Does Hypothyroidism Affect Fertility?

by Mary
(Manhattan, NY)

Hi Amelia,
I have just been diagnosed with hypothyroidism and I was told by my acupuncturist (who is from China and has been doing acupuncture for 40 yrs) that in China they don't believe the thyroid interferes with fertility, like the docs believe here in the US. Is this the case?

I have regular 28 day cycles and I am getting surges on my opk test sticks, so I don't have irregular cycles and believe I'm ovulating, because I am having ovulation pains. So how does hypothyroidism affect fertility?

Thanks!
Mary

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Hypothyroidism and Fertility - Part 2
by: Amelia

Hi Mary, This is Part 2 of my answer on hypothyroidism and fertility. Many women actually go on thyroid medication that supplies their bodies with the T4 hormone, in order to get pregnant. This is very common. Sometimes T3, the active thyroid hormone is prescribed, but that can be very difficult to dose. A third alternative is a combination of T4 and T3. When taking thyroid medication, it's important to work with a doctor, who thoroughly understands the thyroid, so that you are taking the best form and dose for your condition.
It's very important for all women attempting to get pregnant to thoroughly have their thyroids checked out. I recommend the following tests:

Recommended Thyroid Tests:


  • TSH (thyroid stimulating hormone)

  • T4 (thyroid hormone)

  • T3 (active thyroid hormone)

  • anti-TPO (thyroid peroxidase antibody)

  • anti-TG (anti-thyroglobulin antibody)



I'm glad to hear that you have regular cycles and that you ovulate regularly. This is a very good sign. Ideally, you would also have a good 5 day medium flow with bright red blood, no cramps, no clots and no ovulation pain. Generally, after getting acupuncture for a cycle or two, women no longer have menstrual cramps, clots or ovulation pain, all of which are considered some form of qi or blood stagnation in TCM. I'm sure that your Chinese acupuncturist would agree with this.

Thank you so much for raising this point about the thyroid. It's an area that I wish to address more in my podcasts, videos and classes.

Sending Baby Dust Your Way,
Amelia Hirota
Licensed and Board Certified Acupuncturist and Herbalist

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Hypothyroidism and Fertility - Part 1
by: Amelia Hirota

Hi Mary,
I'm glad that you asked about hypothyroidism and fertility. I just had a patient the other day with a TSH of 1.6, who tested positive for anti-Thyroglobulin Antibodies. Her medical doctor told her not to worry, as the thyroid has nothing to do with fertility. So, it seem that this misconception spans the globe from China to the U.S. and permeates both modern Western medicine and traditional Chinese medicine.

Since traditional Chinese medicine is over 2000 years old and predates modern blood tests and any knowledge of the thyroid, most traditionally trained acupuncturists don't learn about the thyroid during their schooling. Also, modern Western doctors aren't really trained extensively in the functions of the thyroid either.

The function of the thyroid is very complicated and it's involved in many fundamental processes in the body, including metabolism, body temperature modulation and hormone regulation. It's so complicated that many people in various forms of medicine just don't delve in to studying the thyroid.

When it comes to treating someone for fertility this is a mistake. I believe that a significant number of "unexplained infertility" cases could be "explained" if the thyroid was thoroughly checked out. I'll give you one simple reason why an optimal functioning thyroid is important in fertility. Your thyroid must be strong enough to support the fetus, as the fetus is dependent on your thyroid for its thyroid hormones.

This is why many women become hypothyroid following a pregnancy. A pregnancy is very hard on the thyroid. I had a patient who's TSH was 1.6 before becoming pregnant, which would superficially be considered good. She miscarried at 6 weeks and her TSH shot up to 6.2 after the miscarriage. She hadn't had her thyroid antibodies checked and since they were attacking her thyroid, her thyroid was weak and couldn't sustain the pregnancy.

I will continue my response in the next comment.

Sending Baby Dust Your Way,
Amelia Hirota
Licensed and Board Certified Acupuncturist and Herbalist

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Hypothyroidism and Fertility
by: Anonymous

Hi Amelia,
Thanks so much for your detailed response about hypothyroidism and fertility! I am actually 6 mths post partum and believe my thyroid issues are from pregnancy! My TSH came back at 5.2 and they like to see it under 3 now. I had my T4 tested and that is normal and now I'm waiting on antibody tests!

I meant to ask you also if you don't mind, how much EPA/DHA do you recommend taking, as in dosage per day, to promote fertility? I have been taking it, but not sure if I'm taking enough!

Also, you said ovulation pain means qi or blood stagnation. I don't usually have ovulation pains but did have them last month. What can be done about that? I have been going to acupuncture since February of this year.

Thanks again!
Mary

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Hypothyroidism and Fertility
by: Amelia Hirota

Hi Mary,
It's important to really look at sub-clinical hypothyroidism and fertlity. I want to ask you a few questions. Did you have a baby 6 months ago and are already trying to conceive? How old are you and your partner? Did you conceive naturally or with reproductive drugs? Are you currently nursing?

When you are pregnant, your thyroid has to produce thyroid hormones for both you and the baby. This is why pregnancy can be hard on your thyroid. Actually, you ideally want your TSH to be 1.5 or lower. Some doctors that really understand the thyroid, say that a TSH of .86 - 1.00 is really the ideal.

Anything higher is an indication that the pituitary gland is yelling louder and louder for the thyroid to produce T4. If you're trying to get pregnant, I recommend getting your TSH down to 1.5 or less.

Acupuncture, herbs, and dietary therapy should take care of those ovulation pains. Acupuncture is usually very effective to deal with qi stagnation. I recommend getting treatments once a week.

I recommend buying a good quality fish oil from a health food store. Make sure that it's tested for heavy metal residue. I advise my patients to take 2000 mg/ day of EPA and DHA.

If you've had a baby recently, I advise you to nourish your body back to an optimum state of health before trying to conceive again. I understand that there may be a ticking clock, but you want to put your health and the health of your future child first.

If you're getting regular acupuncture, I hope that you're also on a good herbal regime, as herbs are extremely helpful in nourishing the body post-partum.

Take care and nourish,

Amelia Hirota, Licensed and Board Certified Acupuncturist and Herbalist

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