What is Thyroid and what does it do?
The thyroid is a butterfly-shaped gland in the front of the neck which produces two thyroid hormones known as T3 and T4.
There is a pituitary gland in the brain which releases Thyroid Stimulating Hormone (TSH). This TSH regulates/controls the release of these thyroid hormones.
These thyroid hormones are required for metabolism and proper working of the female reproductive system including the uterus and ovaries.
What is hypothyroidism?
Hypothyroidism is when the thyroid gland is not functioning adequately and is producing less thyroid hormone than what is required by the body.
Subclinical hypothyroidism is where TSH is more than the upper limit of normal range but T 4 is normal.
What are the features of hypothyroidism?
If you are suffering from hypothyroidism you may have
- Weight gain
- Dry Skin
- Intolerance to cold
You may have irregularities in your periods with cycles becoming heavier and less frequent
- Low energy
- Easily getting tired
- Difficulty in conception
- Complications during pregnancy
What causes hypothyroidism?
Hypothyroidism is most commonly caused due to autoimmune diseases. Autoimmunity is when our body’s immune system attacks parts of our own body with antibodies and damages it; for example, the cells in the thyroid gland are destroyed causing it to function less.
Deficiency of iodine in the diet can lead to enlargement of the thyroid gland (goiter) and hypothyroidism. Other causes may be due to radiotherapy for cancers of head and neck, any previous surgery of thyroid.
Those who have diabetes or other autoimmune diseases or a family history of the same; or are obese or used some medicines like amiodarone, lithium, etc. are also at more risk to develop hypothyroidism. In some cases, the cause of hypothyroidism is not known.
How do we test for hypothyroidism?
We test for hypothyroidism mainly by testing for TSH. The levels of TSH are raised in case of hypothyroidism which means the thyroid gland is producing less T3 and T4 hormones and so the pituitary releases more of TSH to the prod thyroid gland to make more hormones.
We can also check the levels of T3 and T4 hormones. Autoantibodies produced by our body against the thyroid gland can also be checked if present or not and their levels.
How does hypothyroidism affect fertility or the ability to get pregnant?
Women who have regular periods release one egg from either ovary every month. Hypothyroidism can interfere with the process of egg formation and release causing irregular periods and difficulty in conceiving.
Hypothyroidism can also affect the development of the embryo causing repeated miscarriages. If you get pregnant and have untreated hypothyroidism, you may have complications like miscarriages, preterm labor, the baby may have low birth weight and the child’s mental faculties may be affected.
Because of these reasons, if you are trying to conceive the doctor will try to maintain your TSH in the normal or low normal range.
Does hypothyroidism affect fertility in males also?
Hypothyroidism can affect men also though less commonly than women. Hypothyroidism in men can affect sperm motility and volume and decrease their libido and decrease male fertility hormones. So if present hypothyroidism should be treated in men also.
How is hypothyroidism treated?
A medicine known as Levothyroxine is given most commonly to treat hypothyroidism. This tablet has to be taken once daily empty stomach in the morning. After 4-6 weeks blood tests are done to check if you are taking medicine in the right dose and is there any need to adjust the dose.
Hypothyroidism can’t be treated or cured naturally but the dose requirement of medicine can change over a period of time. So you need to be in regular follow up with your doctor as advised very 3- 6 months.
What you can do to help is eat regular healthy meals, do some sort of physical activity, try to maintain your weight in the normal range for your height and reduce your stress by doing some meditation, etc.
Around 10 % of the world population suffers from hypothyroidism and 4-8 % of women in reproductive age may have subclinical hypothyroidism.
So if you suspect you may have hypothyroidism or if you are planning to conceive, it is best to consult your doctor and get yourself tested to rule out thyroid disease. It is an easily correctable problem.