Why is Thyroid function important to fertility and your health?

Since I get asked a lot of questions on what testing others should do I am going to start blogging about different issues I have dealt with in hopes it can help others on their journeys.

Today I am going to talk about Thyroid.


Normal thyroid levels refer to the proper functioning of the thyroid gland, which regulates the body metabolism. The thyroid gland produces two types of hormones Thyroxin (T4) and Triiodothyronine (T3). In the liver, T4 is converted by using iodine and the amino acid Tyrosine into T3, which is the active form.

These hormones are very important in the human body because they regulate proper metabolic function and affect reproductive health. When the thyroid gland is out of balance, regular ovulation may not happen each month leading to thyroid infertility.

PCOS and Thyroid issues go hand in hand.

EVERYONE dealing with fertility issues should have there thyroid tested. A complete Thyroid blood workup consists of 9 blood tests not just the 1 most Dr. do. They are TSH, FT4, FT3, FTI, Resin T3 uptake, TPO and TGB Antibodies.

Where pregnancy and fertility is concerned and for optimal health you should have a thyroid level under 2.0.Elevated TSH, T3 and T4 levels indicate that the thyroid gland is underactive and you will most likely be given the diagnosis of hypothyroidism. If the thyroid TSH levels are low, hyperthyroidism is instead a most likely diagnosis.  

Thyroid antibodies also can effect your fertility and raise your risk of early miscarriage. When you consider the quote below how many of us dealing with infertility issues also are positive for these antibodies but go undiagnosed. It's important to ask for the complete thyroid blood panel.

"According to the American Thyroid Association, 10 to 20% of all pregnant women in the first trimester of pregnancy are positive for Hashimoto’s antibodies, but they are euthyroid. Euthyroid means they have normal thyroid functioning based on their TSH (thyroid stimulating hormone) level, the most common measurement of thyroid function. Their thyroid function in early pregnancy appears to be normal and they may even feel well, all the while their body is silently attacking and destroying their own thyroid gland. By testing TSH alone, thyroid antibodies in Hashimoto’s may be missed, and your doctor may have no idea your baby is at risk."

Even if your TSH is normal before you start any fertility treatments you should ask to have it checked during the cycle because what many Dr. will not tell you is taking fertility medications (clomid, femara, injections) can raise your TSH so monitoring of it during cycles needs to take place to keep it under the 2.0 is very important. If your levels raise higher than 2.0 while on medications during your cycle you should be on a thyroid medication to lower your TSH as this will help prevent implantation failure or early mc. 

Some other info on how thyroid effects IF:

1) Low thyroid production (High TSH) causes high prolactin. High prolactin causes you to not ovulate. No ovulation = no pregnancy.

2) Being hypothyroid interferes with all bodily funtions including ovulation and your ability to sustain a pregnancy, so if you are hypothryoid you must be on thryoid meds to bring your thyorid levels to normal for conception and holding a pg.

2) However, that being said, unfortunately for many of us that's not enough.  Testing positive for thryoid antibodies (either of them- there are 2 types) indicating that the uterus is "toxic" is true for many women. The reason for this is: It is not these thyroid antibodies themselves that interfere with pg, rather that having them indicates that your body is in an autoimmune state, meaning your body attacks it's own tissues. So having thyroid antibodies is a MARKER for having underlying immune conditions which cause IF and m/c. For example many women with thyroid antibodies test positive for elevated NK (natural killer) cells which are cells that attack developing embryos, causing implantation failure and m/c. So these underlying problems must be treated, rather than just taking thyroid meds which will not change the autoimmune condition. You must see a reproductive immunologist (RI) to deal with these problems. Can read more about this: www.repro-med.net 

3) Can my thyroid problems affect FSH-- this goes back to the autoimmne state. Many women with thryoid antibodies test positive for another autoimmune condition- AOA- anti-ovarian antibodies which cause women to go into premature ovarian failure- thus elevated FSH. This can be addressed by an RI and can be reversed.

 Symptoms you may have thyroid issues:
1. Fatigue
2. Weight Changes
3. Depression and Anxiety4. Cholesterol Issues
5. Family History
6. Menstrual Irregularities and Fertility Problems
7. Bowel Problems
8. Hair/Skin Changes
9. Neck Discomfort/Enlargement
10. Muscle and Joint Pains, Carpal Tunnel/Tendonitis Problems    

The following are potential factors that prevent normal thyroid levels:
1. Exposure to enviromental toxins like chemicals, heavy metals, pesticides, electromagnetic radiation. Mercury fillings and drinking chlorinate and fluorinated water. Bromide/bromine present in food products like baked goods, can negatively affect the thyroid gland. An increase in plasma bromine, in fact, can cause an increase of TSH probably by inhibiting thyroid gland activity.
2. Genetic predisposition.
3. Mineral deficiency like iron, selenium, zinc, iodine, copper, calcium, magnesium, manganese, etc...
4. Autoimmune disorders.
5. High levels of stress.
6. Infections.
7. Adrenal insufficiency.
8. Estrogen dominance.
9. High levels of prolactin.
10. Diet high in refined grains, soy, alcohol, coffee, and hydrogenated oils. 

For More Information:
Book you can beat thyroid disorders
Ten Things You Can Do To Stop Hair Loss With Thyroid Disease 
 

*For myself personally I had all these test done with the RI I recently saw Dr. Kwak-Kim. She also did a u/s of my thyroid to check for any abnormal growth or size. Everything came back ok (no autoimmune issues) except for my TSH level 4.81 way over the 2.0 you want for optimal health and fertility. I just started today on synthroid 25mg to start to lower that number and will get blood work in 2 wks and 4wks etc. to monitor and adjust medications as needed till we get it to the right level. This is all very important to do before we do anymore fertility treatments.