The birth control and thyroid connection is real! And many women have written to me questioning if the birth control pill could be sabotaging their thyroid health. The common story I hear from these women and the women in my practice is that most of their problems started when they committed to that daily pill consumption.
This has been a question on my mind too, after all I did my time with The Pill and was diagnosed as hypothyroid later in life. After I was diagnosed with Hashimoto’s hypothyroidism, I knew I had some work to do if I was going to get my health back on track and that this was definitely not the time to get pregnant. After having over a ten year relationship with birth control pills I knew I didn’t want to go back, but it did make me curious about what effects the birth control pill could have on thyroid health.
So I dug into the research and found that:the pill does more than prevent pregnancy — it sabotages thyroid health. - Dr. Jolene Brighten Click To Tweet
Today I want to share with you how birth control pills can create problems for your thyroid. This is information I’ve been sharing with my patients for years and now, I want you to be informed too.
Before we dive into how The Pill and Thyroid are connected, let’s take a quick review of the thyroid and why women should pay close attention to their thyroid health.
What You Should Know About Your Thyroid Health
Nearly 1 in 3 people have thyroid disease, the majority of which are women. In fact, women are 5 to 8 times more likely to have thyroid disease. Yet more than half of those with a thyroid condition don’t know they have it.
While a thyroid condition can be detected with a simple blood tests, many women go years before they receive a diagnosis. To evaluate thyroid function I recommend the following tests:
Thyroid 101: How Thyroid Hormones Work
Thyroid Stimulating Hormones (TSH) is the brain hormone that tells the thyroid gland to make thyroid hormone. Your thyroid responds to this signal by secreting mostly T4, although a small amount of T3 is also released. T4 is considered inactive and travels to other tissues in the body, like the gut, liver, and kidneys, in order to be converted to T3—your active thyroid hormone.
T3 is responsible for your mood, energy, metabolism, and ability to keep warm. Anything that inhibits TSH secretion, T4 production, conversion to T3, or the ability to use thyroid hormone by the cell can cause hypothyroid symptoms.
Heavy metals, autoimmune disease, fluoride, inflammation, infections, stress, nutrient deficiencies, and medications are some of the common causes of thyroid disruption.
The majority of thyroid conditions are autoimmune, with Hashimoto’s hypothyroidism being the most common.
Symptoms of Hypothyroidism include:
Dry skin, brittle nails
Women with Graves' disease, or autoimmune hyperthyroidism, can also be affected by the pill. The hormonal, inflammatory, and nutrient depleting effects can aggravate autoimmunity and lead to an increase in symptoms.
Symptoms of Hyperthyroidism Include:
How Does the Birth Control Pill Impact Your Thyroid Health? The Birth Control And Thyroid Connection
Birth control pills deplete vital nutrients your thyroid requires and can interfere with thyroid hormone on multiple levels. For example, selenium and zinc are needed to produce thyroid hormone and to convert it to its active form, T3. Zinc is also required for getting the thyroid hormone and cell receptor talking.
Just by depleting zinc alone, the pill can prevent you from making, activating and using thyroid hormones. But the pill affects more than just your minerals.
Crucial B vitamins are also depleted by the pill. Without these key vitamins, you can not synthesize thyroid hormone…not to mention the hundreds of other uses for them in the body.
So, let’s recap where these nutrient depletions are impacting your thyroid:
- Interferes with synthesis of thyroid hormone
- Interferes with conversion from T4 (inactive) to T3 (active)
- Interferes with using thyroid hormone at the cellular level
The pill affects just about every level of thyroid hormone synthesis and utilization. You make less, you convert less and you use less…this alone is enough to advise against taking the pill if you have a thyroid condition.
But there’s more…
The Pill Increases Thyroid Binding Globulin
On top of interfering every which way it can with your thyroid hormone, the pill also elevates Thyroid Binding Globulin (TBG) and as you can probably guess, it binds thyroid hormone.
Once thyroid hormone is bound to TBG it is not available for use by the cell. This means that even if you manage to overcome the nutrient depletions and make enough thyroid hormone, much of it will be bound and therefore, not available to your cells. Keep in mind, every cell in your body requires thyroid hormone.
So, in addition to depleting nutrients needed to make and use thyroid hormone — the pill also causes your body to bind up any thyroid hormone you actually manage to make.
The elevation in TBG is so well recognized that it is what researchers use to validate that a woman in a birth control trial is actually taking it.
The Pill is Inflammatory.
You know what else is inflammatory? Autoimmune disease. And it is the number one cause of thyroid disease in the United States.
Why is this important? Well, there are 3 big reasons.
ONE: Inflammation is at the root of all chronic disease.
If you already have an autoimmune condition then you probably already understand that more inflammation is bad. Like, can’t get out of bed, or move, or even think bad.
TWO: Inflammation will take your T4 and convert it right into Reverse T3 (RT3).
And when RT3 is up, you are beyond tired. I call it the hibernation hormone because it is designed to make you store calories (aka fat) and go to sleep…you know, hibernate.
THREE: Inflammation makes your cells walls less responsive to ALL OF YOUR HORMONES.
This includes insulin…and we all know where insulin resistance leads to. Actually, let me tell you that it is not just diabetes, but also neurological issues and heart disease that you have to worry about.
Think inflammation as fire and the pill as gasoline.
C-Reactive Protein (CRP) is a common inflammatory marker that is measured with via a blood test. With the pill, women not only experience an elevation in the CRP (the lower the better), as well as other acute phase proteins, including fibrinogen and ceruloplasmin.
Ok, so we’ve established the pill isn’t great for thyroid health, but what choice do we have?
Non-Hormonal Alternatives to The Pill
Your choice for a contraceptive should be made after doing your research and having a conversation with your doctor. This is an individualized decision and as such, there is no one-size-fits-all answer. Talk to your doctor about non-hormonal options and ask for the pros and cons of these methods as they relate to your health and needs.
If it feels appropriate, have a conversation with your partner too. There may be options they are willing to explore as well.
What About Fertility Awareness Method?
Regardless if you want to use this as your pregnancy prevention method or not, learning how your body works is invaluable. Your cycle gives you superpowers and knowing how to leverage them can make you feel on your game like never before.
I’ve written about the efficacy or ‘just how well does FAM really work’ here. I must admit, even I was surprised by what I found in the literature
For my high-tech gals, check out Daysy Fertility Monitor. Actually, you don’t have to be high-tech at all. Daysy makes it so easy and has so much data that she can help get your cycle dialed in quickly. This is the method I use because “green light go” and “red light stop” work really well when my mind is on pregnancy prevention.
You can read more about Non-Hormonal Contraception here.
How to Support Thyroid Health
The obvious decision would seem to quit the pill to overcome the birth control and thyroid condition, but I understand that not all women have the option to just go off the pill immediately. If you’re on the pill, coming off of it or have a history of using it, you’ll want to consider having thorough lab testing to investigate your health.
Looking for nutrient depletions, gut infections, inflammatory markers, as well as screening for cardiovascular and metabolic conditions is in important in evaluating the whole picture of your health.
In addition, comprehensive hormone testing should be performed, especially if you are having symptoms of Post-Birth Control Syndrome.
Eat Nutrient Dense Meals
Grass fed meats, seafood, leafy greens, mushrooms, and other vitamin and mineral packed foods can help you replenish the nutrients depleted by the pill. You can read more about specific foods to support your thyroid here.
While eating a nutrient dense diet is essential in keeping your thyroid functioning, I find that many women in my practice require supplementation to regain thyroid function and eliminate symptoms of fatigue, brain fog, weight gain, and period-related symptoms.
If you’re looking for help getting started, please download my hormone balancing 7-day recipe guide here.
Supplement for Thyroid Health
Selenium, iodine, vitamin A, and zinc are essential to thyroid health. Adaptogenic herbs like Ashwagandha, Rhodiola, and Ginseng support both adrenal and thyroid health. Nourishing the adrenals, along with using fish oil can promote a healthy immune response and appropriate inflammation, which is important for thyroid health.
Move Your Body Regularly
Exercise is important in lowering inflammation and supporting conversion of T4 to its active form, T3. I know it can be difficult to get moving when you feel fatigued, which is why focusing on what you can do and working your way up to more intense exercise is important.
Give Your Liver Support
The birth control pill has been shown to directly impact liver function. Your liver is responsible for detoxifying metabolic waste, environmental toxins, and hormones. When you take the pill you are ingesting a dose of hormones high enough to suppress your brain from functioning. The result is a suppressed menstrual cycle, which means no ovulation and a lower chance of becoming pregnant. It also means a lot more work for your liver.
The liver is also a major site of thyroid conversion, which is why supporting your liver is important whether you’re on or off the pill.
In my clinic we typically have women complete a 14-day doctor grade liver detox as a means of supporting their body’s natural functions and replenishing nutrients.
To learn more about what foods to eat and how to get a quick start on supporting your health, grab my Post-Birth Control Syndrome Quick Start Detox Guide
Are you a woman with thyroid disease who has taken the pill? Share your experience in the comments below.
- Panzer C1, Wise S, Fantini G, Kang D, Munarriz R, Guay A, Goldstein I.. Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction. J Sex Med. 2006. 3(1). 104-13.
- McArthur JO1, Tang H, Petocz P, Samman S.. Biological variability and impact of oral contraceptives on vitamins B(6), B(12) and folate status in women of reproductive age. Nutrients. 2013. 5(9). 3634-45.
- Palmery M1, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013. 17(13). 1804-13.
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc. 1980. 76(6). 581-4.
- A S Prasad, D Oberleas, K S Moghissi, J C Stryker, K Y Lei. Effect of oral contraceptive agents on nutrients: II. Vitamins. The American Journal of Clinical Nutrition. 1975. 28(4). 385–391.
- Massey LK, Davison MA. Effects of oral contraceptives on nutritional status. Am Fam Physician. 1979. 19(1). 119-23.
- Prabhudas R. Palan,1 Felix Strube,1 Juraj Letko,1 Azra Sadikovic,1 and Magdy S. Mikhail 1. Effects of Oral, Vaginal, and Transdermal Hormonal Contraception on Serum Levels of Coenzyme Q10, Vitamin E, and Total Antioxidant Activity. Obstetrics and Gynecology International. 2010. 2010(925635). 1-4.
- Cecilie J. Sørensen ,Ole B. Pedersen,Mikkel S. Petersen,Erik Sørensen,Sebastian Kotzé,Lise W. Thørner,Henrik Hjalgrim,Andreas S. Rigas,Bjarne Møller,Klaus Rostgaard,Mads Riiskjær,Henrik Ullum,Christian Erikstrup. Combined Oral Contraception and Obesity Are Strong Predictors of Low-Grade Inflammation in Healthy Individuals: Results from the Danish Blood Donor Study (DBDS). PLOS ONE. 2014.
- M. Palmery, A. Saraceno, A. Vaiarelli, G. Carlomagno. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013. 17(13). 1804-1813.