Now we’ve talked about symptoms that may indicate your thyroid needs some support, labs to ask for to assess thyroid function, and some foundational ways to support your thyroid (read Part 1 and Part 2). Now it’s time to chat about the most common thyroid issue: hypothyroidism
What is hypothyroidism?
Hypothyroidism is a condition in which the thyroid gland is considered ‘underactive’, meaning it does not produce enough thyroid hormone for the body.
How common is hypothyroidism?
Hypothyroidism impact about 5% of the population with the estimated 5% going undiagnosed. Hypothyroidism is more common in women vs. men.
What causes hypothyroidism?
Worldwide, the most common cause is iodine deficiency. In the US, which is considered iodine sufficient (but many people still fall short), Hashimoto’s thyroiditis (an autoimmune condition in which the body attacks the thyroid) is the most common cause of thyroid failure and hypothyroidism.
What are the symptoms of hypothyroidism?
Nearly every cell in the body uses thyroid hormone so when there’s not enough, symptoms can show up across the board. They include:
- fatigue
- brain fog
- dry skin
- irregular cycles
- heavy periods
- infertility/pregnancy loss
- hair loss
- elevated blood lipids
- constantly feeling cold
- stubborn weight loss
- unintentional weight gain
- among many more
How is hypothyroidism diagnosed?
Hypothyroidism can be diagnosed by your physician via a blood test measuring thyroid hormone levels. The most common thyroid lab test measures TSH (thyroid-stimulating hormone) but that doesn’t give you a full picture of thyroid function. I recommend clients get a full thyroid panel (TSH, total and free T3, total and free T4, reverse T3, and thyroid antibodies). That’s the only way to truly assess the functioning of the thyroid as a whole. Hashimoto’s is typically diagnosed by the presence of thyroid antibodies (which is why it’s important to have those measured!)
When being “diagnosed” with hypothyroidism, it should be noted that there’s a scale or range of diagnosis. You could be diagnosed with overt hypothyroidism (usually when TSH is high and major thyroid hormones are low). Or you could also be diagnosed with subclinical hypothyroidism (one example being when TSH is high but other major thyroid hormones are normal).
How does hypothyroidism impact fertility?
Your menstrual cycle relies on thyroid hormone for a number of reasons so when there isn’t enough thyroid hormone available, interruptions in your cycle can occur. That includes: reduced or extended time between cycles, anovulatory cycles (when you don’t ovulate), and heavy periods, among other symptoms. It can lead to what’s called subfertility meaning you still have the physical ability to get pregnant but there are obstacles in the way.
With thyroid autoimmunity (for example Hashimoto’s thyroiditis), it can make it more difficult to get pregnant by reducing thyroid function when the ovaries require thyroid hormone to recruit and mature follicles to ovulate. Having the presence of thyroid antibodies can reduce the number of follicles and lead to low ovarian reserve.
How does hypothyroidism impact pregnancy?
If untreated, hypothyroidism can pose a number of risks during pregnancy including: developing gestational hypertension or preeclampsia, placenta abruption, miscarriage, preterm delivery, or stillbirth. If treated but not adequately, there’s a risk of intrauterine growth restriction (IUGR) and/or low birth weight, and delays in neurological development.
With subclinical hypothyroidism, there is an increased risk of miscarriage and preterm delivery.
How is hypothyroidism treated?
With overt hypothyroidism, a medication consisting of synthetic T4 most likely will be prescribed to help provide the body with sufficient amounts of thyroid hormone. Sometimes desiccated thyroid that contains T4 and T3 hormone can be prescribed. With subclinical hypothyroidism, it depends on a number of factors including if you’re positive for thyroid antibodies, how high are TSH levels, and how total and free T3 and T4 look. It’s usually on an individual basis and also dependent on your doctor’s philosophy of a) whether subclinical hypothyroidism is a thing and b) if they think it needs to be treated or not.
In both cases of overt and subclinical hypothyroidism, it’s also helpful to continue doing the foundational habits to support your thyroid (read about that in this blog post), as well as some additional supportive habits.
What else can I do to support my thyroid?
Here are some more advanced ways to support your thyroid:
- eating enough throughout the entire day
- eating adequate amounts of protein (including seafood multiple times per week!)
- reducing exposure to endocrine disruptors
- consuming thyroid supporting vitamins and minerals
- getting good quality and adequate amounts of sleep
- effectively managing stress
- supporting digestion and absorption
Your thyroid plays a significant role in your fertility and future pregnancies (issues can also arise during postpartum but that’s for another blog post!) It’s worth it to provide your thyroid with what it needs to function properly!
If you find yourself struggling to get pregnant and suspect it might be your thyroid, reach out for help and support! I’m accepting new clients and you can apply to work with me here.
