The intricate workings of the immune system sometimes lead to the production of thyroid antibodies, unintentionally targeting the thyroid gland. This immune response, known as thyroid autoimmunity (TAI), goes beyond affecting just thyroid hormone levels. It significantly influences ovulation, fertility, and increases vulnerability of early pregnancy loss. This blog aims to uncover the complex connection between thyroid antibodies and reproductive health.

 

Thyroid Antibodies, Fertility & TTC:

Thyroid peroxidase antibody (TPO) and thyroglobulin antibody (TgAb) are the cardinal markers of thyroid autoimmunity, signifying an autoimmune assault on the thyroid gland. Emerging research indicates a noteworthy association between TAI and fertility issues, particularly among women grappling with “unexplained (in)fertility” (is it really unexplained?) and polycystic ovary syndrome (PCOS). Moreover, studies suggest correlations between thyroid autoimmunity and conditions such as premature ovarian insufficiency (POI) and endometriosis, further underscoring its intricate role in female reproductive health.

Thyroid antibodies mess with how oestrogen works in the body, affecting fertility. Importantly, women facing fertility challenges may have higher levels of thyroid antibodies. A study released in 2019 showed that thyroid antibodies can actually be present in our blood, prior to the onset of thyroid hormone disruption.

What does this mean?

You know when you are told thyroid has been tested and “everything is fine”? Well,  I’m here to tell you, it usually hasn’t and its often not. Medical convention is to test TSH (thyroid stimulating hormone) and if you’re lucky, T4 to check thyroid function. Or dysfunction. Unfortunately TSH is not testing your thyroid function though. TSH is literally testing your brains communication with your thyroid, telling it to make more or less thyroid hormones.

T4 is the inactive one of two thyroid hormones. Yup, it’s inactive.

Hardly a fair measure of thyroid function then.

T3, our active thyroid hormone, yep the one you actually want to know its level as it is the one that does everything, is seldom tested. And god forbid you should have your thyroid antibodies or Reverse T3 tested.

 

252 Days:

Now, heres where is gets interesting.  Thyroid antibodies can be in our blood up to 252 days prior to the onset of thyroid dysfunction. So, nothing actually wrong with the thyroid yet, and nothing showing in the bloods that would cause alarm (because only TSH has been tested), but still the presence of thyroid antibodies. The problem? Thyroid antibodies cause their own problems, beyond thyroid function . They affect fertility, they affect oestrogen & ovulation, they lead to early pregnancy loss, preterm birth, and preeclampsia. Thyroid dysfunction during pregnancy can also impact foetal development and increase the risk of developmental problems in the baby.

If you are trying to conceive, preparing to conceive, going through IVF, PLEASE have your thyroid antibodies checked. I pretty much always recommend a complete thyroid check. Always. 

Understanding the role of these thyroid antibodies is crucial, especially for those undergoing assisted reproductive treatments (like IVF). If we catch these issues early and take specific actions, it might just help improve your chances of conception. 

 

Thyroid Antibodies in Pregnancy:

Pregnancy is your thyroids greatest stress test.

For those who successfully conceive, the impact of thyroid antibodies continues into pregnancy. Having these antibodies has been linked to problems during pregnancy, like not having enough thyroid hormone (hypothyroidism) and a higher chance of early pregnancy loss. A fascinating thing is that the levels of thyroid antibodies change as the pregnancy goes on, underlining how important it is to check them early.

Pregnancy involves a lot of body changes, including more iodine leaving the kidneys, increased proteins that carry thyroid hormones, more production of thyroid hormones, and the thyroid-stimulating effects of hCG hormone. All these changes make traditional thyroid tests like TSH and FT4 a bit tricky, as the normal ranges can vary a lot among different groups of people.

In adherence to guidelines laid out by the American Thyroid Association, testing for TPO antibodies during pregnancy becomes imperative, reflecting the broader recognition of the potential impact of thyroid autoimmunity on maternal health and foetal well-being. The complexity of hormonal changes during pregnancy underscores the necessity of understanding and addressing thyroid antibodies to mitigate potential risks and optimise outcomes.

Reference: PMID 131467701

I understand the interconnected dynamics between thyroid antibodies and reproductive health equips me with a more nuanced approach to patient care. Beyond the usual check of thyroid hormone levels, acknowledging the wider impact of thyroid autoimmunity allows for personalized interventions, targeting not only the symptoms but the underlying immunological imbalances. Collaborating with conventional medical practices becomes crucial, as it provides a comprehensive and integrative strategy to support women navigating the intricate landscape of thyroid autoimmunity and its effects on fertility and early pregnancy.

If you’re seeking guidance, I invite you to consider the opportunity to work together for a holistic and tailored approach to your reproductive health journey. BOOK AN APPOINMENT WITH ME AT MY CLINIC