Thyroid Awareness Month

Thyroid Shenanigans and Fertility

There are a bazillion reasons why women are unable to conceive and a bazillion more why miscarriages occur. And although we are unable to explore all these reasons, one of the reasons why I love naturopathic medicine is that it allows us to uncover issues that can go unnoticed at first glance.

One of these reasons can be thyroid issues. And in light of thyroid awareness month, (who comes up with these btw!?) I thought it would be good to shine some light on this area - labs to check out when wanting to conceive, and treatment.

Bloodwork assessment:

Thyroid is your gland that runs your basal metabolic rate. It affects pregnancy in that ideal thyroid hormone levels are produced in order to maintain a pregnancy. Thyroid stimulating hormone (TSH) is in your pituitary gland which comes down and stimulates thyroxine (T4) to be produced. Which then goes into your tissues and converts to T3. Thyroid antibodies - these are little mini (bad) soldiers that choose to attack the thyroid called thyroid peroxidase antibody (TPO). Again, when these are elevated they have been shown to effect pregnancy and can cause miscarriage.

So in short - I ALWAYS (thats a strong word, yet I’m certain in this situation I can use it) ask women to check their TSH, T4, T3, and TPO prior to conception and/or after miscarriage(s) and/or pre fertility treatments.

Did You Know?

Did you know? Thyroid autoimmunity (in labs this can look like antibodies being elevated) is associated with a higher risk of premature ovarian insufficiency as well as miscarriage.

Did you know? Fertility patients with treated subclinical hypothyroidism can improve embryo production, implantation rate, and live birth rate.

Did you know? The more exposure ovaries have to thyroid autoantibodies in patients with polycystic ovarian syndrome (PCOS), the more destruction there is. This can further provoke premature ovarian failure.

Here’s how naturopathic medicine can support this:

First Things First

Get all your thyroid markers tested - not just TSH. I know I mentioned this yet it is the first step! 

Working Alongside Medication

Oftentimes synthetic T4 is given to treat a low functioning thyroid. If patients come in already on this, there are ways that we can support this! By giving certain herbs and nutritional supplements, we can support the body’s conversion of T4 into T3 thereby producing a negative feedback on TSH to bring that level down to within normal limits. 

Treatment 

Vitamin D: This little nugget of gold is so simple yet so powerful as its been shown to improve auto antibodies as well as improve thyroid function in subclinical hypothyroid patients. Optimal levels were shown to be 125 nmol/l. Not often do I ask for blood levels, as I assume most are deficient unless supplementing consistently. However ideally we know your exact levels and get it to the optimal range.

Anti inflammatory eating regime: This is a tough one as putting women on restrictive diets who are already fighting for control over their fertility journey, is often times just too overwhelming. Yet there’s a pull towards ADDING IN good fats, proteins and fiber and reducing foods that cause inflammation in your gut track - this often includes gluten and north american cow dairy. The pull is because as we reduce inflammation in the body, the auto antibodies can benefit. I also like screening my patients with hashimotos for celiac disease (allergy to gluten) as this connection is definitely present and we want to rule it out (or in! And treat).

Selenium and inositol: Also shown to reduce antibodies in hashimoto's patients. Selenium deficiency can inhibit the conversion of T4 to T3 so making sure levels are optimal is helpful.

There are various herbs that I love using in combination formulas that help to reduce oxidative stress on the body and therefore help the overall immune system/inflammation; I’ll use others to help the conversion of T4 to T3.

Lastly - in patients struggling with fertility and subclinical hypothyroidism or hashimotos, we want to check levels of vitamin B12 as they are needed in methylation which helps to form the strand of DNA for babe! We also want to make sure we have optimal iron levels (ferritin) as suboptimal can worsen thyroid function (and increase risk of miscarriage and prevent pregnancy from occurring).

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