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Thyroid Disorders and Fertility: What You Need to Know

Thyroid Disorders and Fertility: What You Need to Know

Chanel Dubofsky | October 14, 2020 | Getting Pregnant

Your thyroid is a tiny gland with an enormous job. Located in your neck and part of your endocrine system (that's the system responsible for producing and generating hormones), your thyroid's function impacts, among other things, your energy levels, your metabolism, your mood, and yep — your fertility. 

The pituitary gland (1), another small but mighty organ, located below your brain, releases thyroid stimulating hormone (TSH). TSH speaks to — you guessed it — your thyroid, and causes it to issue three other hormones: triiodothyronine (T3), thyroxine (T4), and calcitonin. When your thyroid malfunctions, and you have too much or too little of these hormones, specifically T3 and T4, things can get tricky in terms of ovulation, getting pregnant and maintaining a healthy pregnancy. So what should you know about thyroid disorders in general, and specifically, how they relate to your fertility? Read on to get the nitty-gritty. 

Thyroid disorders 101

Anyone can develop a thyroid disorder, but they are significantly more common in women than men (5 to 8 times (2) more likely, in fact). But what exactly are thyroid disorders? What symptoms should you be aware of, and how are thyroid disorders diagnosed and treated? 

Hypothyroidism

Hypothyroidism is what happens when your thyroid is underactive, or not producing enough thyroxine (T4) for your body to be running as it should. Hypothyroidism may be caused by an autoimmune disorder, such as Hashimoto's Disease (3), or the absence of a thyroid.  

Symptoms (4) include weakness, puffiness in the face, thinning hair, and increased menstrual bleeding that's heavier than normal, but you also might not have any symptoms in the early stages. 

Risk factors for hypothyroidism include a family history of thyroid problems, having an  immune disorder, receiving treatment for a thyroid issue, and/or being pregnant or giving birth in the last six months (more on this later). 

Hypothyroidism is diagnosed via a medical exam and a blood test that will evaluate your levels of T4. If you do have hypothyroidism, your doctor may treat it with synthetic thyroid, and consistently monitor your thyroid function, as well as suggest dietary changes. 

Hyperthyroidism

Hyperthyroidism occurs when your thyroid is overactive, producing too much thyroxine and causing bodily functions to speed up. Indications of hyperthyroidism may include a racing heart, weight loss, tremors in the hands, muscle weakness, anxiety, brittle hair, and, in the case of Grave's Disease (5), the most common form of hyperthyroidism, a bulging of the eyes. Periods that are lighter and more infrequent may also occur with hyperthyroidism. Those with hyperthyroidism don't necessarily have symptoms, or they may not recognize the symptoms if they're mild. Risk factors for hyperthyroidism are similar to those for hypothyroidism, including a family history of thyroid disorders. 

If you are diagnosed with hyperthyroidism, which happens through a physical exam, a blood test, and a thyroid scan/ultrasound, treatment may include medication that will stop your thyroid from overproducing T4. 

It is possible to have subclinical hyperthyroidism (6) or subclinical hypothyroidism (7), which means your thyroid is working, but your T4 levels aren't exactly where they should be. Depending on your symptoms (whether or not you're having any), your doctor may decide to take action or continue to monitor your thyroid. 

Thyroid disorders and trying to conceive

As we mentioned, your thyroid's function dictates a lot about your hormones and therefore, your fertility. More specifically, if your thyroid is producing too much or not enough T4, that can interfere with ovulation. The symptoms of both hypo- and hyperthyroidism include heavy (hypo) and light and even absent (hyper) periods, which make it hard to predict when ovulation is happening or is about to happen. And of course, knowing how ovulation works and how to track it is a big part of the process of trying to conceive (8).  

If you're not feeling like yourself and you suspect that something is up, follow your gut and talk to your doctor. Being diagnosed with a thyroid problem doesn't mean you won't be able to get pregnant. In fact, in a 2012 study (9), of 394 women having trouble conceiving, 29.3% were found to have hypothyroidism, and once treated, 76.6% of those women got pregnant within a year.

Depending on what's actually going on with your thyroid, your doctor may advise that you wait to continue trying to conceive. For example, if you have hyperthyroidism and you're being treated with iodine, you will likely be told to wait until that treatment is over before you start trying to conceive. (10)

Pregnancy may be impacted by thyroid dysfunction, so it is advisable to check with your doctor to get things under control before getting pregnant. Untreated hypothyroidism (11) has been linked to an increased risk of miscarriage, as well as preeclampsia (12), and premature birth. If you have hyperthyroidism that's untreated at the time of pregnancy (13), that can also lead to miscarriage and preeclampsia, plus a condition called a thyroid storm (14), which is a rare condition that comes with a high mortality rate. Fortunately, thyroid conditions are super treatable and manageable once they've been identified, so if you are diagnosed with one, it is very possible to live a normal life and conceive successfully (15). 

You've got the information you need to take control and get proactive  — don't hesitate to bring your concerns to your doctor and consider tracking your symptoms and cycles in Kindara to get familiar with what’s normal for your menstrual cycle.

References +
2

General Information/Press Room. (n.d.). Retrieved August 19, 2020, from https://www.thyroid.org/media-main/press-room/

3

Hashimoto's disease. (2020, February 11). Retrieved August 19, 2020, from https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855

4

Hypothyroidism (underactive thyroid). (2020, January 07). Retrieved August 19, 2020, from https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

5

Graves' Disease. (2017, September). Retrieved August 19, 2020, from https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease

6

Management of Subclinical Hyperthyroidism. (Published online 2012 Apr 20). Retrieved August 19, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693616/

7

Subclinical Hypothyroidism: Deciding When to Treat. (1998 Feb 15). Retrieved August 19, 2020 from https://www.aafp.org/afp/1998/0215/p776.html

8

Could a fertility awareness-based method of family planning work for me? (2020 August 12). Retrieved August 19, 2020 from https://www.kindara.com/blog/could-a-fertility-awareness-based-method-of-family-planning-work-for-me

9

Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. (2012 Jan-Jun). Retrieved August 19, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657979/

10

Pre-Conception Counselling in Graves' Disease. (Published online 2012 Feb 29). Retrieved August 19, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821453/

12

Preeclampsia. (2017 December). Retrieved August 19, 2020 from www.marchofdimes.org/complications/preeclampsia.aspx

13 Hyperthyroidism in Pregnancy. (n.d.) Retrieved August 19, 2020 from https://www.thyroid.org/hyperthyroidism-in-pregnancy
14

Endocrine and metabolic emergencies: thyroid storm. (2010 Jun).  Retrieved August 19, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475282/

15

Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. (2012 Jan-Jun). Retrieved August 19, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657979/#:~:text=Hormone%20therapy%20with%20thyroxine%20is,to%201%20year%20of%20therapy.