Fertility and Thyroid Function

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As an important part of the endocrine system, the thyroid gland secretes hormones that regulate metabolism in every cell of the body. If the thyroid gland is underactive, as is the case with hypothyroidism, then fertility is often compromised. Women with hypothyroidism may have heavy and prolonged menstrual bleeding. They may have irregular cycles due to problems with ovulation. If a hypothyroid woman does become pregnant, she is more likely to miscarry, or experience premature labour or stillbirth.

Symptoms of hypothyroidism are due to the decreased rate at which the body is using fats, proteins and carbohydrates. Weight gain along with cold sensitivity, especially cold hands and feet, are common. Cholesterol and triglycerides can also increase with hypothyroidism, and blood vessels can become more permeable resulting in tissue swelling or water retention (edema). The skin may become dry and rough, and the hair dry and brittle. Hair loss is common, and the nails can also become thin and brittle.

The psychological component of low thyroid function can result in depression and a feeling of weakness and fatigue. In fact, these are often the first symptoms. As it progresses, a person suffering with hypothyroidism may have difficulty concentrating and be extremely forgetful. As a naturopath, I often ask my patients what their energy levels are like, and if they feel that their energy and sense of well being has worsened over the years. For many women dealing with fertility problems and who believe that their energy, mood and ability to concentrate is not what it used to be, it would be important to look into the issue of hypothyroidism.

Some women show elevated levels of prolactin, which would have an inhibitory affect on ovulation, and can occur with hypothyroidism. Hypothyroidism is also associated with an increased risk of ovarian cysts. Even polycystic ovarian disease may be linked to hypothyroidism, where irregular cycles or amenorrhea are common.

Typically, women are prone to hypothyroidism, and as such should be tested regularly to ensure that their thyroid gland is healthy. A simple blood test to check levels of TSH, or Thyroid Stimulating Hormone, can indicate if there is hypothyroidism. I offer a word of caution if your TSH is 2.5 or higher but still falls within the normal range: you may be experiencing subclinical hypothyroidism. This means that while the blood test shows a normal value, you are experiencing symptoms of hypothyroidism.

If you have a TSH level that is above 2.5, but is still within the normal range, and you are experiencing symptoms of low thyroid function, you can check your basal body temperature to see if your metabolic rate has slowed. This is not a definitive test, but if you find that your basal body temperatures are consistently low, then you may want to consider further testing. You simply take your underarm temperatures upon waking. You must not get out of bed before taking your temperature, and it is important to make as little movement as possible. For women, perform the test on days 2 – 6 of your cycle. Men can perform the test at any time for five consecutive mornings. Basal body temperatures should be between 36.4C (97.6F) and 36.7C (98.2F). If your basal body temperatures are consistently lower than these values, then you may have hypothyroidism.

Although there are pharmacological treatments for overt hypothyroidism, naturopathic medicine can offer help for individuals who are dealing with subclinical hypothyroidism. The naturopathic approach can allow a woman to regain her energy and improve her health, and also allow her fertility to normalize. In this article, I will outline the general approach that would be taken by a naturopathic practitioner. Please keep in mind that the best option is to visit with a naturopath to receive more specific care.

One type of food that should be limited in the diet is the goitrogenic foods. The reason for this is that the goitrogens can induce an iodine deficiency by combining with the iodine and preventing its uptake by the thyroid. Thyroid hormones are made from iodine, and without adequate levels, the thyroid gland cannot function properly. Goitrogenic foods include brassica family foods (such as turnips, cabbage, rutabagas, and radishes), as well as cassava root, soybeans, peanuts, pine nuts, and millet. If these foods are cooked, then this is enough to break down their goitrogenic constituents.

It is also important to eat foods that are good sources of iodine. These include sea fish, sea vegetables (arame, kelp, dulse, nori, wakame, kombu), and iodized salt. Another mineral to consider is zinc, and it can be found in seafood, beef, oatmeal, chicken, liver, spinach, nuts, and seeds. B vitamins have a role to play in the normal manufacture of thyroid hormones, and the best sources are yeast, whole grains, and liver. If possible, it is best to buy organically grown foods since soil levels with organic foods tend to be higher in trace minerals important for a healthy thyroid.

Zinc, copper and selenium are the trace minerals that are required by the body to convert T₄ (inactive thyroid hormone) to the active T₃ thyroid hormone. As well, the B vitamins (B₂, B₃ and B₆) are needed to manufacture thyroid hormones. Nutritional supplements that are often recommended are kelp tablets for their iodine content, zinc supplement that also has copper, selenium and a B complex. For actual dosage levels, please consult with your naturopathic doctor or nutritionist.

The herbs listed here are for information purposes only; it is not a complete list. For herbal treatment, please consult with a naturopathic doctor or herbalist. As always, it is recommended that you do not take any herbs with fertility drugs. There may be the potential for a drug/herb interaction.

Bladderwrack: A source of iodine, and it is often used for underactive or enlarged thyroid (goiter). It is used to increase the metabolic rate and helps to balance blood lipids.

Motherwort: Known mostly for its help with menopause, it is also used to balance thyroid function and to treat swollen thyroid.

Ginger: A mild herb that can improve circulation, increase energy, and help to increase the thyroid’s metabolic rate.

Cayenne: As with ginger it increases circulation and energy, and helps to balance the metabolism.

Black Walnut: A herb that is rich in organic iodine and manganese that nourishes and strengthens thyroid function, helping to improve a sluggish metabolism.

Kelp: Kelp is used to promote healthy function of the thyroid. The iodine found in kelp is important in the treatment of an underactive thyroid.

Bayberry: It is a stimulating herb that increases thyroid function. It is known to improve circulation and is believed to balance hormones.

Mullein: As an herb it has anti-inflammatory properties, and is thought to protect the thyroid gland. It is known to reduce swelling in the thyroid.

It is estimated that acupuncture has been in existence for over 2000 years. In Canada and the United States, acupuncture is a relatively new therapy, and it is important that you find a reputable acupuncturist (L.Ac), doctor of Oriental Medicine (D.O.M.), doctor of Traditional Chinese Medicine (D.TCM), or naturopathic doctor who has been trained in acupuncture. Acupuncture is used to move qi (energy) and blood, and to balance Yin and Yang. In order to help with hypothyroidism a practitioner should perform tongue and pulse diagnosis, and pose questions that will help determine which particular pattern or syndrome is causing the hypothyroidism. There are different syndromes, or patterns that are assessed with tongue and pulse diagnosis. The treatment will therefore be unique depending on what particular syndrome is found.

It is often a good idea to seek out regular acupuncture treatment. A typical treatment schedule would be weekly acupuncture sessions for a minimum of eight weeks. Some acupuncturists begin with bi-weekly or even tri-weekly visits. It does require your ability to commit to regular treatment in order to obtain good results. Most people find that regular acupuncture does help to boost their energy and well-being, as well as helping to relax them. Of course, many fertility patients are very aware of the increased success rates when combining acupuncture treatment and ARTs.

There are a number of homeopathic remedies that can be considered for hypothyroidism. I find that homeopathy tends to address the emotional aspects of hypothyroidism very well. I have listed some of the homeopathic remedies that may be considered, but as with the other categories of naturopathic therapies, be sure to seek the advice of a naturopathic doctor or homeopath.

There can be a great deal of confusion when it comes to determining whether your fertility problems may be related to hypothyroidism. It is estimated that between 10 to 20 percent of the population is hypothyroid, but their TSH levels are in the normal range. Therefore, they are not eligible for medical treatment. If you find yourself dealing with low energy, thinning hair, dry skin, weight gain, sensitivity to cold, difficulty concentrating and mood issues such as depression, I would urge you to seek help with a naturopathic doctor or other reputable therapist. The therapies that have been discussed in this article may help you to turn the corner and feel well again. I also hope with all my heart that any fertility issue you may be facing will improve as well.

Judith Fiore, ND, is a registered naturopathic doctor, who practices in Toronto, Canada. She is dedicated to providing naturopathic care to individuals and couples with fertility issues. She can be reached at (416) 231-4477, or through her website: www.naturalfertility.ca