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Thyroid

picture of a woman's neck who has hypothyroidism showing her thyroid gland and where the thyroid is located
The Thyroid Gland

Thyroid Problems 

Thyroid problems are one of the more common reasons for infertility.  These problems fall into 3 categories: overactive (hyperthyroid, Graves’ disease), underactive (hypothyroid), or Hashimoto’s disease (autoimmune thyroiditis).  I will correct these problems in different ways depending on the type and cause of the problem.

Hyperthyroid/Graves’ Disease

What is Graves’ Disease?

Graves’ disease is an autoimmune disease that results in high levels of circulating thyroid hormones.

What are the Symptoms of Graves’ Disease?

The symptoms of Graves’ disease include nervousness/anxiety, insomnia, heat intolerance, heart palpitations, and unexplained weight loss.

What Causes Graves’ Disease?

As with any autoimmune disorder, there is over-activity of the immune system.  Possible triggers for this hyperactivity of the immune system include latent or low-grade infections, food sensitivities, lack of beneficial bacteria in your digestive tract, and vitamin/mineral imbalances.

Naturopathic Treatment of Graves’ Disease

To treat Graves’ disease, we want to balance immune system function by addressing bacterial/viral/fungal infections, test for and remove food sensitivities from the diet, restore good bacteria to your gut, and correct any vitamin or mineral deficiencies.

Hypothyroidism

Being hypothyroid or having hypothyroidism means that you have an underactive or sluggish thyroid. Because the hormones that your thyroid produces regulate the function of every tissue and cell in your body if your thyroid isn’t working properly, neither will your ovaries or other glands.

What are the Symptoms of Hypothyroidism?

The symptoms of an underactive thyroid include weight gain, feeling cold, mental lethargy, hair loss, irregular periods, infertility, recurrent miscarriage, fatigue, low energy, dry skin, coarse dry hair, and/or weakness.

What Causes Hypothyroidism?

Good question!  If your thyroid isn’t working, the most obvious reason may be a lack of the right vitamins and minerals. Your thyroid gland needs iodine, selenium, copper, and tyrosine to function properly. Deficiencies of iodine, iron, selenium, and zinc may impair its function. Other nutrient deficiencies usually observed in patients suffering from thyroid disease are protein deficiencies, vitamin A, C, B6, B5, B1 deficiencies, and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium). DO NOT supplement with iodine without a naturopathic doctor’s supervision.  Too much iodine can induce thyroid nodules and/or induce/aggravate Graves’ disease. While these deficiencies do sometimes occur, the more common cause of hypothyroidism is Hashimoto’s disease.

Naturopathic Treatment for Hypothyroidism

As a naturopathic doctor, in the treatment of hypothyroidism, I would address any possible vitamin/mineral deficiencies, do blood work to determine whether there is Hashimoto’s disease, and support the rest of your endocrine system.

Hashimoto’s Disease

Hashimoto’s is an autoimmune disease, where your body is attacking and destroying thyroid tissue. Many of the patients that I see who are hypothyroid have undiagnosed Hashimoto’s. Medical doctors rarely test for Hashimoto’s as the outcome of the test doesn’t influence the prescribed medication. Naturopathically, treatment does change when an underactive thyroid is due to Hashimoto’s.  The emphasis of treatment then shifts to an approach that is similar to the approach for Graves’ disease: address all the factors that may have overstimulated the immune system causing it to attack a vital gland.

How do you test the thyroid?

The standard blood test for the thyroid is called TSH, which stands for Thyroid Stimulating Hormone. This hormone is produced by your pituitary to stimulate the thyroid gland to make its hormone, which is called T4 or thyroxine.  T4 is then converted to T3 which is the more active form of the hormone.  The normal range for TSH is 0.35-5.00 mIU/L. In infertility, TSH, free T3, and free T4 should be measured, as well as screening for anti-thyroid antibodies, anti -TPO, and anti-thyroglobulin antibodies. In infertile women with basal TSH levels of 2.5 to 5.0 mIU/L, a TRH stimulation test should also be done to detect subclinical hypothyroidism that may require treatment to improve pregnancy outcomes.  I can order some of these tests.  If they haven’t been done, they should be.

Thyroid and Infertility References

Guastamacchia E. Selenium and Iodine in Autoimmune Thyroiditis. Endocr Metab Immune Disord Drug Targets. 2015 Jun 18.

Degirmenci PB, Kirmaz C, Oz D, Bilgir F, Ozmen B, Degirmenci M, Colak H, Yilmaz H, Ozyurt B. Allergic rhinitis and its relationship with autoimmune thyroiod diseases. Am J Rhinol Allergy. 2015 Jun 10.

Merrill SJ, Mu Y. Thyroid autoimmunity as a window to autoimmunity: An explanation for sex differences in the prevalence of thyroid autoimmunity. J Theor Biol. 2015 Jun 21;375:95-100. doi: 10.1016/j.jtbi.2014.12.015. Epub 2015 Jan 6.

Okosieme O, Gilbert J, Abraham P, Boelaert K, Dayan C, Gurnell M, Leese G, McCabe C, Perros P, Smith V, Williams G, Vanderpump M. Management of Primary Hypothyroidism Statement by the British Thyroid Association Executive Committee. Clin Endocrinol (Oxf). 2015 May 23. doi: 10.1111/cen.12824. [Epub ahead of print]

Kawicka A, Regulska-Ilow B, Regulska-Ilow B. Metabolic disorders and nutritional status in autoimmune thyroid diseases. Postepy Hig Med Dosw (Online). 2015 Jan 2;69:80-90. doi: 10.5604/17322693.1136383.

Lee YJ, Kim CH, Kwack JY, Ahn JW, Kim SH, Chae HD, Kang BM. Subclinical hypothyroidism diagnosed by thyrotropin-releasing hormone stimulation test in infertile women with basal thyroid-stimulating hormone levels of 2.5 to 5.0 mIU/L. Obstet Gynecol Sci. 2014 Nov;57(6):507-12. doi: 10.5468/ogs.2014.57.6.507. Epub 2014 Nov 20.

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