Cold Weather and Winter Thyroid Concernsby Mary Shomon Patient Advocate
Is your thyroid ready for cold winter temperatures? If you are hypothyroid, cold weather can have a number of effects on your thyroid treatment, and can cause symptoms such as winter depression, and cold hands and feet. Let’s explore how to best weather the winter chill as a thyroid patient.
Your dosage of thyroid medication may need to be adjusted
Your thyroid is a key player in your body’s thermoregulation — the process of maintaining a normal body temperature. The typical resting body temperature for adults is 98.6 Fahrenheit and 37 degrees Celsius.
A 2013 study published in the Journal of Clinical Endocrinology and Metabolism suggests that cold exposure affects your thyroid stimulating hormone (TSH) level, causing it to rise.
For someone with a normally functioning thyroid, as temperatures drop, TSH levels increase. As a result, the production of thyroid hormone typically increases slightly to help compensate for exposure to the cold. If you are hypothyroid, and rely on thyroid hormone replacement medication such as levothyroxine or natural desiccated thyroid, the TSH can rise in response to cold temperatures. Even if you still have a semi-functional thyroid gland, however, it may not be capable of ramping up the production of the hormone on its own to maintain your body temperature.
This increase in TSH can be accompanied by common hypothyroidism symptoms, such as fatigue, depression, brain fog, and weight gain. You may also notice that you feel especially intolerant of the cold, and feel like your hands and feet, in particular, are susceptible to the cold temperatures.
For people with hypothyroidism, the risk of a cold-induced thyroid slump increases as you get older.
To avoid this seasonal slump, consider taking several key steps:
Make sure that you have a baseline TSH test level that shows your optimal TSH level when it’s warmer.
After the onset of colder temperatures, recheck your TSH and other thyroid-test levels to determine if your thyroid hormone levels have dropped.
Work with your healthcare provider to readjust your dosage of thyroid hormone replacement medication to get to your optimal level.
In the future, have a plan in place with your practitioner to schedule automatic changes in the dosage of thyroid medication to coincide with the beginning and end of colder temperatures.
Don’t forget that when temperatures warm up again, you may need a slight decrease in your dosage, to avoid being overmedicated.
Some other ways you can help stay warm include:
Regular exercise, which raises your metabolism
Using hand and feet warmers, electric blankets, and space heaters
Eating thermogenic foods — foods that generate heat as they are digested. These include peppers, avocado, saturated fats from meats and butter, and coconut oil.
Eating more hot soups and stews, and drinking hot or warm beverages
You are at higher risk of seasonal affective disorder (SAD)
Thyroid patients are at increased risk of seasonal affective disorder, also known as SAD. SAD is a type of depression that is related to the seasons, and is most commonly associated with shorter days and less light exposure in winter.
The signs and symptoms of SAD include:
Brain fog; concentration problems
Lack of energy
Overeating, and craving sugar and carbohydrates
Avoiding social interactions
In addition to optimizing your thyroid treatment during the winter, one of the most effective treatments for SAD is light therapy. This involves a daily session sitting in front of a special light that filters out ultraviolet rays and delivers 10,000 lux of cool-white fluorescent light, a level that is 20 times normal indoor lighting.
Some people with SAD also find that outdoor exposure to sunlight helps. You can take a daily walk during midday and/or drive with your window open to get some daily outdoor light. Remember to avoid sunglasses during that time, as they can block the SAD-fighting benefits of outdoor light.
If your SAD doesn’t respond to light therapy, in some cases, antidepressant medication can be helpful. You should also get your vitamin D levels checked, and supplement with vitamin D if they are not optimal.
If you have autoimmune thyroid disease, you are at higher risk of Raynaud’s syndrome
If your hypothyroidism is due to autoimmune Hashimoto’s or Graves’ disease, you are at higher risk of other autoimmune conditions, including Raynaud's phenomenon. (It is also frequently spelled Reynaud's). Raynaud’s interferes with the flow of blood to your fingers, toes, nose, and ears, which can make you especially sensitive to the cold.
The signs and symptoms of Raynaud’s include:
Extremities that turn white or blue when exposed to the cold
Numbness and cold feeling in your fingers, toes, nose and/or ears
Throbbing, tingling, and/or pain in your fingers, toes, nose and/or ears
Swelling of your fingers, toes, nose and/or ears
You should see your healthcare provider for tests that can diagnose Raynaud’s, along with a treatment plan. Treatments include:
Keeping your body and extremities warm, wearing layers of cold weather-rated clothing, and feet and hand warmers
Avoiding extreme temperatures and extreme temperature changes
Wearing gloves when handling frozen foods
Stopping smoking, since smoking can worsen Raynaud’s symptoms
Managing stress, which is a trigger for Raynaud’s attacks
In more severe cases of Raynaud’s, doctors may prescribe medications, including calcium channel blockers and/or antidepressants.
An important note: If you have Raynaud's but have not yet been diagnosed with hypothyroidism, ask your healthcare provider for a complete thyroid evaluation.Experts feel that the relationship between the two conditions is significant enough to warrant thyroid screening in people diagnosed with Raynaud’s phenomenon.