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Every Woman’s Guide to Hypothyroidism and Fertility

Every Woman’s Guide to Hypothyroidism and Fertility

Article

Hypothyroidism is a leading cause of difficulty in achieving and maintaining pregnancy. Low thyroid function has a negative impact on reproductive health and is more common than most women realize. In this guide we’ll be discussing thyroid imbalances and their effects on fertility and pregnancy, proper nutrition for hypothyroidism, and the 12 most effective herbs to help support the thyroid including fertility super herbs vitex and maca root.

In the ever-changing medical system, new information on thyroid testing has narrowed the ranges in which thyroid function impacts a woman’s ability to achieve pregnancy. For women struggling to get pregnant, questioning thyroid health and getting proper testing is a first critical step to a successful outcome.

Fortunately, for the thousands of women that are diagnosed with hypothyroidism, there are a variety of natural ways to support thyroid health. Along with your doctor monitoring thyroid hormone levels and prescribing thyroid medication, there are specific foods, key nutrients and herbs that can all be used to improve thyroid health. The thyroid is a key link to whole body wellness.

Get to Know The Thyroid

The thyroid is a small butterfly shaped gland that surrounds the wind pipe.

The thyroid is a small butterfly shaped gland that surrounds the wind pipe.

The thyroid gland is a butterfly shaped gland that partially surrounds the wind pipe. The thyroid produces thyroid hormones, mainly thyroxine (T4) and small amounts of triiodothyronine (T3). T3 is the more active form of thyroid hormone that tells cells what to do, and T4 is converted into T3 inside the target cells.

What thyroid hormones do:

  • Control metabolism by regulating the rate of oxygen consumption and consequent heat production at the cellular level.
  • Influence carbohydrate, protein and fat metabolism.
  • During pregnancy, fetal growth and development are controlled by maternal thyroid hormone, with the help from fetal thyroid hormone later in pregnancy. Growth and development continue to be regulated by the thyroid postpartum.
  • Healthy thyroid function is also required for the activity of other hormones, like growth hormone, for controlling heart rate and blood pressure, and even for proper brain function.

The Bigger Picture – The Thyroid and the Endocrine System

The thyroid is part of the endocrine (hormonal) system and is controlled by the hypothalamus and the pituitary gland in the brain. To understand the role the thyroid plays as an endocrine gland, let me break it down into the cycle of communication that takes place…

➞ The hypothalamus produces Thyrotropin Releasing Hormone (TRH), which tells the pituitary gland to make Thyroid Stimulating Hormone (TSH).

➞ TSH tells the thyroid to make thyroid hormone, which is then carried to the target cells by Thyroxine Binding Globulin (TBG). Thyroid hormone that is bound to TBG is inactive until released and entering the target cell.

➞ Importantly, thyroid hormone regulates its own production by telling the pituitary to reduce production of TSH in a “negative feedback loop”.

You may recognize TSH from your lab test, as it’s commonly used to measure thyroid activity. As confusing as all this may sound, the more thyroid hormone there is, the lower TSH levels will be. The lower thyroid hormone is, the higher TSH will be (usually!).

Doctors use high and low TSH to diagnose hypothyroidism (low functioning thyroid) and hyperthyroidism (over-functioning thyroid), respectively. However, reliance of TSH levels alone in diagnosing thyroid issues gives an incomplete and potentially misleading picture (more on this later).

A Delicate Balance – Endocrine Glands & Hormonal Balance
Also under control of the hypothalamus and pituitary gland are the ovaries and adrenal glands. In response to Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) produced by the pituitary, the ovaries produce estrogen and progesterone. In response to Adrenocorticotropic Hormone secreted by the pituitary, the adrenals make cortisol (“stress hormone”). A similar negative feedback loop exists between ovarian and adrenal hormones and the hypothalamus and pituitary, just like with thyroid hormone.

You can think of all of these glands — hypothalamus, pituitary, thyroid, ovaries, adrenals — as being a part of a spider’s web. When something happens at one part of the web, it’s felt through the entire web. Thus, imbalances anywhere in this system will influence the other glands and hormones in the system.

Hypothyroidism

When thyroid function is not sufficient to meet the body’s needs it is called hypothyroidism, and may stem from various sources…

➞ For one, the thyroid may not make enough of the T4 form of thyroid hormone due to a problem with the thyroid itself. In this case, T4 levels would be low and TSH would be high because there wouldn’t be enough T4 to inhibit the pituitary’s production of TSH in the negative feedback loop. Hashimoto’s Disease is an example of this in which the thyroid can’t keep up with the body’s needs because it is being targeted by the immune system for destruction (“autoimmunity”).

➞ Iodine deficiency is another cause of hypothyroidism, because iodine is necessary for production of thyroid hormone. (T4 has 4 iodides and T3 has 3.)

➞ Another reason T4 might not be made is due to problems upstream with the hypothalamus and/or pituitary. In this case, both T4 and TSH may both be low.

➞ Alternatively, there may be plenty of T4 made by the thyroid, but it is not being converted to the more active T3 in target cells. In this case, T4 and TSH levels may look fairly normal, but T3 will be lower than usual. Yet another issue may be that T4 is being converted into an inactive form of T3 known as reverse T3 (rT3). Again, T4 and TSH may appear relatively normal in this case.

Signs of Low Thyroid Function

If you have more than three of the following signs, consider having your thyroid tested:

  • Fatigue, weakness
  • Depression, irritability
  • Mind fog, memory loss
  • Digestive issues – usually constipation/slow food transit (can measure this via the beet test!)
  • Weight gain or difficulty losing weight
  • Dry/rough skin, dry/brittle hair, hair loss
  • Eczema
  • Shortness of breath
  • Cold intolerance
  • Low body temperature
  • Slow pulse
  • Goiter (swollen thyroid)
  • Muscle cramps
  • Reduced libido
  • Menstrual cycle abnormalities
  • Difficulty conceiving or carrying pregnancy

New Thyroid Testing Guidelines

The Importance of Complete Thyroid Hormone Testing
Many doctors only measure TSH, or TSH and T4 as recommended by the American Thyroid Association. This means that you may have symptoms of hypothyroidism and are told that your thyroid function is normal, when in fact there may be problems such as poor T4-to-T3 conversion or high levels of rT3 that wouldn’t be uncovered without additional tests. When having thyroid function checked, a more comprehensive approach would be to assess TSH, total T4 (T4 bound or not bound to TBG), free T4 (T4 not bound to TGB), total T3, and free T3. rT3, if available, should also be included, as well as tests for the presence of thyroid autoantibodies.

Understanding TSH Levels to Diagnose Hypothyroidism
Today experts consider 0.3 to 3.0 mIU/L the normal range for TSH levels to fall (14). Anything above 3.0 is considered hypothyroid. Some endocrinologists believe that a percentage of women may find it difficult to get pregnant — or maintain a pregnancy — at a TSH level above 2.0 mIU/L, which may indicate poor thyroid function. Some studies indicate that TSH levels should be below 2.5 mIU/L prior to conception, while other studies suggest it should be at or below 1.2 mIU/L as shared by the American Thyroid Association.

Thyroid Monitoring is Imperative to a Healthy Pregnancy
Along these lines, The American Thyroid Association has released new TSH and T4 testing guidelines for pregnant women, based on trimester. For the first trimester, the normal TSH range is 0.1-2.5 mIU/L, for the second it’s 0.2-3mIU/L and for the third it’s 0.2-3.0 mIU/L. For comparison, the normal range for women who are not pregnant used to be 0.4-4.0 mIU/L, which was considered the normal range for both pregnant and nonpregnant women. Overt hypothyroidism is now defined in pregnancy as either (i) TSH levels greater than 2.5mIU/L and decreased free T4 or (ii) TSH levels greater than 10mIU/L regardless of free T4 levels. Subclinical hypothyroidism is now defined in pregnancy as TSH levels between 2.5 and 10mIU/L and normal free T4 levels.

Reproductive Hormones & Medications Impact Thyroid Health

Thyroid function influences reproductive hormone balance, but reproductive hormones also influence thyroid function. High levels of estrogen, whether due to estrogen dominance or taking exogenous estrogen, may reduce the amount of active thyroid hormone. This is because excess estrogen increases TBG, the protein that binds and transports T4 and T3 but also renders them inactive upon binding. In those with normal thyroid function, a compensatory increase in thyroid hormone takes care of this but in hypothyroid women, this compensation doesn’t happen and symptoms of hypothyroidism may worsen in the presence of excess estrogen (New England Journal of Medicine).

Finally, many prescription medications also block thyroid function, including steroids, beta-blockers, barbiturates, cholesterol-lowering drugs, and certain seizure medications. If you are experiencing signs of low thyroid function, be sure to research any medications you are taking to look for impacts on the thyroid.

Hypothyroidism, Fertility and Pregnancy

Pregnant BellyFertility & Conception
Conception is more difficult for hypothyroid women due to associated ovarian dysfunction (remember the spiderweb analogy). Both hypo- and hyperthyroidism disrupt reproductive hormone balance and women with thyroid disorders often have menstrual cycle abnormalities such as flooding, scanty periods or irregular cycles. While the precise mechanisms of hormonal disruption have yet to be defined, research in The Journal of Obstetrics and Gynecology of India shows hypothyroidism has been associated with reduced FSH and LH levels which are needed for egg follicle maturation and ovarian production of estrogen and progesterone. Hypothyroidism has also been linked with the development of ovarian cysts, and such cysts may regress upon thyroid treatment (Journal of Pediatric Endocrinology and Metabolism, 2011).

Pregnancy
It is not uncommon for thyroid disorders to develop during pregnancy, with an incidence ranging from 10-15%. Thyroid hormone is important for both placental and fetal development. Pregnancy can be seen as a “stress test” for the thyroid in that the mother’s thyroid hormone production needs to increase by 20-50% to accommodate the increased metabolic needs of mother and developing fetus. If a woman is unable to produce enough thyroid hormone due to overt (“full blown”) hypothyroidism, or even to subclinical hypothyroidism then that becomes a problem under the increased demands of pregnancy, the risk of miscarriage, preterm birth, low birth weight, and postnatal developmental issues is higher according to research in The Journal of Women’s Health and Pakistan Journal of Biological Sciences.

The most common cause of hypothyroidism in reproductive aged women is Hashimoto’s Disease, an autoimmune condition. The presence of thyroid autoantibodies is used to diagnose autoimmune thyroid reactions. British researcher’s, May 2011 meta-analysis proves that when these thyroid autoantibodies are present, the rates of miscarriage, preterm birth and neurodevelopmental issues are higher, even when thyroid function appears normal by other tests (British Medical Journal). Thus, the American Thyroid Association recommends screening every 4-6 weeks for women with thyroid autoantibodies, even in the absence of disease, due to the increased risk for developing hypothyroidism during pregnancy.

Healthy Adrenals are Important for Healthy Thyroid

It’s important to realize that not all thyroid issues originate with the thyroid. Adrenal dysfunction will influence thyroid function (that spiderweb again…). Thus, treating the thyroid without providing adrenal support may not be productive. The adrenal glands sit on top of the kidneys and mediate the body’s multiple responses to all forms of stress. To do this, adrenals secrete hormones such as cortisol, adrenaline and noradrenaline that act on multiple body systems including nervous, muscular, immune, and cardiovascular. The link between adrenal and thyroid function was recognized decades ago based in part on the coexistence of adrenal diseases with thyroid disorders (King’s College Hospital Medical School, London).

Poor eating habits, a busy schedule, emotional stress, caffeine, food intolerance, immune disorders and other triggers contribute to adrenal stress, with elevated levels of stress hormones such as cortisol being produced. Adrenal stress may manifest in fatigue, mood disturbances, reduced immunity, insomnia, cravings, blood sugar imbalances, and other problems. It also manifests in thyroid imbalances through various mechanisms. For instance, excess cortisol influences hypothalamus and pituitary function in part by altering TRH release by the hypothalamus. Remember that TRH tells the pituitary to make TSH, which tells the thyroid to make thyroid hormone. Adrenal stress also reduces the conversion of T4 to active T3 in target cells and may even decrease the activity of receptor sites on the thyroid that are important for production of thyroid hormone.

If adrenal stress continues long term, adrenal fatigue will eventually develop such that the adrenals no longer make sufficient levels of cortisol and other hormones to meet the body’s needs. Adrenal insufficiency has been linked to subclinical hypothyroidism according to research out of the University of Alabama School of Medicine, and also to increased incidence of autoimmune thyroid reactions like Hashimoto’s (Hormone and Metabolic Research).

Getting Your Thyroid in Shape for Conception and Pregnancy

With the link between hypothyroidism and reproductive fitness, it’s important to support thyroid health directly and also indirectly through supporting adrenal and immune system health before trying to conceive.

Medical Treatment of Hypothyroidism

The American Thyroid Association recommends treatment with levothyroxine (T4) for hypothyroidism regardless of the cause. The problem is that T4 alone is unlikely to help women whose symptoms are due to inefficient conversion of T4 to T3, or from production of elevated levels of rT3. Because of this, many opt for an approach that provides both T3 and T4. Also, if the adrenals are not healthy, this will simply continue to add fuel to the fire.

Nutrition and Hypothyroidism

Focus on nutrient dense, anti-inflammatory foods, with the majority of the diet being a variety of colorful vegetables and fruits, augmented with a smaller amount of healthy proteins, fats and whole grains. The following are some of the key nutrients important for thyroid health. These can be provided by good quality supplements but you should always strive to get as much as possible from food.

Iodine: Iodine is necessary for the production of thyroid hormone and is important for fetal and early postpartum development. Dietary iodine requirements are higher in pregnancy because the demand for T4/T3 is higher and it’s not unusual for iodine levels to drop through pregnancy. Studies have shown that the children of women with mild-to-moderate iodine deficiency (urinary iodine concentrations between 50-150ml/L) during pregnancy are at increased risk for neurodevelopmental issues. The U.S. Institute of Medicine has set the RDA for iodine in pregnant women at 220 μg and 290 μg during lactation, while the RDA for non-pregnant women is 150μg. Be careful not to over-supplement with iodine as it can actually lead to hypothyroidism in susceptible women.

Food sources: Seaweed, seafood, organic dairy, eggs, strawberries.

Selenium: Selenium is important for the function of several enzymes involved in thyroid function. Moreover, selenium has been found to diminish thyroid autoantibody levels. Selenium levels may be low in some pregnant women, and low selenium levels may be a contributing factor to the postpartum thyroid dysfunction that afflicts many women. The RDA for pregnancy is 60 mcg. There is some evidence that long term supplementation with higher levels (200mcg) may contribute to the development of type 2 diabetes.

Food sources: Organic lean meat, fish, Brazil nuts, cheese, eggs, nutritional yeast, liver, butter, cold water fish, alliums (onions, garlic, leeks, etc), mushrooms, tomatoes, green vegetables.

Zinc: Zinc may be involved in many aspects of thyroid function and is both influenced by and influences the thyroid. Make sure your whole food multivitamin contains the RDA for pregnancy, which is 11mg.

Food sources: Organic lean red meat, cheese, duck, goose, turkey, herring, Brazil nuts, pumpkin seeds, whole grains, cucumbers, watermelon rind, peas, carrots, beets.

L-Tyrosine: This is used in the synthesis of thyroid hormone. Should you choose to supplement with L-Tyrosine, be sure not to over-supplement and please talk to your doctor before using it as a supplement if you are taking thyroid hormone.

Supportive foods: Eggs, seaweed, fish, organic poultry, organic pork, game meats, beans, sesame seeds, pumpkin seeds. This may be best from food.

Omega 3 essential fatty acids: These decrease inflammation and support balanced immune system function. Infants born to women with insufficient omega 3 levels are at increased risk for nerve and vision problems. Fish-derived is more bioavailable than flax-derived. The International Society for the Study of Fatty Acids and Lipids recommends 300 mg of DHA daily for pregnancy. DHA is a fish-derived omega 3. Be picky about brand: Poor quality fish oils are actually damaging rather than beneficial.

Food sources: Cold water fish such as salmon, herring, sardines, anchovies, mackerel, trout. Avoid larger fish like tuna that bio-accumulate high levels of mercury.

Vitamins E, C and A: These vitamins are powerful antioxidants, are anti-inflammatory and also immune supporting. The daily recommendations for pregnancy from the Linus Pauling Institute: A (770mcg), C (85mg), E (15mg).

B vitamins: Vitamin B12 deficiency is common in women with hypothyroidism (Journal of Pakistan Medical Association). It is best to get the full range of B vitamins to prevent B vitamin imbalances by taking a vitamin B complex. A good quality fertility-specific, whole foods-based multi will provide the RDA for B complex.

Food sources: Organic meat & poultry, fish, brewerʼs yeast, dairy, eggs, nuts (buy in shell, refrigerated), sunflower seeds, sesame seeds, whole grains, asparagus, spinach, sweet potatoes, avocados, bananas, dried apricots, dates, figs, lentils, beans, peas.

Click here to learn more about a nutritional and herbal supplement for thyroid health…

What to Avoid

  • Overeating – May contribute to autoimmune thyroid disorders
  • Wheat gluten – Research suggests that Celiac Disease, an autoimmune disorder related to wheat gluten in the diet, has the potential to trigger autoimmune thyroid reactions. Gluten is inflammatory due to the difficulty in digesting it.
  • Other inflammatory foods – Processed or damaged fats, alcohol, sugar, processed flour.
  • Excess salt – Another potential contributing factor to autoimmune reactions
  • Soy – May inhibit thyroid function
  • Flaxseeds – May inhibit thyroid function
  • Raw cruciferous vegetables (eg. Broccoli, cauliflower, kale, cabbage, etc. Cooked are OK) – May inhibit thyroid function

Herbal Support

The best time for herbal support is in preparation for conception. Talk to your doctor before using any supplements if you are taking thyroid hormone.

Maca (Lepidium meyenii) – A nourishing superfood that supports pituitary, thyroid, adrenal and reproductive function. More information here…

Vitex (Vitex agnus-castus) – Endocrine support via actions on the pituitary gland. Primary effects are on the ovaries, but it may provide thyroid and adrenal support as well. More information here…

Asian Ginseng (Panax ginseng) – An adaptogen (influences hypothalamus and pituitary function to increase stress resistance). Also it is an adrenal and reproductive tonic while stimulating thyroid function. This herb is best for seriously debilitated folks and is not appropriate for those under the age of 40. It may be overstimulating otherwise.

Eleuthero (Eleutherococcus senticosus) – An adaptogen and adrenal tonic. It may be overstimulating for some people, but is less stimulating overall than Asian Ginseng.

Ashwagandha (Withania somnifera) – An adaptogen, adrenal tonic, reproductive system tonic and thyroid stimulant. Because it is an immunomodulator that may modulate the body’s inflammatory responses, it is used for support with Hashimoto’s Disease. May help with stress-related infertility.

Schisandra (Schisandra chinensis) – Adaptogen, adrenal tonic and immunomodulatory herb with thyroid stimulating activity. Used for support in Hashimoto’s. Supports liver health and may help with stress-related infertility.

Rhodiola (Rhodiola rosea) – Another adaptogen and adrenal tonic that provides reproductive system support.

Licorice (Glycyrrhiza glabra) – An adaptogen and adrenal tonic that also contains phytoestrogens that may balance the body’s estrogen activities. It is also an immunomodulator. Also provides liver support. Healthy liver function is required for hormonal balance.

Guggal (Commiphora mukul) – Ayurvedic tonic that supports T4-T3 conversion and healthy reproductive function.

Milky Oat Tops (Avena sativa, A. fatua) – Supports thyroid function and is a nourishing adrenal tonic that also supports nervous system.

Gotu Kola (Centella asiatica) – Supports thyroid function. Has been used for support in Subclinical Hypothyroidism. May support improved FSH and LH production in low thyroid function. Note: It can be hard to get good quality Gotu Kola, be sure to purchase from a reputable source.

Seaweed – A good source of minerals, including iodine. Don’t overdo, as too much iodine will suppress rather than support thyroid function. The iodine in seaweed may protect the thyroid from radioactivity.

Closing Thoughts

It is absolutely vital for women who have been struggling to conceive, have experienced 2 or more miscarriages or suspect a thyroid issue to get proper testing prior to trying to conceive. Request that your doctor run a full thyroid hormone panel for proper diagnosis. Support thyroid health and total body wellness through key foods, nutrients and herbs shown to positively impact thyroid health and the entire endocrine system. Work closely with your doctor to ensure thyroid hormone levels are stable enough to sustain a healthy pregnancy. Continue to have your thyroid levels monitored and adjusted if needed throughout pregnancy and breastfeeding.

Too learn more about related subjects covered in this article, please visit the following links:

Is My Adrenal Health Affecting My Fertility?

Cod Liver Oil Essential for Healthy Fertility and Pregnancy

Celiac Disease Increases Risk of Infertility

References

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[-] 49 Comments
  1. Hi, great information. I was diagnosed with hypothyroidism when I was 14 now I am 30. My doctor said that I have a problem with ovulation. can I get pregnant if I married? at present, I am using 100mcg and novleon for my irregular periods

    • Dear Bhagi,

      Given I know so little and truly can not know if you can get pregnant, so ask your doctor this question. He/she is best able to evaluate your overall and fertility health to help you know if natural conception is possible.

  2. Hi,
    Great info here. I was just diagnosed with subclinical hypothyroidism (free T4 level 0.9 and TSH 6.53). I requested that my doctor order a thyroid test because I was trying to figure out why we are having trouble conceiving. Now with this information given, I don’t see my doctor until a couple of weeks after my ovulation date and I would like to start using maca root. Would you suggest that it’s ok to use maca root (as I’m not currently on any medications), or wait until I see my doctor, or request that my doctor order levothyroxine now so that I don’t delay another month of ttc. Thank you

    • Dear Ashley,

      If you are going to take thyroid medication and wish also take Maca or another herb, it will be best to talk to your doctor for approval. We can not suggest the combination of herbs with medications unless your doctor will monitor and guide you.

    • Sorry I guess I should have re-worded the question. I won’t see my doctor until a month, so I won’t be able to take Levothyroxine until I see her. In the meantime, would it be ok to take maca and then discontinue it once I start Levothyroxine?

    • Hi again Ashley!

      It would be fine to take Maca given what I know and if you feel it may benefit you. Do ensure your doctor knows all that you are/were doing up until the appointment in the event she runs additional tests.

  3. Love this article. My mom, sister and I have low thyroid levels. I am 32, and have always had slightly low Free T3 but never used medication for it as I was mangening ok. Now, my husband and I are planning to start trying to concieve and my doctors want to start me on thryoid medication.One doctor wants to do nature-thryoid and the other synthryoid. From what I understand, synthroid is just T4 while the other has both. My T4 and TSH levels have been within normal ranges (T4 has ranged from .9 to 1.2 ng/dL and TSH from to 1.6 to 1.9 mU/L). My free T3 is usually around 1.6 to 2.2 pg/mL.
    Absolutely, my thryoid levels were on the better end when I followed a strict autoimmune diet…
    Anyways, I am wondering your thoughts? I think I have a problem with converting T4-T3, so would the nature-thryoid be better? or are my levels good enough to not need medication and just follow a diet and supplementation to help support my system. I have been on thryoid medication for a few months years ago and it made me feel like crap, so im nervous!

    Thank you!

    • Dear Leslie,

      In all honesty if you are managing with diet and supplements, given your experience in the past with medication, it seems best to keep doing what you are doing. Consider also learning more about a product called ThyroFem. There are also diet tips for review again, above under the heading Nutrition and Hypothyroidism.

      Keep up the great work!

  4. hello
    i am having hypothyrodism.First when my docter diagnose tsh levels was 3.8 and i start taking 25 mg levothyroxin.After some months level came to 0.9……my question is this will it be difficult to conceive???plzzzzzz

    • Dear Shami,

      Do talk about this with your doctor. Many women use thyroid medication and conceive. I can not know if you will have difficulties for not. I certainly hope it will not be difficult for you!

    • Dear Shami,

      If it’s a comfort at all, my husband and I were trying to conceive for over a year with no luck. We went to see a fertility specialist and were given the unexplained fertility diagnosis. We tried various medicines (clomid, etc) and IUIs with no success. After a year there, they referred us to an IVF clinic. After initial testing there, it was determined my TSH levels were high (hypothyroidism). I was placed on levothyroxine in Dec 2017 & found out in Feb 2018 I am pregnant naturally! I can’t say for sure it was the thyroid medicine, but I feel in my heart it was my issue all along! Finally pregnant after almost 2.5 years! I hope you have the same luck!

    • Congratulations Amanda! And thank you for sharing your story and offering hope!

  5. Hello, My TSH level is .66 – I’ve been TTC for 1.5 years and am 27 – low AMH (1.47) but otherwise all is normal. I recently saw a TCM who said my TSH level may be too low as she said the ideal range is between 1 – 2. Can you provide your thoughts on this and suggestions to increase my TSH? Thanks!

    • Dear Emily,

      Given what we know and have shared here, a TSH of .66 is on the low end. Diet is the first way to impact thyroid health positively. This article author shares wonderful tips starting above under the heading Nutrition and Hypothyroidism. I would suggest a reread of that part if the guide for tips. There are supportive herbs as well that you will read of there. An herbal blend to consider learning more about would be ThyroFem.

      I hope this is helpful!

  6. Hi, thank you for the article. I have been TTC for 1.5 years. I am 37 and have hypothyroidism (TSH levels aroud 3.0, slightly enlarged thyroid). I take levothyroxine for the last 3 months but not much has changed. I am eating healthy, have to avoid certain foods due to food intolerances. I also started learning hormonal yoga recently. My health coach suggested, I could stop taking the hormones, as my TSH levels are not too high and I eat a healthy diet. My question is, will it make any difference in TTC if I take the hormone or not? Could I potentially endanger my baby if I don’t take the hormones? Or can I really support my health and my baby just with a healthy diet and supplements? Thanks

    • Dear Pavlina,

      The first question would be great asked of your doctor and health coach. They are best able to evaluate your need for the medication, as well as the changes in your health since making dietary and lifestyle changes. The thyroid can be successfully supported with diet and supplements alone in some, but not all cases. Each person with hypothyroidism deals with it differently given their age, diet, lifestyle, stress levels and overall health. There isn’t just one approach to supporting thryoid health naturally, with medication or a combination of both.

  7. Hi, thank you very much for this article. I have question. The article says it’s a ‘women’s guide’. Does vitex and maca also help men with hyperthyroidism?

  8. Hi, Your article on Thyroid is very helpful. I was diagnosed with hypo thyroid 3 years when I was pregnant for our 2nd kid and doctor told me that it may have come after my first delivery. Me and my husband are trying for a kid since a year and it doesn’t seem to be happening. i had a miscarriage in between. I take thyroxine 180mg everyday. Can I start your “Fertile Woman One Daily – Whole Food Multivitamin (60Tabs)” or can you please recommend some other multivitamin ?

    • Dear Sakina,

      I am glad the article was helpful. I’m sorry to hear conception again has been challenging.

      Fertile Woman One Daily – Whole Food Multivitamin is a great multivitamin we feel. It’s best to learn all you can about it to determine if it’s right for your needs. If you are concerned about combining it with your medication, do at least call your doctor’s nurse to ask.

  9. Thank you, very informative!
    Our yd has been ttc for a year now. Her periods have, since coming off the pill, been gradually getting further apart (before the pill they were spot on 30 days) around 36-42 days now. She seems to be ovulating (bbt) but not until 7 days before her period.
    We had a private blood test as she was showing symptoms of hypothyroidism, her late Grandmother had it too.
    Her TSH was 3.54 (range 0.27-4.3) T4 98.4 (64.5-142) antibodies minimal. Her GP says these levels are fine so won’t medicate. She has always had a low bbt, around 35.8.
    She’s taking Vitex now and her bbt has increased, would this skew further test results if she insists on help from the GP please?

    • Dear Carrie,

      Vitex doesn’t contain hormones itself, but it acts on the pituitary gland, so theoretically could influence the outcome of the results, since the pituitary gland plays a key role in hormone manufacturing and regulation. We feel it is best to not take any herbs that have an influence on hormones in the same cycle hormone testing is performed.

    • Hi, she sounds like her thyroid is underactive based on her T4 results. Free T3 would also be a good number to know. Both should be in the top half of the range. I would suggest a natural desiccated thyroid medicine but discuss with a functional medicine doctor. They know best. Endos are not up to date on better testing and treatments.

  10. Hi, I’m nearly 30 years old and my husband and I have been trying to conceive for around 7 months with no joy. I recently had blood tests which showed I could possibly develop an under-active thyroid in the future (the reading came back at around 4 but was told it should ideally be at around 2 or 3). The Dr has prescribed me tablets to take daily (I believe they’re called levothyroxine). My husband has also had testing but we are awaiting his results.
    We desperately want to be parents so I just would like to know if there are many success stories surrounding other couples who have been in a similar situation? I know stress doesn’t help but I’m so worried about everything.
    Thank you.

  11. Hi. I am 26 years old. I was diagnosed with hypothyroid about 5 years ago. I did not take any thyroid medications to help support my thyroid function but i did refrain from foods such as wheat and sugar to avoid body inflammation. I am now 8 weeks pregnant and my doctor is convinced that i have normal thyroid function despite my symptoms. She says thyroid lab report is in normal range but she cannot explain the symptoms i am feeling. Please help. I am aware that hypothyroidism does not magically go away, so i dont know why my doctor is convinced that i am healthy. What should i do ?

    • Dear Sara,

      Congratulations on your pregnancy! How exciting!

      I have no reason to dispute your doctor. There are so many symptoms of early pregnancy that mirror those experienced by women with an underactive thyroid. It could be that your dietary changes did impact thyroid function. Thyroid levels can also change in pregnancy. It is my understanding that thyroid levels should be tested routinely through pregnancy. Your doctor can help you know how often. With all of that, if you are worried or not believing your doctor, it is okay to seek a second opinion. You are entitled to that.

      Again, congratulations!

  12. Hello. Thanks for the helpful article on hypothyroidism. However I was hoping to see more on hyperthyroidism. Does an overactive thyroid have equally negative impacts on fertility? And what are the recommendations as far as using herbals, for healing? Anything you can share will be greatly appreciated

  13. I am a hypothyroid patient, it was detected when I was 12 years old. Now I am a women and I am 31 years old. Presently I am taking 112.5 mg of thyrox. In Dec16 i had a miscarriage through medicine (prescribed by my gyne) as my baby was not growing and I had started bleeding. Since Sept 17 I am trying to conceive again but no luck I have done every test but the results are normal. In this month (June) I will be having folicullar monitoring from 14th. I had this test last month also and referring to the reports my dr told that probably I am ovulating properly. I am confused dont know what else to do. I desperately want to become a mother!

    • Dear Swati,

      I am sorry for your loss and what you’ve been through!

      There can be many reasons for miscarriage and often no reason can be found at all. It is so hard, we know. I hope our guide Pregnancy and Fertility After a Miscarriage shares helpful thoughts and a way to move forward. Has your husband had fertility testing? Often testing of the male is overlooked, yet sperm health and male fertility can be a cause of miscarriage. I wanted to ask as this is something to think about.

      If it might be most helpful, we can also work one on one with you and guide you in the right direction, on the right program, for your specific fertility health needs through a Fertility Consultation.

  14. Great Article, great read really informative.
    I developed hypothyroidism on my first pregnancy and it never went I am on a small dose of Thyroxin daily (.25mg) to maintain the correct level, in your opinion would it affect my getting pregnant again ? just curious more than anything

    thanks
    E

    • Dear Elaine,

      I have not heard that Thyroxin inhibits conception or interferes with one’s ability to conceive. It is my understanding that it can be used in pregnancy, yet this is best to discuss with your doctor who is likely to reevaluate thyroid function in pregnancy.

  15. Hi – I have recently had my thyroid tested as we have unexplained secondary infertility and i feel tired a lot, feel the cold, and have a very low resting heart rate etc. My results look ok, but i have heard that free t3 and free t4 might be better to be in the upper end of the range (they are both in the range but the lower end, TSH is 1.46) . can you advise on what i can do naturally to help raise these? thanks

  16. My husband and I have been trying for over a year and had a very early miscarriage early on… this past year I’ve felt exhausted, emotional, depressed, I’ve gained weight, I’ve had mind fog… pretty much every symptom on the list.

    I recently got my blood tested for thyroid issues and my TSH level was 11.73. (From what I understand it should be between .03 and 3. I was recently put on a low level of Levothyroxine to start out.

    I have never had thyroid issues before. Could our miscarriage have caused my hypothyroidism? Possibly the hormones and changes in my body at that time?

    Do many of the symptoms reverse once you start taking the medication?

    Thanks,

    Ali

    • Dear Ali,

      I am very sorry for your loss!

      I was thinking as I was reading, oh it sounds like a thyroid-health issue. You should see symptoms subside with medication. Consider also dietary and lifestyle changes to support healthy thyroid function, as shared in this guide.

      I have not heard that having a miscarriage causes hypothyroidism, rather the other way around that a woman with untreated thyroid health issues like hypothyroidism may be at greater risk for having a miscarriage. This would be a great question to ask your doctor.

      Be gentle with yourself and do not blame yourself! Most miscarriages have no known cause and of course are out of any woman’s control. I hope you soon feel the symptoms subside and more like your true self again soon!

  17. My age is 59 years femail. My thyroid report is T3 is 93.68 T4 is 9.00 TSH is 12.30 iTsh is high is any risk for me before 6-7 days my left side is pins n needles. I have daily take 100 Eltroxin till 28 years. I have knee pain also now what can I do is any risk for me

    • Dear Narinder,

      I am sorry for all you are going through! It really would be best to find a practitioner, whether medical or natural (or both) to work one on one with you. This isn’t a health issue to try to figure out or go thru alone.

      I hope you are able to find support easily!

  18. I have had repeated miscarriages. My obgyn tested my thyroid, though only the TSH, which came back at 4.25 (range of .5-4.5) the day before the miscarriage started (5 weeks). She said it is within the normal range and won’t test further. (I’ve been to a primary care dr. and an endocrinologist before with the same results.) Do you have links to the studies that show I should ideally be below 2.5 in order to conceive? I have other symptoms of hypothyroid. Dry skin, fatigue, BBT is 96.4 pre ovulation and 97.1 after. Any sources I can share with my doctor?

    • Dear Jennifer,

      I am so sorry for your losses!

      This is the reference for the studies, as per your request: 4. Stagnaro-Green, A. et al (2011) Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum. Thyroid. 21(10):1081-1125.

      It is now time, given multiple miscarriages, to request a full thyroid panel be run. Please also feel free to bring this very guide with you and share the New Thyroid Testing Guidelines portion at least.

      I hope this helps!

  19. Hello!
    I am trying to conceive.I had some blood work done to my thyroid and it came back normal except the HPTHI(Parathyroid) that is a little higher then it should be and in the ultrasound it showed two small nodules in the right side.Can this two things affect my ability to conceive?
    Thank you!

    • Dear Ana,

      This will be best asked of your healthcare provider. He/she knows your overall health and is best able to evaluate what these test results mean for you. Discuss with your doctor what might be the cause of the slightly eleveated level – could it be the nodules?

  20. My TSH was recently tested and the results indicated that I have an underactive thyroid. I was prescribed a thyroid medication and take it each morning, 1 hour prior to eating. I was previously taking Vitex in the morning due to very short cycles of 21-23 days. The vitex made a world of difference and my cycles jumped back up to 28 days on average. However, I stopped taking the vitex for fear it might interact with the thyroid meds and my cycle shrunk back to 23 days. Clearly the vitex was working before!! This article lists vitex as a possible supplement that can support my system. Is it ok to take even though I’m on thyroid meds? If so, what time of day should I take it?

    • Dear Liz,

      It is best to be guided by a healthcare provider – doctor, herbalist, naturopath – if wishing to combine Vitex with your medications. If the practitioner you consult is willing to guide you, ask that they suggest when to take Vitex.

      All my best!

  21. A few questions around supplements that I should be taking. We’ve been ttc for 18 mths & I recently saw a nutritionist/Chinese herbalist who prescribed the following as my thryriod levels have been low, have light periods and type A negative blood as well as two miscarriages last year:
    Evening Primrose Oil, a linolenic acid blend, Super Vit B Complex, Magnesium, Iodizyme (Ioidine) and GTA Forte II. I also take Maca, CoQ10, Omega 3, Iron & vitamin D & thryoid medication.

    My concern is that he said to stop taking prenatal supplements and start eating soy, both of which I’ve read is something you shouldn’t do and would like to seek your advice on this?

    • Dear Fleur,

      There are many paths to health and many practitioners that can take you there. The options available to us in the natural health world are vast and many different programs and remedies will produce the desired effect we are seeking. Practitioners of different paradigms will have differing opinions and thoughts about what to do and not to do as well.

      I am sorry this is confusing! I am not a Chinese Herbalist or Nurtitionist, but we suggest against consuming soy and are pro prenatal multivitamins when preparing for conception and actively trying to conceive. Here are two articles that speak to soy consumption with dealing with infertility:
      Top 5 Anti-Nutrients That Affect Fertility and Fertility: One More Reason To NOT Eat SOY. Likewise, information about why boosting nutrient levels with a wholefood multivitamin is important for fertility health can be be read in the article Prepare for Conception With a Multivitamin.

      We also feel that if currently working with a healthcare practitioner and they have you on a program, it is best to follow that program for the suggested amount of time before you change it or start a different program. Have patience!

      I hope this is helpful!

  22. Wow! This information has been so informative & helpful! So detailed about how the whole system works with thyroid, adrenals & reproductive. Where I thought I was really eating so healthy with regular Kale juices, could actually be part of whats harming my chances of conception.. Also I’ll be making sure I reduce or illiminate soy & switch my omega 3 intake from flaxeed to fish oil!! Thank you so much!!

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