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July 12, 2023 10 min read

Are you tired of feeling like a walking contradiction? Brave yourself for this mind-blowing revelation: birth control and thyroid disease might be connected! Yes, you heard it right. It's not just your imagination playing tricks on you. The interplay between these two seemingly unrelated aspects of your health could have surprising effects that will leave you in awe.

Now, before you dismiss this as mere sensationalism, let's dive into the nitty-gritty details. Your thyroid gland is like the conductor of an orchestra, orchestrating various bodily functions to keep everything running smoothly. On the other hand, birth control pills are hailed as superheroes that swoop in to save the day by preventing unwanted pregnancies and regulating menstrual cycles. But what happens when these two forces collide? Let's take a closer look!

What is hypothyroidism?

Who among us hasn't spent an early morning hour with a steaming cup of coffee, dragging our weary bodies to life, cursing our ever-pervasive fatigue? Well, guess what? It might not always be a lack of caffeine or disrupted sleep at the root of the fatigue. Yes, something else could be lurking in the shadows, a hidden culprit known as hypothyroidism!

Hypothyroidism, or underactive thyroid, is one of the most common thyroid disorders. It's a condition where the thyroid gland doesn't produce enough thyroid hormones. This imbalanced hormone production can impact many aspects of your health. It's a condition that occurs when the thyroid gland, a small butterfly-shaped organ located in the neck, fails to produce sufficient amounts of thyroid hormones, specifically triiodothyronine (T3) and thyroxine (T4).

These hormones play a crucial role in regulating your metabolism, maintaining body temperature, and driving muscle strength, amongst other important functions. When there's a deficiency, the body slows down, which can affect a range of functions and lead to a variety of symptoms.

Common symptoms of hypothyroidism often include fatigue, weight gain, sensitivity to colds, constipation, dry skin, thinning hair, depression, and a slower heart rate. However, these symptoms can often be vague and can easily be attributed to other health conditions, which is why hypothyroidism sometimes goes undiagnosed.

What is birth control?

When discussing birth control options, hormone-based methods are often the first to come to mind. They contain essential reproductive hormones like estrogen, progesterone, or a blend of both and are available in diverse forms such as oral contraceptives, shots, patches, intrauterine hormonal devices (IUDs), and vaginal rings.

Then again, birth control is not limited to hormonal options. There are also non-hormonal methods like condoms, diaphragms, sponges, and natural family planning techniques. However, in the context of this discussion, let's keep our lens focused on those tiny but mighty game-changers - hormonal birth control pills or oral contraceptive pills (OCPs).

Hormonal birth control is prescribed not only for pregnancy prevention but also for a variety of other reasons. These include managing irregular periods, alleviating severe cramping, combatting acne, relieving premenstrual syndrome (PMS) symptoms, managing polycystic ovarian syndrome, preventing anemia, treating ovarian cysts, relieving endometriosis, managing menstrual migraines, and in some cases, even reducing the risk of ovarian cancer.

When it comes to picking the best OCP, the decision rests on a variety of factors, ranging from the user's medical history and symptoms to her current breastfeeding status. Broadly, oral hormonal birth control can be classified into combination birth control pill and progestin-only pill.

Combination pills contain synthetic estrogen and progestin. They function by inhibiting ovulation and thickening the cervical mucus, creating a dual barrier against potential pregnancy. These pills come in three variants: monophasic, multiphasic, and extended-cycle pills.

Monophasic pills follow a 28-day cycle, with three weeks of active hormone pills followed by a week of inactive pills coinciding with the menstrual cycle. Multiphasic pills carry varying hormone concentrations through the cycle to mimic natural hormone fluctuations. Meanwhile, extended-cycle pills, spread across 13 weeks, with 12 weeks of active pills followed by a week of inactive pills, resulting in fewer periodic menstrual cycles annually.

Progestin-only pills, also known as mini-pills, work by thickening the cervical mucus and slimming the uterus lining. They may or may not inhibit ovulation. These pills serve as a suitable option for women who are breastfeeding or cannot take estrogen for health reasons. Unlike combination pills, progestin-only pills have no inactive pills, and some women may not experience menstruation while on the pill.

How does oral birth control affect your thyroid?

Birth control and thyroid problems, is there a connection?

Oral birth control pills, particularly those containing estrogen, have an interestingly intricate relationship with thyroid function. Essentially, our bodies work like a harmonious concert, with different hormones acting as different musical notes. Key among them is estrogen, a star player in most hormonal birth control and our body's thyroid hormones. When these two interact, a lot can happen.

Estrogen is known to increase thyroid-binding globulins (TBG), proteins that carry thyroid hormones through your circulatory system. This prevents the thyroid hormones from freely circulating in your blood. When TBG levels rise, the freely available thyroid hormone decreases, which could result in your body requiring an adjustment in your thyroid hormone replacement medication.

Apart from this, increased estrogen can also influence how iodine, essential for thyroid hormone production, is taken up by your body. Given that iodine deficiency is the leading cause of hypothyroidism, the significance of birth control's influence on the body's iodine uptake can't be underestimated.

Research suggests a strong association between prolonged use of hormonal birth control and hypothyroidism, especially in cases where use exceeds ten years. Hence, those suffering from hypothyroidism or having an underlying thyroid disorder may experience changes in their condition when initiating hormonal birth control.

Despite this, a healthcare provider might still recommend hormonal birth control for women with hypothyroidism. Yet, it is likely accompanied by closer monitoring of their thyroid function and possible adjustments in thyroid medication doses to maintain normal thyroid hormone levels.

Interestingly, oral contraceptives could also cause nutritional deficiencies by hampering your ability to absorb nutrients from food. The thyroid requires specific vitamins and minerals to produce thyroxine (T4), and oral contraceptives can decrease the absorption of essential elements like zinc, selenium, magnesium, and certain vitamins. Since these nutrients might already be lacking due to our cooking and storage methods, adequate supplementation might be necessary to counter a potential deficiency.

Additionally, women with subtle or subclinical hypothyroidism are at a higher risk of developing cardiovascular issues like blood clots while on oral birth control. This is attributed to hypothyroidism increasing the number of blood platelets, which further heightens the risk.

Can birth control pills decrease the absorption of thyroid hormone replacement therapy?

Oral birth control pills, hormones, and the timing of daily doses can all play a significant role in the effectiveness of thyroid hormone replacement therapy. Most thyroid hormone replacement medications must be taken meticulously to ensure maximum absorption, which includes taking them on an empty stomach, ideally 30-60 minutes before any other medications, food, or drink. This timing ensures the gut can absorb and circulate the synthetic hormone before anything else has the chance to interfere with the process.

Oral contraceptive pills, especially those containing estrogen, abide by a similar rule. If you're taking birth control pills, it's essential to take your thyroid hormone medication separately from your birth control pill. As explained above, estrogen in the contraceptive can increase your requirement for synthetic thyroid hormones, which necessitates this timing strategy.

Moreover, shortly after you start an oral contraceptive regime, your doctor may wish to recheck your thyroid functioning to ensure that you're receiving an adequate dose of thyroid hormone.

Can birth control pills affect thyroid test results?

Birth control pills, especially those containing hormones, can surprisingly impact your thyroid test results. Despite not having any pre-existing thyroid conditions, the inclusion of birth control in your body can affect hormonal equilibrium and, consequently, the outcomes of thyroid function tests.

Medroxyprogesterone acetate (DMPA), a progestin-only birth control administered as a shot, has been shown to increase the levels of thyroxine (T4) more than a copper intrauterine device (IUD). However, it remains unconfirmed as to whether this alteration has significant clinical implications.

Oral micronized progesterone, on the other hand, can potentially lower the levels of thyroid-stimulating hormone (TSH) and increase levels of free T4, though it seems to leave free T3 levels unaffected. Nonetheless, evidence suggests that these changes in thyroid hormone metrics are usually mild in nature.

Hypothyroidism diagnosis and monitoring most often rely on symptoms and blood test results, including measurements of TSH, T3, and T4. The pituitary gland, sitting at the helm of your hormonal control system, releases TSH to stimulate your thyroid gland to release T3 and T4, hormones vital for body metabolism. When levels of these hormones are low, the pituitary gland compensates by producing more TSH. Consequently, a high TSH level accompanied by a low T4 level is a standard indicative marker of hypothyroidism.

Engaging with this complex setup is estrogen, a key hormonal component in many birth control pills. It can influence thyroid test results by increasing T3 and T4 levels while typically leaving TSH levels within the normal range.

Can hypothyroidism affect birth control's effectiveness?

There is currently no solid evidence suggesting that an abnormal thyroid function or thyroid medications would impact how well your birth control works. However, the key to getting the most out of your oral contraceptive pills is consistency. You should aim to take them correctly and at the same time each day to maintain their 99% effectiveness rate. Otherwise, the risk of pregnancy can increase to around 4%-7% if the pills are not taken consistently.

As for thyroid medications, here are some tips to ensure they work effectively:

  • The medication should be taken on an empty stomach, and it's best to avoid eating for 45 to 60 minutes afterward.

  • Try to take your thyroid medication at the same time each day.

  • If you have to change brands or stop the medication, let your healthcare provider know.

  • Lastly, keep an eye out for symptoms such as heart palpitations, anxiety or restlessness, shakiness, sweating, or rapid weight changes. This could mean your dose is too high.

Despite the apparent lack of direct impact from thyroid health on birth control effectiveness, some data do suggest a possible link. This further emphasizes the importance of discussing it with your healthcare provider before starting any medication. It's crucial always to address and treat any thyroid disorder, especially if you're using birth control for period regulation or pregnancy prevention. Whether you're thinking of the effectiveness of your birth control or the management of your thyroid health, an open and ongoing conversation with your healthcare provider is always a smart move.

What are the types of thyroid hormone replacement for hypothyroidism?

Below are some of the options you can consider:


One of the most commonly prescribed medications for hypothyroidism is levothyroxine. It's a synthetic form of the thyroid hormone thyroxine (T4), which your thyroid gland produces naturally. Once in your bloodstream, your body converts levothyroxine into triiodothyronine (T3), the active form of thyroid hormone that can be utilized directly by your cells. Levothyroxine is widely prescribed because it provides a steady, continuous dose of thyroid hormone, making it easier for physicians to predict and tailor individual patient responses.


Another option for thyroid hormone replacement is liothyronine. This medication is a synthetic version of T3, the active form of thyroid hormone. Unlike levothyroxine, liothyronine doesn't require your body to convert the hormone before it can be used by your cells. However, because liothyronine has a shorter half-life and is faster-acting than levothyronine, it can be harder to maintain consistent thyroid hormone levels in your blood, often resulting in more frequent dosage adjustments.

Natural Desiccated Thyroid (NDT)

Natural desiccated thyroid (NDT) is yet another option for thyroid hormone replacement. Unlike synthetic forms, NDT is derived from the desiccated (or dried) thyroid glands of pigs. A significant advantage of NDT is that it provides a mix of T4, T3, T2, T1, and calcitonin, more closely imitating the mix of hormones that a healthy human thyroid gland would produce.

Recently, NDT has become a preferred choice for thyroid hormone replacement among certain patient groups and physicians. The main advantage of NDT over synthetic alternatives like levothyroxine and liothyronine is that it provides a balance of thyroid hormones more similar to what the body naturally produces, potentially leading to a more holistic and effective management of hypothyroid symptoms.

The most popular brands of NDT in the US are Armour Thyroid and NP Thyroid. However, you can also buy desiccated thyroid online in supplement form, such as VitaliThy. This NDT supplement is free from lactose, gluten, eggs, fish, and shellfish, as well as artificial color and flavor. Thus, it's safe for anyone with certain dietary restrictions.

Best birth control if you have thyroid problems

Non-hormonal methods offer an alternative approach to birth control that can be beneficial for individuals with thyroid issues. These methods work either by implementing a barrier to prevent sperm from reaching an egg or by managing the timing of ovulation.

A notable example is the copper intrauterine device (IUD). This device is inserted into the uterus and protects against pregnancy for up to 10 years. Importantly, a copper IUD does not contain any hormones, making it a good choice for those with thyroid concerns.

Barrier methods, like condoms or diaphragms, are another non-hormonal option. These methods keep sperm from entering the cervix, preventing fertilization. As they do not interact with hormones in the body, these methods can be chosen safely by those monitoring their thyroid health.

Fertility awareness-based methods are another choice. These involve tracking your menstrual cycle to estimate when you are likely to be fertile and avoiding intercourse during these periods. While these methods do need careful tracking, they can be effective when used correctly. With these non-hormonal birth control options at hand, people with thyroid problems can make a choice that aligns well with their health needs.


It's crucial to remember that hormones play a significant role in our body's functioning. The relationship between birth control medications and thyroid health has become an area of interest in the scientific community. If you are a woman dealing with hypothyroidism, it's important to discuss your birth control options in detail with your healthcare provider. Non-hormonal alternatives might be a preferable choice, given the potential interactions and complications with birth control pills.

While advancements in research are still being made, if you're grappling with hypothyroidism and finding conventional treatments lacking, Natural Desiccated Thyroid (NDT) may offer a solution. NDT provides a balance of various thyroid hormones akin to what your body would naturally produce. This may lead to more effective symptom management and a better quality of life. If you want to switch to this natural option, consider VitaliThy, a natural desiccated thyroid you can buy online.

Wojciech Majda
Wojciech Majda

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