Sara Gottfried, M.D.: Coffee Hijacks Your Thyroid: A Case of Good ...

First the good news: There's a workaround.

Now the bad news: Coffee is working against you in more ways than one. You may think it's your ally, and the most recent New England Journal article would agree.

Here's the rub: Do you take thyroid pills or struggle with anxiety, sleep issues, or bruxism?

As a Harvard-trained physician scientist, I'd add that the problem with claiming a huge population-based study as rationale for your coffee habit is the following: It does not translate well to the individual, especially if you are a woman of a certain age, say between 35 and 55-plus.

High cortisol slows down production of thyroid hormone even further.

Starting with the earliest stages of perimenopause -- such as when your period comes every 26 or 27 days instead the usual 28 to 30 -- you are entering what I call the perfect storm. Progesterone drops, which causes night sweats before your period, closer and heavier menses, anxiety, disrupted sleep, PMS, less self-regulation (and sometimes thoughts of divorce). Androgens, the hormones such as testosterone and DHEA which promote sex drive, vitality, and confidence, well... they wither. Estrogen, the hormone that keeps you juicy and lubed all over (from joints to vagina) is all over the map, from normal one month to freakshly high the next, to missing in action. Cortisol, the main stress hormone, rises sky high.

Perfect storm. And then comes thyropause.

Thyropause is a term I learned from the awesome Mary Shomon, patient advocate, bestselling author, and thyroid guru. It's when you're 35-plus and suddenly you face the trio of weight gain, fatigue (maybe not all day, just 2-5 p.m.), and mood swings/depression. Estimates vary, but thyropause happens about 10-20 times more commonly in women than men.

Now, for the cortisol backstory few realize.

As if the perfect storm of perimenopause weren't enough, I've got two bits of additional data.

1. High cortisol slows down production of thyroid hormone even further.

2. Drinking coffee within 60 minutes of taking your thyroid hormone reduces absorption.

Badness associated with high cortisol.

"Thyroid hormone" in your body consists of two main players: T4 and T3. T4 is the lame duck storage hormone, and you need to make it into T3 to see some action. T3 is the biological go-getter and boosts metabolism, keeps your weight on the easeful side of town, and keeps your mood in the "joy" position. High cortisol, such as from a stressed-out life, blocks production of T3. Hijacked. Result? Thyropause.

And you may not know it because few docs check your T3. They obsessively check your Thyroid Stimulating Hormone (TSH), which may or may not reflect the cortisol hijack of your thyroid hormones.

All about absorption.

Do you take thyroid medication? Judging from my integrative medicine practice, I believe we have an epidemic of underfunctioning thyroid on our hands.

If you are already on thyroid hormone, a new study from the journal Thyroid may affect your use of coffee in the morning (hopefully you've joined our cleanse virtually and are either off or almost weaned off of the junk by now). According to the recent article, in folks who consume coffee at the time of taking their thyroid medication, we see a 25-57 percent drop in T4, one of the thyroid hormones, compared to non-coffee drinkers. This adverse effect persists for up to one hour.

Drinking coffee within 60 minutes of taking your thyroid hormone reduces absorption.

I tell my patients to take their thyroid hormone first thing in the morning with a small sip of filtered water, and nothing else to eat or drink for 20 to 60 minutes after. Most of my patients are able to do 20 minutes during the week, and 60 on the weekend. But many of them have a wicked caffeine habit, and that small sip just might be of coffee. Based on this study, I will ask my patients to wait an hour if they are having coffee. Time to go back to the filtered water, and to wait 60 minutes before you cup of Joe, or better yet, before your cup of hot water with 1/4 lemon and cayenne.

Thanks to Mary Shomon for bringing the Thyroid article to my attention.

For more by Sara Gottfried, M.D., click here.

For more on personal health, click here.

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