Getting proper medical care for Hashimoto’s Disease affects every area of a patient’s life—including her desire to be a mother. Proper care isn’t easy to find, however, because traditional Western physicians approach Hashimoto’s in a shallow way: they rely far too much on thyroid-hormone replacement and fail to address the many cases in which medication does not alleviate symptoms.
My approach to patient care is very different. Hashimoto’s Hypothyroidism is an autoimmune disorder, requiring anti-inflammatory, whole-body care, with attention to diet, exercise, lifestyle and nutritional supplementation. A healthy reproductive system is one benefit of this comprehensive care. For more information, I offer a free, 15-minute phone consultation. For scheduling, see the Contact Us page or call (704) 853-8000.
Infertility, Antibodies, Cortisol and TBG
A woman with untreated or poorly treated Hashimoto’s Disease may have trouble getting pregnant, because a low level of thyroid hormone affects her ability to ovulate—to produce an egg for fertilization. Pregnancy isn’t possible without fertilization.
There are many reasons for this decrease in usable thyroid hormone. Hashimoto’s antibodies recognize the body’s own thyroid-hormone-producing system as an enemy. In Hashimoto’s Disease, antibodies are present against thyroid peroxidase (an enzyme to make thyroid hormone) or thyroglobulin (helps with thyroid hormone synthesis and release) or both. Therefore, if the autoimmune aspect of Hashimoto’s isn’t addressed properly, an inflamed immune system continues to attack the patient’s ability to make thyroid hormone.
An unaddressed autoimmune disorder results in two problems: less thyroid hormone is produced, and there is an inability to benefit fully from prescription thyroid hormone. No matter how much prescription thyroid hormone is increased, the results remain unsatisfactory, because an inflamed immune system increases cortisol, a stress hormone. Cortisol blocks thyroid hormone from entering receptor sites and being helpful.
Yet another problem with cortisol is that it stimulates enzymes that convert T4 (the inactive form of thyroid hormone) into rT3 (Reverse T3). Reverse T3 is meant to be a safety valve which prevents too much T4 from being converted into the active form of thyroid hormone: T3. Too much T3 is as physically destructive as too little T3.
Reverse T3 does not benefit cells in the way T3 does: it delivers no oxygen or energy to cells. When reverse T3 is too high, there isn’t enough active T3 available to reduce low-thyroid symptoms. As a Functional Medicine physician, I work with Hashimoto’s patients to reduce the inflammation that floods the system with cortisol.
Another cause of low thyroid-hormone levels involves estrogen, a female hormone which surges at various times. These estrogen surges cause an increase in TBG (thyroid-binding globulin). More thyroid hormone is then “bound up” by an increase in TBG, and less “free” hormone is able to enter thyroid-hormone-receptor sites in cells. If a woman has Hashimoto’s Disease, an increase in TBG has an even greater effect, because her thyroid-hormone levels are already lower. Her body has an ongoing thyroid-hormone deficit that may prevent proper ovulation.
Birth Control and Depleted Nutrients
Estrogen-containing medications, like birth-control pills, cause women to make more Reverse T3 than normal. Also, anyone with a progesterone deficiency and estrogen dominance will make more Reverse T3 than is helpful. Even an iron deficiency (low ferritin) will cause the conversion of too much T4 into reverse T3.
Another problem with birth-control pills is that they deplete the body of nutrients needed to produce enough thyroid hormone: tyrosine, magnesium, zinc and folate. Birth-control pills also cause a dramatic increase in SHBG (sex-hormone-binding globulin). Just as TBG binds thyroid hormone, SHBG binds a sex hormone like testosterone. Testosterone is needed to convert T4 into the active T3 form, so a loss of testosterone eventually leads to a deficiency of usable thyroid hormone.
With Hashimoto’s Disease, the effects of birth-control pills, nutrient deficiencies and low testosterone levels are even more intense, in terms of emotional stability and other low-thyroid symptoms. Most traditional Western doctors do not routinely test for a high level of rT3 or the presence of thyroid antibodies that flag our own thyroid-hormone-producing system for destruction.
The Challenges of Pregnancy
For a woman with untreated or poorly treated thyroid disease, pregnancy may involve a number of problems: maternal anemia; premature delivery; still birth; miscarriage; placental abruption (the placenta separates from the inner wall of the uterus before birth); postpartum hemorrhaging; or an infant with short stature or impaired intellectual development. Proper treatment with both thyroid-hormone medication and natural Functional Medicine care make these problems far less likely, however.
It is best to see a Functional Medicine physician prior to becoming pregnant, in order to give the body time to heal from the inflammatory damage caused by Hashimoto’s Disease. Functional Medicine doctors treat the whole body, with in-depth lab testing, an anti-inflammatory diet and nutrient supplementation.
I work closely with my patients, and our Success Stories show how lives are changed by greatly reducing the impact of an autoimmune disorder. For a free, 15-minute phone consultation, see our Contact Us page for scheduling or call (704) 853-8000.
