Your thyroid and your fertility Women with PCOS, endometriosis and uterine fibroids are at higher risk of having a low thyroid function than women without. (1-6). Your thyroid gland is the main metabolic gland in your body. If your thyroid is defective, it may affect your female hormones, energy levels, and weight loss will be a challenge. Imagine seven women next to each other. Each one of them reports that they have the exact same symptoms: heavy fatigue, difficulty losing weight, constipation, lack of motivation, cold hands and feet, and feeling ‘puffy’. These are all classic symptoms of a low functioning thyroid gland. However, did you know, each of these women can have a different thyroid defect? The problem is; there is a strong possibility that none of them will have had a correct diagnosis. Let me explain … Every cell in your body has thyroid hormone receptors. Low thyroid hormone leads to elevated cholesterol, triglycerides and gall stones (7). Low thyroid hormone leads to poor digestive function. There are connections between the thyroid and other hormones, such as insulin (8,9) and progesterone (1,10), linking poor thyroid function to PCOS, endometriosis, and uterine fibroids. Low thyroid hormones can impact neurotransmitters like dopamine, influencing motivation and will-power. The reality is that millions of women with a thyroid problem do not know they have a problem because of flaws in understanding the basics of thyroid physiology and in the way the thyroid is tested today. Some low thyroid symptoms include: • Fatigue • abnormal menstrual cycles depression • irritability • decreased libido. • weakness • weight gain • difficulty losing weight • dry hair and skin or hair loss • cold intolerance • muscle cramps and frequent muscle aches • constipation • memory loss (11) Problems with testing Before you get tested, you need to understand that there are two problems with laboratory testing. 1. Broad reference ranges – Ranges are created using people who go to the doctor, not healthy ones. Therefore the reference ranges are far too broad to catch minor fluctuations in thyroid physiology. 2. Non-standardized reference range – Not only is the reference range too broad, but it varies from lab to lab, and state to state, country to country. Therefore you can have a thyroid issue in one state, but not another. Thyroid physiology Thyroid physiology is complicated, but I will outline the basic foundations. There is a section in your brain called the hypothalamus that releases thyrotropin releasing hormone (TRH). This tells the pituitary gland to produce thyroid stimulating hormones (TSH), which then tells the thyroid how much hormone to produce. The thyroid gland itself puts out a number of thyroid hormones, most of it being thyroxine, otherwise known as T4. Over ninety percent of thyroid hormones produced by the thyroid gland is T4, which is considered to be a pro-hormone because it has minimal metabolic effects on the body. Triiodothyronine (T3) is the active thyroid hormone, but only seven percent is produced by the thyroid gland. The rest has to be converted from T4. The majority of thyroid hormones produced by the thyroid are bound to a protein (thyroid binding globulin) to transport them around the rest of the body. At some point in their travels, T4 is converted to T3 in many tissues of the body, primarily the kidney and liver, and free T3 then gets into the cells to exert its metabolic effect. It should also be noted that twenty percent of thyroid hormone, T3 sulfate and T3 acetic acid, must be converted to active T3 by gut bacteria. What can go wrong? Getting back to the line of seven women, all experiencing the exact same symptoms, here is how they can all have a thyroid issue, but have a defect in a different area of thyroid physiology and therefore all requiring different treatment. Defect #1 – Pituitary If the pituitary is not functioning correctly, it cannot produce adequate amounts of TSH to stimulate their thyroid. This is most often due to suppression of the pituitary by the stress hormone cortisol. If you are under long-term, ongoing stress, your cortisol levels could be elevated and start interfering with thyroid function. Natural support is available to improve pituitary functioning and available from qualified natural therapists. Defect #2 – Thyroid This defect is medically referred to as primary hypothyroidism, which is the one dysfunction doctors actually look for. However, the reference range for TSH is so wide, many people with this defect will be missed. (12) Also, many people with this defect have an autoimmune thyroid condition which can be improved with targeted herbal and nutritional support. Defect #3 – Too much Thyroid binding globulin (TBG) due to oestrogen dominance If there is too much thyroid binding globulin, thyroid hormone will be bound and is unable to get into the cell. Thyroid function may be perfect, but if it’s all bound, it can’t get into the cells. This is most commonly caused by elevated oestrogen, such as seen in women with endometriosis, PCOS and uterine fibroids. (13) Herbal medicine and amino acid chelation therapy is a fantastic way to improve this defect. Defect #4 – Not enough Thyroid binding globulin (TBG) due to elevated testosterone If there is not enough thyroid binding globulin, there can be too much free thyroid hormone available for cells. While this doesn’t sound like a problem, elevated free thyroid hormone shuts down receptor sites and can therefore cause hypothyroid symptoms, despite high free thyroid hormone levels. The most common cause of this is elevated testosterone (13), for instance in women with PCOS. Balancing testosterone naturally is easy with the right knowledge and support. Defect #5 – Poor conversion due to stress If inactive T4 cannot be converted to T3, there will not be enough active thyroid hormone for cells. This can be due to a number of issues including certain mineral deficiencies (i.e. selenium), elevated cortisol or excessive oxidative stress. All of these factors can be overcome with targeted nutritional therapy. Defect #6 – Dysbiosis It is difficult to know the degree to which dysbiosis (unhealthy gut flora) can cause thyroid physiology issues. Because twenty percent of thyroid hormone is converted to active T3, if there are significant gut issues, or lack of healthy gut bacteria, there may be low thyroid symptoms. A tailored digestive repair program is available from most natural therapies clinics and can effectively restore and reverse the effects of dysbiosis. Defect #7 – Thyroid Receptor defects due to stress If thyroid hormone cannot get into the cell there will be low thyroid symptoms despite normal thyroid hormone levels in the body. Receptor site defects can be caused by elevations in cortisol due to stress or inflammation, elevated homocysteine levels or vitamin A deficiency. This is why targeted orthomolecular therapy available from naturopaths is so effective – it improves thyroid receptor function. Seven different women. Seven different issues. All resulting in the exact same symptoms. And most of the issues probably missed in the conventional medical system. What to do To be honest, I’d love to tell you what to do for each of these. But it is not as easy as that. Without proper testing and a complete assessment or updated review, it’s hard to pin down the one or two things you’ll need to do to resolve a thyroid issue. However, you must start with the first few steps. Here they are. Take a good look at the hypothyroid symptoms listed earlier in the article. If you have many of those symptoms, you may want to contact a qualified natural health care practitioner for further assessment. Next, consider getting a good blood work thyroid panel done. A good panel includes TSH, total T4, free T4, total T3, free T3, T3 uptake and thyroid antibodies (thyroid peroxidase TPO and anti-thyroglobulin TG). In the end, the thyroid is a very important gland when it comes to health and your hormones, as well as our ability to lose weight. When functioning well, you’re laughing. However, when your thyroid system isn’t functioning well, there are a lot of links in the chain that need to be examined. This research was brought to you by Narelle Stegehuis MHSc, BHSc (Naturopathy), a practicing medical herbalist and naturopath specializing in restorative endocrinology for women, with over 14 years clinical experience. She is an accomplished writer, editor and technical training advisor for the media. A recipient of the Australian Naturopathic Excellence Award, Narelle adopts an integrated approach of both medical science and traditional complementary health care principles and can be contacted at, bumpfertility.au" References: 1. Alawneh SM, Hananeh WM, AhmedD, Yarmouk, “Hypothyroidism A possible Risk Factor for Polycystic Ovary Syndrome among Jordanian Women” - Journal of Advanced Biomedical & Pathobiology Research Vol.2 No.4, December 2012, 155 -164 2. Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Strattion P, “High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis” – Hum Reprod 2002, 17:2715-2724 3. Morgante G, Musacchio MC, Orvieto R, Massaro MG, de Leo V, “Alterations in thyroid function among the different polycystic ovarian syndrome phenotypes” – Gynecological Endocrinology, 19th August 2013, (doi:10.3109/09513590.2013.829445) 4. Burney RO, Giudice LC, “Pathogenesis and pathophysiology of endometriosis” – Fertility & Sterility, Sept 2012, Vol 98, issue 3, p 511-519 5. Kim MH, Park YH, Lim DJ, Yoon KH et all, “The relationship between thyroid nodules and uterine fibroids” – Endocr Journal, 2010;57(7), 615-21 6. Sherif K, “Hormone Therapy, a clinical handbook” – Springer Science + Business Media, New York, 2013, p 93-94 7. Khan MAH, Majumder I, Hoque M, Fariduddin M, Mollah FH, Arslan MI, “Lipid profile in hypothyroid patients: a cross sectional study” – Medicine Today, 2013, vol 25, no1, 21-24 8. Celik C, Abali R, Tasdemir N, Guzel S, et all, “Is subclinical hypothyroidism contributing to dyslipidemia and insulin resistance in women with polycystic ovary syndrome?” – Gynecological endocrinology, Aug 2012, vol 28, no 8, p 615-618 9. Kapadia KB, Bhatt PA, Shah JS, “association between altered thyroid state and insulin resistance” – Journal of Pharmacology and Pharmacotherapeutics, April-June 2012, vol 3, no 2, p 156-160 10. Mancini A, Giacchi E, Raimondo S, et all, “Hypothyroidism, oxidative stress and reproduction” – Hypothyroidism – Influences and treatment, InTech 2012 11. Laws ER, Ezzatt S, Asa SL, Rio LM, Michel L, Knutzen R, “Thyroid hormone deficiency”, chapter 16 in “Pituitary disorders”, March 2013, DOI: 10.1002/9781118559406.ch16 12. De Carvalho GA, Silva Perez CL, Ward LS, “The clinical use of thyroid function tests” – Arq Bras Endocrinol Metab, 2013;57/3, p193-204 13. Mansourian AR “Female reproduction physiology adversely manipulated by thyroid disorders: a review of the literature” – Pakistan Journal of Biological sciences, 2013, vol 16, no 3, p 112-120
Posted on: Tue, 01 Oct 2013 22:47:41 +0000
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