right amount of hormones, all is well. But when it produces either too much hormone or too little, many of these bodily processes, become un-balanced. Yes, it’s that powerful.
Your thyroid is a busy organ and during menopause, because of the powerful negative feedback response of all of our hormones, menopause is a vulnerable time for our ageing thyroid. So, if your lifestyle is busy and active, your thyroid needs a bit of loving when you move through menopause. You must look after it – especially if you want your energy levels to return and if you want to improve your longevity.
Your thyroid is changing as you age. It is ageing too.
Thyroid epithelium undergoes degenerative processes that lead to both its flattening and a decrease in size (Gietka-Czernel, 2017) as we age. Thyroid cells (also called thyroid epithelial cells) are the major cell type in the thyroid gland, and are responsible for the production and secretion of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). Many of you may be aware of these hormones because of blood tests you have had over the years.
The consequence of your ageing thyroid gland during menopause and into your 60’s, is that its size reduces over time.
This has major implications for us as we move through menopause, especially those of you who are quite active and/or have physically demanding jobs and you are always busy and exhausted.
You see, with a smaller thyroid gland, it’s ability to uptake iodine diminishes – to the point that in older women, (over the age of 70 years), it becomes up to 40% lower in activity than in women in their 30’s. If you remember your own mother or another elderly woman you know, feeling tired all the time as she got older, and putting on lots of weight, then this may be why.
In contrast, there are also many women who lose weight as they age and this can be due to hyperthyroidism, whereby too much thyroid hormone is produced, causing the metabolism to speed up. This may be the issue with some of you who are thinner and leaner and are on HRT and you are losing weight, because this medication also impacts your thyroid function.
Common symptoms of hyperthyroidism include weight loss, a more rapid heart rate, hot flushes and/or night sweats and feelings of anxiety. If this sounds like you, then it may be time you looked at your intake of B-vitamins and of course, the food that is high in magnesium, such as wild black rice!
Help Your Thyroid to Thrive – My Top 3 Strategies:
- Sleep All Night: I can’t reiterate the importance of a good night’s sleep. This is so important to the regulation of your thyroid function and is the foundation to turning around your hot flushes as well. There is a powerful connection between your sleep hormones (produced in your pituitary gland), thyroid hormones and your ovarian hormones – they all ‘talk’ to each other. As such, when oestrogen production declines, so too does our beautiful sleep hormone called Melatonin and when we don’t sleep this affects our thyroid function too.
Walking the Iodine Tightrope Requires Optimal Gut Health: Your thyroid gland depends on iodine to manufacture thyroid hormone. It doesn’t take much, but it does need the right food. Whilst the amount needed is miniscule, your thyroid gland can’t do its job without even a tiny amount of this trace mineral.
So hungry is your thyroid gland for iodine, that when it doesn’t get enough, the gland grows larger as it tries to suck up as much iodine as it can. Eventually, the thyroid gets larger and this swelling is called a Goitre.
This condition was previously common in countries where iodine (and selenium) is deficient in the soil and therefore, became deficient in the population. But there’s another problem as well for women going through menopause and this is to do with the gut.
Iodine from the diet is absorbed throughout the gastrointestinal tract, so too is magnesium, hence, sorting out gut health concerns such as IBS, is equally important for your healthy ageing. It’s why, in my 12 week programmes, I have a Gut Health Restoration module too.
Dietary iodine is converted into the iodide ion before it is absorbed, so if iodine intake is insufficient or you have an under-active thyroid, then your digestion slows down. This in turn may result in constipation.
Because the iodide ion is bio-available and absorbed totally from food and water, if your gut health isn’t optimal, then please come on board with me if you can, so you understand how to turn around your gut health too. Having a healthy gut is the foundation for improving the health of your ageing thyroid and your ability to absorb iodine as you move through menopause.
Diet is the sole source of iodine, which in turn is dependent upon the iodine content of water and soil. Iodine is metabolized in our body through a series of stages involving the hypothalamus, pituitary, thyroid gland and blood [Ahad & Ganie, 2010).
So, if you aren’t on thyroid medication (if you are, then talk to your Doctor about your dietary needs for iodine), then have a look at your diet and make sure that you are getting enough iodine-rich and magnesium-rich food. Your body needs around 380-420mg of magnesium daily, with the upper amount as your guide if you are sweating a lot or exercising frequently too.
Salmon, green vegies (if soils are deficient in iodine) and magnesium-rich foods such as Wild Black Rice and nuts and seeds help. Then there is iodised salt, but the double-edged sword with too much salt, is that we need to manage our intake of salt so that our blood pressure doesn’t increase, especially as we move into post-menopause.
Don’t Exhaust Yourself: Easier said than done for women in midlife as we still have so much going on in our lives. However, thyroid hormones are altered by energy imbalances and these imbalances are often present in female endurance athletes or women who have busy, active jobs.
It’s not so much about the immediate effects of the training/ exercise either. It’s about the accumulation of fatigue over the course of your week.
If your nutrient intake isn’t sufficient for all that you are doing or you are fasting too much, then your thyroid will be working over-time to keep your metabolism going.
I’ve taught about Overtraining Syndrome (OTS) for years in my role as a sport and exercise-science educator. OTS appears to be a maladapted response to excessive exercise without adequate rest, resulting in disturbances of multiple body systems (neurologic, endocrinologic, immunologic) coupled with mood changes.
As I often say in my Masterclass on Menopause, women in their early 60’s today, are the first generation of women to be doing lots of exercise, especially higher-intensity exercise and heavy strength training, but have little or no idea, how much this is sending them into OTS as they move into peri-menopause and menopause.
The reason this occurs is because of the high levels of our chronic stress hormone called ‘cortisol’. When cortisol levels remain higher than they should, our thyroid, adrenals and pituitary hormones change in response to trying to balance out the cortisol. As such, it is well known that many symptoms of overtraining in older female athletes, mimic the symptoms of menopause.
What’s the result of too much exercise and not enough sleep or an insufficient dietary intake of not only the total volume of food, but iodine and magnesium-rich food? Yes, your exhausted thyroid plays up as does your cardiac function, your sleep and your weight as well.
REFERENCES
Ahad, F., & Ganie, S. A. (2010). Iodine, Iodine metabolism and Iodine deficiency disorders revisited. Indian journal of endocrinology and metabolism, 14(1), 13–17.
Bellastella G, Scappaticcio L, Caiazzo F, Tomasuolo M, Carotenuto R, Caputo M, Arena S, Caruso P, Maiorino MI, Esposito K. Mediterranean Diet and Thyroid: An Interesting Alliance. Nutrients. 2022 Oct 4;14(19):4130. doi: 10.3390/nu14194130.
Dhungana A., Shreevastva, N et al. A study of serum calcium, phosphorous and magnesium level in hypothyroid cases. Journal of Pathology of Nepal (2022) Vol. 12, 1933 – 1937.
Gesing A. (2015). The thyroid gland and the process of aging. Thyroid Research, 8(Suppl 1), A8. https://doi.org/10.1186/1756-6614-8-S1-A8
Gietka-Czernel M. (2017). The thyroid gland in postmenopausal women: physiology and diseases. Przeglad menopauzalny = Menopause review, 16(2), 33–37.
Kirkland AE, Sarlo GL, Holton KF. The Role of Magnesium in Neurological Disorders. Nutrients. 2018 Jun 6;10(6):730.
Kolanu BR, Vadakedath S, Boddula V, Kandi V. Activities of Serum Magnesium and Thyroid Hormones in Pre-, Peri-, and Post-menopausal Women. Cureus. 2020 Jan 3;12(1):e6554. doi: 10.7759/cureus.6554.
Kreher, J. B., & Schwartz, J. B. (2012). Overtraining syndrome: a practical guide. Sports health, 4(2), 128–138. https://doi.org/10.1177/1941738111434406
Nerhus, I., Wik Markhus, M., Nilsen, B. M., Øyen, J., Maage, A., Ødegård, E. R., Midtbø, L. K., Frantzen, S., Kögel, T., Graff, I. E., Lie, Ø., Dahl, L., & Kjellevold, M. (2018). Iodine content of six fish species, Norwegian dairy products and hen’s egg. Food & nutrition research, 62, 10.29219/fnr.v62.1291. https://doi.org/10.29219/fnr.v62.1291
Slopien, R., Owecki, M., Slopien, A., Bala, G., & Meczekalski, B. (2020). Climacteric symptoms are related to thyroid status in euthyroid menopausal women. Journal of endocrinological investigation, 43(1), 75–80. https://doi.org/10.1007/s40618-019-01078-7