The thyroid is a butterfly-shaped gland in the front of your neck. Every cell in the body depends upon thyroid hormones for regulation of their metabolism.
Conception is more difficult for women with thyroid disorders as it is associated with ovarian dysfunction. Both hypothyroidism (underactive) and hyperthyroidism (overactive) disrupt reproductive hormones and women with thyroid disorders often have abnormal menstrual cycles, such as irregular cycles, very heavy or very light periods. Thyroid hormone is necessary for the production of estrogen and progesterone. Both of these may have a big impact on fertility. Hypothyroidism is the most common thyroid disorder. In this article I will focus on hypothyroidism for this reason.
Hypothyroidism affects both sexes, but women are up to eight times more likely to develop the condition. According to Thyroid Australia, 850,000 Australians are suffering hypo- or hyperthyroidism.
This does not take into account the many undiagnosed people with hypothyroidism. Some sources estimate that one in 20 people will experience a thyroid disorder in their lifetime. I see this in clinic every day. I estimate that 70% – 80% of women I treat for fertility problems have an underactive thyroid or suffer from subclinical hypothyroidism and 90% of them are undiagnosed.
What are the symptoms of hyothyroidism?
The symptoms of hypothyroidism can include Depression, Fatigue, Sensitivity to cold, Weight gain, Lower body temperature, Dry skin, Hair loss, Constipation, Heavy or irregular periods,
Infertility, Low libido, Impaired memory, Muscle aches and pains and low sperm count.,
Testing for hypothyroidism
The standard Thyroid Function Tests which are performed in Australia are:
• Thyroid Stimulating Hormone (TSH)
• Free Thyroxine (Free T4 or fT4)
• Free Triiodothyronine (Free T3 or fT3)
The Medicare protocol for screening patients who have not yet been diagnosed with a thyroid function problem is to test TSH and only if the result of this test is outside the reference range to test Free T4. Medicare will only fund screening tests which satisfy this protocol. A typical (statistical) reference range for thyroid-stimulating hormone (TSH) in many laboratories is around 0.3-5.5 mU/L. If TSH is lower, this indicates Hyperthyroidism (overactive thyroid) and if it is higher, it indicates Hypothyroidism (underactive thyroid).
However, a study published in The Lancet 2002 has shown that individuals with TSH values greater than 2.0 mU/L have an increased risk of developing overt hypothyroidism over the next 20 years. Further research has indicated that TSH values above 2.0mU/L are already an indication of subclinical hypothyroidism. Despite your TSH levels being “within range”, you may be experiencing symptoms of hypothyroidism, one of which could be infertility. However, many patients are told, their thyroid is fine, as their TSH levels are in the “normal range”. When I inquire about thyroid tests, most patients tell me that they were told their thyroid is fine. Once I request a copy of their blood test, more often than not I find that their TSH is well above 2 and no further investigations have been done. Patients with a sluggish thyroid go undetected and are therefore not treated appropriately. Thyroid function is very important for fertility and can often be the underlying cause of unexplained infertility. Thyroid also plays a big part in PCOS and a majority of women who suffer with PCOS also have suboptimal thyroid function.
What can you do to find out if you have hypothyroidism?
You can ask for more tests to be done, but you will have to pay for them yourself. These include the following: TSH, T4, T3, TPO (Thyroid peroxidase antibody) and TGAb (Thyroglobulin antibody). Alternatively, you can test your thyroid with this simple test (according to Dr. Wilson)
Test your temperature by mouth, every 3 hours, 3 times a day, starting 3 hours AFTER waking. Do this for several days, but not the 3 days prior to your period, since it’s higher then. For each day, add the 3 temperatures together and divide by 3 to get the average. If you temperature consistently averages below 37 degrees Celsius, then you may be suffering from an underactive thyroid.
Thyroxine replacement therapy is the mainstay of medical treatment for hypothyroidism and is usually lifelong. There is no cure for hypothyroidism, and therefore most people will remain on medication for the rest of their lives.
Factors that adversely affect thyroid function include nutritional deficiencies such as selenium, zinc, iodine, chromium, insulin resistance, toxicities such as heavy metals and environmental toxins. To support your thyroid functioning, changes in diet, specific homeopathic treatment and some supplements or herbs can be of help. Thorough thyroid investigation is part of the treatment for every fertility patient. It is an absolute must and you can need to discuss any concerns you have with your GP.