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Sara Gottfried, M.D.

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Coffee Hijacks Your Thyroid: A Case of Good News/Bad News and Your Hormones

Posted: 06/14/2012 11:46 am

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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12:59 PM on 07/24/2012
Thyroid patients can also consider taking their medication at bedtime - here's a study about the potential benefits of that - http://www.thyroid.org/patients/ct/volume4/issue5/ct_patients_v45_7.html

"This study suggests that taking levothyroxine at bedtime results in better absorption than taking it before breakfast. This confirms that taking levothyroxine at different times can result in different levels of thyroid hormones in the blood, emphasizing the need to take it at the same time every day. However, this also confirms that taking levothyroxine at bedtime is an effective alternative to taking it before breakfast. Further, bedtime may be better in patients who appear to have problems absorbing levothyroxine."
07:18 AM on 07/24/2012
Another option, also covered in the journal Thyroid, is to take thyroid medications at bedtime -

http://www.thyroid.org/patients/ct/volume4/issue5/ct_patients_v45_7.html

WHAT ARE THE IMPLICATIONS OF THIS STUDY?
"This study suggests that taking levothyroxine at bedtime results in better absorption than taking it before breakfast. This confirms that taking levothyroxine at different times can result in different levels of thyroid hormones in the blood, emphasizing the need to take it at the same time every day. However, this also confirms that taking levothyroxine at bedtime is an effective alternative to taking it before breakfast. Further, bedtime may be better in patients who appear to have problems absorbing levothyroxine."
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Wozzeck
Pearl Bay, Australia
04:31 PM on 06/19/2012
This was an extremely small study and the results have not been confirmed independently..
02:41 PM on 06/18/2012
we are all aware about sleep and coffee or caffeine they don't mix well but thyroid?
well it makes sense since it is the thyroid that can make you hyperactive or the reverse but to link this with caffeine - well must have been a pretty hard study to do!
>>Michelle
01:35 PM on 06/18/2012
One week, some researcher says coffee is bad for you. The next week, another researcher says coffee is good for you. I'm a glass is half full kind of guy and I'm going with the "coffee is good for you"
research.
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HUFFPOST SUPER USER
mwood33333
01:30 PM on 06/18/2012
which drug does coffee reduce the sales of?
09:33 AM on 06/18/2012
As one who is going through this right now I can tell you I couldn't get out of bed if it were not for coffee. Thanks for acknowledging what's going on w/so many of us tho! Why don't Ob/Gyn's and GP docs know anything about this? I've been suffering w/all symptoms of hypothyroidism for years yet my numbers are supposedly "fine". I have to take seizure med. which further hijacks my thyroid but all my docs have been clueless for the last 3 years (and still are!). Also, do you think glucocorticoid (asthma meds) induced dementia is caused from the high cortisol blocking T3?
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HUFFPOST SUPER USER
Kai Ferano
What would Freud say?
08:33 AM on 06/18/2012
High levels of cortisol can be toxic. It's implicated with the onset of autoimmune diseases. Now it's linked to thryoid problems? As for consumption of coffee...well, java always had a calming effect on me. I love the stuff, taken black, no sugar and couldn't enjoy life without it!
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ginadeoliveira2008
Seen a shooting star tonight and I thought of you
05:39 PM on 06/14/2012
Ok. Thanks for the news about thyroid and coffe. As for the water, lemon and cayenne in an empty stomach-- a very nice ulcer to you too.
04:04 PM on 06/18/2012
actually, both lemon and cayenne create alkaline conditions in the gut. other citruses and chilis are aggravating to ulcers and acid conditions, but lemon and cayenne are special cases. there is plenty of good info online if you are curious.
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ginadeoliveira2008
Seen a shooting star tonight and I thought of you
05:22 PM on 06/18/2012
I'm not sure about cayenne, but you mean citric ACID creates alkaline conditions?