This is my perimenopause health journey part III. It is why I chose progesterone before thyroid medication.
If you want to go back and read part two, the lowdown details about my thyroid you can do that here. I also got into detail about my HTMA results in part one, which you can read here.
You can listen to this blog post here.
Why I Didn’t Jump Straight to Thyroid Medication
After sharing my thyroid labs in Part II, I received a lot of questions asking, “If your thyroid labs aren’t optimal, why aren’t you taking thyroid medication?”
It’s a great question and I have spent a lot of time considering it. Ultimately, as both a practitioner and a patient, I try very hard not to chase symptoms or individual lab values. Instead, I want to understand physiology. I want to know why something is happening before deciding how to treat it.
Looking at my symptoms alone, thyroid medication would not have been an unreasonable next step. In fact, my doctor does not hate the idea of it.
Over the past year, I experienced:
- Hair breakage and coarseness
- Dryer, aging skin
- Lower belly fat gain
- Puffiness and fluid retention
- Cold feet at night
- Elevated LDL cholesterol
- Sleep disruption
- Increased stress sensitivity and irritability
Those are all symptoms that can be associated with low thyroid function, and when I looked at my labs, I found some evidence pointing in that direction as well.
What My Thyroid Labs Suggested
My TSH had risen from June 2025 to May 2026. My Free T3 had increased over the same time period. And while that increase in Free T3 was encouraging, it still remained below the functional range I prefer. Then my Reverse T3 came back at 16 which is higher than we want it.
So while these labs do not show my thyroid gland as “failing,” these labs basically show a body that has not been utilizing thyroid hormone as efficiently as it once did or could.
Then I looked at the bigger picture..
My HTMA suggested reduced thyroid effect at the tissue level. My cortisol had been rising over time. My sleep had become fragmented. And perhaps most importantly, my progesterone had declined.
Where Progesterone Fits Into the Thyroid Conversation
This is where things in my perimenopause health journey started getting interesting.
One of the earliest hormonal changes of perimenopause is often declining progesterone. Many women think of progesterone simply as a reproductive hormone, but it does far more than regulate menstrual cycles.
Progesterone supports sleep, helps calm the nervous system, buffers the effects of cortisol, influences fluid balance and body temperature and indirectly, it can affect thyroid function.
When progesterone begins to decline, women often become more sensitive to stress. Sleep becomes lighter. Cortisol rises more easily. Recovery becomes harder.
In other words, lower progesterone may create an internal environment where thyroid hormones become less effective, even when the thyroid gland itself is still functioning.
As I looked back over the past year, that pattern fit my experience surprisingly well.
I had gone on nine trips in nine months. I was drinking more alcohol than my body could comfortably tolerate. My sleep was suffering. My nervous system felt overstimulated.
At some point, my body simply stopped compensating as effectively as it once had.
What I’ve Done So Far
The good news is that I had already begun seeing improvements before adding any medication.
After my HTMA results came back in April, I intentionally started supporting my nervous system more aggressively by slowing down. I began journaling more, spent more time reading in bed with Frank and added breath work, foam rolling, walks, and quiet moments throughout the day.
Nutritionally, I focused on food first. I increased animal protein to support tissue repair and provide amino acids, iron, zinc, and B vitamins. I began eating more seafood for iodine, selenium, copper, and other trace minerals. Also, I added egg yolks, onions, garlic, bitter greens, and mineral-rich foods to support thyroid function, digestion, and hormone metabolism.
And something remarkable happened..
My sleep improved dramatically, my cravings decreased, my mood became more stable, recovery improved and my body started giving me signs that it was responding. So that improvement played a major role in my decision not to pursue thyroid medication right now.
To be clear, I am not anti-medication. Thyroid medication can be life-changing and absolutely necessary for many people, but in my case, my symptoms were already improving by supporting the systems upstream of the thyroid.
Why I’m Starting Progesterone
For that reason, my doctor and I decided that progesterone support made more sense at this stage of my journey.
In a couple of weeks I will begin 100 mg of progesterone taken for two weeks each month in the back half of my cycle.
Progesterone naturally rises after ovulation during the second half of a woman’s cycle, known as the luteal phase. Taking progesterone for roughly two weeks on and two weeks off attempts to mimic that natural rhythm during perimenopause.
The goal is to improve sleep, support the nervous system, buffer stress hormones, and create an environment where the body can function optimally. And hopefully, this will also help improve my thyroid markers over time as well.
The Bigger Picture
I want simply to create the conditions that allow the body to work the way it was designed to.
I wanted to share my perimenopause health journey with you because I believe health is often more nuanced than simply chasing a diagnosis or a number on a lab report.
And as always, I’ll continue sharing what I learn along the way.
Your Coach,
Kyra