Thyroid and infertility

Thyroid and infertility

Autoimmune disorders such as Hashimoto’s thyroiditis, Lupus, Celiac disease and Diabetes have all been shown to have a potentially negative impact on both fertility and pregnancy outcomes showing higher rates of infertility, miscarriage and preterm deliveries. Due to the potentially negative outcomes, it is important for women of reproductive age to be properly assessed for potential autoimmune conditions before trying to conceive. This is particularly relevant when it comes to Hashimoto’s thyroiditis as it often goes undiagnosed.

Hashimoto’s thyroiditis is the most common cause of hypothyroidism or underactive thyroid function. It is very common and affects up to 4% of the population. Hypothyroidism is a condition in which the thyroid doesn’t make enough thyroid hormone either T4 or its active form T3. Some of the symptoms of hypothyroidism include weight gain, mental fog, dry skin/hair/nails, constipation, difficulty regulating temperature (generally presents with feeling cold) and fatigue. When we look at thyroid function there are 5 lab values of relevance.

1. Thyroid stimulating hormone (TSH) – this is a hormone that comes from the pituitary and tells the thyroid to make thyroxine (T4)

2. Thyroxine (T4) is a hormone made by the thyroid

3. Triiodothyronine (T3) is a thyroid hormone that is made through the conversion of T4. T3 is the hormone that works actively in our cells.

4. Thyroid peroxidase antibodies (TPO). These are antibodies that can be a sign of Hashimoto’s thyroiditis. You can also see TPO antibodies in a condition called Graves’ disease. This is also an autoimmune disease and the most common cause of hyperthyroidism. Hyperthyroidism is a condition in which the thyroid makes too much of certain thyroid hormones.

5. Thyroglobulin antibodies (Tg). These antibodies can also be a sign of Hashimoto’s disease. Most people with Hashimoto’s disease have high levels of both Tg and TPO antibodies.

TSH tells the thyroid to make T4. Then T4 goes out into circulation and converts into T3. T3 is active in our cells and regulates several processes in the body including metabolism and temperature regulation. Once T4 and T3 reaches a level where the cells are happy, feedback is given to the pituitary to slow down the production of TSH. If not enough T4/T3 is getting into the cells, we will see the TSH levels increasing on our lab work.

A combination of looking at all five of these lab values is needed to properly determine if a patient has Hashimoto’s and to determine if treatment is working.

When it comes to pregnancy if a woman has elevated antibodies, even with other thyroid labs values being normal, it can still have a negative impact for reproductive outcomes.

How can we lower elevated antibodies?


Research has shown some patients with Hashimoto’s are sensitive to a protein called gluten. If you have a gluten sensitivity (gluten is found in grains including wheat, rye, spelt and barley) this can promote inflammation in the body and therefore contribute to thyroid symptoms. Gluten has a similar appearance to thyroid tissue so in some cases, when the immune system starts attacking gluten, it also will attack the thyroid tissue. The same mechanism can happen with corn. For anyone who has seen elevated antibodies it is a great idea to start by eliminating both gluten and corn from their diet for at least three months. Repeat the antibody testing after three months to see if numbers have improved. For some patients, I find it helpful for them to follow a modified paleo diet to reduce overall inflammatory load. This involves focusing the diet on lean proteins, healthy fats, lots of fruits and vegetables and limiting any processed or packaged foods, sugars and grains.


The oil of an Indian seed called black cumin has research showing it can help lower TSH as well as antibodies. It also works to help reduce inflammation – a very useful oil when it comes to supporting patients with Hashimoto’s.

Curcumin, which is an extract from a spice called turmeric, also has some great research promoting a healthy immune balance by changing the body’s response to inflammation. Over time it can shift the immune system function to reduce its attack on itself.

Omega 3 fatty acids, predominantly derived from fish, help our bodies to promote a healthy response to inflammation. Most people in North America are deficient in omega 3s which can promote pain and inflammation in the body. Fish oil can also help improve the signalling of thyroid hormone within cells. As the feedback loop improves, we will see a natural lowering of TSH levels.


For patients that have elevated TSH levels it is recommended that, along with diet changes, they also use a thyroid medication such as levothyroxine. Ideally, this will result in their lab values normalizing and antibody levels coming down. For other patients though, being on a thyroid medication may normalize their TSH, T4 and T3, but their immune system can still present elevated antibodies showing it is still actively fighting itself.

Regulating thyroid function or other autoimmune conditions is essential to conceiving and being able to maintain a healthy pregnancy. If you suspect you have any thyroid related symptoms, have your blood tests run with your health professional so you can work to optimize these levels before your pregnancy. Once you do have a positive pregnancy test you should continue to monitor your blood levels especially during the early stages of pregnancy. This is a time where we can see a lot of fluctuation and adjusting medication levels may be needed.

Autoimmune conditions such as Hashimoto’s thyroiditis can be complex to manage, so please seek the care of your health professional for support.

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The Importance of a Preconception Multivitamin

The Importance of a Preconception Multivitamin

The Importance of a Preconception Multivitamin

By Dr. Jodie Peacock ND

Optimizing your health before trying to conceive can help improve the overall health of your future baby. The development of both egg and sperm takes approximately three months, so this is a particularly critical time to focus on the health of both partners.

In general, your diet should be rich in fruits, vegetables, lean proteins, healthy fats and minimally processed carbohydrates. You should strive to limit or eliminate refined sugars, alcohol and processed foods.

Both men and women should consider starting a prenatal or preconception multivitamin about three months before trying to conceive. There are several nutrients that when not at optimal levels can have a negative impact on both overall health, conception and health pregnancy. When choosing a prenatal you should be aware that there are more and less desirable forms of several vitamins. You want to ensure that the dose is between 2-4 capsules per day. A one-a-day will not be able to provide the essential nutrients that you require.

Here are some key things to look for:


Taking either folate or 5-methyltetrahydofolate (5-MTHFR) will be better utilized then folic acid which is synthetic and not as easily converted to its active form. Approximately 50% of the population has a reduced ability to convert synthetic folic acid to its active form 5-MTHFR. If you are one of these individuals and are not consuming the active 5-MTHFR form, this can contribute to higher rates of infertility, miscarriage and neural tube defects. For this reason, if I don’t know the genetic status of my patient, I recommend a supplement with the active form of folate 5-MTHFR.


Making sure your iron is at an optimal level before trying to conceive is very important. If iron is low this can impact the ability for your body to circulate both nutrients and oxygen necessary to sustain a healthy pregnancy. Heme iron or iron glycinate forms are both well absorbed and are generally well tolerated causing very little constipation, while seeing good improvements in iron levels.


B12 comes in different forms with methylcobalamin being one of the active forms that is more easily absorbed. B12 is a nutrient that is important for neurological development and for DNA replication. Ensuring optimal levels is both important for development of sperm and egg as well as overall health for the baby.

Vitamin D

Low vitamin D can contribute to bone loss, depression, sleep disorders, immune deficiencies, and hormonal imbalances. There are also multiple studies that have shown deficient vitamin D can impair the body’s ability to achieve, as well as maintain, a pregnancy.

A simple blood test can be run to assess your status of each of these nutrients. This is something you can discuss with your health provider.

There are several other supplements such as CoQ10, carnitine, NAC, ALA, inositol, chastetree, maca and others that may be helpful depending on your individual situation. For example, there are some important nutrients that can help to optimize hormonal regulation, egg and sperm quality and can be added to a supplement regime based on your individual requirement.

For more tips on fertility, please follow us on Facebook and Instagram @enhancefertility.

While the world is healing we wanted to share this story of how the pandemic has temporarily divided one new family.

While the world is healing we wanted to share this story of how the pandemic has temporarily divided one new family.



While the world is healing we wanted to share this story of how the pandemic has temporarily divided one new family.

It is brought to you by Gaia Fertility, one of the partners of the International Fertility Company.

Intended parents A and C approached Gaia in 2018 with a burning desire to start their own family. As a married same sex couple they had previously considered a number of options which all turned out to be fruitless. Determined, the couple contacted Gaia and chose our same sex surrogacy programme which offered a pregnancy guarantee using sperm from both men and a single egg donor.

They were delighted to welcome their first born, a son in 2019 and the new parents returned home after four short weeks to begin family life. Keen on having a sibling for their son, the couple immediately began their second journey and received the fantastic news that baby number two, another boy was expected in April 2020!

It became evident some time ago that Covid-19 was making steady progress towards Cyprus where Gaia are based so the parents were advised to return to the island before any travel restrictions were put in place. As one dad is a key worker the decision was made that he would remain in the UK with their son whilst his partner travelled to Cyprus.

Gaia’s advice was well timed. The dad managed to get a seat on the last plane to the island before travel was halted but had to be quarantined for 2 weeks in order to secure the safety of those around him.

At Gaia we are always prepared to walk an extra mile to ensure we provide a service for our intended parents and surrogate mothers which is second to none. We had no hesitation therefore in opening up our own home to the dad to ensure that his quarantine period was as comfortable and stress free as possible.

During this period baby number two was born healthy at 37 weeks but due to the obvious restrictions he has not been able to receive a cuddle from either dad!

We arranged for a full-time nanny, who is also a paramedic, to care for the little one at her own home until he is able to join his parents and brother. We celebrated his arrival with a cake and online greetings from his dad’s and grandma which have subsequently become a daily occurrence!

We recognise the situation is not ideal and is perhaps one which is being experienced by intended parents across the world. We do have the technology and commitment however to ensure families remain together, albeit virtually in some cases and we look forward to a time when this particular family can be reunited at home!

Get more information about Gaia and the services it offers here, quoting IFC.