Could a Thyroid Disorder be Affecting your Fertility

OK – hands up: who isn’t entirely sure what the thyroid gland is, or where it is in the body for the matter? If your hand is raised then you are in safe company as I was unsure too. I mean, I’d heard the name in passing conversations or as part of a section on women’s health on daytime TV, but it wasn’t until I was on my fertility journey that I learned more about the important part this little gland has to play in our reproductive health. So – what is it, what does it actually do, and how might it be causing some of your fertility issues?

The thyroid gland is actually located in the neck and it plays a crucial role in controlling the production of hormones and regulating their levels within our bodies. When thyroid production is disrupted by being either under or overactive leading to an imbalance of these hormones, our fertility can be affected as thyroid hormones are important in the regulation of the menstrual cycle and ovulation. Imbalances in these hormones can lead to irregular cycles or no periods altogether, impair ovulation, and affect progesterone levels increasing the risk of miscarriage. It is also important to highlight that thyroid disorders are not limited to females; men can also be affected, with thyroid function also having an impact on sperm count.

Thyroid disorders are incredibly common with 1 in 10 women being affected. What is also concerning to discover is that about 60% of people with a thyroid problem are unaware of their condition and are therefore unable to manage it appropriately. In the context of infertility, an unmanaged thyroid issue that has gone undetected by medical professionals may be leading many women down a difficult path of fertility tests and treatments, many of which may not have been necessary at all.  For fertility investigations, Thyroid function is typically tested with a simple TSH blood test where doctors will be looking at whether the level of hormone production is within an optimal range. However, there are further blood tests measuring other factors of hormone production by the thyroid that could give a more in-depth picture of how it is working and might identify issues that could be addressed by some simple lifestyle changes.

Let’s look in a little more detail about the two main thyroid disorders and their symptoms:

Overactive thyroid

Hyperthyroidism (an excess of thyroid hormones) affects up to five percent of women. Symptoms of this condition can include:

• unexplained weight loss
• increased appetite
• feelings of nervousness and anxiety
• difficulty sleeping
• fewer or lighter menstrual cycles
• increased sweating and heat intolerance.

How might this affect your fertility? In healthy, reproductive-aged women, luteinizing hormone (LH) peaks mid-cycle and signals the ovaries to release an egg. But when the body produces too many thyroid hormones, LH can remain elevated during the entire cycle. With these chronically increased levels of LH, the “peak” is not drastic enough to signal the ovaries to ovulate. In other words, it confuses the body. Unusual ovulatory function can often lead to irregular or absent menstrual cycles. Put simply, if you’re not ovulating, you can’t get pregnant naturally — your ovaries do not release an egg that can get fertilized by a sperm.

Underactive thyroid

Hypothyroidism (too little thyroid hormones) is found in two to four percent of women. Some common symptoms seen in hypothyroidism are:

• weight gain
• fatigue
• constipation
• feeling cold
• thinning hair
• pale skin
• increased or heavier menstrual bleeding

When you have low levels of thyroid hormones, as you might have guessed, the body does not produce enough LH. Lower LH levels can inhibit that mid-cycle surge. As a result, your thyroid won’t signal to the ovaries that it’s time to release an egg. Without this signal, ovulation does not occur regularly, making conception difficult.

What treatment is available?

• Medication: An underactive thyroid is usually treated by taking daily hormone replacement tablets called Levothyroxine which replaces the thyroxin hormone that your body is lacking. For an overactive thyroid, medicines called Thionamides are a common treatment. These stop your thyroid producing excess hormones. In both cases, the levels of medication given will be closely monitored through regular blood tests and adjusted as needed.
• Radioiodine: This is a treatment where radiation is used to damage your thyroid, reducing the amount of hormones it can produce. It's a highly effective treatment that can cure an overactive thyroid. A drink or capsule is given that contains a low dose of radiation, which is then absorbed by your thyroid. Most people only require a single treatment.
• Surgery: Occasionally, surgery to remove all or part of your thyroid may be recommended. Removing the entire thyroid gland will cure an overactive thyroid and means there's no chance of the symptoms coming back. But as a result, you'll need to take medication for the rest of your life to make up for not having a thyroid – these are the same medications used to treat an underactive thyroid.
• Nutrition: Maintaining a healthy diet that contains vitamins and minerals to support your thyroid can be beneficial. Working on improving gut health with dietary changes and eating in a way that calms down autoimmunity and keeps blood sugar stable should also be integral parts of a treatment plan to restore thyroid health. For example - elimination diets. These often involve avoiding gluten, soy, dairy, processed sugar, and alcohol and instead focusing on eating a more organic, minimally processed, whole-foods-based diet and have proven successful for many.
• Holistic therapies: Acupuncture focuses on addressing an imbalance of energy and flow within the body, including a hormonal imbalance. In a similar way, reflexology can be helpful for balancing hormone levels, and therefore both therapies could be incredibly beneficial for the management of thyroid disorders.
• Stress management: Focusing on getting regular sleep and exercise as well as working to reduce stress with acupuncture, yoga and meditation can also promote healthy thyroid functioning.

If you are suffering with any of the symptoms listed above and feel that these could be having a negative impact on your fertility, be sure to seek the advice of your GP and insist on thorough investigations; addressing a hormonal imbalance such as this could be all that is needed rather than following a more invasive and stressful route.

If you would like advice on how acupuncture or reflexology could be used to help manage a thyroid disorder, as well as information on how to make positive changes to your diet and lifestyle, please contact the team at The Natural Fertility Clinic where we look forward to arranging a consultation with you.

By Suzanne Higgins