Latest / Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease / 185 // Hashimoto's and Fertility: How Thyroid Antibodies Affect Conception and Miscarriage Risk [Interview with Dr. Grace Charles]

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185 // Hashimoto's and Fertility: How Thyroid Antibodies Affect Conception and Miscarriage Risk [Interview with Dr. Grace Charles] · Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease

• 0:00
  Hashimoto's often starts during the three Ps, puberty, pregnancy, and perimenopause.
• 0:05
  That is why I am so excited for this interview today.
• 0:08
  I have Dr. Grace Charles. She is a naturopathic fertility doctor,
• 0:12
  and she's going to talk to us all about Hashimoto's autoimmune problems and
• 0:17
  pregnancy and fertility in general.
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  This is probably one of my favorite interviews that I have done yet,
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  and I am so excited for you to listen.
• 0:26
  As far as the good, better, best gut stuff.
• 0:29
  We'll come back to that next week. Welcome to the health with Hashimoto's podcast.
• 0:32
  This is where you will find clarity and simple, sustainable strategies to feel better.
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  I want to help you figure out your root causes.
• 0:41
  My name is Esther Yunkin. I am a registered nurse. I know how exhausting it
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  is to live with fatigue, brain fog, and the ups and downs of Hashimoto's. And that is why I'm here.
• 0:51
  I'm here to cut through the confusion and to give you practical steps.
• 0:56
  Support your body, calm your immune system so that you can regain your energy
• 1:00
  and feel like yourself again. I have Dr.
• 1:02
  Grace Charles here with me today. She is a naturopathic fertility doctor who
• 1:07
  helps women uncover the why behind infertility, especially when thyroid or autoimmune
• 1:13
  issues are part of the picture.
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  After years of watching women get told, just keep trying, or push straight into
• 1:19
  IVF, she developed her root cause fertility formula, which is a systematic approach
• 1:24
  to finding and fixing what's really going on.
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  She has helped hundreds of women conceive naturally by addressing the underlying
• 1:31
  issues like Hashimoto's, PCOS, and nutrient deficiency before jumping into expensive treatments.
• 1:38
  Dr. Grace, welcome to the Health with Hashimoto's podcast. Tell us a little bit about yourself.
• 1:44
  Oh, thank you so much for the great introduction. I think you said it.
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  My job is to help women and couples understand why they haven't gotten pregnant
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  naturally before investing in IVF.
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  I work a lot with women who have the diagnosis of unexplained infertility.
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  And my deliverable is getting them an explanation for what's going on and why it hasn't happened yet.
• 2:06
  And I'll tell you, for a lot of those women, it's Hashimoto's.
• 2:11
  Yeah. So on the podcast before, I've mentioned that a common time that women
• 2:16
  develop Hashimoto's is the three Ps.
• 2:19
  It's puberty, pregnancy, and perimenopause.
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  Being that you are a fertility expert, will you talk about that pregnancy piece
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  and the hormone changes and why Hashimoto's develops and then what can we do about it?
• 2:32
  Absolutely. And it's something that I see in my practice really frequently,
• 2:35
  especially with women who are trying for their next child.
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  So we call that secondary infertility. When baby number one was just no problem.
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  And then three or four years later, couples are wondering why baby number two hasn't come.
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  And it's often because of that second P during pregnancy, these hormonal shifts
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  that change the thyroid cascade, change the way the immune system is working,
• 3:00
  and can trigger Hashimoto's.
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  We see it especially, I catch it often in the postpartum period,
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  when women are having especially difficult postpartum periods.
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  That's when I'm really pushing them to say, make sure we're getting the thyroid
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  antibodies tested, because this is the time that we're going to see it.
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  And then the effects of those antibodies and the effects of the thyroid dysregulation,
• 3:22
  especially if it hasn't been caught, can change fertility altogether.
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  And I'd love to walk you through the ways that fertility and thyroid really overlap.
• 3:33
  Yeah, let's do that. You can kind of take that one at a time because it's a big topic.
• 3:39
  It is very big. There are three main ways. And the first way is,
• 3:45
  and growing a little bit of biochemistry, I hope that's okay with your listeners.
• 3:48
  When TSH is elevated, and we all know about this one, when TSH is elevated,
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  something called TRH, thyroid releasing hormone, is going to pick up on the
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  fact that thyroid function is low and downstream.
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  And it goes up. And when TRH goes up, something called prolactin goes up.
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  Prolactin is a hormone that when that's up, it's going to suppress FSH and LH.
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  And those are really important hormones for fertility. Those are the ones that
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  ripen the egg and release the egg.
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  They're the brain telling the ovaries to ovulate.
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  So when those are low, we see poor ovulation because the egg hasn't ripened
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  sufficiently and we're sending out kind of an underripe egg.
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  Or the ovulation doesn't happen at all. So we see anovulatory cycles.
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  So this pathway, this high TSH causing poor to no ovulation,
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  that gets caught pretty frequently by conventional medicine.
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  Because that's when somebody goes to their gynecologist and says,
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  I haven't gotten pregnant and we've been trying for a year.
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  That's one of the tests they will run. They will run TSH.
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  So that one usually gets caught. If TSH is above 2.5, the gynecologist says,
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  well, here's some thyroid hormone to correct this.
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  And sometimes that's all it takes because that's the pathway that is being affected.
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  Now, another way that thyroid can affect fertility is that there are thyroid
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  receptors inside the follicle.
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  There are TSH receptors and there are thyroid receptors.
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  The thyroid receptors are for a thyroid hormone called T2.
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  We don't talk about T2 a lot because we can't test for it.
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  T3 turns into T2. We can test for T3. So we assume if a T3 is robust,
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  if there's enough T3 there, then we're going to have to assume that there's enough T2 there.
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  But conventionally, we're not testing for T3. So if you have a good TSH and
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  maybe they've tested for T4, T4 is good too, we're not going to catch this low
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  thyroid in the follicle.
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  And that thyroid is very important because it also helps the development of the egg.
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  The right amount of thyroid getting into the follicle and stimulating the uva,
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  then we're going to, again, have poor quality ovulation.
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  And then the third pathway is more specific to Hashimoto's.
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  So there are those TSH receptors and thyroid receptors inside the follicle.
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  And there's also tons of TSH receptors in the endometrium.
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  So if there's a thyroid, if there's any sort of antibodies,
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  autoimmune at work, attacking these thyroid hormones,
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  attacking the thyroid hormone receptors, attacking the TSH receptors,
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  and that's what Hashimoto's is, it's happening in the wall of the uterus where
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  the zygote goes to attach and become that pregnancy.
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  So we'll see in women with Hashimoto's, because of the inflammation and the.
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  Autoimmune activity in the wall of the uterus that we're seeing miscarriages
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  or just infertility in general.
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  So those three columns are really what we're, we want to make sure we're looking
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  at all three when it comes to thyroid and infertility.
• 7:00
  Wow. That's, I didn't know a lot of that. Thank you for explaining it.
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  And it's like, I read about pregnancy and the chance of miscarriage and infertility
• 7:11
  related to thyroid, but nobody has explained it in that way.
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  So thank you very much for explaining that to my audience. Of course.
• 7:20
  Yes. So what would somebody do if, number one, they're not getting pregnant,
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  and then number two, if they actually get pregnant, but they're miscarrying?
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  Would that be the same thing that both people are going to do?
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  Are there are two different approaches.
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  Well, I think step one applies to everyone, and that's get the full thyroid panel done, right?
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  Let's find out what the TSH is. That's super important for that first column.
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  Let's find out what the free T4 and the free T3 is, very important for egg development.
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  And let's run all the antibodies and see what the status is there.
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  Now, your listeners, I think they already know they have Hashimoto's,
• 7:58
  so this isn't a big reveal to them.
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  But knowing your antibody numbers can be very helpful because it gives us a
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  starting point, a baseline of how we're going to go down from there and pull those antibodies down.
• 8:09
  I think there's kind of two parts.
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  There's so many parts to Hashimoto's care, but there's two parts to Hashimoto's
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  thyroid care, which is one, let's get the numbers right.
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  So let's use what's available to us to.
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  Get the TSH below a 2.5. I like it
• 8:27
  a little bit below a 2 for my fertility patients. We keep it really tight.
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  We want to get the T4 above a 1. We want to get the T3 well above a 3.
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  So we prescribe or support until those numbers are right.
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  And then we have to do the work of how do we get the antibodies down.
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  For a lot of women coming into my clinic, Hashimoto's is a big reveal diagnosis.
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  It's, I didn't know I had this. Nobody's ever checked.
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  But even if somebody comes in with the diagnosis of Hashimoto's,
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  my job then is to go even further and say, well, why do you have Hashimoto's?
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  What's the root cause of the autoimmune disease?
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  Something is telling the immune system to go ahead and attack your own body.
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  So we have to identify that and treat that.
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  And if we can get to that level of work, we will see those antibodies go down
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  and fertility improve. Thank you.
• 9:21
  So the main thing I'm hearing is you could do something if you're so much to do.
• 9:29
  And you, I mean, you, you guys speak about this on your, you speak about this
• 9:32
  on your podcast all the time of all the different systems that we need to consider
• 9:36
  when we're looking at Hashimoto's.
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  Because, I mean, as I said, the women who are listening, they have Hashimoto's.
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  They know that the thyroid is an issue, the immune system is an issue.
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  And they know that there are so many other places in their health that they
• 9:53
  can start improving that will have this effect on improving the thyroid and
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  the immune system. Yeah.
• 9:59
  So let's go back to when somebody is pregnant, maybe first pregnancy or second
• 10:06
  pregnancy, and developing Hashimoto's?
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  You said you often find it in the postpartum period.
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  What would be things that they're looking for, symptoms that they're observing,
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  that would tell somebody, I need to pay attention to my thyroid,
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  this might be happening?
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  What I see the most is scary thoughts postpartum.
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  And that's an odd answer, I know, and that's what I've seen clinically.
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  I don't have a ton of studies to back this up, but I.
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  Depression, postpartum depression, postpartum anxiety, these are kind of blanket
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  terms, and they can include a lot of symptoms.
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  But specifically what I'm looking for is hearing somebody say,
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  I worry about the baby so much, I worry about the crib breaking in the middle
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  of the night. Or what would happen if I drove off the road?
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  Or the dark thoughts that can come along with postpartum anxiety and depression.
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  So that for me is a real red flag symptom.
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  But anything in that realm of not being able to sleep, and that's a tricky one
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  because babies is why you can't sleep usually. But sometimes baby's sleeping
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  and you're not. That's a symptom.
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  Feeling grumpy, feeling tired that can't be explained by your lack of sleep,
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  feeling like just like the mental fog.
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  Those are things we're looking for. Oh, as you're talking through that,
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  I'm thinking back to my third baby, postpartum.
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  I'd never had any problems driving, and all of a sudden, postpartum,
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  him, I had this irrational fear every time a semi was driving by me,
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  especially like passing me or going the same way, like.
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  All of the physical symptoms of anxiety, semis, I just had this irrational fear.
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  And after our third baby, I had my first miscarriage.
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  I was not diagnosed with Hashimoto's at that time. And so I wonder if maybe
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  during my third pregnancy, that was it for me.
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  That was your second P. Yeah.
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  And in talking to my husband and on this Hashimoto's journey,
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  learning all about it, doing, you know, 170, 200 podcasts.
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  Like, I've never been able to pinpoint when I probably got it.
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  But listening to your stuff, I'm like, maybe that was it. Could be.
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  And that's my certain, like, if a friend tells me that someone who's not in
• 12:31
  my patient base, right, if somebody mentions that kind of thinking,
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  I'm like, go to your doctor, make them test your thyroid antibodies.
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  Don't stop until, like, don't let, don't take no for an answer.
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  Because that's usually what it is. the TSH is way off the charts,
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  and there are antibodies there.
• 12:47
  Wow. So tell us about the root cause fertility formula that you've created,
• 12:52
  because it helps women find out why they're struggling to conceive, right?
• 12:57
  Yes. So what I...
• 13:02
  What I really want to make sure women and couples understand is that we can't
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  be throwing treatments at them until we have a diagnosis.
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  That's good medicine, right? We diagnose and then we treat.
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  And especially women who are given this diagnosis of unexplained infertility,
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  that's not really a diagnosis.
• 13:22
  That's a, we haven't figured out your diagnosis yet. And they're being told
• 13:26
  to go to IVF. And that's a really big treatment.
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  So going into a big treatment without an adequate diagnosis is really step one.
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  So we've got to get these patients a diagnosis.
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  And sometimes it's Hashimoto's. Sometimes it's subfertility in the male.
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  Sometimes it's endometriosis. I mean, there's all sorts of reasons.
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  But we can find it and we can use functional testing to really get to the bottom
• 13:51
  of what's keeping them from getting pregnant or what's keeping them from staying pregnant.
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  And then our job, it's not, I'm not going to say it's easy, but once we have
• 14:01
  a diagnosis and three or four things that we need to be treating,
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  then it all kind of falls into place.
• 14:07
  Well, gosh, you've got a really big imbalance of your gut microbiota. We need to fix this.
• 14:12
  We need to treat your gut. Or you get three minutes of deep sleep a night,
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  so you're missing this opportunity to heal when antioxidants are the most active.
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  That's between 10 p.m. and 2 a.m.
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  You're not getting any deep sleep there, so you're not really accessing this
• 14:27
  very important step of keeping your reproductive health.
• 14:32
  So once we can pinpoint the issue, then we take it step by step and treat until
• 14:39
  the fertility markers improve and patients are able to get pregnant naturally.
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  And if not, they're really in a much better place, much more successful IVF outcomes.
• 14:50
  What are some of the most common things that you see with your patient population that are easy to fix?
• 14:57
  That's a great question. I don't want to sound flib here because I know what
• 15:02
  a journey Hashimoto's is.
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  But I do find that once it's identified, once we can get to the root cause of
• 15:09
  Hashimoto's, once those factors are identified, it's fairly straightforward to fix.
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  It takes time and it takes commitment, but there's a path.
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  I mean, there are steps we can do to heal that gut, to increase that deep sleep,
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  to do all the pieces here.
• 15:27
  So I think that's one that I enjoy working with because I know I'll bring those
• 15:32
  antibodies down and we'll have success.
• 15:35
  PCOS, it's another really nuanced diagnosis that is spectrum diagnosis.
• 15:43
  You can have low levels of antibodies with Hashimoto's and high levels of antibodies,
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  and symptoms don't necessarily need to match those levels of antibodies.
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  Similarly with PCOS, the symptoms and the lab presentation can be a really wide
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  spectrum of presentation.
• 15:57
  People with PCOS can all look very different from each other,
• 15:59
  from the outside and from the labs, from the inside. So that's another diagnosis
• 16:04
  that when that's what we're working with, it's, okay, we're going to work on
• 16:08
  this insulin. We're going to get rid of the inflammation.
• 16:10
  We're going to help you lose a little bit of weight if that's necessary.
• 16:14
  And we're going to get the brain and the ovaries talking to each other again.
• 16:17
  So those are a couple diagnoses that I particularly love to work with because
• 16:23
  I have a pretty strong path forward with them.
• 16:26
  And the other one is male fertility. And this is not easy to treat because it's
• 16:31
  difficult to get the men on board.
• 16:33
  Unfortunately. But it sure is easy to diagnose because with a semen analysis
• 16:38
  and some good blood work, we know if male factor infertility is an issue.
• 16:42
  Right. For a woman with Hashimoto's who's trying to get pregnant, she comes to see you.
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  What is a realistic timeline for her to expect? Like we want microwave results.
• 16:53
  We want to go see you and then the next cycle we're pregnant.
• 16:57
  We want the baby yesterday. Yeah. Right.
• 17:00
  What's a realistic timeline? And I'm so glad you asked.
• 17:04
  I work almost exclusively, not on purpose, with type A patients,
• 17:08
  women who really know what they want and are not used to not getting exactly
• 17:14
  what they want because they're good at their jobs.
• 17:17
  They're good at making their dreams into reality. So when infertility is on
• 17:24
  their plate, it can be overwhelming to my type A patients.
• 17:28
  And the timeline is probably the hardest pill to swallow.
• 17:34
  I would say six months is reasonable. Six months of care, of treatment,
• 17:39
  is probably a good average.
• 17:41
  Sometimes it takes up to eight if those antibodies are really stubborn.
• 17:45
  But if someone's really on board with the treatment plan, they're willing to
• 17:48
  make some dietary changes, they're willing to make room in their life for better
• 17:54
  boundaries, better self-care,
• 17:56
  we can usually get it done in about six months once we know what we're working with.
• 18:02
  And what's important, though, is that we're not trying during those six months.
• 18:06
  That they are taking a break from it. And that's very important for a lot of
• 18:09
  reasons, right? Because when a woman isn't getting pregnant every cycle,
• 18:15
  there's no disconnecting from that.
• 18:16
  Because every time they get a period, they're reminded. Every time they have
• 18:19
  a symptom of PMS, it could look a lot like an early pregnancy symptom, they're reminded.
• 18:23
  Every time they ovulate, every time they're gearing up for ovulation, it's unending.
• 18:28
  So taking them off of that period.
• 18:31
  Roller coaster can be very helpful for their mental health. But we also don't
• 18:35
  want the pregnancy to end in a loss.
• 18:37
  We want the pregnancy to be the baby, the healthy baby.
• 18:41
  And for Hashimoto's, I try not to give patients the green light to start trying
• 18:47
  again until we've really gotten to the root cause and healed a lot of these systems.
• 18:52
  So it's a six to eight month timeline.
• 18:55
  Okay. That is very good to know. So tell us how people can work with you and
• 19:00
  how they can connect with you?
• 19:02
  Oh, great. Yes. You can connect with me with a free call. I'll talk to anyone.
• 19:07
  Talk to anyone. I love talking about fertility. I do it all day long.
• 19:10
  And if you hop onto my website, drgracecharles.com, drgracecharles.com,
• 19:17
  you can just click a link and get on my schedule for a free call.
• 19:21
  That's mostly how I reach out to people. I'm not super active on social,
• 19:25
  and there's a reason for that.
• 19:26
  And I know my patients are, my future patients are there, but I really don't,
• 19:30
  I really don't love it. I don't want my patients there.
• 19:32
  So I don't do a ton of outreach via social. So my old-fashioned approach is my website.
• 19:40
  That's awesome. And did you have a freebie?
• 19:44
  Oh, yeah, yeah, yeah, of course. If you type in drgracecharles.com slash today,
• 19:50
  you'll get a list, really detailed list, 10 things you can do today to improve your fertility.
• 19:57
  And it goes through all sorts of great ideas that you may not have thought about yet.
• 20:02
  Perfect. I will have that link down in the show notes so everybody can just scroll down and click.
• 20:07
  If the listener is like, this was a lot of information, all fantastic,
• 20:11
  but I'm a little overwhelmed. What is one thing you want her or him to remember
• 20:17
  from our conversation today?
• 20:19
  Great question. And it is overwhelming. And it's a lot of biochemistry that
• 20:23
  you don't need to know necessarily.
• 20:25
  I think the one takeaway is that we can treat it.
• 20:31
  And if you are someone with Hashimoto's
• 20:33
  who's struggling to get or stay pregnant, there's hope for you.
• 20:38
  Because if we can get to that root cause diagnosis of what's worsening the Hashimoto's,
• 20:43
  we can heal those systems. We can heal your reproductive function.
• 20:49
  And we can even like reverse age things and get you back to fertile.
• 20:53
  So if you have Hashimoto's and you're struggling with pregnancy,
• 20:58
  there is a path forward for you. is what I'd like you to know.
• 21:04
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• 21:07
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• 21:10
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• 21:14
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