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How Thyroid Problems Can Impact Your Ability To Get Pregnant

Most people think of the thyroid as the butterfly shaped gland that is responsible for the inner workings of our metabolism. It truly does a lot for us, as one of its main roles is to produce the hormones that are vital to the functioning of our major organ systems. Seeing that nearly every cell in our body depends upon thyroid hormones to function, without them we simply would not survive.

Having a dysfunctional thyroid gland can affect the body in a number of ways, some of which are more noticeable than others. One area that is often overlooked yet is of great importance is within the realm of fertility and reproduction. Many couples are surprised to learn that optimal thyroid function is necessary to conceive and maintain a pregnancy. Even the slightest imbalance can contribute to difficulty conceiving in both men and women, as the thyroid interacts closely with our sex hormones and plays a key role in the maturation of our reproductive cells.

In women both low (hypothyroidism) and high (hyperthyroidism) thyroid function can cause irregular menstrual cycles and may even cease menstruation altogether. They are a common cause of anovulation, which happens when an egg fails to develop properly and does not get released from the ovary at the time of ovulation. When there isn’t an egg to be fertilized, conception is impossible. It is important to note that if a woman is anovulatory it is still possible for her to experience a bleed each month. In the case of hypothyroidism the flow may actually be heavy. If no investigations are performed she may think that she is cycling properly and may never realize that her fertility is impacted.

Suboptimal thyroid function is also associated with recurrent miscarriage, most commonly in the initial weeks of pregnancy or before a period is even missed. This happens for a few reasons, the first being that an underactive thyroid can cause the second half of the menstrual cycle – the luteal phase – to shorten. When this occurs, the uterine lining is not strong enough for an embryo to implant and sustain a pregnancy – even if fertilization had taken place. In most cases the pregnancy is lost before the woman even realizes that she is pregnant. The second reason specifically has to do with an autoimmune subtype of thyroid disease wherein the body inappropriately attacks the thyroid gland. This type of condition results in the production of antibodies that can affect a woman’s ability to sustain a pregnancy shortly after conception takes place. Since many patients with autoimmune thyroid problems can present asymptomatically, it often goes undiagnosed until several miscarriages have occurred or testing is acquired.

Since our thyroid hormones are so tightly linked with our reproductive hormones, an imbalance in one may cause an imbalance in the other and vice versa. For example, if estrogen is high in relation to progesterone the liver will produce more of a protein called thyroid binding globulin, which essentially acts to do just that – bind up the thyroid hormone and make it unusable by the cells. This is the reason why low thyroid function is often associated with other reproductive health concerns such as polycystic ovarian syndrome (PCOS) and endometriosis. As such, thyroid imbalances should not be addressed in isolation but instead looked at as a whole with the other reproductive hormones.

If you have been trying to have a baby for some time, have irregular periods, or have been diagnosed with unexplained infertility it might be worth looking into the function of your thyroid gland. Many thyroid problems unfortunately go undiagnosed because a full thyroid evaluation is not usually offered as part of routine care. In most cases only the TSH level is measured, which is a hormone sent out by the brain whose job is to instruct the thyroid gland to produce more or less thyroid hormone depending on the needs at the time. The result of this test is merely for screening purposes and only provides a brief snapshot of the overall thyroid function because it does not look at the level of the available thyroid hormones themselves. Research suggests that the TSH level should be between 1-2 mIU/L for optimal fertility. However, for completeness, the actual thyroid hormones (free T3 and free T4) and thyroid antibodies (anti TPO and anti TG antibodies) should also be included.

Thyroid conditions can present in a number of different ways, depending on the severity and what other hormones may be involved. In many cases the symptoms are vague or are not present at all, which can make it even more difficult to identify.

Common symptoms of an underactive thyroid may include:

  • Fatigue

  • Weight gain

  • Feeling cold

  • Constipation

  • Heavy and irregular periods

  • Low mood

  • Dry skin

  • Brain fog

Common symptoms of an overactive thyroid may include:

  • Fatigue

  • Weight loss

  • Anxiety

  • Heart palpitations

  • Feeling hot

  • Insomnia

  • Light and irregular periods

  • Sweating

If you suspect that your thyroid may be contributing to your fertility troubles and want to have it properly assessed, schedule an appointment with Dr. Jessica Geil at 905-769-4100 or by clicking the following link:

Dr. Jessica Geil, ND

Naturopathic Doctor

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