Empowering your Thyroid Levels to Get Pregnant
USEFUL RESOURCES FROM THIS FERTILITY TV EPISODE
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So today I’m going to be talking about that little, tiny gland in the back of your neck called the thyroid gland, and we’re going to be talking about how it affects or potentially affects your fertility. So if you want more information on your thyroid and reproductive function, then keep watching.
Hi, I’m Dr. Marc Sklar, the fertility expert, and I work with couples from all over the world helping you get pregnant naturally. If you want more information on how I can help you, then hit that bell to subscribe so that you know when I put out a new video to help you. So today I’m talking about thyroid function and how it affects your fertility and reproductive function. But before I do that, I just want to let you all know that if you’re looking for more support and more help on your fertility journey and you want to get results naturally, then I want you to apply for discovery call with me and my team to see if we can help you too. To do that, just go down to the description below and click that link and fill out that application. So now let’s start talking about thyroid and fertility.
For those of you who don’t know, your thyroid is a small gland that is in here. If you feel your adam’s apple, it’s going to be right behind there. And hopefully, you actually can’t feel it because if you can’t feel it, that’s a good thing. If you can feel it, right, in your neck, then I suggest that you reach out to your GP so that they can take a closer look at what’s going on with your thyroid. All right. So your thyroid is a big part of your endocrine system, and your endocrine system is the system that controls all the hormones in the body, including the hormones that affect your fertility and your menstrual cycle. Right? So the thyroid can absolutely affect fertility as well, but we’ve got to understand what your thyroid does first before we can get into how it can potentially affect your fertility.
Your thyroid is a big part of your endocrine system, and it is responsible for metabolism. This is where your body takes food and drink, and converts it into energy. So the main hormone that is constantly checked by most of your physicians is called TSH, thyroid stimulating hormone. Thyroid stimulating hormone is actually not a hormone that is produced in the thyroid. It’s produced in the pituitary and it’s released by the pituitary to stimulate your thyroid to release T3 and T4, the two primary thyroid hormones. So, that is a small way about how your thyroid functions. Most of us think that TSH is the only thyroid hormone around and that it controls everything that we do with our thyroid. In reality, there are other hormones which I just mentioned, two of them, right, T3 and T4. So in just a little bit, I’m going to tell you all which are the main tests that you need to have checked when you’re checking and doing a full thyroid panel.
Before that, we do need to understand the whole gamut of what thyroid function is and what it means because the thyroid could be overacting, hyperfunctioning, or underacting, hypofunctioning. Right? And so, the two main disorders associated with the thyroid are hyperthyroid and hypothyroid. One of the common misunderstandings associated with this is when you read thyroid labs, it’s very natural that when you see a TSH that’s elevated that you automatically associate that with being too high, hyperfunctioning. Right? And if you see a number that is too low, if you see your TSH being too low, it’s very common to associate that with low functioning, hypothyroid. But the reality is, is that it’s the reverse. And the reason that it’s the reverse is because it’s the TSH that is determining this, and the TSH is not in the thyroid. Like I explained earlier, it’s in the pituitary.
And so what happens is, is that there’s a constant communication between your hormones, the T3 and T4 in your thyroid, and your TSH, the thyroid stimulating hormone, in your pituitary, and they’re talking back and forth, and then they’re telling each other, “Well, I’ve got enough of this, so you don’t have to produce more,” or “I don’t have enough of this so I need you to produce more of it,” or “I have too much of this. I need you to produce less of it.” Right? So now that I’ve just said that, hopefully, that starts to paint a picture for you. If you have not enough T3 or T4, then that’s going to send a signal to your brain, to your pituitary, to produce more TSH. So when your TSH goes up, it really means that your thyroid is hypofunctioning, hypothyroid. And when you have enough or too much of it, it sends a signal back to your pituitary to tell your TSH, “We don’t need more, hold up. We need much less of this.” And that’s hyperthyroid because your thyroid is functioning too fast. Those are the two main forms of thyroid disorders.
Now there’s extensions of both of those and those extensions relate to autoimmunity. So we’ve got hypothyroidism and hyperthyroidism, and the autoimmune components of either one are called of hypothyroidism it’s called Hashimoto’s and of hyperthyroidism, it’s called Graves’ disease. The more common disorder with your thyroid that there is to see is actually hypothyroidism and Hashimoto’s. We see that in actually 50% of women who come in with thyroid disorders actually present or have, and are positive for Hashimoto’s disease, which is for all intents and purposes, a more complicated version of hypothyroidism. So it’s important that you understand those scenarios and those extensions of one another so that you understand what they all mean. Now we need to know what does it look like in the body?
Right? So if I say that you’re hyperthyroid, what are the symptoms associated with it? Okay. So the symptoms of hyperthyroidism are unexplained weight loss, or extreme fast weight loss, increased appetite, feelings of nervousness and anxiety, difficulty sleeping, fewer or lighter menstrual cycles so there’s less of it, and increase sweating and heat intolerance. So think of your body. This is your metabolism, right? This is regulating, this is the thermostat in the body. So think of it as being hyperfunctioning. Right? It’s functioning too high, and so you lose… If your metabolism’s revved up and running so fast, you lose weight. Right? You have increased appetite. You feel anxious or nervous. You feel more warm or hot. These are the typical signs of hyperthyroidism. All right. Now the other thing that’s really interesting as it relates to your fertility that you might notice with hyperthyroidism is that if you’re tracking your basal temperature, BBT, then your BBTs might be elevated higher than normal.
Right? I’ve seen some women who show me their basal temperatures, and they are on either, actually for both the luteal and follicular phase, you’ll start to see that these temperatures are a full degree, potentially, higher than where they should be. Right? So this is a sign that we need to potentially check your thyroid or dig deeper to your thyroid. Hypothyroidism, when it’s sluggish, it’s not functioning fast enough, right, in terms of your thyroid, then we might have symptoms that are the opposite of what I just explained. So weight gain, or potentially, quick weight gain, fatigue, constipation because your metabolism is sluggish, feeling cold, so in the other one, you were hot and this one you’re more cold. Thinning hair, pale skin, increased or heavier menstrual bleeding. These are the sorts of things that we need to look out for, and just like I mentioned before, with the basal temperature being a full degree, potentially, higher in hyperthyroidism, in hypothyroidism, we might see it the opposite, a full degree lower in both the follicular and luteal phase.
So these are signs of things that we need to look out for that might give us clues that we may have a thyroid issue. Now, with all that being said, some of the key components that we need to take into account when we’re looking at thyroid issues are family history, so does else in your family have thyroid issues because then it’s more common for you to have a thyroid issue. And I’ve had many women, just spoke to one today actually, who her mom and her sister, or both sisters, I can’t remember, all have thyroid issues. When I asked her how she’s feeling, she doesn’t complain of any issues whatsoever. She says she feels healthy, but she’s having difficulty getting pregnant. So we’re going to do a deeper investigation, a deeper dive into her thyroid to rule it out. I suspect that we’ll actually find something because her family history is there.
Right? So how many of you watching right now have a family history of thyroid issues? If you don’t or if you do, whichever way, comment below. Let me know. I also wonder how many of you have ever were asked your parents or grandparents if anybody has ever had a thyroid issue. I encourage you all if you’ve never asked to go back and ask and find out because this is important information to know and rule out, genetically. Okay. And even if you don’t have symptoms, like this woman who I was just explaining, you still may have thyroid issues. It just means that they haven’t started to express themselves yet so they’re early enough to catch and, hopefully, start to reverse. So a cofactor, right, another condition that we often see with thyroid issues or often want to rule out and confuse with thyroid issues is PCOS.
And the reason for this is that it’s not uncommon with thyroid issues and with PCOS, for that matter, to have longer cycles or be anovulatory, that you’re not releasing an egg, you’re not ovulating. So the reason for this is that thyroid issues can actually disrupt the release of GnRH, gonadotropin-releasing hormone, which is responsible for a series of processes that occur that lead to the growth and release of an egg or a follicle. And if there’s thyroid issues, this is actually not happening or potentially not happening and that is why you might have longer cycles or have an anovulatory cycle which means you’re not ovulating. Hypothyroidism can also impact other hormones like prolactin. So it’s often important to also check prolactin levels and make sure that they are normal and functioning healthy. When you get tests by your gynecologist, REI, or GP, often, as I mentioned earlier, they only test TSH, thyroid stimulating hormone.
My preference is that all of you do a full thyroid panel and the hormones that are important for you to have tested in a full thyroid panel are TSH, thyroid stimulating hormone, T3, and T4, and then the free version of both, so free T3, free T4, and then reverse T3, and then both antibodies, which you can either just ask for your thyroid antibodies or TPO antibody, thyroglobulin antibody. If you’re trying to rule out Graves’ disease, then you do need to add in another one, which is TSI. So those are the main hormones that you should have done.
Now, don’t be surprised if you go and ask for all of these hormones and they don’t do them. Often, they won’t do it because, really, the main hormone that they want to know what its levels are is TSH because that’s primarily what they’re treating when they prescribe medication. So often they don’t care about looking at the other hormones, but those hormones are still very, very important and more so important for your fertility. So we want to make sure that they’re all functioning properly even if your GP, OB-GYN, or REI can’t do much about it. It doesn’t mean that having those results aren’t valuable for you because there’s a lot of things that you can potentially do naturally or through other medical modalities that could have a huge impact on your thyroid function and your fertility.
So how many of you have actually requested a full thyroid panel and been denied? I’m really curious. I want to know. Comment below and let me know if you’ve asked for more thyroid testing and they said, “Mm-mm (negative). You don’t really need it. You’re all good.” I want to know. So we’ve talked so much about thyroid function, but how does it impact your fertility? Well, here are the main things that I want you to understand. First and foremost, that having a thyroid that is hyperfunctioning or hypofunctioning, so hyperthyroid or hypothyroid, can make it more challenging for you to get pregnant.
Okay. It can make it more difficult. So we do want this to be controlled. One of the best examples for this, and one of the reasons why you can potentially have a harder time getting treatment for fertility, and I see this all the time, truly, all the time is that there are different ways to view thyroid function in terms of lab results. So a normal TSH result, again, which is the main hormone that most of your OB-GYNs are looking at, the main hormone has a reference range of 0.45 to 4.5 or even higher at 5.4. And so, if you’re anywhere in that range, your OB-GYN is potentially going to say, “It looks good. You’re doing just fine.” But for fertility purposes, we want that number to be lower. We want that number to be between 1 and 2. So anytime I see a TSH creeping up to 2 1/2, or 3, or above, I get concerned and want to see improvement and change. But sometimes, you might have to go a different route to get that treated because your OB-GYN is not thinking about fertility. They’re just looking at your reference range and they’re going to say, “No, it looks fine.”
So remember, we were talking about where the TSH is produced. It’s produced in the pituitary. So we’ve got the hypothalamus and pituitary, which are two glands in the brain, which are communicating with your thyroid. This access is very important. And so if your hypothalamus and pituitary are compromised in some way or not functioning properly, then they’re going to have an impact, not only on your thyroid, but also on your fertility because what are the other hormones produced in your hypothalamus and pituitary? FSH, follicle-stimulating hormone and LH, luteinizing hormone.
And so it also goes the other way that if there’s an issue in your thyroid with, let’s say your primary thyroid hormones, T3 and T4, they’re going to have an effect on your pituitary and that, over time, will also affect your fertility. So we want to make sure that both or all three, in this case, your hypothalamus, pituitary, and your thyroid are all functioning optimally to give you the best chance to conceive any given cycle. Additionally, if you have an autoimmune component or an autoimmune form of a thyroid disease, so Graves’ disease or Hashimoto’s, it can make it more difficult to hold a pregnancy. Autoimmune issues can make it more complicated, can be a complicating factor, excuse me, in holding a pregnancy and many women who have autoimmune thyroids are more likely to miscarry. So, one aspect of thyroid issues make it more difficult to get pregnant, the other aspects makes it more difficult to stay pregnant.
I did want to briefly read this little study that I found. It says in a group of almost 400 women suffering from infertility, 24% of participants were found to have hypothyroidism, but within a year of treatment, 76% were able to conceive. That is truly, truly amazing. Okay. Now, one piece with that because they said once they were treated, within a year they were able to get pregnant, this brings the question of, well, what do we do about our thyroid issues? So you know that my preference is to treat everything as much as we can naturally. Treating thyroid issues naturally can be difficult because the regulating your TSH and regulating your thyroid hormones can be challenging to regulate naturally, especially if things are really off in an extreme way. So, if you’re actively trying to get pregnant, my recommendation typically will be to err on the side of caution and actually have your REI, or GP, or OB-GYN prescribe thyroid medication to keep it stable.
Thyroid medication will make it much easy to keep your thyroid hormones in a more balanced state, which is really important, not only for your health and for conception, but really important for when you’re pregnant because naturally what happens when you do conceive is that your TSH will naturally rise a little bit. So if it’s already in that direction, already has that tendency to do that, then that’s going to happen more easily, and that can be a complicating factor for a healthy pregnancy and for the development of the fetus, so we don’t want to compromise any of that. So this is a time where I actually err on the side of caution and would prefer to have medication. With that being said, there are different types of thyroid meds. And so something like levothyroxine or Synthroid are the more common prescriptions used.
They’re used more commonly because it’s very easy to prescribe and regulate. Give, once everything’s stable, your doctor doesn’t have to worry about it, and they can kind of somewhat forget about it. If you use one of the more bio-identical forms of thyroid medication, like Armour, or Westhroid or Nature-Throid, it does take a little bit more effort and management on your physician’s part to be able to manage and regulate and stabilize your thyroid function and keep it there. So they often don’t like to do that, but that is my preferred method or form of treatment for couples. I think it works better on the body. It’s more gentle on the body, and those of you who have Hashimoto’s or Graves, you’re more sensitive because of the autoimmune component and Synthroid and levothyroxine do have some fillers that can trigger and affect your autoimmune thyroid.
Now you might say to me, “Well, what can we do if we have Hashimoto’s or Graves?” I want to separate these two things for just a moment. Okay. The treatment you typically get will only treat your TSH, sometimes your T3 or your T4, depending on what medication you’re given. The autoimmune side of things is not treated with these medications. That’s a misunderstanding. Often, many of you think that as long as I’m given Synthroid, then my Hashimoto’s is being managed and controlled. Not the case. What is being managed and controlled is just your TSH or, depending on the medication you’re given, T3 and T4. It’s not managing the autoimmune side of things. This is where we need to do a lot of other things like lifestyle changes, supplements, dietary changes, making sure that we’re managing stress and sleep. This is where all the other things that I do for all of you and have talked about in all of my other videos, is going to be really, really valuable and essential for managing both your thyroid, your immune function, and helping you get pregnant.
So keep all those things in mind as you are making decisions about how you’re going to approach and manage your thyroid function and your fertility. So thyroid function doesn’t just affect women. It also affects men, rightly so, because we all have a thyroid. We all have an endocrine system. So this is important for men as well. So if your partners have their thyroid checked, and I do recommend that they all do, then hyperthyroidism, untreated and unregulated, can absolutely affect sperm quality. It can affect volume, density, motility, morphology. These are all variables that are really important to understand as we’re looking at the whole picture for male fertility as well. And then hypothyroidism actually more specifically will affect sperm morphology. So sperm quality across the board can absolutely be impacted by thyroid function as well. And even though most of this video was talking about women and your cycles and how thyroid affects all of you, as always, fertility takes two to tango and we can’t ignore the male side of this either.
So, hopefully, you all found this video useful and helpful and really practical on your fertility journey. If you did, let me know. Comment below, let me know what you liked and how it can support you more. If you want more videos like this, then you have to make sure you subscribe. So you make sure you hit that bell so that I can let you know when I put out a new video the next time to help you on your journey. And just a reminder, if you want more personalized care, and attention, and a plan created specifically for your needs on your fertility journey, then you can always apply for a discovery call to see if we can help support you on your fertility, naturally. To do that, just use the link below in the description. All right, everyone, until next time, please stay healthy, stay safe, and most of all, stay fertile.