Over the years I have discussed thyroid antibodies with patients and how it relates to their fertility. When suggested to some physicians that these should be tested due to various studies about thyroid antibodies and fertility issues, I have heard them say, "Not worth the time or money. If TSH is normal, then thyroid antibodies can't be elevated."
But now, to my pleasant surprise in the New York Times there was an article by a prominent doctor in the United States that has been studying the relationship of thyroid antibodies to fertility issues for years. Apparently he sees in a certain percentage of patients that the thyroid antibodies can be elevated with normal TSH and seem to be correlated to miscarriage as well. His conclusions have been the same conclusions in several studies around the world.
How they treat this issue in one study out of Italy, I believe, was with thyroid medication, i.e. thyroxine. This treatment changed the miscarriage rate of those with elevated thyroid antibodies to similar numbers seen in women who do not have thyroid antibodies. So a huge difference was made through this treatment.
However, its important to look at other reasons for elevated thyroid antibodies and address those to not only improve fertility but to optimize thyroid health for the future. If thyroid antibodies are present for a long period of time (i.e. if the body continues to make antibodies which attack the thyroid, a disease called Hashimotos) then the thyroid is likely to fail and need medical support for life or in some cases the thyroid is surgically removed. So if you can do things to avoid surgical removal and the failure of the thyroid why not atleast try.
Other areas that should be assessed and addressed along with or instead of utilizing thyroid hormones like thyroxine, are diet and adrenal health.
It is common for gluten sensitivity or gluten intolerance i.e. Coeliac Disease to be associated with elevated thyroid antibodies. So if your antibodies are elevated, make sure you remove gluten from your diet.
It has also been demonstrated that adrenal insufficiency and thyroid antibodies are associated with one another. Your adrenals sit on top of your kidneys and help you respond to stress. But too much emotional and or physiological stress can take its toll on these endocrine glands. Therefore supporting and promoting optimal adrenal health with stress management, herbs and other nutritional supplements is extremely important in improving thyroid health, cardiovascular health and fertility as well as post partum health too.
If you haven't had them already, have the thyroid antibody tests (there are 2 or 3), TSH, FT4, and FT3 to assess thyroid function and a morning serum cortisol test to begin to assess adrenal function. If these levels are on the middle to bottom half of the normal range then further tests would be warranted OR if you are fine in the morning and exhausted by the middle of the day then further assessment of adrenals through saliva tests are also warranted.
Remember your cortisol levels are associated with your progesterone levels (this is true of thyroid hormones as well). Therefore even if you don't have elevated thyroid antibodies if your progesterone levels are not optimal or the lining of the uterus is thin, the thyroid and adrenals should be assessed and addressed if needed.
By improving the health of the thyroid (in both men and women) you can improve fertility, decrease the risk of postpartum depression and decrease the risk of cardiovascular disease in the long term. Sounds like a good plan to me.
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