Estrogen and Your Thyroid

Many women today have estrogen dominance – a condition where estrogen is high in relation to progesterone. It doesn’t necessarily mean that estrogen is elevated (although most of the time it is) – it means that there is not enough progesterone production to oppose estrogen and keep it in check.

As if hypothyroidism wasn’t enough of an epidemic, estrogen dominance is epidemic as well and can have some serious implications for thyroid function. Kind of a double whammy.

The role of estrogen in hypothyroidism is well-researched. Estrogen directly affects the thyroid by thwarting its ability to produce thyroid hormones. To get that thyroid fired and humming along, it’s critical to address estrogen.

[My best selling cookbook is now available: The Essential Thyroid Cookbook: Over 100 Nourishing Recipes for Thriving with Hypothyroidism and Hashimoto’s.]

Although women of any age can be estrogen dominant, it can be especially evident during perimenopause and menopause, when our reproductive hormones are supposed to take a natural downturn. When estrogen remains high while progesterone wanes, women can experience more hair-raising menopausal symptoms.

There is a misconception that the symptoms of menopause are normal. They may be common, but they’re not normal. Today, women are experiencing eight to ten years (or more), of life-disrupting perimenopausal wackiness.

It wasn’t meant to be this way. We were meant to see some mild symptoms leading up to menopause; menopause is technically one year without a period. Perimenopause, which wasn’t even a term until about 15 or so years ago, should only last about a year or maybe two, and again, should be mild.

Hot flashes, flushing, weight gain, unstable moods, brain fog, and heavy periods are signs of estrogen dominance. Add some hypothyroidism in there and you’ve got thyropause. That double whammy thing.

Here’s what few healthcare practitioners will tell you. When the ovaries ramp down progesterone production, the body looks to its backup system, THE ADRENALS. Has anyone ever told you this? 

The adrenals make some progesterone. As the back-up glands, the adrenals start taking on the role of four glands as menopause approaches – two adrenals and two ovaries. So if our cute little adrenals are already overworked (the first phase of adrenal dysfunction – making too much adrenaline and cortisol) or are pooped out (the second phase of adrenal dysfunction – making too little adrenaline and cortisol), we have no backup system for making progesterone.

In the first phase, the adrenals are like, “Hey, man, I’m too busy making adrenaline and cortisol to keep up with your crazy busy, stressed-out lifestyle. Gimme a frickin’ break.” In the second phase, there’s simply no capacity to take on another role.

When I mentioned this to a doctor I was seeing a few years ago, he chuckled and said that the progesterone that the adrenals make is so miniscule, that it’s a negligible amount that shouldn’t even be considered. I knew this jerk doctor was wrong, and as I went on to learn more about hormones (especially in Dr. Janet Lang’s Restorative Endocrinology course for healthcare practitioners), it was driven home to me how critically important the adrenals are for easing through menopause without losing your mind.

And my menopausal clients are seeing huge improvements in their symptoms – sleeping through the night without sweats, more energy, no hot flashes, and abatement of their hormonal mood swings.

The proof is in the puddin’, don’t you think? When women start nourishing and supporting their adrenals, thereby helping the body produce more progesterone, and when they nourish and support their thyroid, which can help normalize estrogen levels, their reproductive hormones are more in balance and they start to see perimenopausal symptoms vaporize. Most of the time without hormone replacement therapy.

Here are some other whys – I love getting to the whys. Besides waning progesterone, why are we seeing these elevated estrogen levels? There are a number of reasons:

  • Xenoestrogens in plastics (“xeno” means “outside the body”)
  • Synthetic estrogens in the birth control pill
  • Phytoestrogens from food – mostly soy and flax products (“phyto” means plant) 
  • Environmental toxins that mimic estrogen

A trap that many women fall into is eating soy (a phytoestrogen) during perimenopause and menopause. Firstly, if they’re estrogen dominant in the first place, that’s a recipe for disaster. Secondly, xenoestrogens and phytoestrogens don’t replace estrogen, they mimic estrogen and can send other hormones into a confused tizzy.

What You Can Do:

  • Avoid xenoestrogens – steer clear of plastics and other endocrine disruptors.
  • Avoid phytoestrogens – steer clear of soy and soy products, with the occasional exception of fermented soy like tempeh.
  • Choose a safer form of birth control – but know that IUDs have been shown to decrease progesterone.
  • Go organic. Limit your exposure to pesticides, herbicides, and fungicides.
  • Drink warm lemon water first thing in the morning. Follow it with a tsp. of fiber powder, in the form of psyllium or triphala, in 8 oz. of water, followed by another glass of pure water.

Comments

Unfortunately, all comments on this post written prior to Feb. 28, 2013 were inadvertently wiped out. Ouch.

Hi, so does using an estrogen patch during menopause help or hinder the thyroid? Thanks! I would so appreciate an answer!

 

Lori

It’s difficult to answer this. If a woman is estrogen dominant, which testing doesn’t necessarily reveal, then taking more estrogen isn’t a great idea. And it depends on how much estrogen the supplementation/patch is providing. If it’s too much, then yes, the thyroid can be affected. We’ve found that many women are overdosed on supplemental hormones, including progesterone.

Hi Jill,

I would love some advice.  I have been on a bit of a health journey since menopause started in 2011.  I have the C677t homocesteine gene, Autoimmune antibodies were positive (smooth muscle and anti nuclear), the gene that makes gluathione is absent and my ability to detox markedly reduced.  I have been diagnosed osteoporsosis and I have low estrogen and progesterone  (through bloods).  The advice  that I am asking for is that I am seeing an integrative health practitioner who put me on bio identical estrogen and progesterone.  I did not feel great on the estrgoen  (progesterone fine previously) but with the estrogen  my thyroid would race at times and be abnormally sluggish at others.  Sleep vry much affected.  Now the autoimmune condition of Hypothyroid. The practitioner wants me to go on thyroid medication.  Given that I have had an undiagnosed autoimmune condition previously  I don't know if taking estrogen has caused the expression of hypothyroid and if by taking the thyroid supplements that she is suggesting will make it worse in the long term.  My body respond to the estrogen through nausea, and feeling like I have an infection and thinking very foggy. The practitioner gave me antibiotics which worked short term but it now feels as if infection is comng back. I also have low levels of DHEA.   I am super sensitive to what I put into my body and I wondered about your comments that if we get the adrenals right, I will start naturally making progesterone.  Do I need the Estrogen?  I am rattling through taking an awful lot of supplements. .

Hello Glori, 

Thank you for your comments and your interest in our work. Your question and collection of symptoms represent a complex condition and cannot be answered responsibly on a blog comment. We’d love to help you – if you’d like to speak with one of our coaches, you’re welcome to schedule an introductory session via our Contact page.

http://www.healthfulelements.com/contact

Thanks!

Thanks for all this info! I've read it before but it is a good reminder. I drink lemon water in the morning, but I'm wondering if I'm canceling out my thyroid pill? I take Westhroid first thing then drink warm lemon water. Am I flushing out the thyroid? TIA! 

From what I understand, you want to wait about 15-20 minutes between your thyroid hormone replacement and lemon water.

Wow! It's interesting to know that lemon juice could potentially cancel out the benefits of your thyroid medication, much the same as calcium or even caffiene can have a similar effect for some. Duely noted thank you

Hi -- Great article!  I'm currently taking hormone replacement therapy - vivelle dot 0.050, I don't have uterus or ovaries.  I've been taking this for 5 years.  I am 50 years old.  I have recently been diagnosed with hyperthyroid.  Thyroid problems do not run in my family.  I have 4 sisters who are older than me and did not have any thryoid problems when they went through naturally occuring menopause.  My question is could my HRT be the reason for they hyperthryoid? I do not want to start on thyroid meds as they seem to have not so good side effects one being damage to the liver.  If the simple solution of going off the vivelle patch would solve the thyroid problem, I would definitely do it.  Thanks!

Hi Elizabeth,

Thank you for your kind words. We’re sorry to hear of your diagnosis, but your question and collection of symptoms represent a complex condition and cannot be answered responsibly on a blog comment. We’d love to help you – if you’d like to speak with one of our coaches, you’re welcome to schedule an introductory session via our Contact page.

http://www.healthfulelements.com/contact

Thanks!

Women need to be aware that soy is found in many food items that would surprise you.  I am 63, natural menopause, always felt that my thyroid was low whenever my estrogen was high during menstrual cycle.  In January I started eating low sodium tuna in packets twice a week because the fish and Omega 3's would be good for me.  It didn't take long before I felt as though I had low thyroid and PMS...weight gain, dry, brittle hair, dry skin, crabbiness, lack of motivation, crying easily...the lightbulb went on and I read the back of the tuna packet; "Contents:  tuna; SOY.  Within days of discontinuing the tuna I started feeling normal again, the weight came off and has stayed off, I am happy, energetic, no longer want to kill my husband (LOL!)  And my total cholesterol dropped 2 points and LDL went down 7, so I didn't have to start on a statin for that.  I had stopped the tuna by the time my thyroid was tested, so only the T4 came back barely below the normal range and all else was in range.  I seem to be fine with eating 1 tablespoon of ground flax seeds every day, but that tuna (even tried rinsing it, not helpful) pushed my system over the top.  It doesn't take much, apparently!

Canned Central Market brand solid white no salt Albacore tuna from HEB and Central Market only contains Albacore tuna and water. It DOES NOT CONTAIN SOY.

Thank you for the great article. I have one question-I an 33 years old and I have "slow" thyroid-meaning that my T4 and T3 are normal, bur TSH levels are somewhat on the higher side, sometimes they are out of the normal range. No Hashimoto, no antibodies. Since I had CIN and endometrial polyps afterwards, and now two failed IUI-s can it be the estrogen? I mean can high estrogen disrupt my thyroid in that manner, and can it affect my endometrium?Thank you.

Hi Ivana, I take “normal” thyroid labs with a grain of salt because if outdated references ranges are used, it doesn’t give a full picture of what’s going on. I can’t answer your question because I don’t know where your estrogen levels are. But yes, estrogen can affect thyroid function and the endometrium.

I was diagonised with hypothyrodism following the birth of my daughter,taking thyroxine supplements (125mg). I am 33 now and have been unlucky twice to have large dermoid cysts on my ovaraies and as a result have no ovaries now ( follow oophretemy). So i am in surgical menopause.I was reccommneded by my doctor that I have estrogen patches ( 25mg) as part of HRT especially considering my age and an IUD to supplement Progestrrone. Since my estrogen patches my Thyroid levels have gone sluggish and doctor has reccommneded that I up my thyroxine supplements. Would uping the doasge sort this out!! i am interested in alternate therapy to strengthen my thyroid that take supplements forever! just wondering what your thoughts are.

Great article. Thanks for sharing!

Hi, stubbled apone  your web site as I was asking a question about, was it alright to  take my thyroid pill at the same time I put my Estrogen patch on? I'm 50 and going through pre menopaus and I have my overlies and Uterus. My gynecologist put an IUD in and I use  Estrogen patches. I take 100mcg of Levothyronxin once a day in the morning before I eat. I put on a Estradiol 0.0375mg/d twice a week. They were to manage my mood swings, hot flashes and regulate my periods, but the patches keep coming off my skin, so I've been lightly bleeding off and on which makes me irritable. Am I getting to much of one thing or both? I thought these two would these three methods would stop my mental cycle all together but its made it irratic. Can you help?

 

 

Hello Susanne,

Thank you for your comments and your interest in our work. Your question and collection of symptoms represent a complex condition and cannot be answered responsibly on a blog comment. We’d love to help you – if you’d like to speak with one of our coaches, you’re welcome to schedule an introductory session via our Contact page.

http://www.healthfulelements.com/contact

Thank you!

 

I have a very strange problem i'm 58 and taking thyroid medication for some time now every year or so my tsh goes very low from 1.46 to .24 while taking 100 mg synthroid and 5mg of cytomel every time it does this my doctor will give me less thyroid medication because it is too low yet i will get alot of hypo syptoms as well as hyper syptoms and gain weight also. Could this be because my estrogen is too high? 

Hello Donna,

Thank you for your comments and your interest in our work. Your question and collection of symptoms represent a complex condition and cannot be answered responsibly on a blog comment. We’d love to help you – if you’d like to speak with one of our coaches, you’re welcome to schedule an introductory session via our Contact page.

http://www.healthfulelements.com/contact

Warmly,

Blair

Hi! Thank you for this wonderful article. I have been in menopause now for 4 years and it has been a slow stroll through hell. I have tried EVERYTHING to help my symptoms (hot flashes/nightsweats/weight-gain): herbal supplements, tinctures, birth control pills, HRTs and finally an estrogen patch. I have gained 30lbs and have not been able to take it off with a modified veggie based diet and excercise. I believe I am absolutely estrogen dominant with hypothyroidism...the "thyropause" double whammy, as you called it. My question are there tests that can show if you are estogen dominant? If you are estogen dominant will progesterone cream and an adrenal supplement help? If you have the double whammy thyropause...would you need a thyroid medication, progesterone and an adrenal supplement? I have felt so bad for so long I no longer remeber what it feels like to have peace in my body. 

Hi! Question, I am have Hasomotios. They started me on Testerone shots due to how low my levels are. Once I started those I beginning spotting, bloated, and weight gain. Could this be estrogen dominance?? 

hello I have been diagnosed with hypothytoidism and have also high estrogen and all the symptoms that go with both: total shut down exhaustion, muscle and joint fatigue, infertility, massive unexplained weigh gain in spite of healthy diet and lots of exercise, lower ab pain and bloated belly, lost libido etc etc. 

they have put me straight on levothyroxyn but I would like to address the hormone imbalance as I velieve doing that will bring back my thyroid to health. Would progesterone cream help to address the hormone balance ? Anyone tried to tackle estrogen dominance this way? My gp won't help and has suggested I go to an expensive private Gino which I can't afford. 

Hi Jill,

I had to write after reading the previous emails and would love your opinion.  I had a blood test that revealed my thyroid was very high (5.310) (TSH/T4/Thyabs/TPO/Tp3/TSH and estrogen was 121.5!? Progesterone .04!  What is going on? I am very physically fit, swim 4-5 miles a week, weights, yoga and hike- I'm not tired, depressed nor have gained weight and my OB/Gyn suggested Hahimoto AutoImmune Disease? What am I eating or doing?  I'm giving up Kale/Flax/ and Green Juices....could it be a false bloodwork? What symptoms should I have and what do I do about it?  Thanks!?!!

Thanks 4 the insight!

I have been experiencing breast tenderness/pain, weight gain, dry brittle nails, hair, eyes, joint pain and fatigue.  Moods have also been up and down.  My lutenizing hormone is high but TSH seems to be normal or more low.  I believe i have what you describe as Estrogen dominance and hypothyroid symptoms.  Would supplememts to balance hormones, such as progesterone and testosterone, and adrenal supplements mitigate the dominance of estrogen and balance everything? 

hello! I am a 40 yr old female and have just begun seeing a Nurse Practitioner to help me get a handle on my insomnia, foggy thinking, and pre menopause symptom. My labs came back and showed normal progesterone but high serum estrone, low iron, low b 12 and low vitamin D.  She put me on a bunch of very high quality vitamin packs in addition to iron, vit D, b12 and DIM evail. She also put me on 100 mg of progesteron. 5 days into starting everything I noticed some hormonal pimples, dizziness and blurry vision. I had pretty clear skin for most of my life So just a few pimples is very odd for me. After speaking with her we stopped the progesterone and decided to just use the DIM and other supplements to hopefully get the high serum estrone down. Does this seem like a good plan? And do u think the progesterone supplementation was the cause of the sudden breakout? I just want to be confident that I am on the right path to balancing my hormones. Thanks so much

Hi Jill,

I have been  a crazy journey for several years but it's gotten really bad the last 2 years.  Will start off saying I got Lymes in 2001 and was not treated for 10 mos because my Western blot was negative even though the CDC says you should diagnose by symptom.  Have had chronic Lymes as well as at least 5 new infections since then.  Might I add, they never found the initial tick but I had the lymes vaccine a year before.  So got treated for the Lymes and was doing pretty well until 2 1/2 years ago during a very stressful time in my life as far as family events and illnesses and I got sick.  I was on prednisone for constant ulcers in my throat ( which the ENT said was a virus) and certainly the prednisone did not help my immune system.  I knew better than to take prednisone because it feeds lymes but my mother in law was in ICU and very critical and I was the nurse in the family.  Anyway, I also played tennis and injured my back and ended up having a cortisone shot so I could deal with the pain.  Another no- no.   I developed severe pain in my neck as well and was just not well and thought the lymes had flared again. Was treated for the lymes again and did well until I stopped taking the gabapentin for my back because I had no pain.  I stopped sleeping and it got really bad.  The pain management dr was no help in weaning off and I ended up going back on the gabapentin and  going  to a psychologist and a psychiatrist and being put on a benzo for sleep ( just desperate for sleep).   I was 53 at this point and still had my period and no other peri menapausal symptoms.  I had just also recently started on thyroxine for a slight decrease in my TSH. I also started going to a naturalpath who was a nurse practitioner through pure meridian and she tested my levels for cortisol and said they were really high mid day to the evening. She started detoxing me with herbs and supplements and I had massive headaches .  She said my liver and pancreas were blocked and suggested adrenal gland fatigue.  I was not tired, just wound up all the time and couldn't sleep.  I continued with her and started to develop anxiety and panic attacks and went back to counseling and started on an antidepressant.  The antidepressant worked wonderfully to help me sleep and stabilize my mood but it caused me to retain water, 10 pounds in a week and to develop cystic acne so I had to stop that.  I also developed severe acne rosacea which was very traumatizing since I had always had clear skin. I was still going to the naturalpath but took a break from the herbs and felt better.  She then told me she thought I had epstein barr virus that was still active from mono I had in college.  I continued to detox through the summer and had panic and anxiety attacks all the time due to the flushing of my system.  In October, on vacation, at the urging of my husband I stopped all the herbs and supplements and the anxiety got better.  I was doing well until mid December of 2016 when i stopped sleeping again.  I had weaned off the gabapentin very slowly and was completely off at the beginning of December.  My primary was no help and I just used the benzos to help but I literally was sleeping less than 5 hours a week until just recently.  My primary had increased my thyroxine to 75 mcg in August because my TSH was high.  At the end of January he started me on zoloft to help with sleep but it did not help.  I recently weaned off that and it was a bear to wean off of.   I noticed I was startind to have some anxiety in mid December and attributed it to my son having problems.  It would have been nice if my primary had made the suggestion to check my TSH but he did not and I did not think of it.  Anyway, in February my physical showed my TSH being 0.02.  He told me in August that it was good to have your TSH between 1-2 for most people.  At my visit, he said nothing about it and then I requested my labs.  I called to ask him what he thought 4 times but could not get through his staff and they kept telling me it was normal.  Anyway, i was feeling anxious and the zoloft was not working to help me sleep.  My progesterone was low and my estrogen was high so initially I tried premetrium but then went to natpro progesterone cream and followed their reccomendations.  At first the oestrogen dominance raised its ugly head but then as I increased the dose it got better but only for about a month.  I weaned off the zoloft probably too quickly  and I think the progesterone cream helped my thyroid to function better and all of a sudden I was out of control crying and anxious, having panic attacks like I had never experienced.  This went on for 2 weeks.  I reduced my thyroxine for a week and asked my doctor to redo my thyroid panel and he said he wanted me to go on 50 mcg of thyroxine for 3 weeks and then he would retest.  My question was if my TSH was so low in early February and it is mid March, lets test them now. He refused. He told me to take xanax.  I told him I wanted to get to the bottom of this not just slap a bandaid on it but he refused.  After telling me he would call me in 2 days and not following through, I called his service twice to get him to call back and asked him to test my TSH, Free T3 and T4 , reverse T3, Thyroid antibodies (TPO), iodine levels, progesterone and estrodial, parathyroid.  In the meantime I had completely stopped the thyroxine and had to start back on the gabapentin ( very low dose) just to function and xanax as needed.  I was a mess.  He reluctantly agreed to order the tests but has written me off unofficially.  Anyway, my TSH was 5.61. my T4 was0.8 ( .8-1.8) ( some say 4-11) . my T3 was 60 ( 76-181)( some say 100-200). My thyroid peroxidase Antibodies ( TPO) was 523  ( < 9) so that suggests Hashimotos to me.  I asked him specifically, do you think i may have hashimotos?  I have since started back on 50 mcg of thyroxine and see a new physical medicine doctor next week and hope she can help.   I am still taking about 200 mg of progesterone cream a day but my P:E2 levels are lower than before I started on the cream.    FSH went from 21.2-43.9 so I am definitely in menopause now.  My progesterone went up from 2.8-4.4  and my E2 definitely went up from 31-114.  My P:E2 level went from 55:1 to 38.5:1.  My acne rosacea cleared up with using a small amount of progesterone on my face.  My skin is clear again.  My iodine level was also moderately low, hence constant cold hands and feet, at 40 ( optimal is 100-199)  some say ( 52-109).  So I know you have to be careful taking iodine with hashimotos but I have been taking 6 drops per day ( about 15 mg ) for a little over a week and feel so much better. I give all credit to the Lord Jesus who is healing me and showing me wisdom as to where to find help and find answers.  It should not have to be this hard.  I am sleeping better with a small dose of gabapentin ( 150 mg) and some clonapen and some natural herbs.  All this to say, the endocrine system is a very complex and integrated system of which each gland affects the other.  I see another specialist that specializes in balancing hormones in May which should also help.  It is a shame doctors are so uneducated in a disease that is so prevalent.  I am a nurse but am not able to work at this time due to all the difficulties I have had.  I have the advantage of a medical background and an research- oriented mind and a strong work ethic.  I do not follow the typical model of being overweight, in fact I have lost weight unintentionally.  I am 5' 7 and used to weigh 135 pounds as I was very active in sports and gardening.  I now weigh 126 and have been as low as 124. I am starting to get active again and want to get my life back!  I am avoiding xenoestrogens ( Dr.Peter Eckhart is a good source on that and sells progestelle) and as many phytoestrogens as possble and avoiding plastics.  I have tried a ton of herbs for sleep but am going to try L- tryptophan again and will hopefully be able to get off these benzos and gabapentin.  Thanks for listening.  Oh, my hair is thin but it always has been and my eyebrows are sparse on the ends but my nails are really weak now and tearing even though I keep them really short. Thanks!  

I have suffered with hypothyroidism for 28 years, since the age of 16 (interestingly the same year I entered puberty and got my first period; I was a late bloomer due to ballet training).  In 2005 I had a total hysterectomy and lost both ovaries at the age of 33 due to endometriosis.  I slammed into surgical menopause like a brick wall, and it was horrid.  It took three years of experimenting with various hrt to find something my body would absorb evenly and give me back my life as I was severely deficient in hormones.  I am on the Vivelle Dot patch.  

Currently, I take 112 mcg Synthroid and .075mg Vivelle Dot patch.  I have also been a vegan for six years.  I am concerned because much of what I rely on for sustenance involves photoestrogens...leafy greens like kale and cabbage, flaxseeds and chia seeds, very rarely but occasionally soy products, nuts, beans...My TSH goes all over the map, up and down, but T3 and T4 always seem relatively stable.  I get symptoms such as fatigue, brain fog, joint aches, muscle aches, mood swings, sore breasts.  I am only 112 lbs and 5'5.5" (I was very underweight for years but gained to this weight in 2014 to get healthier due to severe osteoporosis).  I'm just not sure that I would consider myself estrogen dominent, but is this possible?  I once tried various forms of compounded progesterone cream or troches, but had a terrible time  on it.  Worse moods, awful nausea, headaches, fatigue.  I feel best on straight estradiol but wonder how much this affects my thyroid.  I try to avoid soy and soy products and eat a very strict whole foods based plant diet, but it would be impossible to avoid all phytoestrogens that are naturally in a lot of plant foods.  I have excellent cholesterol levels, triglycerides, glucose (though runs low normal), etc.  But the fact that my TSH fluctuates so much and i have symptoms makes me wonder if diet plays a role?  but then again, I had the same issues when I ate meat, dairy and eggs.  Any ideas what causes TSH to fluctuate and cause symptoms when other levels remain normal?  By fluctuate, I mean my levels have been anywhere from .02 to 32.  Right now they are at 3.75 and doctor will not increase thyroid dose, but I feel miserable (cold, fatigued, bruising easily...iron ferritin also tested and was normal).  

you sound like you may have Hashimoto's thyroiditis. I just got diagnosed. I lost 15 pounds in the last year and my tsh had been fluctuating a lot. In February it was 0.02 and my dr said it was normal. Meanwhile had all the symptoms of being hyperthyroid. Increased anxiety and losing weight; I was crying all the time! It was horrible. He did nothing . Asked if he thought I had Hashimoto's and he did not think so. Told me to take xanax. Told him let's get to the root of the problem but he was not on board. Got him to order thyroid antibodies against his wishes but he would not put down diagnosis code hoping I would back out knowing insurance may not pay for it. Told me it could be really expensive and the estimate was $70. Thyroid antibodies were close to 600 and should be under 9. Went to integrative dr and she put me on nature thyroid and within a few days I was feeling better. Feeling better and better! My iodine was also low( cold hands and feet all time so I am starting iodine soon. Also had my adrenals checked as they are interrelated as well as endocrine system. Trying to avoid xenoestrogens as they are a problem. Dr. Peter Eckhart has some good info on clear woman.com and if you buy his product you get a guide that lists safe cosmetics, laundry detergents etc and lists of phytoestrogens. His product didn't help much but he says if you get off all xenoestrogens for 3 months, estrogen dominance will get much better and you will not need progesterone. I also take ashwagandah 500mg 2x a day which is really supposed to help with thyroid issues. I also take mag citrate mag gluconate and buffered vit c and d3(10000-20000) per day with 90 mcg vit k2 with each 10000.

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