Check Your Gas Tank Meter…It Might Be Time to Refuel: The Thyroid and TTC
In many ways, the thyroid is like the man behind the curtain. You have never seen him and are not really sure what he does, but you know he’s there. You’ve heard about him, maybe blamed him for your weight gain or sleeping through your alarm clock, and considered that errors in his way could be keeping you from getting pregnant. But how he is masterminding all of this may remain unclear.
While the intricacies of the thyroid are more delicate than a lace shirt, the basics come down to a simple Goldilocks type of situation: the thyroid is working too fast, too slow, or just right. When it’s really off, you usually feel really off. When your thyroid is running on empty or very close to it and is under active, you will feel like a car without gas, putt putt puttering through your day, feeling tired, cold, and constipated, with dry skin and hair loss, to name a few. On the flip side when your tank has been topped off just a bit too much, you feel like you had one too many shots of espresso and experience insomnia, diarrhea, palpitations, hot flashes/sweating, and anxiety.
However, sometimes the deviations are subtle, and your thyroid is just slightly off (medically termed subclinical). You may not know it unless a doctor checks through blood work. While the subclinical part will usually not cause you any noticeable symptoms, it can increase your risk of miscarriage and infertility and lead to negative pregnancy outcomes.
As a result, fertility MDs are somewhat fixated on hitting the thyroid hormone level sweet spot! We check it on nearly all of our patients pre-pregnancy and then again during pregnancy. We are somewhat OCD in getting it to the perfect point and will labor over when to start some additional medication, when to increase or decrease it, and when to stop it. Getting the tank live just right is key for sustained performance and a healthy pregnancy!
What and where is this elusive “gas tank”? The thyroid is a small butterfly-shaped gland that sits at the base of the neck just above your clavicles. In most women who are free from thyroid disease, it is small and cannot be seen or felt. The thyroid produces thyroid hormones (T4 and T3); these hormones travel through the blood throughout the body to target organs. Almost all of your vital organs are target organs in desperate need of a little thyroid juice! The ovaries and the uterus are also quite “thirsty.”
Thyroid hormone plays a role in regular ovulation, pregnancy, implantation, and miscarriage. Additionally, babies don’t start to produce their own thyroid hormone until about 13 weeks of age (in utero). Therefore, for the first trimester of pregnancy, babies rely exclusively on their mothers. If you are borderline low making thyroid hormone, they will be super low. And given that thyroid hormone is essential for brain development, this is not an area you want to be lacking in! It is for this reason that doctors will frequently start a thyroid supplement early before the situation hits rock bottom.
While your thyroid may not be to blame for all of your problems, it’s under (termed hypothyroidism) or over production (hyperthyroidisim) may be the cause of some serious ailments. Sometimes the thyroid is off due to an autoimmune condition (where the immune system gets confused and starts attacking different organs including the thyroid). Women are about six times more likely to be diagnosed with thyroid disease and most of those diagnoses will be made in the reproductive years (30s and 40s).
In Eastern medicine, the actions of the thyroid are linked to the source of your energy “reserves” like an energy battery. This battery consists of a balance of opposites (Yin and Yang energy). When the warming/activating energy is low (Yang), it presents as fatigue, feeling cold, foggy thinking, weight gain, and hair loss, etc. as well as irregular or long cycles with heavy flow or lots of spotting. When the cooling/anchoring energy is low (Yin) or too much “heat” is in the body, it presents as feeling hot or easily overheated, anxious, insomnia, weight loss, palpitations, and also potentially irregular cycles. The organ systems involved in Eastern medical theory are often the Kidney energy (more like adrenal functions), Heart (aka emotions or spirit), and Spleen (gut and immune function). In all cases customized herbs, acupuncture, dietary and lifestyle changes are prescribed with the goal to conserve or boost energy and either increase yin or yang and warm or cool the body to support the correction of the thyroid.
Helping the thyroid naturally using Eastern tools can take time (like months) and is also somewhat unpredictable, so if you have the time and are not yet trying to conceive, you can explore these options, but in modern day when it comes to fertility and pregnancy, we do not advise trying to manage thyroid disorders with Eastern medicine alone because if thyroid hormones get too out range, it can cause miscarriage. Rather, a holistic approach using both Eastern and Western methods helps keep patients feeling good and hormone levels stable to provide consistent support while ttc and throughout a pregnancy.
Not only is the thyroid important for pregnancy and fertility, but the start of it’s decline often occurs during the reproductive years. So it is always a good idea to have your thyroid level checked, particularly when contemplating pregnancy. Who knows? You may just need a little refueling to help put an end to those annoying symptoms and boost your odds of conceiving!