A woman’s body is always changing. Hormones rise and fall across the month, across the decades, and especially through perimenopause and menopause. Your thyroid, the small gland at the base of your neck, sets the pace for your metabolism, energy and temperature. When either system drifts out of balance, you can feel “off” long before anyone gives it a name.

The good news is that most of these changes can be understood, tested and supported. This article gives you a quick self-check quiz, explains which symptoms point toward the thyroid and which point toward sex hormones, and walks through the lab tests and everyday habits that help.

Thyroid and Hormone Self-Check Quiz

Read each statement and count how many are true for you over the last three months.

1. You feel tired most of the time, and rest does not seem to fix it.
2. You are more sensitive to cold (or heat) than you used to be.
3. Your weight is creeping up even though your eating has not changed.
4. You have lost weight without trying.
5. Your hair is thinning, including the outer part of your eyebrows.
6. You notice new, unwanted facial hair.
7. You have new adult acne, especially along the jawline.
8. Your muscles or joints feel stiff, achy or weak.
9. You have hot flashes, night sweats or heavy daytime sweating.
10. You have new bladder leakage.
11. You have trouble falling asleep or staying asleep.
12. You feel like you are in a constant PMS state: anxious, irritable, bloated or overwhelmed.

Thyroid Signs vs. Hormone Shift Signs

Several symptoms overlap, but there are patterns.

Signs that often point to an underactive thyroid

The most common symptoms of hypothyroidism are fatigue, feeling cold, constipation, dry skin, weight gain, a slowed mind and voice changes (1). Clinical hypothyroidism affects about 1 in 300 people in the US, and subclinical (mild) hypothyroidism affects about 3.7%. It is far more common in women than in men, and more common with age (1). An overactive thyroid can do the opposite: weight loss, heat intolerance, a racing heart and anxiety.

Signs that often point to changing sex hormones

Hot flashes, night sweats, sleep disruption, mood changes, vaginal dryness and bladder changes are classic symptoms of the menopause transition (2). Acne along the jawline and new facial hair can reflect a shift toward relatively more androgen activity, which is seen in conditions such as polycystic ovary syndrome (PCOS) and sometimes after menopause.

Because the two systems talk to each other, it is common to have both at once. That is why I like to test rather than guess.

Tests to Ask Your Doctor About

• TSH (thyroid-stimulating hormone): the main screening test. A high TSH suggests an underactive thyroid (1, 3).
• Free T4: helps tell mild (subclinical) hypothyroidism apart from overt hypothyroidism (1).
• Thyroid antibodies (TPO): a positive result suggests an autoimmune cause such as Hashimoto’s thyroiditis (1).
• Sex hormones when indicated: estradiol, progesterone, FSH, testosterone and SHBG, depending on your age and cycle.
• Related labs: vitamin D, ferritin (iron stores), B12 and fasting glucose, since low levels or high blood sugar can mimic hormone symptoms.

If you are diagnosed with hypothyroidism, standard treatment is thyroid hormone replacement prescribed by your doctor (1, 3). Supplements are not a substitute for that medication. Never stop or change a prescription without talking with your physician.

Daily Habits That Support Thyroid and Hormone Balance

1. Get the key thyroid nutrients from food

Your thyroid needs iodine to make hormone and selenium to protect itself and to convert T4 into the active hormone T3. Selenium is found in the thyroid in high concentration, and research links low selenium status to autoimmune thyroid problems (4). Good food sources include seafood, eggs, iodized salt, and Brazil nuts (one or two is plenty). Zinc and iron matter too. More iodine is not always better; too much can also disturb the thyroid.

2. Eat cruciferous vegetables

Broccoli, cauliflower, cabbage and Brussels sprouts contain compounds the body turns into DIM (diindolylmethane), which is involved in how the body processes estrogen. I explain more in how DIM may help balance hormones during menopause. Cooking these vegetables is fine and makes them easier to digest.

3. Balance blood sugar

Swings in blood sugar and insulin affect estrogen, testosterone and cortisol. Build meals around protein, fiber, vegetables and healthy fats, and limit sugar and refined carbs. Many women over 40 do well on a lower-carb approach; see how keto affects women’s hormones after 40.

4. Protect sleep and manage stress

Chronic stress keeps cortisol elevated, which can worsen fatigue, belly weight and sleep. Aim for 7 to 8 hours, keep a regular schedule, and build in daily stress relief: a walk, prayer, deep breathing or time outdoors. If fatigue is your main symptom, read why you are always tired.

5. Strength train

Muscle helps blood sugar, metabolism and bone health, which all become more important as estrogen falls. Two or three sessions a week of resistance training is a good goal.

6. Keep vitamin D in range

Vitamin D acts more like a hormone than a vitamin and supports bones, muscles and immune health. Ask your doctor to check your level. I discuss forms of vitamin D in vitamin D3 vs D2.

Where Supplements Fit

Once you have talked with your doctor and have a plan, some women choose targeted nutritional support alongside healthy habits. I formulated a few options for that purpose:

• Thyroid Zone is designed to support healthy thyroid function, energy and metabolism with nutrients such as iodine, selenium and zinc along with herbal extracts.
• Hormone Zone is designed to support healthy hormone balance, with DIM plus vitamins D3 and K2.
• The Hormone Zone Starter Pack bundles thyroid, adrenal and hormone balance support in one place.

Thyroid Zone and Hormone Zone may be used together. Because Thyroid Zone contains iodine and herbs, check with your doctor first if you take thyroid medication, are pregnant or nursing, or have a thyroid condition. Men looking for support can read about Testosterone Zone, which features Testofen® fenugreek extract.

For more ways to rebuild energy, visit our More Energy hub.

Bottom Line

Fatigue, weight changes, poor sleep, hot flashes and mood swings are common, but they are not something you simply have to accept. Take the self-check quiz, bring your answers to your doctor, and ask for the right tests. Then build the daily habits that support your thyroid and hormones, and add targeted nutritional support if it fits your plan. You can feel like yourself again.

Frequently Asked Questions

What are the first signs of thyroid problems in women?

Common early signs of an underactive thyroid include fatigue, feeling cold, constipation, dry skin, weight gain and thinning hair. Because these overlap with other conditions, a TSH blood test is the usual first step.

How can I tell if it is my thyroid or menopause?

Hot flashes and night sweats point more toward menopause, while feeling cold, constipation and dry skin point more toward the thyroid. Many symptoms overlap, so blood tests for TSH, free T4 and sex hormones help sort it out.

What blood tests check thyroid and hormone levels?

TSH is the main thyroid screening test, with free T4 and thyroid antibodies when needed. Depending on your age and cycle, your doctor may also check estradiol, progesterone, FSH, testosterone and SHBG.

Can supplements replace thyroid medication?

No. If you have diagnosed hypothyroidism, thyroid hormone prescribed by your doctor is the standard treatment. Supplements may support overall nutrition but should never replace medication.

Which nutrients support thyroid health?

Iodine and selenium are especially important, and zinc and iron also play roles. Seafood, eggs, iodized salt and a Brazil nut or two are good food sources. Too much iodine can also cause problems.

References

1. Wilson SA, Stem LA, Bruehlman RD. Hypothyroidism: diagnosis and treatment. American Family Physician. 2021.
2. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America. 2015.
3. Garber JR, et al. Clinical practice guidelines for hypothyroidism in adults (AACE and ATA). Endocrine Practice. 2012.
4. Ventura M, Melo M, Carrilho F. Selenium and thyroid disease: from pathophysiology to treatment. International Journal of Endocrinology. 2017.

This article is for educational purposes only and is not medical advice. Talk with your own doctor before changing your diet, starting a supplement, or changing any medication. These statements have not been evaluated by the Food and Drug Administration. Products mentioned are not intended to diagnose, treat, cure, or prevent any disease.

The post Need Thyroid or Hormone Support? 12 Signs and a Self-Check Quiz appeared first on Dr. Don Colbert, MD.

The post 7 Tips to Enjoy Your Best Health During Menopause appeared first on Dr. Don Colbert, MD.

We have some natural help for hot flashes.

Here’s what they are, why women get them, and what you can do starting today.

What are Hot Flashes and Why Might You Need Help for Hot Flashes?

The post Natural Help for Hot Flashes appeared first on Dr. Don Colbert, MD.

If you haven’t heard of DIM, or Diindolylmethane, it’s time to get acquainted.

It’s a compound that’s produced by our own bodies when we eat cruciferous vegetables, and it can help your body balance hormones during menopause.

Amazingly, you can now supplement it in addition to eating vegetables for the most benefit!

And, its advantages go beyond hormones.

In fact, DIM is a whole-body health promoter, from reduced cancer risk to improved skin to anti-viral properties.

If you’re looking to balance your hormones during menopause, and want nutrients that promote health overall, consider DIM. Here are 7 Ways DIM Can Balance Hormones During Menopause.

7 Ways DIM Can Balance Hormones During Menopause

1. Hormone Balance and Estrogen Metabolism

What hormone level is typically discussed during menopause?

That’s right, estrogen.

But did you know it’s not just about the level of estrogen? Its metabolism and balance in relation to other hormones matter just as much.

DIM alters the metabolism of estrogen in order to help our bodies balance hormones.  Estrogen levels and function can change in both women and men as we age.

Some experience estrogen dominance (elevated estrogen relative to other hormones) and others experience loss of testosterone and progesterone.

DIM may also help by blocking aromatase, the enzyme that converts testosterone to estrogen. This is a great first step toward hormone balance.

2. Bad Estrogens vs. Good Estrogens

Next, DIM shifts estrogen metabolism toward the more favorable 2-hydroxy pathway and away from 16-alpha-hydroxyestrone, often called a “bad” estrogen metabolite. In a pilot study of postmenopausal women, DIM supplements increased this favorable 2-hydroxy metabolite (6). Less favorable estrogen metabolites are thought to contribute to many premenstrual and menopause complaints, including fat gain, cramping, acne, and low energy, and they have been studied in relation to breast cancer risk.

Good estrogens promote leaner bodies with more muscle, high-quality collagen in connective tissues, healthy bone density, and good cholesterol levels.

DIM encourages estrogens to metabolize to the beneficial forms while deterring negative forms.

3. Anti-Cancer Properties

In research studies, DIM has been shown to possibly induce cancer cell death, reduce cancer cell growth, and potentially reduce risk. It is specifically thought to be important against breast, endometrial, and prostate cancer (1, 2).

4. May Help Against Human Papillomavirus (HPV)

Human papillomavirus (HPV) causes multiple medical disorders including cervical lesions, cervical cancer, and some throat (oropharyngeal) cancers.

A small pilot study evaluated oral DIM as a possible nonsurgical treatment for cervical dysplasia, the abnormal cervical cells usually caused by HPV. The research is still early, so DIM is not a substitute for regular Pap tests and HPV care with your doctor (3).

5. Supports Fat Loss

Loss of muscle and gain of fat is another unwanted side effect of menopause for many women.

DIM can help.

In lab and animal research, DIM reduced the formation of new fat cells and limited weight gain in mice fed a high-fat diet (4).

In addition, balanced hormones promote healthy weights and the ability to lose unwanted fat.

6. Strong Anti-inflammatory 

DIM helps activate an enzyme called AMP-activated protein kinase (AMPK).

AMPK is a key energy-sensing enzyme with anti-inflammatory effects, and it has been studied for its role in reduced cancer risk, overall bodily inflammation, and heart health (5, 2).

7. Skin Health and Acne Reduction

With hormonal changes, many women experience changes in skin health and appearance. This can include acne.

Hormonal acne is driven largely by androgens and by the shifting balance between estrogen and other hormones. Because DIM changes how estrogen is metabolized, it may help reduce these imbalances, although human research on DIM for acne is still limited.

Watch: What You Need to Know About Estrogen

In this Divine Health Podcast episode, Mary and I explain the three types of estrogen and how this hormone affects the immune system and the body in both women and men.

DIM Supplements to Balance Hormones During Menopause

There are many DIM supplements available, so it’s important to get one that supports whole-body health and overall balanced hormones.

A complete hormone support formula such as Hormone Zone, which combines DIM with vitamin D3 and vitamin K2, is a great choice.

DIM Supplement Warnings

In studies, DIM supplements have generally been well tolerated at typical doses.

However, if you are pregnant or breastfeeding, or have cancer, kidney disease, or other chronic diseases, it may be contraindicated for you. If you take tamoxifen or hormone therapy, talk with your doctor first, since one randomized trial found DIM lowered blood levels of active tamoxifen metabolites (7). Always talk to your doctor before beginning a new supplement.

Why not just eat cruciferous vegetables?

If you don’t have any hormone balance concerns, you may get enough DIM by simply eating cruciferous veggies. However, vegetables do not contain DIM itself. They contain compounds that your stomach converts into DIM, and long-term storage and cooking can reduce how much of them you get.

What’s more, if you need help with hormone balance, you may need a higher dose than what you can get by eating these vegetables.

DIM supplements, such as Hormone Zone, are an effective way to get the DIM you need.

Bottom Line

DIM is an impressive compound that can promote hormone balance, especially during menopause. If you are suffering from menopausal symptoms including hormone imbalance, acne, weight gain, or inflammation, consider adding a hormone-balancing supplement that includes DIM such as Hormone Zone.

Frequently Asked Questions

What does DIM do for women in menopause?

DIM (diindolylmethane) forms in your stomach when you eat cruciferous vegetables like broccoli and cabbage. It influences how your body breaks down estrogen, shifting it toward the 2-hydroxy pathway that is considered more favorable. Small studies in women have shown this shift in urinary estrogen metabolites, which is why many women use DIM to support hormone balance during perimenopause and menopause. Large trials on menopause symptoms themselves are still lacking.

Can I get enough DIM from vegetables alone?

Vegetables do not contain DIM directly. They contain glucobrassicin, which becomes indole-3-carbinol and then DIM during digestion. Eating cruciferous vegetables every day is a great foundation, but the amounts used in studies are generally higher than most people get from food, and cooking and storage reduce these compounds.

How long does it take for DIM to work?

Studies that measured changes in estrogen metabolism generally lasted from about one month to several months. If you try a DIM supplement, give it at least two to three months, and work with your doctor to track your symptoms and, when appropriate, your hormone levels.

Can DIM help with weight gain during menopause?

It may play a supporting role. In mice fed a high-fat diet, DIM reduced the formation of new fat cells and limited weight gain, and a small 2022 study in premenopausal women reported more favorable estrogen metabolism and lower body fat with DIM. It works best alongside a healthy diet, regular exercise, and good sleep, not as a replacement for them.

Who should not take DIM?

Avoid DIM if you are pregnant or breastfeeding. If you have a hormone-sensitive cancer, take tamoxifen, or use hormone therapy, talk with your doctor first, because one randomized trial found DIM lowered blood levels of active tamoxifen metabolites. Some people notice headaches or digestive upset, so start with a low dose.

References

1. Dalessandri KM, et al. Pilot study: effect of 3,3′-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Cancer. 2004.
2. Thomson CA, et al. A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. Breast Cancer Res Treat. 2017.
3. Godínez-Martínez E, et al. Effectiveness of 3,3′-Diindolylmethane Supplements on Favoring the Benign Estrogen Metabolism Pathway and Decreasing Body Fat in Premenopausal Women. Nutr Cancer. 2022.
4. Del Priore G, et al. Oral diindolylmethane (DIM): pilot evaluation of a nonsurgical treatment for cervical dysplasia. Gynecol Oncol. 2010.
5. Yang H, et al. 3,3′-Diindolylmethane suppresses high-fat diet-induced obesity through inhibiting adipogenesis of pre-adipocytes by targeting USP2 activity. Mol Nutr Food Res. 2017.
6. Draz H, et al. Diindolylmethane and its halogenated derivatives induce protective autophagy in human prostate cancer cells via induction of the oncogenic protein AEG-1 and activation of AMP-activated protein kinase (AMPK). Cell Signal. 2017.

This article is for educational purposes only and is not medical advice. Talk with your own doctor before changing your diet, starting a supplement, or changing any medication. These statements have not been evaluated by the Food and Drug Administration. Products mentioned are not intended to diagnose, treat, cure, or prevent any disease.

The post DIM Can Help Balance Hormones During Menopause appeared first on Dr. Don Colbert, MD.