How to manage hypothyroidism during winter

Hypothyroidism slows down your metabolism. But because its symptoms can be subtle at first, you might not notice until they become severe.

Winter, however, might just make the diagnostic process easier. That’s because the coldest season can amplify your underactive thyroid symptoms. Here’s how to manage your hypothyroidism during winter.

What’s hypothyroidism, and what causes it?

Hypothyroidism is the medical term for an underactive thyroid gland. Your thyroid is a small butterfly-shaped gland in the front of your throat, responsible for regulating your metabolism. It does this mainly by producing two hormones — triiodothyronine (T3) and thyroxine (T4).

Your thyroid, in turn, is regulated by your pituitary gland, which produces thyroid-stimulating hormone (TSH). When your body requires more T3 and T4, your pituitary springs into action by increasing TSH levels, which causes your thyroid to work harder.

If you have hypothyroidism, your thyroid can’t produce enough T3 and T4 to service its needs. This prompts your pituitary gland to pump higher and higher levels of TSH into your blood in a vain attempt to stimulate your thyroid into making more T3 and T4.

In the earliest stages of the disorder, symptoms may be subtle enough to go unnoticed. More severe hypothyroidism, however, can significantly impact everything from your sleep to your weight to your energy levels, and more. Just how much hypothyroidism affects the metabolism of your body depends on how much T3 and T4 your thyroid is able to generate.

The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto’s Thyroiditis, but that’s not the only cause. Being iodine deficient, having radiation on your head or neck, and sometimes even viral illnesses can also trigger it.

Additionally, certain medications, such as opioids, cancer, bipolar disorder, or cardiac medications, may affect your thyroid’s functioning. Even pregnancy can be a precipitating factor, leaving some women with postpartum thyroiditis in the year following their child’s birth.

Whatever its cause, if you’re dealing with a thyroid problem, your next step should be to see an endocrinologist. These physicians specialize in hormonal conditions, including reproductive matters, diabetes, and thyroid issues.

With Maple, you can connect with a Canadian-licensed doctor or endocrinologist from your phone, tablet, or computer at a time that’s convenient for you. Your endocrinologist can develop a treatment plan, order additional testing as needed, and provide a prescription if necessary. Best of all, with Maple, you don’t need a referral to see an endocrinologist online.

What are the symptoms of hypothyroidism?

Hypothyroidism can make you feel tired. However, symptoms like fatigue and weight gain are common and don’t always indicate there’s a thyroid problem. If you have hypothyroidism, you’ll likely see additional indications such as:

• An increased urge to sleep
• Depression
• Constipation
• Weight gain
• Slowing of movements and reaction times
• Feeling cold
• Dry skin
• Thinning hair
• Brittle nails
• Irregular periods
• Fertility issues
• Bradycardia (slow heart rate)
• Muscle cramps
• Low libido

Does hypothyroidism get worse in winter?

Yes, hypothyroidism can get worse in winter, whether you’re currently taking medication for it or not. Because temperatures drop in winter, your body has to expend more energy to keep you warm.

This demand for an increase in metabolic rate causes your TSH levels to rise in the winter, as your body prompts your thyroid to work harder to keep your body warm.

If your thyroid is underactive, however, it can’t. This opens up a larger deficit between where you need your thyroid to operate and where it’s actually able to get to. As the weather gets colder and your thyroid can’t keep up, your symptoms become more noticeable.

If you have subclinical hypothyroidism, your TSH levels are elevated despite T3 and T4 levels within the “normal” range. This may be because even though your T3 and T4 levels are within acceptable limits, they’re not fully meeting your needs — everyone’s different, after all. This can result in slight symptoms or none — hence the subclinical part.

Because you’re skating on the edge, however, increasing energy needs in the winter can tip subclinical hypothyroidism over into overt hypothyroidism territory. This can amplify any symptoms you experience. For example, you may go from being more sensitive to cold temperatures to being unable to tolerate cold temperatures.

Do you need more thyroid medication during winter?

Even if you take medication for hypothyroidism, you may find that your dose doesn’t cover your expanded winter needs. In this case, you may need an increase in your thyroid hormone replacement dosage on a seasonal basis.

This won’t apply to everyone, however. If your hypothyroid symptoms don’t get worse during winter, you likely don’t need to up your dosage.

The link between vitamin D and thyroid issues

Winter may affect your thyroid function in another way. Much of your vitamin D intake comes from sunlight, which decreases during the winter. And research shows that vitamin D is critical to thyroid function — as many as 25% of individuals with hypothyroidism are deficient in it. This is especially true for those with Hashimoto’s disease.

Why levels of vitamin D are often lower in individuals with hypothyroidism isn’t clear. Regardless, research shows that vitamin D-deficient individuals with hypothyroidism who took vitamin D supplements were able to lower their TSH blood levels. However, increasing their vitamin D intake didn’t restore their T3 and T4 levels.

In short, while the two are linked, it’s not clear exactly how vitamin D affects thyroid functioning. Nevertheless, taking a daily vitamin D supplement is a good idea — both for your thyroid and overall health.

Tips to manage hypothyroidism symptoms during the cold season

Staying healthy in the winter can be challenging, but worsening hypothyroidism issues can add an additional layer of difficulty. Here’s how to manage those symptoms during the coldest months.

1. Get your hormone levels checked. If you think winter is slowing you down, speak to your healthcare provider or endocrinologist. They’ll likely suggest you have your TSH and T3 and T4 levels checked to ensure they’re within the “normal” range.

2. Consider your diet to help with hypothyroidism. While there’s no single best diet for hypothyroidism, avoid overly processed items in favour of whole foods. High-fibre foods like whole grains and vegetables will provide the energy you need to function throughout your day. As well, they’ll leave you feeling fuller for longer, helping to counteract the weight gain that hypothyroidism can bring.

Moreover, eating a balanced diet helps to provide the nutrients your immune system needs to function at its best. To ensure full absorption of your thyroid medication, however, take it on an empty stomach. That means you’ll want to avoid food for up to an hour after taking your medication.

3. Practice stress reduction strategies. From disrupting your sleep to playing a role in cancer, stress is toxic. Unsurprisingly, stress can also affect hypothyroidism patients. To help thwart its effects on your functioning, make some time for stress-busting activities every day. Try progressive muscle relaxation, guided meditation, or even a half-hour walk in nature to help clear your mind and reduce stress.

4. Get enough sleep. Excessive sleeping can be a symptom of hypothyroidism. So it may sound counterintuitive to hear that an underactive thyroid can cause sleep issues like difficulty falling and staying asleep. But, hypothyroidism and lack of sleep often go together too.

To wake up feeling refreshed, keep yourself on a strict wake and sleep schedule and practice good sleep hygiene. If this doesn’t get you your requisite seven to nine hours a night, it’s probably a good idea to speak to your healthcare provider.

5. Keep your skin hydrated. Dry skin isn’t hypothyroidism’s only dermatological symptom. It can also cause a skin rash-like condition known as eczema craquelé, where the skin becomes so dry that it takes on a red, scaly appearance.

To help relieve dry skin that hypothyroidism (and winter) can bring on, use a thick moisturizer on your face and body twice a day. Lowering the temperature of your bath or shower a little and investing in a humidifier will also help your skin retain more moisture.

6. Bundle up. How do you stay warm with hypothyroidism? To start, you’ll want to make sure you’re wearing enough layers. People with hypothyroidism are sensitive to cold as their bodies can’t keep up with the increased energy needs that warming up brings.

But, while dressing for the weather is a must, having to wear a parka indoors isn’t normal. If you’re layering up and still find yourself shivering, it’s time to talk to your doctor about your thyroid functioning.

How an online endocrinologist can help

Your thyroid works harder to function in winter — essentially, it has to run faster just to stay in the same place. But, if winter is making your hypothyroid symptoms unmanageable, speaking to an endocrinologist online should be your next step. An online endocrinologist can provide a diagnosis and a treatment plan for your thyroid condition.

Moreover, an online endocrinologist can order additional testing, such as a blood test to look at your level of thyroid hormones. If necessary, they can also prescribe medication for your thyroid condition or adjust prescription thyroid hormone medication that’s no longer adequately addressing your needs.

Winter shouldn’t mean dealing with daily discomfort. If your hypothyroid symptoms increase when the temperature drops, reach out to speak to an online endocrinologist today.

This blog was developed by our team and reviewed by a medical professional.