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Circulation and Hashimoto's

Learn how hypothyroid and Hashimoto’s patients can ensure optimal circulatory health.
Circulation and Hashimoto's
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Hypothyroidism significantly impacts circulation, affecting blood flow and vessel elasticity due to insufficient thyroid hormones. Ensuring optimal circulation with medication, lifestyle changes, and regular monitoring is crucial for optimizing cardiovascular health in thyroid patients.

Hypothyroidism’s impact on circulation

Hypothyroidism has a significant influence on the body’s circulatory system, which can disrupt the delicate balance for optimal blood flow and vascular health.

To understand how this happens, it is crucial to understand the role of thyroid hormones on blood circulation. The thyroid gland produces two hormones, thyroxine (T4) and triiodothyronine (T3), both essential for regulating metabolism. One of the common symptoms of an underactive thyroid gland is a sluggish metabolism and low basal body temperature. When this happens, it also causes a slowdown in blood circulation. When metabolism is reduced, it leads to both a decrease in oxygen consumption and nutrient demand by body tissues.

Thyroid hormones are important in maintaining the contraction and elasticity of blood vessels, which is crucial to regulating blood pressure and efficient blood flow throughout the body. T3 hormone specifically affects the endothelial cells that line the blood vessels. These hormones help to regulate the production of nitric oxide, which helps to maintain the flexibility of blood vessels and promote healthy flow. When someone has hypothyroidism and inadequate levels of T3, it can cause a narrowing of the blood vessels and reduced flexibility.

The image below shows how the T3 hormone affects tissue thermogenesis (heat generation), systemic vascular resistance, blood volume, cardiac contractility, heart rate, and cardiac output.

Many effects of thyroid function that is underactive, including fluid retention, can contribute to increased viscosity of the blood. When blood viscosity (thickness) is too high, it makes the blood vessels more resistant to blood flow, compromising the circulatory system’s functionality. Intolerance to cold weather is another common symptom among those with hypothyroidism, and, you guessed it, it is due to circulatory issues. When blood flow is diminished, it can lead to poor thermoregulation, which is why some individuals experience cold hands and feet, even when temperatures are moderate or warm.

Cardiovascular effects of hypothyroidism

Hypothyroidism influences arterial health and can disrupt the delicate balance needed for optimal blood flow throughout the body. When the thyroid gland isn’t producing enough thyroid hormone, as it is in hypothyroidism, it can hinder arterial elasticity and impact smooth blood flow. This can often lead to hypertension, which can further stress the cardiovascular system.

We know thyroid hormones are crucial in regulating the heart’s functions, such as heart rate and cardiac output. In hypothyroidism, reduced hormone levels can lead to noticeable changes in heart function, including mild hypertension (diastolic), narrowed pulse pressure, cold intolerance, fatigue, and a condition called bradycardia when heart rate levels are decreased. In bradycardia, the heart beats more slowly because of the reduced stimulation from thyroid hormones, which can impact overall cardiac rhythm. In hypothyroidism, cardiac output may decrease by 30-50%.

Beyond affecting heart rate, hypothyroidism also decreases the heart’s ability to pump blood. The heart’s muscular layer, responsible for contracting and pumping blood, is called the myocardium, and it can experience reduced responsiveness when there is an absence of adequate thyroid hormones. Severe and/or unmonitored cases can cause inadequate blood circulation to the vital organs.

Recognizing these effects and having appropriate treatment strategies is important to help manage cardiovascular complications that can be associated with hypothyroidism.

What are the signs of circulatory problems?

When you’re hypothyroid, it’s essential to monitor for potential circulatory problems. There are many symptoms to watch out for, including:

  • Painful cramps, especially during activity
  • Numbness, weakness, and swelling, particularly in the extremities
  • Varicose veins in the legs
  • Exhaustion
  • Feeling cold
  • Muscle cramps, swelling, and skin changes such as dryness, tightness, itching, and irritation
  • Numbness and tingling in the extremities
  • Erectile dysfunction in men
  • Swelling in the lower extremities, known as edema
  • Cognitive dysfunction
  • Blue tinge to the nail beds

It’s crucial to get an early diagnosis of circulatory problems because when treated early and competently, you have a better chance at avoiding circulatory conditions such as:

  • Coronary Artery Disease: A condition caused by the buildup of plaque in the arteries that supply blood to the heart
  • Hypertension: High blood pressure, which can strain the heart and cause damage to the blood vessels
  • Stroke: Occurs when the blood supply to the brain is interrupted, leading to brain damage
  • Atherosclerosis: The hardening and narrowing of the arteries, which can restrict blood flow
  • Heart Attack: Caused by a blockage in the blood vessels that supply the heart muscle
  • Peripheral Artery Disease: A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs, usually the legs
  • Varicose Veins: Enlarged, twisted veins, often appearing in the legs due to poor blood flow
  • Edema: Swelling caused by fluid retention, often in the legs and feet, due to poor circulation
  • Aneurysms: Weakened and bulging areas in the walls of blood vessels, which can be life-threatening if they rupture
  • Arrhythmias: Irregular heartbeats that can be a result of circulatory system diseases

Managing circulatory problems in hypothyroidism

Managing circulatory challenges in those with hypothyroidism involves a holistic approach that includes medical interventions, thyroid replacement therapy, and other lifestyle adjustments to optimize blood flow and support overall vascular health.

For more severe cases, healthcare professionals might prescribe medications tailored to target a specific cardiovascular concern. In cases where hypertension accompanies hypothyroidism-induced vascular changes, antihypertensive medications might be recommended. These medications aim to regulate blood pressure, reduce strain on the cardiovascular system, and improve blood flow. For those with issues regulating their cholesterol levels, managing lipid levels through medications might be appropriate. When lipid levels are controlled, it can help reduce the risk of developing thickened and hardened arteries, promoting healthier blood circulation and alleviating stress on the circulatory system.

Medications for the treatment of hypothyroidism, such as synthetic thyroid hormones like levothyroxine or natural desiccated thyroid, can help to restore normal hormone levels within the body. And when thyroid hormone deficiency is corrected, the function of the circulatory system can also improve gradually. However, the use of thyroid hormone replacement medication can also exacerbate the development of cardiovascular disease or any other underlying heart conditions. This is why caution should be exercised, and if this type of therapy is recommended for you, it would be best to start with lower doses and gradually increase until a euthyroid state is achieved.

Some research and analysis from the United Kingdom General Practitioner Research Database noted that while treatment of subclinical hypothyroidism with levothyroxine was associated with a decrease in ischemic heart disease for younger individuals (ages 40 to 70 years), it was not notable for those over 70 years of age. Either way, the use of thyroid replacement therapy to help with cardiovascular symptoms associated with hypothyroidism can still be considered, with the guidance and recommendation of a healthcare professional.

There are interventions you can do at home in your day-to-day life that can support your health. A fundamental recommendation is to follow a balanced, nutrient-dense diet supporting cardiovascular health, including omega-3 fatty acids, antioxidants, and fiber. A heart-healthy diet can help reduce LDL cholesterol levels and promote blood pressure control, which are significant risk factors for cardiovascular disease. A diet rich in fruits, vegetables, whole grains, and low-fat dairy products -- known as DASH: Dietary Approaches to Stop Hypertension -- has been shown to lower blood pressure effectively. This diet emphasizes consuming foods low in sodium and high in potassium, magnesium, and calcium. Anti-inflammatory foods, including fatty fish, nuts, seeds, fruits, and vegetables, can also help support heart health.

Regular physical activity and movement practices also enhance blood flow and cardiovascular fitness. Aerobic exercises, strength training, and yoga all positively influence blood flow and can address some circulatory challenges linked to hypothyroidism. Physical activity also has a positive impact on lipid profiles, including helping to reduce levels of total cholesterol, LDL cholesterol, and triglycerides. It can also improve endothelial function, prompting nitric oxide release. This substance helps dilate blood vessels, improve blood flow, and reduce the risk of developing blood clots and plaque formation.

Chronic stress is another factor that can further develop and progress cardiovascular diseases. Stress management helps maintain optimal blood pressure levels and reduce strain and stress on the cardiovascular system. Effective stress management techniques – including physical activity, meditation, breathwork, social support, professional help such as therapy, and engaging in activities that bring joy – can all help mitigate the effects of chronic stress.

A note from Paloma

Managing circulatory issues in hypothyroidism requires a comprehensive approach that integrates routine screening, medical intervention, and lifestyle modifications. This strategy is meant to restore thyroid function in hypothyroid patients, optimize blood flow dynamics, and promote overall cardiovascular well-being in those affected by hypothyroidism. Make sure you have regular monitoring and follow-ups with your doctor to get the care you need sooner than later. Monitoring thyroid hormone levels assists with optimizing treatment, lessening potential circulatory challenges, and reducing associated risks like hypertension. Being proactive about your health and in the management of your health will result in improved health outcomes and quality of life.

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Neeyaz Zolfaghari

Holistic Nutritionist and Nourishment Coach

Neeyaz Zolfaghari is the founder of Unspoken Nutrition, a nutrition and lifestyle brand dedicated to helping others find and create harmony with their daily habits to support their wellbeing and ‘health’. Her journey began over a decade ago, when she was diagnosed with two autoimmune diseases. Knowing what she learned from her upbringing, Neeyaz turned to nutrition as the first pillar of her healing. As her body began to heal on a physical level, she began to learn how our minds, bodies and souls are all innately connected.  

Now as an Integrative Nutritionist and Patient Advocate, Neeyaz offers the people she works with the support, guidance, and tools they need in order to live a fulfilled life. While Neeyaz initially endeavored to make a difference at the individual level, her vision grew to embrace broader community impacts. She is currently pursuing her Masters in Public Health, serving as a testament to her unwavering commitment to instigate change on a grander scale.

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