Let’s talk about the the link between the Hashimoto’s and fertility. If you’re reading this you might be thinking about trying, actively trying, or struggling to conceive. And regardless of which category you fall into, understanding that link between your Hashimoto’s/ thyroid hormones and fertility is key.

Underactive thyroid in itself is known to cause problems with conception and when we throw Hashimoto’s autoimmune inflammation into the mix, things can become really complicated.

I wanted to highlight here, that if you’re reading this and you’re unsure whether you have Hashimoto’s or not, I would test ASAP. Up to 90% of hypo cases are due to Hashimoto’s and it’s imperative to know whether your thyroid condition is of an autoimmune origin when trying to conceive.

Research consistently highlights the correlation between Hashimoto’s and fertility issues. Women with untreated or inadequately managed Hashimoto’s have a higher risk of experiencing difficulties conceiving, increased miscarriage rates, and complications during pregnancy.

Understanding the Mechanisms

The autoimmune nature of Hashimoto’s plays a pivotal role in fertility challenges. The immune system’s assault on the thyroid gland not only affects thyroid hormone production but also triggers inflammation and disrupts other hormonal pathways essential for reproductive health.

Elevated levels of antibodies targeting the thyroid, such as anti-thyroid peroxidase (TPO) antibodies can lower your egg count, slow down release of the egg from the ovary, and cause difficulty with fertilisation and implantation.

The good news is that once you know what you’re dealing with and the levels of autoimmune inflammation, there’s a lot you can do to support your fertility and increase the chances for successful, healthy pregnancy.

I also wanted to mention here that I have worked with many women with thyroid issues who managed to sustain healthy pregnancies despite with a Hashimoto’s diagnosis so please do know it’s absolutely possible, it just requires a little more strategic approach.

Here’s what I recommend you look into if you’re trying to conceive with Hashimoto’s:

1. Reduce the antibodies

AKA consider an autoimmunity healing protocol BEFORE TTC. The first thing I recommend you address is the autoimmunity itself. The aim is of course remission or significant lowering of your antibodies count.

And as this step takes some time I would plan for at least 6 months of actively working on your antibodies levels before trying to conceive.

This step required a multi level approach: finding out and addressing your unique root cause of the autoimmunity identifying any food intolerances like gluten and dairy via a gentle elimination protocol, healing the gut, lowering inflammation via blood sugar regulation, supporting detoxification pathways and regulating the nervous system (high/ imbalanced cortisol can drive the antibodies up).

Supplementation with selenium, ashwagandha and aloe vera juice, as well as near infrared light therapy can also be helpful (research backed).

Working with a nutritional therapist like myself will help you navigate all the stages of the healing protocol and a tailored supplementation plan.

If your GP is not willing to test for antibodies (and you want to test for both Anti Tg and Anti TPO), please know this is something you can easily test yourself at home, using a finger prick test. Medichecks and Blue Horizon labs are both a a great and affordable options.

2. Optimise your thyroid hormones

Optimising you thyroid hormones levels and TSH is key to conceiving and sustaining a healthy pregnancy. What you want to look into is how your T3 is doing not only T4.

T3 is the active thyroid hormone- about 80% is converted from the inactive T4 (levothyroxine is a synthetic form of T4), and research studies have linked low T3 levels and increased anti TPO antibodies with a lower follicle count.

How to increase your conversion and support optimal T3 levels?

Focus on a balanced diet rich in nutrients like selenium, zinc and magnesium which are the key thyroid cofactors and needed for the conversion to happen.

Conversion mostly happen in the liver and gut so supporting a diverse gut microbiome (probiotics, fermented foods, polyphenol rich foods like berries) and opening detox pathways is key (think green leafy veggies, bitter foods, sweating, dry brushing, castor oil packs)

3. Look into your sex hormones

Hashimoto’s is linked with several sex hormone imbalances like PCOS, Oestrogen dominance and low progesterone. These imbalances have an effect on how easy it is to conceive (at the end of the day all hormones are a part of a broader endocrine web of hormones).

So you are experiencing irregular periods, heavy flow, bad PMS symptoms.. it time to check what exactly is happening with your hormone levels. From a functional perspective I often run a DUTCH (Dried urine testing for comprehensive hormones) for my clients that gives in insights not only into your progesterone and oestrogen levels but also their metabolites (super important when diagnosing the oestrogen dominance), daily cortisol patterns, androgen hormones and melatonin levels

Tracking your cycle will also be useful to pinpoint the exact ovulation phase- temperature tracking is useful here. I use and recommend Ours ring but there are various other options available.

4. Nervous system regulation

I wouldn’t be myself if I didn’t talk about the nervous system!

Chronic stress leading to high or imbalanced cortisol levels affect the ovarian function and lowers the likelihood of getting pregnant.

If you find yourself waking up tired, struggling with energy crashes in the afternoon, feeling constantly wired but tired or feeling demotivated and unable to take action – it’s a sign the your nervous system needs some love.

When our body gets stuck in a dysregulated stress response (like fight or flight or freeze) it prioritises survival and puts other less immediately important ‘tasks’ (like healing or making babies) on a back burner.

Working on increasing our resilience to stress is much more impactful than trying to avoid the stress entirely. Learning self regulation practices like breath work (google physiological sigh breathing!), mediation and vagus nerve stimulation exercises would be a a good place to start.

For some talking therapy might be a good idea, or, especially if you’re dealing with unresolved traumas from the past that might be hindering the healing, looking into modalities like EMDR or hypnotherapy.

In addition to that prioritising rest, saying no to overcommitting yourself, respecting your energy levels, and avoiding over exercising will support your journey back to regulation.

5. How optimal is your nutrient status?

I touched on it briefly above, but nutrient deficiencies are very common with Hashimoto’s and hypothyroidism. The common deficiencies include vitamin D, ferritin and total iron, folic acid, and B12. You can run all these tests via your GP.

To prevent and address these imbalances you can of course supplement but prioritising a varied, well balanced diet is key. You can improve bioavailability of nutrients (nutrient absorption is often a problem in hypothyroidism) from the diet by chewing properly, having some ACV in water before meals or supplementing with digestive enzymes.

6. Prenatal supplementation!

Consider staring prenatal supplementation at least 3 months before TTC.

As a foundational TTC protocol I recommend to my clients a well balanced pregnancy multi with methylated form of B vitamins, prenatal probiotic and an omega 3 high in DHA (crucial for the brain development).

Hope you found this Hashimoto’s and Fertility article useful! If you ever need support on your journey or you just want to hear more from me, you can find me on Instagram.