It took me 18 months to finally see a positive pregnancy test. I didn’t understand for those first 12 months that getting pregnant with Hashimoto’s Disease would be a difficult journey. I was 36 going on 37, a bit older to have a baby but not that old. My thyroid antibodies were coming back high in blood tests and TSH around 3 but i didn’t suspect at the time that this was the reason. Something was wrong and I had to fix it. After some research, I learned that Hashimoto’s is a leading cause of infertility and likely cause of miscarriage. IVF could be an option but what if my Hashimoto’s diagnosis still prevented me from getting pregnant even with IVF? And if I got pregnant, what if Hashimoto’s became the cause of a miscarriage?
IVF with Hashimoto’s
IVF slowly became a last resort for me once I read that the hormones associated with chemical pregnancies had repercussions for the mother post delivery including longer recovery times and higher incidences of postpartum depression, not to mention the costs both financially and emotionally for everyone involved. If the answer was IVF in the end, fine. But it made more sense to get a grip on the Hashimoto’s aspect first and then maybe the pregnancy stuff would follow. I wanted to see if getting pregnant with Hashimoto’s naturally was possible. It finally happened.
Read this first: What I Did To Cure Hashimoto’s Naturally.
Disclaimer: I am not a doctor, nor do I have formal training in medicine. This is my personal experience with putting Hashimoto’s into remission, increasing my chances of getting pregnant with Hashimoto’s, as well as avoiding miscarriage. After consulting with numerous doctors (both conventional and integrative), I learned to question everything and be my own advocate. This article is for educational purposes and not intended to be used as a substitute for medical advice. Always consult with your health care professional.
Infertility, Pregnancy, Hashimoto’s Thyroiditis and PCOS
It started becoming very clear to me that Hashimoto’s and hypothyroidism is linked to infertility and a wide range of scary pregnancy issues. Turns out that many women with Hashimoto’s have PCOS (polycystic ovarian disease), trouble conceiving, higher incidences of miscarriage, higher incidences of babies with low birth weight, a risk of premature labor, higher incidences of gestational diabetes, trouble producing breast milk, preeclampsia and potential to have babies with lower IQ if thyroid hormone is inadequate and untreated during pregnancy. The list goes on and on. But why hadn’t I heard about this before?
Many doctors are uninformed about the links between infertility and both Hashimoto’s and/or hypothyroidism. The American Thyroid Association (ATA) issued new guidelines in 2017 for the diagnosis and management of thyroid diseases during pregnancy and the postpartum period. The guidelines finally cover topics concerning thyroid antibodies, pregnancy complications and lactation. The document also addresses where TSH ranges should be in each trimester and that women with thyroid antibodies or high TSH readings should be tested at least every 4 weeks throughout their pregnancy. TSH should be below 2.5 in the first trimester. Would you believe that many doctors don’t know about proper TSH ranges because they haven’t read the new guidelines? And think everything is okay if your TSH is below 10?!?!
Steps I took to Increase Fertility with Hashimoto’s
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If you’re having fertility issues, the list below is exactly what I did to improve my fertility. It is supplemental advice to what your doctor has already recommended i.e. hormone testing, temperature and ovulation testing, etc etc.
Step 1: Take Folate (not folic acid) and/or a B complex vitamin immediately
Folic Acid is not the same as Folate. Women with Hashimoto’s can have issues absorbing folic acid, it can even be detrimental in high quantities. Folic Acid is a synthesized version of vitamin B9 that is added to processed foods and commonly used in supplements. You need to take it in the methylated, bioavailable form, Folate. Try these brands. I’ve used both.
Step 2: Take a good prenatal vitamin
You probably have nutrient deficiencies if you have Hashimoto’s Even though you may not be pregnant yet, get your body geared up with a good prenatal vitamin. Again, finding a brand that has the methylated, bioavailable forms of the vitamins is important. The supplements should also be free from fillers like soy or gluten. I highly recommend taking either of these.
Step 3: Avoid alcohol and limit caffeine
It’s a bummer, I know. And maybe you’ve heard it before and thought it was an old wives tale. But there is truth to it. Alcohol can affect ovulation and lengthen the time it takes to get pregnant. In women with Hashimoto’s, drinking alcohol is even worse. It can cause thyroid hormone levels to plummet and stimulate immune responses. As for caffeine, it can have a negative impact on your adrenal glands and cortisol production. Remember everything is interconnected. All systems should be at optimal function when trying to get pregnant. The slightest thing may throw you off balance.
Step 4: Supplement with Thyroid hormone
If you read What I did to Cure Hashimoto’s Naturally, you’ll know that I did not take any prescribed medication to get my labs in range and reduce my symptoms nor do I endorse taking Levothyroxine or Synthroid. However for fertility sake, I started taking Natural Desiccated Thyroid (NDT). My functional doctor did comment that I had moderate tissue damage (following a thyroid ultrasound), enough to warrant supplementation of thyroid hormone. He told me that many women with Hashimoto’s had successful pregnancy outcomes with NDT. I finally agreed to a prescription.
Whether NDT was the final piece in the puzzle or not, I don’t know. What I do know is that my body had been prepped for months with healthy eating, good supplementation, stress management and plenty of sleep. I am 100% positive that all of it had a big role to play in my fertility.
Step 5: Avoid High Glycemic Index Foods
We know that Hashimoto’s and inflammation are without a doubt linked. And that many women with Hashimoto’s suffer from Polycystic Ovarian Syndrome (PCOS) which is a leading cause of infertility. Did you know that sugar causes inflammation in your body and weakens your immune and hormonal systems? And that sugar will worsen both Hashimoto’s and PCOS? You don’t have to do a strict no carb or excessively low carb diet, some complex carbohydrates like sweet potato in moderate amounts are good for you. But you should definitely avoid high glycemic foods.
High glycemic index foods spike your blood sugar levels quickly. It can be the root cause for all chronic diseases including PCOS and Hashimoto’s. So avoid the following:
Step 6: Light to Moderate Exercise
I don’t advocate heavy or intense exercise when you’re trying to heal with Hashimoto’s. But I do recommend light activity. Brisk walks and a little weight training can work wonders. I waited four months before I hit the gym on my healing journey. First I started with diet, stress management, high quality supplementation and lots of sleep. Then I moved to a heavier physical routine. But don’t overdue it. Long running stints and high impact aerobics can cause inflammation in our bodies.
Step 7: Avoid endocrine disruptors
I’ve said it before and I’m saying it again. Get rid of the plastic bottles and containers and stop cooking with teflon pans. The thyroid is hugely sensitive to these endocrine disruptors. And if your thyroid is not functioning optimally, it might greatly affect your fertility. Cook in cast iron pans and use glass storage containers!
Step 8. Be careful with Clomid
Clomid is an ovulatory stimulating drug prescribed to many women with fertility challenges. It helps stimulate ovulation by tricking the body into thinking it has less estrogen than it actually does, therefore stimulating an increase in both FSH and LH. It is the most commonly used fertility drug as it can be prescribed by a gynecologist and not just a fertility specialist. Clomid, however, can wreak havoc on women with Hashimoto’s. I, myself, do not have any experience with this drug. But I thought it worth mentioning since so many women with Hashimoto’s in the groups I’m in have complained about “death-bed” type symptoms after taking it. It also set back their fertility by months.
Getting Pregnant with Hashimoto’s and What to Do Right After!
Congratulations! You’ve gotten a positive result… not always an easy feat to get pregnant when you have Hashimoto’s Thyroiditis. Now listen up, the steps you take in the following days and weeks could make a huge difference in the outcome of your pregnancy.
Seriously Consider Taking Progesterone via Vaginal Suppositories
I took progesterone twice a day for the first 12 weeks of my pregnancy. My gynecologist, who coincidentally suffered from thyroid and PCOS issues in the past, agreed with my research that progesterone can indeed prevent miscarriage in the early weeks of pregnancy when the risk is highest, especially for women with Hashimoto’s or hypothyroidism. Topical creams and pills taken orally do not have the same effect as progesterone taken vaginally. There tends to be spikes of the progesterone in your system and then a quick tapering off with these methods so vaginally is best. Also your liver will break down the progesterone whereas, with a suppository, your body will use what it needs and secrete the rest through discharge.
Make sure that you are taking a natural form of Progesterone. Topical cream progesterone is made from wild yams, so it is synthetic. The real stuff will say progesterone on the label as opposed to a synthetic alternative with a different name. Also, talk to your doctor about dosing. Some women may need higher doses. My labs were actually in range for progesterone as well as other sex hormones (FSH/LH/AMH, estradiol/estrogen) but I opted to take progesterone anyway for my pregnancy. Real progesterone will help lower inflammation in your body and can aide with adrenal fatigue and cortisol production. Note I am not endorsing randomly taking progesterone at any time. This step might just be one of the most important during your pregnancy however.
Take blood tests every 2-3 weeks
You must monitor your thyroid labs often, especially during the first 25 weeks of pregnancy. The baby is completely dependent on you for thyroid hormone in your first trimester. And I think it’s a good idea to keep on top of your levels for longer than that. After 25 weeks, monthly tests should be okay. Essential thyroid blood tests while pregnant include Free T4, Free T3, TSH, TPOab, TGab. The last two are thyroid antibody tests which hopefully you’re familiar with by now if you have Hashimoto’s.
Antibody levels are very important. High antibody levels indicate your body is ready for attack. The last thing you want is your immune system attacking your thyroid or a healthy fetus.
If your antibody levels are are not in range, consider supplementing with Selenium and Zinc but make sure to check how much is already present in your prenatal vitamin as you don’t want to exceed maximum daily limits.
Your Free T4 and Free T3 levels should be in optimal range (upper quartile of the range) if possible. Sometimes this can be difficult to achieve but the aim is to try and get there. TSH should be in the pregnancy ranges recommended by the American Thyroid Association. If you are taking NDT, TSH will most likely be suppressed. My TSH was less than 0.02 my whole pregnancy because of NDT. Make sure it is above 0.0 however.
Reverse T3 generally should have a ratio of 20:1 with Free T3.
Increase thyroid medication as needed
Based on the above, you and your doctor will determine medication increases when necessary. I increased my NDT (Natural Desiccated Thyroid) dosage by half a grain 5x during my pregnancy. The first time was immediately following my positive result, even before getting a blood test. the second time was 3 weeks later. The first weeks are especially crucial. I was pregnancy tired but could tell that my levels were not optimal when I got thyroid tired. There’s a difference and you’ll know. Blood tests would confirm that my Free T3 and Free T4 fell and I would immediately up my dosage. So keep on top of your labs.
Remember adequate thyroid hormone is critical for your baby’s neural/brain development.
Baby needs Iodine
I avoided iodine like the plague when I set out to cure my Hashimoto’s naturally. Remember, iodine can be very helpful for people with hypothyroidism, but not necessarily for people with autoimmune Hashimoto’s Thyroiditis as it can trigger an immune attack. But in pregnancy, it’s a different story. Your baby needs iodine for their healthy thyroid development. Make sure your prenatal vitamin has the recommended daily dose. The two I have recommended above and used myself do. And if its any comfort, Mom’s immune system is somewhat suppressed in pregnancy. I didn’t suffer any Hashimoto’s attacks when taking the iodine during pregnancy.
A Note About Post Pregnancy Thyroiditis
Don’t forget that pregnancy can be a root cause for Hashimoto’s Thyroiditis or be the cause for a relapse. So monitor your numbers carefully post pregnancy. A system reboot may very well be in order.
Here’s my baby boy. I delivered last month 🙂 These were taken 1 week post delivery.
Curious About My Pregnancy and Birth Experience in Italy? Click here
I wish you the best of luck on your fertility and pregnancy journey. Please feel free to ask me any questions below.