In such situations it’s wise to determine if Hashimoto’s Disease is a factor, though Hashimoto’s is very loosely diagnosed without sufficient medical evidence.
Prolonged exposure to elevated TSH, while something is blocking the formation of the hormone, can damage the thyroid gland. If the gland is enlarged, but underfunctioning, it can be the result of a high ratio of estrogen to progesterone. Most physicians agree the ratio of estrogen to progesterone should be 1 part to 10 parts, estrogen to progesterone.
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If a person has an enlarged thyroid gland, progesterone encourages secretion and unloading of the stored colloid and can bring on a temporary hyperthyroid state which is a corrective process. A thyroid supplement (Electrical Body recommends Detoxadine) may be used to shrink the goiter before progesterone is given.
Normal amounts of progesterone promote thyroid secretion, while a deficiency, especially when too much estrogen is present, causes the thyroid to enlarge. Low thyroid is one cause of excess estrogen, and when high estrogen is combined with low thyroid function, the skin can look relatively bloodless. Symptoms in cycling women are most common around ovulation and in the premenstrual week, when the estrogen/progesterone ratio is normally highest.