The thyroid:
- Regulates metabolism
- Supports hormone production
- Influences brain function, energy, and body temperature
- Directly impacts menstrual cycles and fertility
When thyroid function is off—too low or too high—it can disrupt the entire endocrine system.
Common Symptoms of Thyroid Dysfunction
Hypothyroidism (low thyroid):
- Fatigue
- Feeling cold
- Brain fog
- Low metabolism
- Irregular cycles
Hyperthyroidism (high thyroid):
- Feeling “amped up”
- Anxiety
- Blood sugar swings
- Weight changes
- Cycle irregularity
Any patient with hormone imbalance or irregular cycles should have their thyroid evaluated.
Comprehensive Thyroid Testing
TSH alone isn’t enough. Dr. Sarah recommends checking:
- TSH
- Free & total T4
- Free & total T3
- Reverse T3 (when indicated)
- Thyroid antibodies (TPO & TG)
Optimal TSH for fertility and women’s health: 0.5–2.5, even if labs report “normal” up to 4.5.
Thyroid Antibodies & Autoimmune Disease
Positive antibodies indicate:
- Hashimoto’s (underactive thyroid)
- Graves’ disease (overactive thyroid)
Even with normal TSH and T4, antibodies can:
- Progress to thyroid dysfunction
- Increase miscarriage risk
- Disrupt fertility and hormone balance
Supporting Thyroid Function
Nutrition is first-line therapy:
- Iodine
- Selenium
- Zinc
- Magnesium
- Vitamin D
Correcting deficiencies may normalize function before medication is needed.
Medication & Long-Term Strategy
- Levothyroxine (T4) is the most common medication
- Take on an empty stomach; absorption is sensitive to fillers and brands
- Medication can often be temporary as blood sugar, stress, and sex hormones normalize
- Hyperthyroidism evaluation may include antibodies and ultrasound
Hashimoto’s Management
- Anti-inflammatory nutrition, stable blood sugar, and adequate protein/fats
- Selenium (Brazil nuts), iodine (seaweed), magnesium (greens & seeds)
- Gluten/dairy restriction only if antibodies are high and response is measured
- Supplements and medications are used strategically to reduce antibodies and prevent flares
Thyroid & Fertility
- T4 is preferred for conception; T3 does not cross the placenta
- Low T3 is addressed by improving T4→T3 conversion, reducing stress, and optimizing nutrition
Key Takeaways
- Thyroid health is foundational to hormones and fertility
- TSH alone is not enough
- Thyroid antibodies must be checked
- Nutrition is first-line therapy
- Medication can be temporary
- Hashimoto’s can improve with consistent care
- Long-term management prevents flares
Next Steps
If you’re struggling with fatigue, brain fog, irregular cycles, or unexplained fertility challenges, a comprehensive thyroid evaluation can be transformative.
