Getting pregnant with Hashimoto’s disease is not always easy. In fact, many women and their reproductive doctors don’t know just how connected thyroid health is with fertility. It took me almost two years to get pregnant. IVF was becoming a serious consideration. My gynecologist tested me for thyroid antibodies even though my TSH kept coming back normal. I was experiencing  classic hypothyroid symptoms like unexplained weight gain, thinning hair, fatigue, brain fog, cold hands and feet, dry skin etc. Even after finding out that my thyroid antibodies were very elevated, repeated visits to endocrine specialists proved to be futile.

I finally started researching the connection between pregnancy and Hashimoto’s disease. The findings, honestly, were a bit unsettling. 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? How was I going to get a handle on such serious issues when my own doctors didn’t know how, let alone acknowledge there was a connection between my fertility problems and thyroid.

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. It states that TSH should be below 2.5 in the first trimester when getting pregnant with Hashimoto’s disease. 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?!?!

IVF, Clomid and Hashimoto’s Disease

Before you think about going down the IVF avenue, I want you to consider a few things. One of the root causes of Hashimoto’s Thyroiditis is estrogen dominance. This can mean you have elevated levels of estrogen, low estrogen or it can mean your estrogen levels are normal but out of balance with progesterone (low progesterone). Fertility drugs like Clomid, commonly used when undergoing IVF, can exacerbate thyroid issues.

IVF slowly took a backseat 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 had to be IVF in the end, fine. But it made more sense to get a grip on healing the Hashimoto’s aspect first.

Clomid causes hyperstimulation, forcing your ovaries to make mature follicles. It does this by tricking your pituitary gland into producing more estrogen. Your endocrine system is made up of your thyroid, ovaries, adrenal glands, pituitary gland amongst other things. What you do to one component of the system will affect all the others. Taking an estrogen stimulating drug may over stimulate your thyroid and set you back not only on your fertility journey but on managing thyroid symptoms… for months.

After learning the above, I knew I had to first solve and manage my Hashimoto’s Thyroiditis and then the pregnancy stuff would follow. The last thing I wanted was to go through the emotional, physical and financial upheaval of IVF only to miscarry later, that’s if IVF was even successful for me in the first place.

Steps for Getting Pregnant with Hashimoto’s Disease

There are always a few clients who hope there is a quick fix to this or that popping a prescription will solve their thyroid and fertility problems. That is wishful thinking. While thyroid hormone supplementation can help, the truth is you must address diet and lifestyle. What you eat, how you handle stress and the supplements you take are, in my opinion, the biggest factors in your fertility success.

So here are the exact steps I took to get pregnant with Hashimoto’s disease:

Step 1. Help your liver. 

I am sure you have seen this before if you are a regular reader of my articles. The liver is responsible for a good percentage of thyroid hormone conversion. It converts the inactive form of thyroid hormone, T4, into its active and usable form, T3. It also rids your body of toxins and excess estrogen. Avoid alcohol at all costs. I promise there are other ways to destress, more on that later. Alcohol is extremely detrimental to anyone with thyroid issues and women trying to conceive. It is also estrogen producing. Read more about Alcohol and Hashimoto’s Disease.

Step 2. Do an Elimination Diet. 

You have to eliminate excess sugar. It is at the root of inflammation, unbalanced hormones and disease in general. Even too much natural sugar from fruits can be harmful to your system. Sugar elevates hormonal responses and makes issues like PCOS, fibroids and ovarian cysts worse. I was diagnosed with PCOS as a teenager and battled ovarian cysts throughout my 20s and 30s. It was when I embraced a paleo /whole foods lifestyle in my mid to late 30s did no cysts ever reappear and I finally got pregnant!!! You know what else I gave up on my fertility journey? Gluten and dairy. I am a new person, no more joint pain, fatigue, moodiness, brain fog. 

To put my Hashimoto’s disease into remission, I did something called the Auto Immune Protocol. It is an elimination diet that rids you of all inflammatory foods for a period of time. Everything from excess sugar, soy, fast foods, dairy, alcohol, coffee and more. It sounds intense but when you have Hashimoto’s disease, your body needs a real reset. My plate was filled with colorful fresh veggies and grass fed meats and good fats. Honestly, it is delicious. You slowly reintroduce foods in a phased manner. I never reintroduced gluten or processed foods. My thyroid antibodies went to 0 in less than two months. I was so taken by how the elimination diet relieved me of symptoms I had for years, that I wrote a guide on it. Here it is:

If you’re not ready to embark on the Auto Immune Protocol, here are things that you should seriously consider removing from your diet when trying to conceive. I am not endorsing a strict no carbohydrate diet. Throw in a small portion of starchy vegetable or sweet potato here and there. Strict no carbohydrate diets can inhibit thyroid hormone and send your adrenal glands crashing.  Another important note: Eat organic meat. Commercial, factory farmed meat spikes insulin and estrogen the way sugar does. Why? They have hormones that contain endocrine disruptors and estrogen mimickers! 

Step 3. Address Nutritional Deficiencies  

You most likely have nutritional deficiencies if you have Hashimoto’s disease. A linkage between intestinal permeability aka leaky gut exists for people suffering from autoimmune disease. And it’s not just autoimmune disease. Leaky gut is connected to people with autism, mental health disorders, ADHD etc etc. You get the picture. Apart from repairing your gut lining, which an elimination diet helps with, you should add back nutrients that are literally being lost through holes in your gut lining. 

If you’re not already, strongly consider a bioavailable B complex vitamin. By bioavailable, I mean methylated versions of the B vitamins. Not all supplements are equal. You’ll want to make sure they are free from fillers and free from inflammatory items like gluten, dairy and soy etc. What’s most important is that your B complex vitamin has Folate and not Folic Acid. Folic Acid is a synthesized version of B9 and added to processed foods. Women with Hashimoto’s disease don’t always absorb this. Folate is incredibly important for pregnancy.

Make sure your Vitamin D levels are in range. Vitamin D deficiency has been connected with many diseases, everything from Hashimoto’s disease to cancer. However, only supplement if you are deficient. This is a fat soluble vitamin so toxicity (above range) is not something you want.

The other thing I would start right away is a Prenatal Vitamin, not just when you get pregnant but now... while you are trying. It has a lot of the nutrients that women with Hashimoto’s disease benefit from like magnesium, zinc and selenium. Again, not all prenatal vitamins are equal. Below is my Pregnancy approved supplements on Amazon.

Step 4. Sleep and Stress Management

This step is not to be taken lightly. In fact, incorporate it from Day 1. To make a long story short, your body enters fight or flight mode when faced with a stressor. It doesn’t know about modern day stressors like work related emails, social media, a disingenuous boyfriend. Your body only knows that it’s time to conserve resources and store sugar so you can flee or fight. Secondary functions like rest, hair and nails, digestion and fertility take a back seat. You want your body to prioritize those things too. I recommend removing as many stressors as possible whether it’s toxic people or toxic situations.

However, if you cannot remove them from your life…. become an expert at managing the stress that comes along with them. Some wonderful techniques are belly breathing, deep breathing and meditation. Start out with 5 minutes a day. Work your way up to twenty minutes. You will start to see a noticeable shift in your thoughts, perception and reaction to things. Feel free to send me a message if you want some free resources.

Make sure you are sleeping at least 7-8 hours a night. Lack of sleep causes your hormones to become imbalanced and your body to crave sugar and store fat.

Step 5. Monitor Your Thyroid Labs Often

Last but not least, keep on top of your thyroid labs. You will want to ensure they are in optimal ranges for fertility and once you become pregnant! The baby is completely dependent on you for thyroid hormone well after the first trimester, you must have adequate levels or complications can occur. My levels dipped several times throughout my pregnancy and I immediately increases my thyroid hormone medication.

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 for pregnancy.  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.

Need help Getting Pregnant with Hashimoto’s Disease? Try My Program.

Send me a message if you would like more information about my fertility program.

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 and if necessary.  I increased my NDT (Natural Desiccated Thyroid)  dosage by half a grain a few times 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.

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.  Continue to take your supplements. Your baby needs a Momma who is feeling well and has energy. I seriously believe that I did not go through post partum depression or a thyroid relapse post pregnancy because I continued to monitor my gluten and sugar consumption as well as take my supplements.