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The thyroid is an endocrine gland that plays a role in many of the bodies functions and hormone balance. It is a small, butterfly shaped gland at the front of your neck. Thyroid hormones regulate your metabolism which determines how your body uses energy. They are also involved in the regulation of your menstrual cycle.
Types of Thyroid Imbalances
There are different types of thyroid imbalances.
Hypothyroidism
Hypothyroidism occurs when your thyroid has low levels of activity.
Symptoms can include: fatigue, constipation, feeling cold 24/7, weight gain, dry skin, hair loss, brittle nails, brain fog, irregular menstrual cycles, miscarriage and infertility.
Typically with hypothyroidism, you will see an increase in TSH (this is a brain hormone) and decrease in thyroid hormones T3 and T4.
Hashimoto’s Hypothyroidism
Hashimoto’s is an autoimmune condition that occurs when the body mistakenly attacks the thyroid gland. Your body will produce antibodies TPO (anti-thyroid peroxidase) and/or anti-thyroglobulin (TgAb) that attach and destroy healthy thyroid cells.
When thyroid cells are destroyed, it can lead to a decrease in thyroid hormone production, which can result in hypothyroidism (see above) but this STARTS as immune dysregulation (root cause), not thyroid dysfunction.
Symptoms can be similar to those of hypothyroidism, but with the increased risk of developing other autoimmune conditions and fertility struggles.
Typically, labs will show the same as Hypothyroidism, in addition to the anti-TPO and TgAb.
Hyperthyroidism
On the other hand, hyperthyroidism occurs when your thyroid is overactive producing too many thyroid hormones. If antibodies are present, it can be associated with the autoimmune condition Graves disease.
Symptoms can include: weight loss, anxiety, heat intolerance, tremors, frequent bowel movements and goiter (enlarged thyroid gland).
Labs typically show low TSH and an increase in T3 and T4.
Does it Impact Fertility?
Undiagnosed thyroid issues are a major cause for subfertility.
Specifically with Hypothyroidism, your menstrual cycle can be significantly disrupted and stop ovulation from occurring. Without ovulation, you will not release an egg, and with no egg there will be no fertilization or implantation.
In addition, Hypothyroidism can affect the luteal phase, interfere with prolactin and ovulation, and imbalance sex hormones… all of which impact fertility.
Then adding the layer of Grave's or Hashimotos- that's immune system dysregulation. One of the most common causes of subfertility is irregularities within the immune system.
Ideal Labs
If you're struggling with your fertility, and don't already have a FULL thyroid panel, I strongly encourage you to get one. In order to accurately assess your thyroid health, it’s important to urge your doctor to run a full thyroid panel. In many cases I see free T3 and T4 as well as antibodies change well before we see a shift in TSH, so if you're JUST getting TSH you're missing the biggest part of the picture and a better opportunity at prevention.
Labs I recommend ordering are:
TSH (Thyroid Stimulating Hormone)
Free T3 and Free T4
Total T3 and Total T4
Reverse T3
Anti-TPO Antibodies
Anti-TG Antibodies
See below for optimal thyroid lab ranges for fertility
Keep in mind that these levels in this graphic are OPTIMAL levels for fertility, they are vastly different than what your doctor is going to use. Your conventional doctor is trying to diagnose or rule out DISEASE, that is not what our goal is over here in functional medicine, we are trying to make you the healthiest you can be and keep you far away from a diagnosis.