Latest / Finally Get Pregnant Naturally: Holistic Fertility Support To Conceive Naturally and Stay Pregnant After Miscarriage / #255 | The Overlooked Thyroid Link to Your Fertility Struggles and Recurrent Miscarriage, Plus Why You Can't Get Pregnant When Your Thyroid Labs Are "Normal"

Transcript

#255 | The Overlooked Thyroid Link to Your Fertility Struggles and Recurrent Miscarriage, Plus Why You Can't Get Pregnant When Your Thyroid Labs Are "Normal" · Finally Get Pregnant Naturally: Holistic Fertility Support To Conceive Naturally and Stay Pregnant After Miscarriage

• 0:00
  Katie: In this episode, you will discover the thyroid gap that is quietly linked to infertility and miscarriage that most fertility workups never catch.
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  Welcome to the Finally Get Pregnant Naturally podcast, the podcast helping women identify the real reasons you haven't conceived or stayed pregnant so you and your partner can finally grow the family of your dreams.
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  I'm your host, Dr.
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  Katie Wood.
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  Let's dive in, shall we?
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  Katie: Three things you'll gain from today's episode: why a TSH in the normal range does not mean your thyroid is functioning at optimal levels to support conception and a healthy pregnancy, the piece of the thyroid picture that is almost
• 0:46
  Katie: never tested and is directly linked to miscarriage risk, and what a complete functional thyroid assessment looks like and what to ask for so you're not leaving this piece of your fertility on the table.
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  Katie: So let's start with the problem with, quote, unquote, "normal TSH."
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  Katie: The conventional reference range for TSH So when I say conventional, I mean if your doctor is ordering you some labs and you go to Quest or LabCorp or anything like that, and you get your labs drawn, and then
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  Katie: you get your paperwork back, you're gonna have your result and then a reference range.
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  Katie: So the conventional reference range for TSH, or thyroid-stimulating hormone, runs roughly from 0.4 to 4.
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  Katie: That is a wide window, and if your result falls anywhere inside that wide window, your lab report will not flag it as low or high.
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  Katie: It will say that it's normal.
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  Katie: Your doctor will tell you that your labs are normal, and we'll move on.
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  Katie: Sometimes, when I'm talking with people on my DMs or my clients and I'm trying to get their lab work, people don't even see their labs.
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  Katie: Their doctors don't even share their labs with them.
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  Katie: They just take their word for it that everything looks normal and move on.
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  Katie: It's kind of wild to me.
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  Katie: But for fertility, that range is not the right target.
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  Katie: Reproductive endocrinologists and functional practitioners who work specifically with women trying to conceive generally agree that TSH should sit between about 0.8 to 2 for optimal fertility and pregnancy maintenance.
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  Katie: Some would say it should be even tighter than that.
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  Katie: A TSH of 3.5 will pass every conventional lab range because it's going to fall within normal.
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  Katie: It will not pass a fertility-optimized range.
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  Katie: And a TSH sitting in that gap between normal and optimal is associated with difficulty conceiving, impaired implantation, and increased miscarriage risk.
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  Katie: This is the first gap.
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  Katie: Your TSH was not flagged because it cleared a reference range that was never built with fertility optimization in mind.
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  Katie: So let's also talk about the elephant in the room about what TSH alone cannot tell you.
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  Katie: TSH is a signaling hormone, the problem is most providers are just testing for TSH.
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  Katie: That's why we're having this conversation right now.
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  Katie: So TSH is a signaling hormone.
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  Katie: It tells your thyroid to produce more hormone.
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  Katie: But what actually matters for your cells, your eggs, your uterine lining, and your early pregnancy is what your thyroid is actually producing and converting, and TSH alone cannot tell you that.
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  Katie: A complete thyroid picture includes free T4, the storage form of thyroid hormone, and free T3, the active form that your cells actually use, and reverse T3, which is the inactive form your body produces under chronic stress that competes
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  Katie: with free T3 and blocks it from doing its job.
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  Katie: We like to think of reverse T3 as like pumping the brakes So a woman can have a TSH that looks acceptable on paper, a free T4 that looks acceptable, and a reverse T3 that's actually elevated from chronic stress
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  Katie: blocking her active thyroid hormone from reaching her tissues, including her ovaries and her uterus.
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  Katie: And that pattern will not be caught by a TSH level alone.
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  Katie: And sadly, this thyroid picture is not rare.
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  Katie: It's actually pretty common.
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  Katie: And then let's talk about the antibody piece that most Western medicine doctors are not checking.
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  Katie: This is the part of the thyroid conversation that I find most consistently missing from fertility workups, and it is the part with the most direct link to miscarriage risk.
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  Katie: So thyroid antibodies, specifically TPO antibodies and thyroglobulin antibodies, are markers of autoimmune thyroid disease.
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  Katie: Hashimoto's thyroiditis is the most common form, and here's what the fertility literature has consistently shown.
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  Katie: Elevated thyroid antibodies are associated with increased miscarriage risk even in women whose TSH is completely normal.
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  Katie: So women who are not diagnosed with hypothyroidism Because the immune system is mounting a response against the thyroid, and that immune activation appears to affect early pregnancy in ways that go beyond thyroid hormone levels alone.
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  Katie: Antibodies are rarely included in a standard fertility workup.
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  Katie: They are not part of the standard recurrent pregnancy loss panel unless your TSH may be flagged or you specifically ask, which means a woman can have autoimmune thyroid disease quietly running in the background contributing to miscarriage risk, or
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  Katie: she's already experiencing a miscarriage after miscarriage, and she's just being told her thyroid is fine because her TSH was never flagged as a problem.
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  Katie: So I wanna be clear about the evidence here because I was very transparent about this in last week's episode on the updated recurrent pregnancy loss guidelines.
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  Katie: The conventional ASRM guideline does not recommend routine antibody testing because RCTs have not shown that treating euthyroid or women with normal TSH that have elevated antibodies consistently improves outcomes.
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  Katie: That is their current evidence base.
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  Katie: What I will say as a pharmacist and a functional practitioner is that knowing your antibody status informs your full picture of what your immune system is doing, even when it does not automatically dictate a specific treatment.
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  Katie: It is a star of your fertility constellation picture, right?
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  Katie: Just one star.
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  Katie: And for the woman looking for answers, it's absolutely hands down, without a doubt, a piece worth investigating.
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  Katie: So let's talk about what you should actually be asking for.
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  Katie: If you want a complete thyroid picture as it relates to your fertility, here is what a functional assessment includes: TSH with the understanding that the fertility optimal target is zero point eight to two point zero, not simply within
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  Katie: the conventional lab range on your lab report.
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  Katie: Free T4, the storage form ideally in the mid to upper range.
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  Katie: Free T3, the active form your cells use, optimal range is about three to four.
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  Katie: And reverse T3, often elevated with chronic stress, blocks active T3, and commonly missed.
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  Katie: And then of course, we want the TPO antibodies and thyroglobulin antibodies, which are markers of autoimmune thyroid activity worth knowing regardless of your TSH status.
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  Katie: You want these to be negative or undetected.
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  Katie: And asking your doctor to run these is not an extreme ask by any means.
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  Katie: These are very accessible and inexpensive tests.
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  Katie: And for the woman trying to get pregnant or who has experienced loss and is looking for answers, having the full picture is worth having the conversation and advocating for yourself with your provider or someone who is willing to
• 9:09
  Katie: help you out, like myself.
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  Katie: So the full thyroid picture is one of the first things I assess with my clients inside Fertil as a Mother because it sits at the intersection of hormones, immune function, and miscarriage risk in a way that conventional care
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  Katie: consistently misses and overlooks.
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  Katie: If you've been struggling to get or stay pregnant and you are ready to have someone to look at your complete fertility picture, head to the show notes and you'll find a link to book your free fertility strategy session.
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  Katie: On this call, we'll look at your journey and pinpoint what's actually getting in the way so you can finally get answers and start moving toward the family you desire.
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  Katie: So book your call now.
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  Katie: The link is in the show notes.
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  Katie: And to recap, a TSH in the normal lab range is not the same as a thyroid that is functioning at the level your fertility actually needs.
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  Katie: The fertility optimal TSH target is .8 to 2, significantly tighter than the conventional reference range.
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  Katie: TSH alone cannot tell you whether your active thyroid hormone is reaching your tissues, whether reverse T3 is blocking it, or whether your immune system is quietly attacking your thyroid even while your numbers look fine.
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  Katie: The full picture includes free T3, free T4, reverse T3, and thyroid antibodies, and of course, TSH.
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  Katie: If you've been trying to get pregnant or have experienced miscarriage and nobody has run this panel yet, you are working with an incomplete picture.
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  Katie: It's time to ask for it or reach out to me on Instagram and let's chat.
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  Katie: The link to my Instagram is in the show notes.
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  Katie: And I just wanna thank you so much for being here and listening and sharing this episode with anyone that you think could benefit from it.
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  Katie: I hope you have a beautiful day, and I'll see you on our next episode, released every Tuesday and Thursday.
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  Are you ready to finally discover why you haven't been able to get or stay pregnant?
• 11:15
  The Ultimate Fertility Blueprint is a quick, insightful quiz designed to reveal your overall capacity to conceive and help you discover potential root causes and areas to address to improve your fertility so you can finally get and stay pregnant.
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  You'll find the link in the show notes.
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  As a quick reminder and disclaimer, this podcast is for educational purposes only and is not a substitute for medical advice.
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  Always consult your doctor or healthcare provider before starting any new supplement or protocol, especially if you're actively trying to conceive or undergoing treatment.