Thyroid Health impacts a range of other systems in the body and the Reproductive system is no exception. At a time when optimal health is crucial for conceiving, growing and nourishing a baby, getting Thyroid health in order from the outset can make a world of difference to your own health and the health of your child.
Firstly, identifying if there are any underlying issues with the Thyroid is important, for several reasons. It’s not just women with existing conditions who need to address Thyroid health, recent studies even advocate that Thyroid screening should be extended to the overall pregnant population.(1) We believe that the preconception period is an even better time to test.
Fertility Assessment includes Thyroid screening
Preconception Care recommendations by our Naturopaths always includes screening for Thyroid disorders for several reasons since Thyroid dysfunction:
- influences the menstrual pattern directly through impact on the ovaries(2)
- can result in cycle disturbances, such as oligomenorrhea (infrequent periods) and functional bleeding.(1)
- can reduce the likelihood of pregnancy and adversely affect pregnancy outcome(3)
- when treated can reverse menstrual abnormalities and thus improve fertility(2)
- Reducing miscarriage risk
Most importantly, the screening for Thyroid antibodies (a marker for thyroid associated autoimmune disease) is part of our thorough routine investigations in the preconception period, affirmed by the fact that several studies have shown that Thyroid autoimmunity may account for the occurrence of repetitive miscarriages.(1) Early detection means that we can implement preventative strategies and create awareness with other healthcare providers from the outset, ensuring good co-management practices.
A further part of our screening process includes assessing Iodine deficiency alongside other nutrient deficiencies which are crucial for both reproductive and Thyroid health. It is well understood that iodine deficiency should be prevented by supplementing prior to conception, during pregnancy and during breast feeding as well.(1) This helps to ensure and maintain well adapted thyroid function, prevent goitre (enlargement of the Thyroid gland which may occur due to iodine deficiency) and ensure adequate thyroid hormone production of the foetus.(4)
When Thyroid Issues arise during Pregnancy
Pregnancy has a huge impact on Thyroid function in both healthy women and those with Thyroid dysfunction and the prevalence in pregnant women is relatively high(5) being the most common endocrine disorder in pregnancy apart from diabetes.(6) The main change is the increased production of thyroid hormone required, which depends on adequate dietary iodine and stability of the gland.(7) The metabolic adjustment cannot easily be reached when the functional capacity of the thyroid gland is impaired(8) especially due to iodine deficiency. Women who are on thyroxine medication for hypothyroidism often have their dose increased by up to 50% during pregnancy.(9)
Screening for both Thyroid dysfunction and Thyroid antibodies ideally in the preconception period but certainly in early gestation is recommended.(9) The good news is that Naturopathic care may prevent the imbalances from arising and can also be very supportive when they do arise.
When Thyroid Issues complicate a pregnancy
It is important to be informed, aware and understand the detrimental effects that untreated thyroid conditions can have on a pregnancy. It’s a sensitive topic but also very important to raise awareness in the hope that women can recognise the real need to be vigilant in managing good thyroid health and get the right attention and earliest intervention when required to ensure the best possible outcome. Pregnant women with subclinical hypothyroidism or thyroid antibodies have an increased risk of complications including:
- perinatal mortality(10)
- recurrent miscarriage(10)
- foetal complications including growth deficiency, premature birth, low birth weight(1)
- disturbances of brain development and low IQ(1)
It is therefore paramount that Thyroid health is addressed at all stages of pregnancy, so make sure you encourage your primary health care provider to be proactive and utilise our testing services if you need further assistance.
When Thyroid Issues occur after Pregnancy
Postpartum thyroiditis (PPT) is transient hyperthyroidism or transient hypothyroidism or often both, with most women returning to the euthyroid (normal) state by 1 year postpartum.(1) It occurs due to the reactivation of the immune system(11) 3 to 9 months after birth. Approximately 25% of women who experience PPT will develop permanent hypothyroidism in the following 10 years.(1)
We sometimes find that the root cause of Hashimoto’s can be traced back to the postpartum period. The condition can be left undiagnosed for several years while the symptoms are simply put down to being a tired and busy Mother. Sometimes it is a subsequent pregnancy when the issue is picked up. PPT is much more common in women who have thyroid antibodies during pregnancy than in those who do not have thyroid antibodies,(12) however, it is worthwhile monitoring the thyroid in the first year after giving birth to identify any issues as they arise.
Hormonal Health is our specialty
Naturopathy offers much in the way of support, education, treatment strategies and co-management of Thyroid conditions and in relation to Reproductive health it offers so much more. Diet strategies, nutritional and botanical medicine and cross referral for treatment such as acupuncture are ways in which we can strategically boost fertility alongside optimising thyroid health, ultimately resulting in positive outcomes. We welcome the opportunity to navigate your Thyroid and Reproductive health.