Underactive and Overactive Thyroid – What is the Difference and How Can it Affect Your Fertility?
Thyroid disorders are characterized by a dysfunction of the thyroid gland, a small, butterfly-shaped gland in your neck responsible for producing hormones involved in metabolism regulation. The thyroid produces two hormones, triiodothyronine, known as T3, and thyroxine, known as T4. Hyperthyroidism is an overproduction of these hormones, and hypothyroidism is an underproduction of them.
Thyroid disorders correlate with infertility by affecting both the ability to conceive and carry a pregnancy to term. Untreated thyroid disorders disrupt ovulation by disrupting normal progesterone production. The most obvious sign of progesterone deficiency will be either longer or shorter menstrual cycles, heavier or lighter bleeding, or longer or shorter bleeding durations. The disruption in this cycle means that a fertilized egg will be unable to complete the implantation process.
Graves’ disease is the most common form of hyperthyroidism. Untreated hyperthyroidism can cause infertility. In women, lighter and irregular periods are often the result. High levels of thyroid hormones can increase the risk of miscarriage and premature birth. Hyperthyroidism in men can result in low sperm counts. Thyroid disorders are considered autoimmune disorders. Due to this characteristic, even with treatment to maintain normal hormone levels, there are often antibodies that create residual inflammation. This inflammation can cause difficulty with egg fertilization and implantation.
Hyperthyroidism is treated with diet, exercise, and medication. Extreme, unresponsive cases are sometimes treated with surgical intervention, using radioactive iodine. During pregnancy, antithyroid drugs are often reduced to their lowest effective dose to avoid harming the baby. High blood pressure, miscarriage, low birth weight, and pre-term birth are all risks of pregnancy with untreated hyperthyroidism. Women with hyperthyroidism must be followed closely by their doctor, both before and after pregnancy.
The most common form of hypothyroidism in women is the autoimmune condition Hashimoto’s Thyroiditis. In hypothyroidism, frequent, heavy menstrual cycles and disrupted ovulation are common. Fatigue, soreness, cold intolerance, and weight gain are other symptoms of hypothyroidism.
Levothyroxine, or thyroid hormone replacement, is the first-line treatment for these disorders. In contrast to hyperthyroid medications, which are decreased during pregnancy, hypothyroid medications are often increased. Without a sufficient supply of thyroid hormones to the baby, there are often miscarriage or pre-term birth complications. Thyroid hormone levels will need to be monitored during pregnancy and postpartum.
A condition called postpartum thyroiditis can occur in 5-10% of pregnancies. This condition usually manifests between 6-12 weeks postpartum, with symptoms of hyperthyroidism. It is usually a self-resolving condition but occasionally turns into hypothyroidism as the body attempts to return the hormones to normal levels. Treatment with levothyroxine for 6-12 months resolves the condition in most patients. One-third of women with postpartum thyroiditis will need to stay on levothyroxine long-term.
Thyroid conditions can complicate conception and pregnancy, but it is important to note that many women with thyroid disorders have healthy babies. It is important to work with a thyroid specialist to optimize your chances of a positive outcome.
Contact me for acupuncture treatment of the thyroid.
Research has shown that acupuncture treatment may specifically help in thyroid disease by:
- Increasing free thyroxine (FT4) and free tri-iodothyronine (FT3) levels in hypothyroidism (Xia 2012; Hao 2009; Hu 1993);
- Decreasing serum tri-iodothyronine (TT3), total thyroxine (TT4), free T3 (FT3) and free T4 (FT4) levels and increasing supersensitive thyrotropin (S-TSH) levels in hyperthyroidism (Li 2006);
- Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
- Increasing the release of adenosine, which has antinociceptive properties (Goldman 2010);
- Improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling;
- Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007);