Your Thyroid and Fertility, Explained
You may have heard your thyroid is important for fertility. This is true.
The thyroid is considered the body’s “master gland.” It controls your metabolism and heart rate, and produces hormones that control other glands (like the ovaries and testicles). It tells the body’s cells how much energy to use so it directs your daily functioning and it is especially important for both men and women when trying to conceive.
What is the thyroid gland?
The thyroid gland is the butterfly-shaped organ in the base of your neck. While it may be small, it has an influence over every cell, tissue, and organ in the body.
Specifically, the thyroid gland is responsible for producing two important hormones: triiodothyronine (T3) which is your short-acting thyroid hormone, and thyroxine (T4) which is the longer-acting thyroid hormone.
These hormones control metabolism, which is the way that your body uses energy. It also regulates vital functions including breathing, body temperature, and heart rate. When the thyroid gland doesn’t work properly, it can impact the entire body.
Both over- AND under-active thyroids can affect fertility
If you feel anxious, have a rapid heart rate, or unexplained weight loss, you may have hyperthyroidism (over-active). On the other hand, if you feel sluggish, or have a low body temperature you have hypothyroidism (under-active).
In some cases you might not yet have symptoms, even though your thyroid is off balance.
Either way, both types of thyroid imbalances can cause challenges with fertility. If you are hoping to start a family, it’s important to know how the thyroid functions, how it can impact fertility, and what steps can be taken to help you along the journey.
Thyroid disorders: what to know
If you have a thyroid disorder, just know that you are not alone. It’s estimated that 20 million people in America have some sort of thyroid disease. Around 60% are unaware of their condition.
While both men and women can be affected, women are much more likely to experience thyroid problems. In fact, almost one in eight women will develop a thyroid problem within her lifetime.
There are several ways in which the thyroid can become imbalanced. You can produce too little hormone (hypothyroidism), too much hormone (hyperthyroidism), or have an autoimmune condition like Graves disease or Hashimoto’s disease.
I see a number of clients who have thyroid disorders and who struggle with fertility. It’s important to make sure you get your thyroid tested if you are having trouble conceiving or simply planning to in the future.
The good news: thyroid conditions can be treated and lifestyle changes can help alleviate symptoms in addition to treatment so that you can become pregnant.
A physician is needed to diagnose any thyroid disorders and prescribe thyroid medication. I highly recommend you get your thyroid checked with your physician and address any imbalances regardless of where you are in the fertility journey.
Hypothyroidism: under-active
When the thyroid gland produces less thyroid hormone than it should, metabolism slows down and causes a variety of symptoms. These include depression, difficulty concentrating, dry skin, fatigue, hair loss, loss of sex drive, sensitivity to cold temperatures, and weight gain.
Just as hypothyroidism has been found to directly affect the body’s function, research has shown that hypothyroidism can negatively affect ovulation. It can create menstrual abnormalities, such as oligomenorrhea (infrequent menstruation in which periods that are more than 35 days apart). It can disrupt ovulation, as the lack of thyroid hormones can lead to anovulatory cycles (menstrual cycles in which an egg is not released).
Can hypothyroidism cause infertility?
The answer is that it can contribute to other symptoms that also negatively impact fertility.
A number of my clients have PCOS and it definitely can impact fertility. Women with PCOS can experience higher than average levels of androgens (male hormones like testosterone). This can cause absent, irregular, or heavier periods.
With imbalances in estrogen and progesterone (hormones essential for fertility), hypothyroidism can make becoming pregnant challenging.
The good news: there are natural nutrition and functional medicine based protocols that can address PCOS along with getting your thyroid in balance as well. I have had a number of PCOS clients go on to get pregnant and deliver babies. For example, my client Alexi had PCOS, elevated blood glucose and irregular periods and she and her husband went through Simplina’s coaching program and she is now pregnant.
“I have PCOS, elevated fasting blood glucose and my hormonal levels were out of balance. My husband and I embarked on Simplina’s fertility program to get healthier and address my underlying health issues. We got our first positive pregnancy test after almost a year of trying to conceive!”
Hashimoto's disease
Hashimoto’s is an autoimmune disease that attacks the thyroid. This often results in an underactive thyroid (hypothyroidism).
Like those with PCOS, women with Hashimoto’s can also face fertility difficulty. Treatment for this condition is usually prescribed with lifestyle changes, supplements, and a daily thyroid hormone replacement like levothyroxine.
It is important to get this diagnosed before TTC. Untreated Hashimotos in pregnancy can lead to a higher risk for miscarriage in the first trimister due to the excess T4 levels, if your thyroid level is uncontrolled. That is why close monitoring by your physician is essential to ensure you have a healthy pregnancy.
Hyperthyroidism: over-active
When the thyroid produces more thyroid than it should, metabolism speeds up. This can cause a variety of symptoms, including anxiety, brittle hair, irritability, rapid heart rates, sensitivity to hot temperatures, sweating, weight loss, and trouble sleeping. Also, not a good way to feel.
Is there a link between hyperthyroidism and infertility? Like hypothyroidism, hyperthyroidism can also have an influence on fertility. It can create fewer and lighter menstrual cycles, throwing off timing when trying to conceive. The altered cycle can also disrupt ovulation, causing challenges for an egg to become fertilized. Similar to hypothyroidism, treatment includes personalized lifestyle programs (which we do at Simplina) and daily medication, which a physician can help you manage.
Graves’ disease
Graves’ is an autoimmune disease that creates overproduction of thyroid hormones that can give you symptoms of rapid heart rate and weight loss. This often results in an overactive thyroid (hyperthyroidism). Although Graves’ can affect anyone, most diagnoses are women under the age of 40.
There can also be an increased risk for developing Grave’s during pregnancy as pregnancy places stress on the thyroid, increasing production of T3 and T4 by almost 50%.
The reason for this is that during the first trimester, your baby is still developing a thyroid gland that’s capable of producing its own hormones. The baby is completely dependent on the mother’s supply, which is delivered through the placenta. While the baby typically begins to produce some thyroid hormones at around 12-13 weeks, they will still continue to need yours until birth. This increased demand from the baby on your body means that you often need more thyroid hormone and sometimes our bodies adjust automatically; but when thyroid disease is present then this is not always the case.
For example, it is common to see elevated TSH levels in the first trimester (which means you don’t have enough thyroid hormone), which can contribute to things like severe morning sickness, an increased risk for miscarriage, or later developmental delays in the baby. It is important for your thyroid levels to be monitored closely by your physician.
While hyperthyroidism can be harder to detect while pregnant because of the varying levels, routine screenings every few weeks can help to assess your status. If you develop hyperthyroidism during pregnancy, you may be placed on a treatment with a low grade antithyroid to help bring T4 levels down. If you already have a diagnosis of hyperthyroidism and are newly pregnant, your healthcare provider should monitor your thyroid closely.
Thyroid and lifestyle
Having hypothyroidism or hyperthyroidism can feel like a journey. But there are steps that can be taken to help you feel better along the way in addition to getting treated by a physician. Many of these tips begin with lifestyle choices, including diet, movement, and mindfulness practices.
For women with either thyroid condition, eating a balanced diet will not only optimize nutrition, but can help you prepare your body for when you do decide to become pregnant.
Nutrition and your thyroid
If you have a thyroid condition, you may have an increased chance of having nutrient deficiency. But, while it’s important to make sure you get your nutrients, taking vitamin supplements at the same time as medication is not advised.
For example, taking calcium, iron, and other medications can potentially interact with your thyroid medication if taken at the same time. It is often recommended to take your thyroid hormone replacement on an empty stomach and then wait a couple of hours to take your vitamins. It’s also important to be careful when consuming products with too much iron or selenium which can cause more harm than good.
Foods for hypothyroidism
If your thyroid is not producing enough hormone and you are sluggish, you want to avoid eating foods that also make you sluggish.
Highly processed wheat and sugar-filled foods should generally be avoided. But is less commonly known is that some “healthy foods” interfere with thyroid hormones and if you have a hypothyroid condition these foods should be eaten in moderation.
Avoid: cruciferous vegetables (broccoli, cabbage, cauliflower), excess fiber (beans, legumes, millet), seeds/ nuts (peanuts, pine nuts, walnuts), and soy (tofu, soy milk, soy sauce).
These foods contain goitrogens, which interfere with the normal function of the thyroid and inhibit thyroid synthesis mainly by limiting how you use iodine. Therefore, you want to restrict foods with goitrogens to one serving a day and cooking your cruciferous (i.e. no raw cabbage, but rather cooked brussel sprouts) can help you have their benefits, but reduce their negative impact on the thyroid.
Add: eggs and lean proteins, fruits (apples, avocado, blueberries), fish (tuna, salmon, white fish), gluten-free whole grains (quinoa, oats, rice), healthy fats (coconut oil, ghee, olive oil), and vegetables (spinach, romaine lettuce, sweet potatoes), which can all help boost your health.
In the case of hypothyroidism, a moderate amount of iodine—found in seaweed, iodized salt and seafood—can also be beneficial. Having seafood two times a week and salting your food if you don’t have high blood pressure can be helpful in the short term.
Foods for hyperthyroidism
If your thyroid is producing too much thyroid hormone, there are some nutrients that can contribute and others to avoid. Low levels of calcium, vitamin D, iron, selenium, and zinc have all been linked to hyperthyroidism.
Incorporate these foods into your diet by eating: berries (blueberries, raspberries, strawberries), cruciferous and leafy vegetables (bok choy, collard greens, kale), healthy fats (avocado oil, coconut oil, sunflower oil), nuts/seeds (brazil nuts, chia seeds, pumpkin seeds), proteins (beans, beef, turkey), spices (turmeric, green chilis).
Keeping iodine levels low is important if you have hyperthyroidism (which is the opposite of hypothyroidism), and depending on the severity may be necessary to avoid certain foods.
Avoid consuming: dairy, egg yolks, fish with high levels of sodium, and sea vegetables like seaweed (no sushi). For some, gluten and soy products may cause irritation and inflammation to the thyroid.
Also avoid: caffeinated drinks and caffeinated foods can worsen symptoms of hyperthyroidism because these also increase heart rate. These include black tea, chocolate, coffee and energy drinks.
Instead, incorporate: alternatives like ginger, green tea (which is lower in caffeine), and some herbal teas such as lemon verbena, chamiolle, ginger or mint.
Exercise and the thyroid
Plenty of research has shown that movement is beneficial for physical, mental, and fertility health.
Finding the right amount may be tricky, especially when balancing your hormones. For women with hypothyroidism, movement can be key for helping with metabolic functions. For women with hyperthyroidism, movement can be key for helping get better sleep.
However, when adjusting to new medications or just beginning, it’s vital to start slow and listen to your body as pushing yourself too hard can lead to adverse effects, injuries, and strain.
The same can be seen for women with hyperthyroidism. Over exercise can be harmful, especially if heart rates are already elevated. Over exercise can also create more hormone imbalances that can further complicate fertility.
Not too much, and not too light, but just the right amount of exercise can help enhance endorphins and fertility. It sounds complicated, but basically you need to move daily and you don’t want to push your body too hard (cycling classes, HIT training, etc) until your thyroid is balanced.
Mindfulness
The thyroid is the master gland and when it is not working optimally, it can impact many areas of your life including your mental health. Depression, nervousness, moodiness, irritability and anxiety can be a result of a thyroid condition so make sure to get your thyroid checked if you feel any of these symptoms.
As important as nutrition and exercise are, finding ways to reduce your mental stress is critical . One of the hardest parts about any health journey is just how much time it can take—doctor’s appointments, lifestyle changes, second opinions, testing, and more testing. With so many things going on in our busy day, it may feel impossible to find time just for ourselves.
But one thing I’ve found that has helped me to cope was doing a short five minute focus meditation in the morning. Squeezing in just 5 minutes a day has helped me to stay focused but also see what needs to be done for me to feel my best.
As you see, the thyroid is complicated! It matters for health and your fertility journey.
Confused on how to best put together a lifestyle plan to
help your health with fertility? Join our coaching program.
The Simplina Full Fertility Functional Medicine & Coaching Program is 4 months for 8 total sessions. You and your partner (if they want to join) have a coaching session every two weeks. This customized functional medicine fertility plan will help you improve your health status in ways to specifically increase pregnancy odds with the step-by-step with the support you need.