Case study : Hypothyroid Annie*

Meet Annie, 34 years

Annie and her partner had been casually trying for a baby for around 3 years. As a result of testing, which is always part of an initial consultation, Annie’s thyroid hormones, T4 and T3, were low. Her TSH, thyroid stimulating hormone, was in range, indicating that the brain/hypothalamus was performing well, encouraging the thyroid gland to make thyroxine, T4, an inactive thyroid hormone. To make thyroxine, the thyroid needs the following nutrients -iodine, zinc, selenium, iron. All of these minerals were low, not because they weren’t available in the diet, but because they were blocked or hindered at the cellular level by heavy metals and environmental toxins.

How many women have low thyroid levels because of nutrient unavailability? Read on to learn the havoc low thyroid levels can wreak on the ovaries, undermining best attempts to conceive and have a successful pregnancy.

The relationship between hypothyroidism and the ovaries is complex, as thyroid hormones play a significant role in regulating reproductive function. Here's how hypothyroidism can affect the ovaries and overall reproductive health:

 

Menstrual Irregularities:

Hypothyroidism can lead to changes in the menstrual cycle, such as irregular periods, heavy bleeding (menorrhagia), or infrequent periods (oligomenorrhea). These irregularities can disrupt normal ovarian function making it more difficult to predict ovulation and timed intercourse for conception.

Ovulation Issues:

Thyroid hormones are crucial for the normal functioning of the ovaries, including the process of ovulation. Hypothyroidism can cause anovulation (lack of ovulation) or irregular ovulation, which directly impacts fertility.

Sexual Dysfunction:

Women with hypothyroidism may experience decreased libido, which can reduce the frequency of intercourse and thus the likelihood of conception.

Shortened luteal phase

Inadequate thyroid hormone levels can affect the luteal phase of the menstrual cycle, which is the period after ovulation. A shortened or defective luteal phase can prevent the uterine lining from properly supporting a fertilized egg, making implantation difficult.

Increased Prolactin Levels:

Hypothyroidism can lead to elevated levels of prolactin, a hormone produced by the pituitary gland. High prolactin levels can interfere with the normal secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus, disrupting the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. This disruption can inhibit ovulation and affect ovarian function.

Polycystic Ovary Syndrome (PCOS):

There is some evidence to suggest that hypothyroidism may be associated with PCOS, a condition characterized by irregular menstrual cycles, anovulation, and multiple small cysts on the ovaries. Both conditions can exacerbate each other, complicating diagnosis and treatment.

Sex Hormone-Binding Globulin (SHBG):

Hypothyroidism can lead to lower levels of SHBG, a protein that binds to sex hormones like estrogen and testosterone. Lower SHBG levels can result in higher levels of free testosterone, which can disrupt normal ovarian function and lead to symptoms like hirsutism (excessive hair growth) and acne.

General Metabolic Impact:

Thyroid hormones influence overall metabolism, energy levels, and weight. Hypothyroidism can lead to weight gain and fatigue, which can further affect reproductive health and ovarian function.

Risk of Miscarriage:

Pregnant women with untreated or poorly managed hypothyroidism have a higher risk of miscarriage, preterm birth, and developmental issues in the baby.

Apart from nutrient availability, hypothyroidism may also arise due to various other factors such as autoimmune diseases, treatment for hyperthyroidism, thyroid surgery, radiation therapy, certain medications, congenital defects, pituitary disorders and pregnancy.

As Annie had no history of thyroid health issues, the starting point for treatment was to make nutrients available within the body and support the critical thyroid nutrients through diet and supplementation. Seafood, nori, and egg yolk are all iodine-rich. Brazil nuts contain selenium, and zinc is in all foods from the soil. If there is a soil deficiency, supplementation is necessary. I always supplement zinc, as it supports stomach acid production which is critical for the breakdown of protein into amino acids, the assimilation of minerals and activation of many B vitamins.

I haven’t mentioned that tyrosine, an amino acid, is required for thyroid function. Stomach acid helps ionize minerals like iron, zinc, calcium, and magnesium, making them more soluble and bioavailable for absorption into the blood stream.