Natural thyroid support during perimenopause

."Why Am I So Tired All the Time?" - When Your 40s Feel Like a Health Mystery

If you're a woman in your 40s asking yourself "what's wrong with me?" - you're not alone. Perhaps you've noticed your hair falling out more than usual, you're suddenly gaining weight for no reason, or you can't sleep through the night anymore. Your periods might be getting heavier and irregular, and you're experiencing brain fog that makes you feel like you're losing your mind.

You might be wondering: Is this just normal ageing? Am I entering perimenopause? Could it be my thyroid?

Here's what many women don't realise - the symptoms of thyroid dysfunction and perimenopause overlap so significantly that it's easy to miss one whilst focusing on the other.

If you're experiencing unexplained tiredness, weight gain, hair loss, hot flushes, or irregular periods in your 40s, both your thyroid function and reproductive hormones deserve investigation.

As a naturopath on Sydney's Northern Beaches with over a decade of experience in perimenopause, I've worked with hundreds of women who've felt unseen, and assumed that their symptoms are "just part of getting older." While hormonal changes in perimenopause are natural and unavoidable, debilitating symptoms don't have to be your new normal.

Our thyroid hormones are important for healthy functioning. The hormone produced by the thyroid gland has an effect on nearly every tissue in the body. Thyroid hormone is crucial for metabolic regulation which affects how the body makes energy. Adequate levels of T3 (the active form of thyroid hormone) affect heart rate, body temperature, brain and muscles, and govern how effective the body is at burning calories. You can check out the tables below for some common symptoms experienced by high or low thyroid function.

Hormonal changes can trigger thyroid dysfunction at any age, but there are some particular lifestages where women are at a greater risk. Studies show us that thyroid disease is more commonly triggered during puberty, pregnancy, perimenopause and when taking the oral contraceptive pill. A study of more than 50,000 Korean women over the age of 40 concluded that hypothyroidism is more prevalent in late perimenopause than in younger age groups.

We also know that men have a much lower risk of thyroid dysfunction because they don't experience reproductive hormone fluctuations like women do.

I have included 2 tables below to show the large overlap between symptoms of perimenopause and those of thyroid dysfunction. This means that subclinical hypothyroidism or hyperthyroidism can easily be overlooked during perimenopause.

The table below compares the overlap of symptoms in perimenopause and hypothyroid:

Perimenopause	Low thyroid function
fatigue	fatigue
changes in menstrual cycle	changes in menstrual cycle
depression/low mood	depression/ low mood
digestive changes - increased bloating	digestive changes - bloating and constipation
slowed metabolism	weight gain
dry skin, thinning hair	dry skin, hair loss
pain or stiffness in joints	pain or stiffness in joints
sleep changes	sleep changes
forgetfulness, brain fog	memory changes, forgetfulness

The second table compares the overlap of symptoms in perimenopause with common hyperthyroid symptoms:

Perimenopause	Thyroid over function
fatigue	fatigue
poor sleep	poor sleep
anxiety	anxiety
heart palpitations	heart palpitations
hot flushes	heat sensitivity
lack of focus and concentration	hyperactivity
mood changes	mood changes

If you're experiencing any of the above symptoms, it's important that you don't assume that it's just perimenopause. A thorough thyroid function test at this time can reduce the problems you experience as you transition through perimenopause.

Progesterone, estrogen, and thyroid hormones

When it comes to our hormones, it's all a delicate balancing act. Every gland in our endocrine system produces hormones that directly affect other glands, and other hormones.

In the early stage of perimenopause, progesterone levels begin to decline. Since progesterone assists with the conversion of T4 (inactive thyroid hormone) to T3 (our active thyroid hormone), low levels of progesterone can directly impact metabolism and energy levels.

Simply supplementing with progesterone is not always the answer, as sometimes supplementation can lead to more inactive thyroid hormone circulating. I like to start with a gentle herbal medicine, such as chaste tree, to increase your body's own production of progesterone, rather than supplementing. Diet and lifestyle changes can all assist your body's ability to produce progesterone.

Because progesterone levels are in decline during the early stage of perimenopause, this leaves estrogen unopposed, often triggering symptoms associated with higher estrogen such as heavy bleeding, migraines and histamine intolerance. Higher estrogen and histamine levels can then exacerbate symptoms of hypothyroidism.

Under active thyroid has been known to slow down liver detoxification of estrogen, worsening symptoms of estrogen dominance in the early stages of perimenopause. If you are experiencing migraines and/or heavy periods, then your estrogen levels are likely to be high and your thyroid function might be impacted.

In the late stage of perimenopause, estrogen levels also start to decline. Low estrogen levels can also impact the thyroid, by increasing hypothyroidism.

So you can see that both high estrogen levels and low estrogen levels can affect thyroid hormones. It's important to have regular check ups with your doctor during perimenopause to monitor any changes in thyroid stimulating hormone (TSH) that occurs with fluctuations in progesterone and estrogen.

Insomnia and exhaustion in perimenopause

Exhaustion is common in perimenopause due to lack of sleep. Low progesterone levels can increase wakefulness, especially in the week leading up to your period. Heightened anxiety can also contribute to poor sleep during this stage, with women describing that they lie awake thinking and worrying, often for up to 2 hours before being about to fall back to sleep. Additionally, lowering estrogen levels occurring in the late stage of perimenopause might cause hot flushes and sweating at night, making uninterrupted sleep difficult.

In hypothyroidism, the exhaustion is driven by low thyroid hormones, or low conversion of the inactive hormone, T4, into the active thyroid hormone T3. This hormone reduction will send your body a message to slow down the amount of energy available. Women with low levels of thyroid hormone often describe exhaustion and fatigue even if they are getting a full nights sleep. With hypothyroidism, you might need to take naps during the day just to manage your usual activity levels.

Fatigue is also a symptom of hyperthyroidism, where the thyroid gland is producing too much thyroid hormone. Your thyroid hormone sets the pace of your metabolism, so high levels can lead to a racing heart and feeling of exhaustion. An increase in thyroid hormone can also cause sleep problems and a feeling of anxiety, because your body wants to go, go, go.

If I am working with a perimenopausal women who is chronically exhausted, we must rule out thyroid problems while also supporting reproductive hormones.

Weight gain in perimenopause

In the later stage of perimenopause, weight gain is common because estrogen levels are no longer supporting insulin sensitivity. During this stage, it's common for women to report that they are eating the same food and doing the same exercise that they were previously, however they keep putting on weight. This weight gain of around 5kg tends to occur in the late 40s to early 50s. I have found that women often maintain their weight more easily on a lower carbohydrate diet during this stage. The weight gain can tend to land in places that you might not have carried weight before, such as your hips.

Low thyroid function can also contribute to weight gain. If your thyroid is under-functioning, it means that you might have less energy to exercise. If you're only just managing to get through each day, it can be harder to make good food and exercise choices, leading to weight gain. Couple this with an active/stressful work and home life, and it's easy to see why women put on weight during this life stage.

Hypothyroidism can impact your whole digestive system, slowing it down, so that you might experience bloating and constipation.

When I see weight gain in women during perimenopause, I like to investigate insulin, fasting glucose and thyroid function. In women younger than 40, I look to thyroid function, glucose metabolism and PCOS before considering perimenopause.

Depression in perimenopause

From my experience working with women in perimenopause, I find it more common for women in the early stages of perimenopause to suffer from anxiety, rather than depression. From my observations, depression tends to come during the lower estrogen, or later stage perimenopause.

So if a woman in her early 40s says that she's feeling depressed, especially if the depression is every day, and not just the week leading up to her period, this is a red flag for me to look more closely at thyroid function.

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Natural thyroid support in perimenopause

Happily, when you choose natural treatments to support your thyroid function, you will also experience benefits in your perimenopause symptoms.

Do you suspect you're struggling with symptoms of low or high thyroid function, however your thyroid tests come back normal?

Here are some ideas to support yourself:

1. Test your levels of nutrients that support healthy thyroid and reproductive hormones. For example iodine, iron, zinc, vitamins D and B12. You may need to supplement with these nutrients if you diet is inadequate, and if you're unable to spend time in the sunshine. Check with your doctor, a naturopath, or nutritionist for support with this.

   
   

2. Move your body. Strength training builds muscle and supports metabolism. Exercise contributes positively to maintaining a healthy weight, sleep and mood during perimenopause.

   
   

3. Support your nutrition. Hormones are completely dependent on the foods we eat. Healthy hormones come from eating good quality proteins (beef, lamb, chicken, pork, fish and seafood, legumes, tofu and lentils); healthy fats (oily fish, avocado, nuts and seeds, good quality oils such as olive oil), and healthy carbohydrates (vegetables, fruit, whole grains, nuts and seeds).

   
   

4. Cortisol, your stress hormone, has a direct influence on progesterone levels and thyroid hormones. Managing stress levels is fundamental to healthy hormone balance. I recommend creating stress relieving rituals such as breathing techniques, mindfulness meditations, or yoga. If you are too busy or stressed out to implement these strategies into your life, then I recommend at a minimum, supporting your adrenal health with herbal medicine and nutrients.

   
   

5. Metabolism has many factors including, of course, diet, exercise and thyroid function. Managing your blood glucose levels will also be important at this time. Once again, you might like to test for fasting glucose and insulin levels. You may find that cutting back on gluten and processed foods has a positive impact on your metabolism.

   
   

6. Ensure adequate sleep. Although this is the sixth point in this list, arguably a good nights sleep is the basis of great health and happy hormones. Healthy sleep routines including not exercising just before bed, paying attention to circadian rhythms by going to bed around 10pm and waking around 6 to 7am, and turning off all your devices at least an hour before you plan to sleep. If sleep is a problem for you, I recommend employing a good bedtime routine and trying herbal medicine or herbal tea.

   
   

7. Address gut health. Getting to the bottom of digestive problems can be a game changer for thyroid conditions, especially if there are autoimmune thyroid antibodies. Leaky gut, gut dysbiosis and histamine intolerance can be linked to autoimmune thyroid condition Hashimoto's disease. If you regularly suffer from constipation or bloating, then addressing gut health might be a priority for you.

   
   

8. Reduce toxin exposure. There are chemicals in our environment that can affect the functioning of our endocrine glands, including the thyroid. I recommend limiting your exposure to unnecessary chemicals in your home and food, which might mean switching to more natural cleaning products, and buying organic foods whenever you can afford to.

   
   

Next Steps to Reclaim Your Energy and Vitality

If you've recognised yourself in the symptoms described above, here's what I want you to know: You don't have to struggle through this alone, and you don't have to accept feeling exhausted and overwhelmed as your new normal.

Start Here:

• Track your symptoms for 2-4 weeks (energy levels, sleep patterns, menstrual changes, mood fluctuations)

• Discuss your concerns about your thyroid function with your GP

• Consider your stress levels and how they might be affecting both your thyroid and reproductive hormones

  
  

Take Action Today: The natural approaches I've outlined - supporting your nutrition, managing stress with herbal medicine, addressing gut health, and reducing toxin exposure - can begin making a difference within weeks. These strategies support both optimal thyroid function and smoother perimenopause transition.

Ready for Personalised Support?

If you're tired of feeling tired, and you're ready to address the root causes rather than just managing symptoms, I'd love to help you. My approach combines the ancient wisdom of herbal medicine with modern understanding of women's hormonal health.

I offer two ways to work together:

1. Individual Consultations: Comprehensive naturopathic assessment with personalised herbal medicine formulations and targeted nutritional support

2. THRIVE Program: My signature 8 week perimenopause coaching program that helps women reclaim their energy, balance their hormones, and feel confident in their bodies again.

   
   

Many of my clients from the Northern Beaches tell me they wish they'd reached out sooner. Don't wait until your symptoms become unbearable - your body is already giving you important messages. I would love to assist you to thrive during perimenopause.

Simone :)

Enrol in my online perimenopause coaching program called THRIVE

Frequently Asked Questions

Q: How do I know if my symptoms are thyroid-related or perimenopause? A: The overlap is significant, which is why proper testing is crucial. Thyroid symptoms tend to be more consistent day-to-day, whilst perimenopause symptoms often fluctuate with your cycle. However, you can have both conditions simultaneously. I recommend thyroid testing alongside tracking your menstrual patterns and symptoms for 2-3 cycles.

Q: Can thyroid problems start during perimenopause? A: Absolutely. Research shows that thyroid dysfunction is more prevalent during perimenopause, particularly in women over 40. The hormonal fluctuations of perimenopause can trigger thyroid issues, especially if you have a genetic predisposition or have been under chronic stress.

Q: How long does it take to see improvements with natural thyroid or perimenopause support? A: Many women notice energy improvements within 2-4 weeks of implementing dietary changes and targeted supplements. However, thyroid healing is a gradual process - significant improvements typically occur over 3-6 months. Hair regrowth and weight stabilisation may take 6-12 months as your metabolism rebalances.

Q: What's different about your approach to other naturopaths? A: I create personalised herbal medicine formulations rather than prescribing standard products, and I understand how the unique lifestyle pressures of Sydney's Northern Beaches can impact women's health. Plus, having navigated my own perimenopausal journey, I bring both professional expertise and personal understanding to your care.

Q: Do you only see women from the Northern Beaches? A: Whilst my clinic is in Manly, I see women from across Australia via telehealth consultations.

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Hi! I'm Simone Jeffries. I am a naturopath, nutritionist, herbalist and certified wellness coach. I am also a foodie and an advocate for a whole food diet.

I love to support you with hormonal conditions, histamine intolerance and vaginal imbalances.

I welcome clients to consult with me at my clinic in Manly on Sydney's Northern Beaches, and online from anywhere in Australia.

The information in this blog is from my Bachelor of Health Science degree, experience from working with women in my clinic, and continuing research.

This blog is for information only and not intended to take the place of medical advice. Please seek assistance for any medical concerns.