Let's cut straight to the chase - I can’t tell you how often I see thyroid dysfunction being ignored, misdiagnosed, or simply brushed off. I've had multiple clients who have suffered through years of infertility or multiple miscarriages, only to find out that their thyroid health was way out of whack, despite GP tests being classed as 'normal'. If you feel like you've tried everything but you're still not having any luck conceiving, it's time to double check your thyroid.
So what is the thyroid exactly and why is it important for fertility?
You could think of your thyroid, a small butterfly-shaped gland at the base of your neck, as your body's very own thermostat - it controls energy, metabolism, and hormone balance. In short, thyroid health affects nearly every organ in your body.
So, when the thyroid is not functioning properly, it can throw everything off - including your fertility. Poor thyroid function has a profound effect on hormonal balance and can:
disrupt ovulation, making it harder to conceive
lead to irregular or absent menstrual cycles
lower progesterone levels, which are needed to support early pregnancy
affect embryo development and implantation
increase the risk of miscarriage
Even mild thyroid imbalances, sometimes called 'subclinical' imbalances, have been linked to fertility struggles and pregnancy complications which is why it's so important to get the right testing (more on that later) and support.
How can you tell if your thyroid is out of balance?
Thyroid issues come in two main forms: hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid), although the latter is much more rare.
The importance of testing
Many conventional thyroid tests tend to only check TSH (thyroid-stimulating hormone), T3 and T4, but this alone does not give a full picture of thyroid function. If you suspect a thyroid issue, especially if you are trying to conceive, it's essential to request a comprehensive thyroid panel that includes the following markers:
TSH (thyroid-stimulating hormone) – produced by the pituitary gland, TSH tells the thyroid to make more hormones. High TSH can indicate hypothyroidism (underactive thyroid), while low TSH can suggest hyperthyroidism (overactive thyroid). However, TSH alone is not enough to assess thyroid function properly
Free T4 (thyroxine) – this is the storage form of thyroid hormone. It needs to be converted into active T3 for the body to use. Low free T4 may indicate hypothyroidism
Free T3 (triiodothyronine) – the active form of thyroid hormone that regulates metabolism, energy, and body temperature. Low free T3 can contribute to symptoms of hypothyroidism, even if T4 levels are normal
Reverse T3 (rT3) – a less active form of T3 that can block active T3 from doing its job. High rT3 levels may indicate stress, inflammation, or chronic illness affecting thyroid function
Thyroid peroxidase (TPO) antibodies & thyroglobulin (TG) antibodies – high levels of TPO antibodies can indicate the presence of autoimmune thyroid disease
In addition to testing thyroid hormones and antibodies, it's important to also test a range of key cofactors. Thyroid cofactors are essential vitamins and minerals that support thyroid hormone production, conversion, and function. Deficiencies in these nutrients can contribute to thyroid dysfunction and fertility challenges:
Iron – iron is crucial for the conversion of T4 into active T3. Low ferritin levels can impair thyroid function and lead to symptoms like fatigue and hair loss
Vitamin D – helps regulate the immune system and supports proper thyroid function. Deficiency is common in people with thyroid issues
Selenium – plays a key role in reducing thyroid antibodies and converting T4 into T3
Zinc – necessary for thyroid hormone production and immune health. Low zinc levels can contribute to sluggish thyroid function and hair thinning
Magnesium – supports thyroid hormone production, conversion, and cellular function
Iodine – a key building block for thyroid hormones, but should be used cautiously in autoimmune thyroid conditions
B vitamins (especially B12 and B9) – support energy metabolism and thyroid hormone activation
Not all tests will include all of the markers but testing a minimum of TSH, T3, T4, autoimmune antibodies, iron, B12, B9 and vitamin D can give a great overall picture of thyroid health as a starting point.
Natural ways to show your thyroid some love when TTC
Ok so your thyroid panel has come back suboptimal. Want the good news? There are plenty of ways to nourish your thyroid and help restore balance naturally.
Eat a nutrient dense diet
Foods to include regularly for a healthy and happy thyroid:
Iodine (seaweed, iodized salt, dairy, fish). Iodine is essential for thyroid function but be mindful that it needs to be consumed with caution if there is an autoimmune picture
Selenium (Brazil nuts, sunflower seeds, eggs)
Zinc (pumpkin seeds, beef, lentils)
Iron (red meat, spinach, quinoa)
Vitamin D (oily fish, olive oil, avocado, nuts, seeds, eggs)
B Vitamins (whole grains, eggs, leafy greens)
Reduce thyroid disrupting factors
Switch tap water to filtered water
Avoid storing, heating or freezing food and drinks in plastic - opt for glass or stainless steel instead
Switch to natural household cleaners and personal care products
Avoid synthetic fragrances like scented candles and room sprays
Keep your blood sugar steady
Eat protein, healthy fats, and fiber at every meal (check out my healthy plate guide here)
Reduce sugar and refined carbohydrates as much as possible. If you fancy a sweet treat, try to have it after a meal to negate its effects on your blood sugar
Avoid skipping meals and include small healthy snacks if necessary
Manage your stress levels
Chronic stress can contribute to a rise in reverse T3, a thyroid hormone that can block active thyroid hormone and with that affect thyroid function. Try to include daily ways to manage your stress such as meditation, journaling, breathwork or nature walks
Aim for 7-9 hours of high-quality sleep. Poor sleep has been linked to stress, disrupted hormone balance and impaired blood sugar control
Love your gut bugs
Include fermented foods such as kefir, kimchi or sauerkraut to promote a healthy gut microbiome. A good quality probiotic supplement counts too!
Include lots of prebiotic foods daily - prebiotic foods such as onion, garlic and leek, feed the beneficial bacteria in our gut and thereby promote a healthy environment
So what next?
If any of the symptoms mentioned in this article have resonated with you, it's time to take a closer look at that thyroid! Because with the right testing, nutrition, and lifestyle changes, you can learn to support your thyroid health naturally and improve your chances of a healthy pregnancy. Get in touch today, I'd love to help you!
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