In my journey, I’ve dealt with hypothyroidism, or an underactive thyroid–and you’d be surprised how impactful your thyroid is on your fertility, pregnancy, and more! Your thyroid during pregnancy can also impact your baby’s development–so it’s a big deal!
In my own experience, I had an uncomplicated first pregnancy–but then suffered from recurrent miscarriages between my first and second child. My provider ended up linking my recurrent miscarriages to issues with my thyroid. Since that experience, I’ve been much more deliberate with my preconception phase, preparing my thyroid for pregnancy and managing it during my pregnancies. I’ll be sharing my personal experience navigating issues with my thyroid in this blog!
We were lucky to interview Dr. Brittany Henderson of Charleston Thyroid Center, in Charleston, South Carolina. Dr. Brittany Henderson is a renowned expert in thyroid health, having previously led thyroid programs at Duke and Wake Forest universities. She now runs the Charleston Thyroid Center in South Carolina, focusing solely on thyroid treatment and integrating conventional and functional medicine approaches.
What is the thyroid??
The thyroid gland produces hormones that are essential for various bodily functions. These hormones influence metabolism, energy levels, and overall health. Thyroid disorders, such as hypothyroidism (low thyroid hormone levels) and hyperthyroidism (high thyroid hormone levels), can have widespread effects on the body.
Dr. Henderson has an in-person clinic in Charleston South Carolina, which exclusively supports your thyroid health to bridge conventional and functional medicine to treat diseases. She also offers telemedicine options in many states, so if you are not local to her, you can still schedule a consult virtually and have your lab work done remotely for her to review.
Importance of Thyroid Health in Fertility and Pregnancy
- Thyroid Disorders and Women’s Health: Thyroid disorders disproportionately affect women more than men. Conditions like hypothyroidism and Hashimoto’s disease (an autoimmune disorder) can significantly impact fertility and pregnancy outcomes.
- Impact on Fertility: Thyroid hormones play a vital role in regulating the menstrual cycle and ovulation. Imbalances can lead to issues like poor egg quality, disrupted ovulation, and even recurrent miscarriages. Proper thyroid function is essential for a healthy conception process.
Thyroid health is often overlooked in discussions about fertility. Many women, including myself, have experienced challenges like recurrent miscarriages due to thyroid imbalances. Thyroid function is closely linked to reproductive health. Dr. Henderson explains that the thyroid influences female hormones and the menstrual cycle. Imbalances in thyroid hormones can lead to irregular ovulation, poor egg quality, and hormonal imbalances that affect fertility.
One key aspect Dr. Henderson highlights is the presence of thyroid antibodies, such as TPO antibodies, which are common in autoimmune thyroid disorders like Hashimoto’s disease. These antibodies can interfere with embryo implantation and increase the risk of miscarriage. Ensuring optimal thyroid function and managing autoimmune conditions are vital steps in enhancing fertility.
Thyroid Function and Hormones
- Thyroid Hormones Explained: The thyroid gland produces hormones that regulate various bodily functions. The main hormones are T4 (inactive form) and T3 (active form). Proper conversion from T4 to T3 is crucial for optimal body function.
- TSH Levels: Thyroid-stimulating hormone (TSH) is commonly measured to assess thyroid health. However, Dr. Henderson points out that the reference range for TSH is often too broad, potentially missing underlying thyroid issues. Ideal TSH levels should typically be between 0.5 to 2.
Understanding Thyroid Diseases and Issues: Hashimoto's and Graves Disease
From Dr. Henderson:
Thyroid issues affect a lot of people, predominantly women. We don’t understand 100 percent why that is but probably has to do something with the X chromosome and where the genes that increase your risk for hypothyroidism and Hashimoto’s are.
Hashimoto’s disease is an autoimmune process that starts attacking the thyroid is not part of you. And because of that attack, over many years, the thyroid stops working at 100%. That’s the most common reason why people develop thyroid disease.
But other people can develop Graves disease, which is a hyperthyroid part. It’s an autoimmune part where the immune system tells the thyroid to secrete extra thyroid hormone and the person develops hyperthyroidism.
Then there are a lot of people who’ve had their thyroid removed for both benign nodules or cancer. All of those people are in a boat where this can affect fertility and it can affect preconception.
Diagnosing Thyroid Disorders
- Comprehensive Thyroid Panel: A thorough thyroid assessment should include TSH, free T4, free T3, reverse T3, and thyroid antibodies (TPO and TG antibodies). This comprehensive panel helps in accurately diagnosing thyroid dysfunctions early on.
- Antibodies and Autoimmune Impact: Elevated thyroid antibodies indicate autoimmune activity, which can affect embryo implantation and increase the risk of miscarriage. Managing these antibodies is crucial for improving pregnancy outcomes.
Traditional guidelines for thyroid screening are outdated, often missing early signs of thyroid problems. Dr. Henderson advises a comprehensive thyroid panel, including TSH, free T4, free T3, reverse T3, and thyroid antibodies like TPO and TG. These tests provide a complete picture of thyroid health, helping to identify issues before they cause significant problems.
Your Thyroid and Your Fertility
In the early 2000s, ACOG, the governing body of OBGYNs, adjusted their guidelines suggesting that not everybody who gets pregnant should get a TSH screen or thyroid screen. Dr. Henderson believes this has been detrimental to a lot of women trying to get pregnant. If thyroid issues are not identified, it can cause fertility issues or recurrent miscarriages. This could solve an underlying cause of infertility!
Optimizing Thyroid Health
To support thyroid health, Dr. Henderson recommends a comprehensive approach that includes:
Regular Screening: Request a full thyroid panel, including TSH, free T4, free T3, and thyroid antibodies, especially if you have a family history of thyroid disorders or are experiencing symptoms.
Nutrition: A diet rich in selenium, iodine, and other essential nutrients supports thyroid function. Dr. Henderson suggests incorporating foods like Brazil nuts, which are high in selenium, and ensuring adequate iodine intake.
Medical Management: Work with a knowledgeable healthcare provider to manage thyroid conditions effectively. This may include medication to optimize thyroid hormone levels and address any autoimmune activity.
Lifestyle Adjustments: Reducing stress, getting regular exercise, and ensuring adequate sleep can also positively impact thyroid health.
Nutritional Support for Thyroid Health
Nutrition plays a significant role in supporting thyroid function. Dr. Henderson highlights several key nutrients that are beneficial for thyroid health:
- Selenium: An antioxidant that supports the conversion of T4 to T3, the active thyroid hormone. Selenium-rich foods include Brazil nuts, which can be consumed in small quantities daily.
- Iodine: Essential for thyroid hormone production. However, it should be taken cautiously and preferably under medical supervision.
- Zinc: Supports immune function and thyroid hormone production. Foods rich in zinc include meat, shellfish, legumes, and seeds.
- Vitamin D: Important for immune regulation and overall health. Sun exposure and supplementation can help maintain adequate levels.
The Role of Thyroid During Pregnancy and Postpartum
- Ongoing Monitoring: Thyroid health must be monitored throughout pregnancy and the postpartum period, as hormonal changes can affect thyroid function.
- Partnering with Experts: Finding a provider who understands the nuances of thyroid health is crucial. Dr. Henderson’s practice offers telemedicine services, making expert care accessible across multiple states.
Pregnancy
Maintaining proper thyroid function is critical during pregnancy for both the mother and the developing baby. Thyroid hormones support the growth and development of the fetus, particularly the brain and nervous system. Dr. Henderson emphasizes that even mild thyroid dysfunction can lead to complications such as preterm birth, low birth weight, and developmental issues in children.
Routine thyroid screening and management during pregnancy are essential. Optimal thyroid hormone levels support a healthy pregnancy and reduce the risk of complications. Dr. Henderson notes that guidelines for thyroid screening during pregnancy may need updating to ensure all women receive appropriate testing and care.
In my own preconception, my provider and I did monthly blood work to assess my thyroid levels. After my levels were not improving quickly enough, we decided that starting thyroid medication was necessary. Throughout my pregnancy, I receive bloodwork every 4-6 weeks to monitor my thyroid levels and adjust my medication dosage, as needed.
Postpartum
The postpartum period is another critical time for thyroid health. Women are at an increased risk of developing thyroid disorders after giving birth, a condition known as postpartum thyroiditis. This can manifest as either hyperthyroidism or hypothyroidism and can significantly impact a new mother’s health and well-being.
Dr. Henderson advises new mothers to monitor their thyroid function postpartum, especially if they have a history of thyroid issues or symptoms such as extreme fatigue, weight changes, or mood disturbances. Early detection and treatment of postpartum thyroiditis can help new mothers recover and thrive during this challenging time.
Conclusion
Your thyroid health is so important in fertility, pregnancy, and postpartum wellness. Women experiencing fertility issues or recurrent miscarriages should consider evaluating their thyroid health comprehensively. By working with informed healthcare providers and maintaining optimal thyroid function, women can improve their chances of a healthy pregnancy and postpartum recovery.
For those interested in learning more, Dr. Henderson’s practice, the Charleston Thyroid Center, offers telemedicine services and educational programs for both patients and providers. You can follow her on social media at @drhendersonmd for more insights and updates.