When the thyroid rides along

The thyroid is a butterfly-shaped gland in our neck that produces essential hormones with a significant impact on our mental health and metabolism. Thyroid dysfunction is one of the most common health issues among women, with the most frequent condition being Hashimoto’s thyroiditis, an autoimmune inflammation of the thyroid that leads to hypothyroidism.

Many of my clients know they have hypothyroidism but are unaware if it's due to Hashimoto’s. In Hashimoto’s, the body’s immune system starts attacking the thyroid, mistaking it for a foreign invader. Over time, this causes the hormone-producing thyroid tissue to be replaced with fibrous tissue, which doesn’t produce hormones. As the disease progresses, the thyroid becomes smaller, resulting in fewer thyroid hormones being produced.

Unfortunately, many doctors view thyroid problems as minor and easy to treat. While it’s true that the symptoms can be managed, standard therapies, like prescribing L-thyroxine, often aren’t enough for many patients.

In my opinion, thyroid treatment belongs in the hands of a specialist—specifically an endocrinologist. Endocrinology deals with hormone-producing glands, and our bodies have a delicate hormonal balance. When one hormone is off, it can throw the others out of sync and affect your overall health.

For women, the thyroid plays a crucial role, especially when it comes to fertility. Often, an inability to conceive is linked to insufficient thyroid hormones in the body.

You might be wondering: What does this mean for me as a rider?

As I mentioned, the thyroid has a big influence on metabolism. Without enough thyroid hormones, you may retain water, gain weight, struggle to lose it, and it can significantly impact muscle tone. Many people with thyroid issues suffer from painful muscle tension when their hormone levels aren’t properly managed.

When I was diagnosed with Hashimoto’s, I went through two years of misery before finding an endocrinologist who focused on my overall well-being rather than just my lab results. During that time, my medication, L-thyroxine, was either increased too quickly or not enough, causing me to swing between hyperthyroidism and being stuck in hypothyroidism. I was constantly exhausted, bloated, drained of energy, in pain, and my emotional state felt like a roller coaster.

At ballet, I’d be wiped out within five minutes. And when riding, my horses gave me looks as if to say, “How can I move freely when you don’t even know what relaxation feels like?”

L-thyroxine replaces T4, one of the thyroid hormones. It’s assumed that your body converts T4 into T3, the hormone more crucial for metabolism and mental health. However, my body wasn’t doing this efficiently, and I’m not alone. This is called a conversion disorder, where your body doesn’t convert enough T4 into T3. Even if your lab results don’t show this, studies now indicate that adding T3 to the treatment can greatly improve well-being. Your body can release excess water, metabolism speeds up, muscles return to a healthier tone, and mental health improves. My endocrinologist told me that T3 supplementation has now been recommended for treating hypothyroidism, though not all doctors are up to date on this.

Some people can’t tolerate synthetic medications like L-thyroxine (T4) or Thybon (T3). In these cases, there’s the option of using natural thyroid hormones derived from pigs, but you’ll need a knowledgeable doctor to guide you through it.

I mentioned earlier how the impact on mental health is enormous. Many people are misdiagnosed with depression or anxiety, treated with antidepressants, or even hospitalized when the underlying issue is a thyroid disorder. That’s why ruling out thyroid issues is crucial when diagnosing mental health conditions.

One of the most common mental health issues linked to thyroid disorders is anxiety, and I see this in my practice all the time. This includes anxiety related to riding.

Now, you might be starting to realize that your anxiety could be connected to your thyroid function. A thyroid disorder can either cause or amplify anxiety. Both anxiety and thyroid imbalances affect muscle tone, flexibility, and ultimately, your riding posture and control.

If you have a thyroid condition, it’s worth diving deeper into it and finding a treatment plan that works for you. It’s essential to understand your blood test results. If you suspect a thyroid issue, it’s best to see an endocrinologist. General practitioners often only test TSH levels, which might indicate thyroid function but are slow to react, meaning your TSH could look fine while you’re already experiencing hypothyroidism.

What’s more important are your free T3 (fT3) and free T4 (fT4) levels in your blood. Many people feel best when their levels are in the upper third of the normal range and close together. If there’s a wide gap between them, with T4 being better and T3 lower, you’re less likely to feel well.

You should learn to interpret your own blood results, and a helpful tool for this is a percentage calculator that shows where your levels fall within the normal range. Personally, I feel best when both my fT3 and fT4 are between 66% and 75%. But everyone is different, so it’s essential to focus on how you feel, not just your numbers.

If you’re taking T3, it’s important to know that TSH levels become irrelevant because T3 supplementation can suppress TSH. Some doctors may mistakenly think you’re hyperthyroid and reduce your meds, even though your free T3 and T4 might still be too low.

Whether you have Hashimoto’s or another thyroid issue, it’s possible to find the right balance and regain your energy and quality of life. I hope you find a knowledgeable doctor who listens to your body’s signals.

Remember: No one knows you better than you do.

Wishing you all the best,

Nicole