How To Master Your Thyroid Hormones Before Pregnancy

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Feeling sluggish lately? Wearing several layers of clothing when your partner is shirtless? Why is your hair falling out?! These are signs that you’re not producing enough thyroid hormone. This is commonly due to an immune system attack on your thyroid gland, making it difficult for it to work properly. It’s called “Hashimoto’s Thyroiditis”, an autoimmune condition that is very common in women (1 out of 8), especially between the ages of 20 and 40.

If you’re thinking of having a baby, been trying for awhile, or worst yet, you’ve experienced miscarriage(s), getting your thyroid thoroughly checked is a must - even if you’re not having symptoms! However, it’s important to know that there are a lot of mixed opinions on how to test and treat. Many doctors miss the boat when it comes to making sure you have the right amount of thyroid hormone on board so you can get pregnant, stay pregnant, and have a healthy baby.

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Catch me up & give me the basics

The thyroid gland is the metabolic workhorse that follows signals given by the brain. The hypothalamus, a small organ in the brain, secretes Thyroid Releasing Hormone (TRH), which signals the pituitary gland to secrete Thyroid Stimulating Hormone (TSH). TSH then tells the thyroid gland, located in the front of the neck, to make thyroid hormone. These hormones are known as T4 and T3. The hormone T4 is inactive and is converted into the active hormone T3 by tissues throughout the body, like the liver.

Specific enzymes are needed to make active thyroid hormone. One enzyme converts ingested iodine to a usable form in the body and other enzymes, called “deiodinases,” are needed to convert T4 to active T3. The minerals selenium, iron, zinc, and iodine are all essential players in optimal thyroid function. That’s one important reason to ensure you’re taking a high-quality prenatal supplement that has enough of these minerals to support your natural thyroid hormone production. You can see our top recommendations on our online store.

What does thyroid have to do with making a baby?

Thyroid hormone is essential for life. It stimulates the growth of tissues and controls metabolic rate and heat production. A fetus depends on the mother’s thyroid hormone for the first 24 weeks, a little over half of the pregnancy term. The fetal brain develops rapidly between weeks 12 and 22 of gestation, which means that optimal thyroid hormone from the mother is essential for fetal brain development. 

Hypothyroidism in pregnancy has been shown to increase the risk of miscarriage, placental abruption, and lower IQ scores in children.  Subclinical and autoimmune hypothyroidism is associated with unfavorable effects during pregnancy, such as preeclampsia, miscarriage, and pre-term birth. In addition, one study indicated decreased intelligence and motor scores in children of women with low thyroid hormone production. A meta-analysis revealed that hypothyroidism was associated with an increased risk of unexplained subfertility. Although the exact mechanism is unknown, studies have revealed thyroid hormone disorders disturb the development of ovarian eggs, sperm, and the fertilization process.

The best way to test & treat

When you’re planning to conceive, having enough thyroid hormone is so absolutely essential that it’s important to test for any dysfunction, not just full-blown hypothyroidism. We want you to ask for a full thyroid panel with antibodies to see if you have the autoimmune condition (elevated antibodies confirms this). The tests to ask for are: TSH, Free T4, Free T3, TPO and TG antibodies.

It’s recommended to treat with replacement thyroid medication when the TSH is over 2.5 (some experts like to see it under 2.0), positive antibodies, or when clinical signs coincide with basal body temperatures below 97°F.  The starting dose is typically 25mcg or 50 mcg of Levothyroxine (Synthroid), a synthetic form of T4. It’s important to retest every 4-6 weeks to ensure you’re at the correct dose. If TSH is below 2.50, but Free T3 is at the low end or out of range, this may be a signal that your liver is not converting T4 into active T3 efficiently. In this case, a more functional approach is needed, but medication may still be helpful to increase available T3.

Dr. David Berger, MD, author of From Preconception to Infancy: Environmental and Nutritional Strategies for Lowering the Risk of Autism, states that,

“Women with true hypothyroidism and those with positive antibodies (especially those with consistently low basal body temperatures under 97°F) should receive consideration for thyroid hormone supplementation and be closely monitored during both pregnancy and lactation.”

It’s important to keep in mind that medication can’t fix an underlying autoimmune condition. Autoimmunity is often a result of poor gut health, which may be caused by food sensitivities, infections, stress, or many other factors. When a women experiences one autoimmune condition, she’s at a much higher risk for developing another one, especially after pregnancy when the body has been through the trauma of childbirth. We recommend taking steps now to heal and seal the gut to minimize your risk and optimize your health - not only for you, but for your future child! The first step we recommend is completing a stool test. Find out why here.

Are you healthy enough to get pregnant?