By Dr. Shreya Batra, ND
Thyroid health and Fertility
The thyroid is involved with almost process in the body such as: metabolism, cardiovascular health (see previous blog about this here), digestive health, and the topic of this blog: reproductive health.
There are multiple ways that the thyroid can interfere with fertility:
Anovulatory cycles (no ovulation/egg release)
High prolactin
Sex hormone imbalances
Low AMH
It is crucial that the thyroid is assessed in a fertility assessment, especially those who have had a difficult time getting pregnant or those with multiple miscarriages. Subclinical hypothyroidism (when the thyroid lab levels fall within normal range, but are not optimal) may be a culprit of infertility and miscarriages and needs to be addressed promptly. Furthermore, it is also important to assess for thyroid autoimmunity by testing anti-thyroid antibodies. Your regular thyroid panel may come back within normal limits, but your anti-thyroid antibodies may be elevated – causing reproductive concerns as well. It is important to note that cases of subclinical hypothyroidism and autoimmunity of the thyroid may present as if nothing is wrong and there may be no physical symptoms, making it challenging to detect unless proper bloodwork is done.
For an appropriate assessment, it is important to test the following:
Thyroid Stimulating Hormone (TSH)
T3
T4
anti-thyroperoxidase
anti-thyroglobulin antibodies
Please note: that a simple test of TSH is often not enough to detect thyroid dysfunction. This being said, TSH is a very important marker for fertility and studies show that ideally, it should be below 2.5. Make sure you get a full thyroid panel tested.
If you do present with symptoms of low functioning thyroid, you may experience the following:
Weight gain, or difficulty losing weight
Constipation
Sensitivity to cold
Low mood
Low energy
Brain fog
Muscle weakness
Preventative measures to ensure proper thyroid function:
Manage stress: when cortisol (stress hormone) levels are high, it will impact thyroid function
Healthy diet: ensuring a diet rich in veggies, protein, healthy fat, is crucial for managing a healthy thyroid. Avoid alcohol, and inflammatory foods. Ensure that your diet is rich in iron, iodine, and other minerals. If you do have a dysfunctional thyroid, it is important to get a dietary plan that is ideal for you.
Ensure you are getting proper and good quality sleep
Ensure you are doing moderate-intensity exercising (no high intensity!)
For treatment:
If your thyroid bloodwork comes back as suboptimal or completely out of range, then for those who are trying to get pregnant, the first-line recommendation is Synthroid. We would also ensure that all other parameters are in normal limits (ex/ ferritin). There are other options and ways to support the thyroid, but it is important to discuss this with your health care team.
What’s Next?
If you are trying to get pregnant, or thinking about getting pregnant in the future, or you experience symptoms of thyroid dysfunction, please reach out so we can get your treatment plan started.
References
Disclaimer
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