The vast majority of people that I see for fertility issues or really any health issue at all, tell me they have had their thyroid checked and it is normal. But what I have learned over the years, ESPECIALLY with the thyroid, that normal is not always optimal.
Honestly, understanding this and addressing the many “normal” areas that I find are not optimal for your fertility may be the key to you having a baby.
Keep in mind that many of my patients come to me after they have seen a long line of practitioners. I often hear, “you are our last hope” or ” Why didn’t I come to you sooner?”. As I go through a patient’s history I am always surprised at the tests that haven’t been done or the issues that have been written off as normal and therefore not addressed.
One of these such issues is the health of your thyroid. Thyroid health is imperative in becoming pregnant and in holding the pregnancy so when a fertility issue persists, in my opinion, more detailed screening of the thyroid should be done, even if the standard tests have come up normal.
This is not only a woman’s issue, i.e. any time there is an issue with the sperm count and quality, it could be related to the thyroid because the thyroid helps to create progesterone and testosterone. Estrogen then comes from testosterone. So many times I see patients who have classic thyroid symptoms but have never had their thyroid screened beyond just doing the standard TSH testing.
Most times if their TSH has come in within “normal” limits, they are told their thyroid is “normal” and there is nothing wrong. When I ask them to begin doing their temperature charts for me and the temperatures indicate that the thyroid is not working optimally (low temperatures are often a sign of a struggling thyroid), I come back to them and request that they have their thyroid screened in more detail. Some people look at me like I am crazy and others just scratch their heads.
The confusion with the thyroid starts in the standard tests. Normally a physician will test TSH which is the hormone that is supposed to be reflective of how the thyroid is working. The pituitary makes more TSH if thyroid hormone created by the thyroid is not enough or slows down in production if the thyroid is making too much.
The pituitary which secretes TSH is continually monitoring the blood to see how much thyroid hormone is present so in theory this should be an accurate indicator of thyroid function, but it doesn’t always seem to work that way. A scientist and MD Dr. George Gillson from Canada once stated in an International Hormone conference that TSH really only tells us what the brain needs for thyroid hormone, not what the rest of the body needs.
Therefore TSH can be normal but the thyroid hormone output may not be optimal for your reproductive hormones.
Another excellent reference for this http://thyroid.about.com The range of “normal” for thyroid hormone varies quite significantly from lab to lab. One lab may say that .4 to 4.0 is normal where another lab may say .3 to 6.0 is normal. Our normal reference range, based on what we see in the clinic is less than 1.5. When the TSH is above 1.5, support for the Five Step Fertility Solution goes a long way to optimising fertility.
I know, its confusing. If you have been dealing with fertility issues for awhile though its a good idea to have a more thorough screening. For example, I would suggest that you ask your doctor to test FT4 and FT3, and Reverse T3 as well as thyroid antibodies. Remember normal for these levels isn’t always optimal either so you want to consider seeing someone trained in my program to help you, or if you are a Platinum Member of our site you receive all the optimal ranges for what I have seen over the last 10 years as optimal for you both to create a baby.
Your physician may be resistant to the additional testing if there is no apparent thyroid history or if TSH is normal so be ready to take responsibility for your own health and give him/her good reasons to test these. In some countries there are labs that you can go to to have these tested without a doctors referral. Realize you will likely have to pay out of pocket for these tests but I can tell you the costs will be much cheaper than doing procedure after procedure with no result.
The other test mentioned above that should be considered if you have been dealing with fertility issues for a while and/or if you have had recurrent miscarriages or difficulty getting pregnant after a miscarriage or stillbirth, is thyroid antibodies. These are tested even less frequently than the thyroid hormones and its a shame as it has been shown that a woman with elevated thyroid antibodies (which can be elevated even if TSH is “normal”) are 3 times more likely to experience post natal depression and more likely to experience miscarriage.
Most physicians do not test this if TSH is normal however thyroid antibodies can be elevated even with normal TSH. This fact has been cited over and over in scientific literature. Though traditionally physicians not familiar with its signficance regarding miscarriage will not treat elevated thyroid antibodies but instead they will usually tell you to wait until the thyroid fails (or TSH rises above its “normal” range) before they will treat this. Personally I would not be satisfied with that approach when there are so many things that you can do to keep the thyroid from failing and addressing the antibodies.
The typical medical treatment for elevated thyroid antibodies is a hormone called Thyroxine. This treatment has reportedly decreased the incidence of miscarriage by half.
Natural remedies for optimizing thyroid function are also available from herbs and nutritional supplements. An Ayurvedic herb called Withania Somnifera or Ashwagandha and Chinese herb Bacopa Monneri are a few herbs that have been shown to support optimal hormone levels.
Reverse T3 is also an important test as it tells us whether the majority of T3 (which influences testosterone, estrogen and progesterone production) is active. If Reverse T3 is on the high end of the normal range or elevated, this can mean that you aren’t producing adequate amounts of active T3 which can effect reproductive hormone production and your fertility. Most times Reverse T3 is elevated due to stress on the system. This could be emotional stress and or physiological stress such as being overweight or having irritants such as gluten in your diet.
All of these tests are extremely important for assessing your fertility as a whole. And addressing the findings can help you go from unexplained (no pregnancy for no reason or not sure why you are miscarrying) to pregnant.