The Connection Between Thyroid Disorders and Your Fertility

What You Need to Know about Hypothyroidism and Fertility

The journey to pregnancy and motherhood can be a challenging, emotional journey. And fertility is complicated.

Numerous health conditions, family history, and environmental factors from both partners can contribute to your fertility. But many people do not realize that your thyroid health can significantly affect your fertility.

But why? What is the connection between thyroid disorders and your fertility?

Thyroid health and fertility have a long and sometimes complicated history. So here is what you need to know about thyroid disorders and your fertility.

What does the thyroid gland do?

The thyroid gland is a small, butterfly-shaped gland in the neck, just below the Adam’s apple. (1) The thyroid gland is an integral part of the endocrine system, which produces and regulates hormones.

The thyroid gland’s primary function is to produce two hormones: thyroxine (T4- the inactive form) and, to a lesser extent, triiodothyronine (T3- the active form). T4 is converted to the active form T3 in the liver and is the primary hormone that helps regulate the body’s metabolism – the rate at which your body turns macronutrients (food) into energy. The pituitary gland, which produces thyroid-stimulating hormone (TSH), controls the thyroid gland and tells the thyroid to produce its hormones in response to free T4 and T3 levels.

Thyroid Disorders

Thyroid disorders are conditions that affect the thyroid gland. When the thyroid gland is not functioning properly, it can lead to various health problems. The two primary thyroid disorders include:

Hypothyroidism

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone. (2) Hypothyroidism can be caused by an autoimmune disease (such as Hashimoto’s thyroiditis). Yet hypothyroidism can also be caused by radiation therapy to the neck, surgery to remove the thyroid gland, certain medications, and various nutrient deficiencies. Symptoms include fatigue, weight gain, cold intolerance, hair loss, constipation, dry skin, and depression.

Approximately 1 in 8 women will be diagnosed with hypothyroidism in their lifetime, making it the most common thyroid disorder. (3) Much of subclinical hypothyroidism is never diagnosed.

Hyperthyroidism

Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone, leading to an overactive metabolism. (4) Graves' autoimmune disease is the most common cause of hyperthyroidism. Still, it can also be caused by nodules on the thyroid gland, inflammation of the thyroid, and certain medications. Symptoms can include weight loss, rapid heart rate, sweating, anxiety, and tremors.

We’ll primarily focus on hypothyroidism's effects on fertility because it is the most common thyroid disorder. However, many of the information and tips can be beneficial if you have other thyroid disorders.

Diagnosing a Thyroid Disorder

Diagnosis of thyroid disorders usually involves a physical exam, blood tests, and sometimes imaging tests. But blood tests are the most commonly used tool to diagnose and monitor thyroid disorders.

While conventional medicine base their diagnosis simply on TSH and maybe free T4, functional medicine practitioners use a more extensive blood panel to diagnose thyroid disorders: (5)

Thyroid-stimulating hormone (TSH): This is a hormone released by the anterior pituitary in your brain to stimulate the thyroid to produce more T4. This test measures the amount of TSH in the blood.
Free Thyroxine (fT4): This test measures the amount of fT4, the primary thyroid hormone the thyroid gland produces.
Free Triiodothyronine (fT3): This test measures the bloodstream's unbound or “free” T3. T3 is the biologically active portion of total T3 and is a more accurate reflection of the body’s thyroid function than total T3. (6)
Reverse T3 (rT3): Reverse T3 is a type of thyroid hormone produced by the body but does not have the same biological activity as other thyroid hormones. Instead, rT3 acts as a regulatory hormone that helps balance other thyroid hormone’s effects. (7) Measuring rT3 can be beneficial when you are experiencing symptoms, but your T3 and T4 levels are normal.
Thyroid peroxidase antibodies (TPO): This test measures for a sign of autoimmune thyroid diseases such as Hashimoto’s thyroiditis or Graves’ disease.
Thyroxine Binding Globulin antibodies (TBG): This test measures the presence of antibodies that attack thyroglobulin, a protein produced by the thyroid, which can be a sign of autoimmune thyroid disorders.

Treating a Thyroid Disorder

Treating a thyroid disorder depends on the specific condition and the severity of the symptoms. The most common conventional treatment for hypothyroidism is synthetic thyroid hormone replacement therapy, such as levothyroxine. (8) This medication and lifestyle and dietary modifications can help restore normal thyroid hormone levels.

The Connection Between Thyroid Disorders and Fertility

Thyroid hormones play a crucial role in the reproductive system, and an imbalance in thyroid function can disrupt the hormonal balance needed for a successful pregnancy.

Yes, you read that correctly. That tiny organ at the base of your neck can affect your ability to become pregnant! But let’s dig a little deeper than that and uncover the connection between thyroid disorders and fertility.

Let’s start with the most pressing question most women with hypothyroidism have about fertility.

Can you get pregnant with hypothyroidism?

The short answer – yes!

With appropriate management and treatment of hypothyroidism, it is possible to conceive and have a healthy pregnancy. But because hypothyroidism can cause irregular periods, ovulation problems, and an increased risk of miscarriage, it can be more challenging to conceive.

The Thyroid’s Impact on Fertility

Now for the more in-depth answer on how a thyroid disorder can impact fertility.

Thyroid hormones play a crucial role in the reproductive system, and an imbalance in thyroid function can disrupt the hormonal balance needed for conception. Your thyroid gland is responsible for your ovulation cycle, and low levels of thyroid hormones can affect the growth of an egg follicle and your uterus’ ability to thicken after ovulation.

The thyroid hormones help stimulate the release of progesterone and support the elimination pathways required to move estrogen out of the body. (9, 10) So, fertilization is more difficult if you have a thyroid disorder, an egg is not released, or your ovulation cycle is irregular.

Missed periods, changes in your pattern, heavier periods, or spotting for days before your period may be signs of a problem with your thyroid. But unfortunately, undiagnosed and untreated thyroid disorders are common causes of fertility issues. (11)

The Thyroids Impact on Pregnancy

Identifying and treating a thyroid disorder before pregnancy is essential because, if left untreated, it can affect fetal development and increase your risk for miscarriage, premature birth, and stillbirth.

Untreated hypothyroidism during pregnancy can lead to (12, 13)

Fetal developmental delays
Miscarriage
Preterm birth
Preeclampsia
Stillbirth

Because thyroid hormones are essential to your baby’s brain and nervous system development, especially during the first trimester, checking your thyroid before you conceive and regularly during pregnancy is essential.

Can thyroid disease cause male infertility?

Ladies, we aren’t the only ones who need to be worried about fertility.

While it is far more predominant in women, thyroid disorders can impact fertility in both men and women. In men, thyroid disorders can affect sperm production and motility, reducing fertility. (14)

Optimizing Thyroid Health for Fertility and Pregnancy

Infertility can have many different culprits. Thyroid disorders can undoubtedly be one of them. That’s why optimizing your thyroid health before and during pregnancy is essential.

Here are some ways to support your thyroid health:

Talk With Your Healthcare Providers

Discuss your plans to have children with your healthcare provider. Even if you are not actively trying to conceive, it’s best to ensure that any health-related concerns are addressed sooner rather than later. If you have any indications that you have a thyroid disorder, your provider can order simple lab testing to help evaluate your risk.

If you have a thyroid disorder and are planning to become pregnant or are already pregnant, it is important to work closely with your healthcare provider to manage your thyroid function throughout your pregnancy.

Take Thyroid Medication as Prescribed

If you have been diagnosed with a thyroid disorder and are taking synthetic hormone replacement therapy, taking your medication as your healthcare provider prescribes is crucial.

Have Regular Thyroid Function Tests

It’s essential to have regular thyroid function tests to ensure that your medication dosage is appropriate and your thyroid function is well-controlled.

Manage Stress

Stress can impact thyroid function, so practicing stress-reducing techniques such as meditation, yoga, or deep breathing exercises is important.

Eat a Healthy Diet

A diet rich in fruits, vegetables, grass-fed/finished meat, SMASH fish, and healthy fats can help support thyroid function.

Exercise Regularly

30 minutes of moderate-intensity exercise most days of the week can help support thyroid function and overall health.

Holistic Fertility Planning in Denver, Colorado

Your thyroid is critical in your cellular processes and metabolism, affecting your overall health. When disrupted, these imbalances can lead to symptoms that affect your well-being, energy levels, fertility, and so much more.

At Denver Sports and Holistic Medicine, we partner with you to uncover the details of your thyroid imbalances so that we can improve your symptoms and imbalance before they get out of hand. Our functional medicine approach allows us to understand the underlying issues and address those to restore balance before and during pregnancy.

Schedule a free consultation today to learn how to get and stay pregnant naturally, safely, and effectively.

Find your trusted partner at Denver Sports and Holistic Medicine for your health journey.

Resources

1. PubMed

2. National Institute of Diabetes and Digestive and Kidney Diseases

3. PubMed

4. National Institute of Digestive and Diabetes and Kidney Diseases

5. National Institute of Diabetes and Digestive and Kidney Diseases

6. PubMed

7. PubMed

8. PubMed

9. PubMed