The AFA Blog

January is thyroid awareness month. If you can't get pregnant, should you care?

by Corey Whelan

Your thyroid, that little gland at the base of your neck, is the master glad of your metabolism, and plays a significant role in many areas of a woman's reproductive life, from conception through to delivery.  59 million Americans, mostly women, currently have thyroid abnormalities in the U.S.  A significant percentage of these women are currently trying to conceive a baby.  Could you be one of them?

Thyroid problems fall along two specific lines, 1) hyperthyroidism, where the thyroid gland is overactive and producing an overabundance of thyroid hormone and 2) hypothyroidism, where the thyroid gland is underactive and not producing enough. 

Ironically, both extremes can present problems for women who are trying to get and stay pregnant.  Women with hypothyroidism may produce too much prolactin, which is the hormone that helps to create and maintain breast milk.  Too much prolactin can adversely affect fertility by inhibiting ovulation and therefore, conception. 

Women with undiagnosed hyperthyroidism may be at greater risk of miscarriage or premature birth, making it hard or impossible to maintain a healthy pregnancy.

It should be a no brainer that your thyroid is tested when you are first experiencing difficulties conceiving but unfortunately that is not often the case.  The reason is simple. The symptoms of both underactive and overactive thyroid are often vague and attributable to a wide variety of other disorders.  Symptoms  include sleeplessness, weight loss or gain, constipation, memory loss, or hair loss.  

A good rule of thumb is simply this.  If you are having trouble getting or staying pregnant, ask for a full battery of thyroid tests.  These tests include the TSH (Thyroid Stimulating Hormone) Test, the T4 test, the Free T3 test, and the Autoimmune Antibodies Test.  In addition, make sure that your physician is a reproductive endocrinologist or other specialist who can accurately  analyze the results of these blood tests and integrate them into your care, by evaluating your symptoms, taking your medical history and performing a clinical exam.  Proper diagnosis, and follow up treatment is key, particularly if you are placed in medication as your dosage will need to be carefully evaluated over time.

 That little butterfly shaped gland called the thyroid affects virtually every system in your body.  If you are trying to get pregnant, particularly if you are over the age of 35, make sure that a full battery of thyroid tests are part of your initial infertility workup.

For more information on this story, check out these important links:

http://www.thyroidawarenessmonth.com/ebook.htm

http://www.thyroid-info.com/pregnancyguide.htm

http://www.thyroid-info.com/articles/fertilitythy.htm

http://thyroid.about.com/cs/basics_starthere/a/couldyou_2.htm

http://www.examiner.com/x-14154-Raleigh-Infertility--Miscarriage-Examiner~y2009m11d23-Hypothyroidism-and-infertility?cid=examiner-email

http://thyroidawarenessmonth.com/

http://thyroidawarenessmonth.com/allyson-averell-facepainting.htm

Reprinted with permission from www.examiner.com

Photo: Allyson Averell

Thyroid Health and Infertility

by Stacey Roberts, PT, MH, Ph.D-C

Today we are going to discuss a very common issue that is often over looked and can for some mean the difference between having a child and not. 

 As I go through a patient's history I am always surprised at the tests that haven't been done or the issues that have been pushed off as normal and not addressed.  One of these such issues is thyroid health. Thyroid health is imperative in becoming pregnant and in holding the pregnancy so when a fertility issue persists, in my opinion, more detailed screening of the thyroid should be done, even if the standard tests have come up normal.  This is not only a woman's issue, i.e.  any time there is an issue with the sperm count and quality, it could be related to the thyroid.

So many times we see patients who have classic thyroid symptoms but have never had their thyroid screened beyond just doing the standard TSH testing.  Most times if their TSH has come in within "normal" limits, they are told their thyroid is "normal" and there is nothing wrong.  Then they begin doing their temperature charts for me and the temperatures indicate that the thyroid is not working optimally so I come back to them and request that they have their thyroid screened.  Some people look at me like I am crazy and others just scratch their heads.  

The confusion with the thyroid starts in the standard tests.  Normally a physician will test TSH which is the hormone that is supposed to be reflective of how the thyroid is working. The pituitary makes  more TSH if  thyroid hormone  is not enough or slows down in production if the thyroid is making too much.  The pituitary which secretes TSH is continually monitoring the blood to see how much thyroid hormone is present so in theory this should be an accurate indicator of thyroid function, but it doesn't always seem to work that way.  A scientist and MD Dr. George Gillson from Canada once stated in an International Hormone conference that TSH really only tells us what the brain needs for thyroid hormone, not what the rest of the body needs.

Therefore TSH can be normal but the thyroid hormone out put may not be optimal for you.  Another excellent reference for this http://thyroid.about.com

The range of "normal" for thyroid hormone varies quite significantly from lab to lab.  One lab may say that .4 to 4.0 is normal where another lab may say .3 to 6.0 is normal.  Our normal reference range, based onwhat we see in the clinic is 1.5 to 2.0 (with .3 to 3.0 being the full range we use), anything over 2.0 or below 1.5  gets our attention and we support the thyroid.   However even men and women who have TSH within this optimal range can show low thyroid out put on further inspection.  I know, its confusing.

If you have been dealing with fertility issues for awhile though its a good idea to have a more thorough screening.  For example, I would suggest that you ask your doctor to test FT4 and FT3, which are the actual hormones produced by the thyroid.  Your physician may be resistant to testing these if there is no apparent thyroid history or if TSH is normal so be ready to take responsibility for your own health and give him/her good reasons to test these. 

The other tests that should be considered if you have been dealing with fertility issues for a while and/or if you have had recurrent miscarriages or difficulty getting pregnant after a miscarriage or stillbirth, is thyroid antibodies.  These are tested even less frequently than the thyroid hormones and its a shame as it has been shown that a woman with elevated thyroid antibodies (which can be elevated even if TSH is "normal") are 3 times more likely to experience post natal depression and more likley to experience miscarriage. Most physicians do not test this if TSH is normal however thyroid antibodies can be elevated even with normal TSH.  Though traditionally physicians not familiar with its signficance regarding miscarriage will not treat elevated thyroid antibodies, but instead will often tell you to wait until the thyroid fails (or TSH rises above its "normal" range, before they will treat this.  Based on research reviewed in the New York Times, medical treatment for this is typically Thyroxine.  This treatment apparently decreases the incidence of miscarriage by half. 

Natural remedies for optimising thyroid function are also available from herbs and nutritional supplements.  An Ayurvedic herb called Withania Somnifera and Chinese herb Bacopa Monneri are a few herbs that have been shown to effect thyroid hormone levels.  And nutrients such as selenium, zinc, iodine and chromium are significantly important as well.  Keep in mind that the thyroid hormone T3 helps make progesterone and the nutrients mentioned are imperative in this process.

Clearly this is important information for any woman who wants to become pregnant or who is already pregnant.   French researchers stated in a recent abstract, "Thyroid autoimmunity is associated with hypofertility, particularly with spontaneous abortion.

Stacey Roberts is a leading herbalist and internationally recognized expert on complimentary medicines.