Many women with thyroid and autoimmune thyroid conditions have fertility problems. And it’s also common for men to experience fertility problems as well. It’s been awhile since I’ve written about this, and so I figured I’d put together a post discussing some of the most common reasons why many men and women have problems conceiving. Although there isn’t always a natural solution to infertility, many women who at one time had problems getting pregnant and who didn’t want to consider fertility treatments such as IVF were able to conceive following some of the advice given below. In addition, while the focus is on people with thyroid and autoimmune conditions, many people suffering from infertility who don’t have a thyroid condition can also benefit from this information.
Infertility is defined as the inability to conceive after one year of regular intercourse without contraception. The prevalence of infertility is estimated between 12% and 14% and has remained stable in recent years (1). There are many different causes of infertility, but not surprisingly, many doctors overlook these causes, and as a result many couples resort to fertility drugs or IVF, which can cost thousands of dollars, and many times these methods aren’t successful. As a result of this I have listed numerous factors which can potentially cause or contribute to infertility.
1. Thyroid hormone imbalance. There is no question that having a thyroid condition can cause infertility, as many studies have shown that thyroid dysfunction can affect the male and female gonads, interferes with human reproductive physiology, reduces the likelihood of pregnancy and adversely affects pregnancy outcome (2) (3) (4). It also seems that both hypothyroid and hyperthyroid conditions can be factors. As a result, anyone with depressed or elevated thyroid hormone levels will ideally want to get this problem addressed before trying to conceive.
2. The presence of autoantibodies. Most thyroid conditions are autoimmune, and besides the thyroid hormone imbalances commonly present in Graves’ Disease and Hashimoto’s Thyroiditis, the autoimmune component of the condition is also a factor that can affect fertility. One recent study showed that there was a high prevalence of infertility among women with Graves’ Disease and Hashimoto’s Thyroiditis (5), as this specific study showed that the prevalence of infertility was 52.3% in Graves’ Disease and 47% in Hashimoto’s Thyroiditis. Some studies show that in female infertility there is a significantly higher prevalence of positive TPO antibodies when compared to controls (6). Another study showed that during the first trimester pregnant women with autoimmune thyroid conditions carry a significantly increased risk for a miscarriage compared to women without thyroid autoimmunity, even when euthyroidism (normal thyroid hormone levels) was present before pregnancy (7). A few other studies have shown an increased risk of miscarriage with thyroid autoimmunity (8) (9).
3. Problems with the adrenals/HPA axis. Obviously low progesterone can be a factor with infertility and frequent miscarriages. But many people don’t make the connection between chronic stress and hormone imbalances, even though numerous studies have shown a connection between stress and infertility. One of these studies revealed that the hypothalamic-pituitary-adrenal axis (HPA) has been shown to be an important mediator of infertility, and that the HPA axis affects the hypothalamic-pituitary-gonadotrophic (HPG) axis (10). The study shows that changes in cortisol secretion due to chronic stress will affect the HPG axis, and can play a role in infertility. Another one of these studies shows how glucocorticoids affect gonadal function at multiple levels at the HPG axis (11). What’s important to understand is that chronic stress can lead to infertility, and it’s not necessarily the stress itself which causes the problem, but instead one’s perception of the stressors. And so if someone is having problems with infertility, then they probably will want to incorporate certain mind body medicine techniques to help with this. In fact, a few studies have shown how yoga and meditation can potentially help with infertility by improving the stress response (12) (13).
4. Mitochondrial dysfunction. Most people don’t think about the mitochondria when it comes to their fertility. However, having healthy mitochondria is important when it comes to fertility. In fact, the authors of a journal article I came across discussed a “fertility diet” to help improve mitochondrial function, which in turn can help to improve fertility (14). Keep in mind that the mitochondria is where cholesterol becomes pregnenolone, and pregnenolone is the precursor to the sex hormones (progesterone, estradiol, testosterone, etc.), as well as a precursor to other hormones, such as cortisol. As a result, if someone has a progesterone deficiency, it very well might be due to mitochondrial dysfunction. One of the best methods of determining mitochondrial dysfunction is through an organic acids test, which is a urine test that looks at certain markers of the mitochondria, as well as other markers. I have put together a separate post on the mitochondria entitled “The Relationship Between Mitochondria and Thyroid Health“.
5. Nutrient deficiencies. To no surprise, having nutrient deficiencies can affect fertility, both directly and indirectly. Nutrient deficiencies can lead to some of the health issues I’ve discussed in this article (i.e. mitochondrial dysfunction), which can in turn cause infertility. But a deficiency of certain nutrients can also affect fertility. For example, in men the deficiencies of zinc and/or selenium can have a negative effect on sperm quality and cause infertility (15) (16) (17).
I’ve spoken about the importance of vitamin D in the past, but not specifically with regards to its importance in fertility. A couple of recent reviews of the literature has determined that vitamin D is involved in many functions of the reproductive system in both men and women, as it might influence steroidogenesis of estradiol and progesterone in women, and can play a role in semen quality in men and increase testosterone levels (18) (19). So this is yet another reason why you want to have healthy vitamin D levels.
6. Chronic infection. Having certain types of infections can increase the risk of infertility. In fact, as I have discussed in previous articles and blog posts, one of the infections associated with autoimmune thyroid conditions is H. Pylori. This is more common in those with Graves’ Disease, but I’ve seen some patients with Hashimoto’s Thyroiditis test positive for H. Pylori as well. And there is evidence that having an H. Pylori infection can be a factor in infertility (20) (21) (22). So if infertility is suspected then it probably would be a good idea to get tested for H. Pylori, and other infections might be a factor as well.
7. Environmental toxins. Not surprisingly, exposure to certain toxins can also decrease fertility. For example, higher blood mercury concentration is associated with both male and female infertility (23). The same source mentioned that higher seafood consumption is associated with elevated blood mercury concentrations, although keep in mind that testing for chronic exposure to mercury is more accurate in the hair and urine. Another interesting study looked at the effects of mercury vapor on fertility of female dental assistants (24). The study showed that women with high occupational exposure to mercury were less fertile than unexposed controls. However, the study also showed that women with low exposure were actually more fertile than unexposed controls. Either way, those who are dealing with infertility might want to get their mercury levels tested, perhaps using multiple sources. There is evidence that other heavy metals might play a role in infertility, including lead and cadmium exposure (25) (26) (27) (28).
I’ve spoken about xenoestrogens in the past, and since these disrupt the endocrine system it shouldn’t be surprising that there is evidence showing that these toxins can affect fertility (29) (30). Unfortunately xenoestrogens are widespread, as they are found in household cleaners and cosmetics, pesticides and herbicides, and of course in bottled water. Although it’s impossible to eliminate one’s exposure to all of these toxins, one of course can do things to help minimize their exposure to toxins, and those couples who are thinking about conceiving will want to consider doing things to help with the detoxification of these chemicals prior to conceiving.
8. Genetically modified foods. As far as I know there is no proof that eating genetically modified foods can cause infertility in humans. However, there is evidence of animals fed genetically modified crops showing complications such as early deliveries, abortions, and infertility (31). Of course even if infertility isn’t an issue I think it’s a good idea to try your best to avoid genetically modified foods, which is difficult if you eat any type of refined foods or eat out, although it’s not impossible if you become an expert in reading ingredients and also are cautious about where you go out to eat, as well as what you consume. For more information on genetically modified foods I’ve written an article entitled “The Impact of GMOs On Thyroid Health“.
9. Moderate alcohol consumption. Numerous studies show that moderate to high alcohol consumption can decrease fertility (32) (33). Some may wonder whether drinking alcohol on occasion will cause problems, such as a glass of red wine each week, or a few alcoholic beverages per month. I don’t know of any studies investigating this, but if someone is having difficulty getting pregnant it’s probably best to play it safe and avoid all alcohol.
10. Vigorous exercise. Obviously I’m not discouraging people from exercising, as doing so on a regular basis is important for optimal health. However, it seems that exercising at a high intensity for a long duration (greater than one hour per day) will affect fertility (34) (35). So while you want to exercise regularly, you don’t want to overexert yourself, and you definitely don’t want to exercise to the point of exhaustion.
11. Obesity/insulin resistance. There is plenty of evidence which shows a relationship between obesity and infertility in both women and men (36) (37) (38). Most people who are obese also have insulin resistance, which is factor in the development of PCOS, another common cause of infertility. I talk about PCOS in a different article entitled “Polycystic Ovarian Syndrome and Thyroid Health“.
12. Gluten and dairy consumption. There aren’t many studies about how common allergens such as gluten and dairy can affect fertility. There are a few studies which show how Celiac disease may decrease fertility, and going on a gluten-free diet can help with this (39) (40). As a result, if you have problems conceiving then it might be a good idea to get tested for Celiac disease, or to just avoid gluten altogether. With regards to dairy, I only came across one “prospective study” which showed that high intake of low-fat dairy foods may increase the risk of anovulatory infertility, while the consumption of high-fat dairy products may decrease the risk (41). I didn’t find any studies which showed a negative correlation between casein consumption and infertility.
13. Stevia. There is a little bit of controversy as to whether stevia can affect fertility. One study conducted on male rats showed that chronic administration of stevia decreased male fertility (42). However, remember that this involved “chronic administration”, and an earlier study conducted on male and female hamsters showed that when given stevioside (which is extracted from stevia leaves) there were no abnormalities in growth and fertility in both sexes (43). To this date there haven’t been any studies showing whether consuming stevia affects fertility in humans, and while my guess is that having a small amount of stevia won’t cause problems, I could be wrong, and therefore if someone is having problems conceiving then it might be wise for the both the male and female to avoid stevia.
So What Can You Do To Overcome Infertility Naturally?
Anyone dealing with infertility will of course want to go through this list and consider each one of these factors as possibly causing or contributing to their infertility problem. Some of these factors can be easily addressed, such as avoiding alcohol and not exercising too hard. And of course you want to try following the basics, such as eating mostly whole foods while trying to minimize your consumption of refined foods, as well as not consuming artificial ingredients and genetically modified foods. Managing your stress is always important, as is reducing your exposure to environmental toxins.
However, other factors can be challenging to address. For example, if someone has mitochondrial dysfunction then this can be corrected, but it can be challenging to determine if someone has this problem. And then if it is detected it will take time to correct this. While one can minimize their exposure to toxins by eating organic food and buying natural cleaners and cosmetics, if they have a mouthful of mercury amalgams then this can be more challenging, as it can be very expensive to get these removed and replaced, and then one still will probably want to do some things to remove toxins from the tissues. Plus, there is really no way to confirm that this is what’s causing the infertility, and so there is a chance that someone might spend thousands of dollars getting the mercury amalgams removed and replaced, and their fertility won’t improve. Of course one can argue that getting these removed would be a good idea regardless of whether or not someone is dealing with infertility issues.
It’s also important to keep in mind that BOTH men and women need to do things to improve their health in order to improve the chances of conception. After all, if a male is stressed out all of the time, is eating poorly, and/or is being exposed to a lot of toxins then this can very well affect his fertility. So both the male and female need to commit to eating well, doing things to improve their stress handling skills, minimize their exposure to toxins, and if there is a health issue such as mitochondrial dysfunction or H. Pylori then these need to be addressed.
And of course the thyroid or autoimmune thyroid condition needs to be addressed as well. Since both depressed and elevated thyroid hormone levels can be a factor in infertility, any thyroid imbalance needs to be corrected. This might mean taking medication on a temporary or long term basis, or you might choose not to take medication and try to overcome your condition naturally. If you have Hashimoto’s Thyroiditis or Graves’ Disease then you should work with a natural healthcare professional to help you suppress the autoimmune component, as this can be a factor in infertility.
It’s also worth mentioning that acupuncture might be able to help with some cases of infertility. I briefly spoke about this in a previous blog post I wrote entitled “Can Acupuncture Benefit People With Thyroid Conditions?“. And so before taking fertility drugs or spending thousands of dollars on IVF it probably would be worth receiving a few acupuncture treatments.
In summary, many men and women with autoimmune thyroid conditions have problems with fertility. Many resort to treatment procedures such as IVF, and while this is something to consider in some cases, one should also look at other factors which can be causing the infertility. Some of these causes include the thyroid hormone imbalance, the presence of autoantibodies, problems with the adrenals/HPA axis, mitochondrial dysfunction, obesity, nutrient deficiencies, environmental toxins, and even a chronic infection such as H. Pylori. And before resorting to fertility drugs or IVF, those people looking for a more natural method of overcoming infertility might want to consider these factors I discussed.