Navigating the labyrinth of fertility can be overwhelming, more so when coupled with conditions such as autoimmune thyroid disease. The journey to motherhood requires physical wellness and a balance of body, mind, and spirit. Lets dive into this a bit.

Hypothyroidism versus autoimmune thyroid disease?

On the surface, it can be difficult to tell if someone has autoimmune thyroid disease. In hypothyroidism and autoimmune thyroid disease, one can have abnormal lab values of thyroid stimulating hormone (TSH) and thyroid hormones triiodothyronine (T3) and thyroxine (T4). Alternatively, someone can have antibodies against the thyroid but still have someone normal thyroid hormones and TSH. In this situation, medication may not always be necessary, but it’s important to differentiate the two from each other. 

How do you know if you have autoimmune thyroid disease?

Key factors here are whether or not you have antibodies, thyroid peroxidase (TPOAb) and thyroglobulin (TgAb), in your blood. These can signal the existence of an autoimmune thyroid condition, highlighting the crucial role of detailed and integrative assessment.

Imagine, for a moment, you’ve been told you have autoimmune thyroid disease, but your “levels are normal” and so you don’t need medication. Your fatigue and [insert thyroid symptom here] must be in your head, and “is it possible you’re dealing with depression?” Sound familiar? Regardless of your thyroid hormone levels, your body is still actively attacking itself (the autoimmune aspect of your condition), and that alone is using energy, immune function, and other processes to try and maintain balance.

What does research show us about thyroid Antibodies and fertility?

The evidence suggests that it’s the antibodies that matter most. Of course, making sure your thyroid hormones are in optimal range is important, but even when these values are perfect, elevated antibodies might negatively impact fertility and pregnancy outcomes. The hypothesis is that the antibodies are creating a toxic environment for your maturing eggs (oocytes), lowering their quality and impacting their ability to become fertilized and grow as a normal embryo (PMID: 35721757). This also means that it can impact both your ability to become pregnant AND stay pregnant. 

Optimal ranges: TSH 0.5-1.8, Free T3: 3-4, Free T4: 1-2, TgAb: NONE, TPOAb: NONE

What can you do to support your fertility and beyond?

If you have antibodies present, meet with an endocrinologist to help you understand what they mean and get a proper diagnosis. Then, find someone who will support you as you work to improve those antibodies through lifestyle and supplement changes. Understand that if you are given thyroid medication, lifestyle changes such as the ones I am discussing here can and likely will change your body’s demand for medication, and you may need a dosage adjustment as you begin supporting your autoimmune condition. 

• Diet: Most importantly, following an anti-inflammatory diet is KEY. You can find an overview of this eating pattern HERE. Be sure to include foods that have inflammation lowering properties, such as turmeric, ginger, cinnamon, and bone broth daily. 

• Selenium rich foods: Vital for thyroid function, helping the body convert thyroid hormone into a usable, active form. Eat foods like grass fed beef, scallops, shrimp, and Brazil nuts. 

• Iodine rich foods: Aids the body to produce thyroid hormone, deficiency can actually lead to hypothyroidism all on its own! Further, selenium needs iodine to work properly in the body. Eat foods such as eggs, seafood, and kelp. Remember though, iodine is NOT helpful in overactive thyroid or Graves disease. Here’s why working with a practitioner is important.

• Zinc rich foods: an essential mineral with many vital functions in our bodies, including metabolism and supporting the immune system. Zinc also plays a critical role in thyroid hormone balance. It lowers cortisol levels (our stress hormone), which balances levels of our thyroid hormones. Zinc is also important for the conversion of T4 into T3 . The best food sources of zinc are beef, turkey, salmon, chickpeas, brown rice, and flaxseeds.

• Cultured foods: The health of your thyroid is impacted by the health of your gut, using the gut to aid in converting some of your thyroid hormones into active forms. By ensuring you eat cultured and fermented foods, you are feeding the healthy bacteria in your gut. Include foods like sauerkraut, Kimchi, kefir, and yogurts.

• Supplements: Should always be used to boost an optimized diet. So, focus on diet first and add supplements where you fall short:

• Selenium, zinc, vitamin D, iodine, and targeted probiotics as needed (Doses vary and should be discussed with your practitioner). 

• A quality prenatal vitamin: I love and use FullWell Prenatal, even for myself

• Essential oils for balancing: frankincense essential oil, lemongrass essential oil, myrrh essential oil (there are many other options here, but some improve an underachieve thyroid and others support an overactive thyroid - someone who specializes in integrative medicine or naturopathic medicine would be able to tailor solutions to you specific situation). 

The Importance of a Trusted Practitioner

As with any autoimmune condition, it’s best to establish a full protocol specific to your labs and situation. Working with an integrative practitioner who understands the complexities of your diagnosis is vital. That practitioner can help bridge the gap between where you are and your goals. When you work one on one with me at Origins Fertility, we find solutions that support your fertility goals while also accounting for your preferences, using evidence based and integrative therapies. 

-Sara Bennett

Medical Disclaimer: The information provided in this blog post is for general informational and educational purposes only. While the author is a medical provider, they are not your medical provider. This content should not be considered as personalized medical advice. Always consult with your own healthcare professional for advice and treatment tailored to your specific needs.

PMID: 35721757 https://pubmed.ncbi.nlm.nih.gov/35721757/