The thyroid and fertility


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The thyroid can have a profound impact on our entire body. This presentation examines the thyroid and its impact as related to issues of fertility.

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The thyroid and fertility

  1. 1. 22/06/2012 THE THYROID AND FERTILITY Morwenna Given Medical Herbalist BA MA (Oxon) BSc m.OHA RH1 ©
  2. 2. 2 22/06/2012 WHO AM I?Iam a Medical Herbalist, trained in University, Hospital and clinics in the UK With a practise in downtown Toronto focussing on cancer & precancerous conditions including thyroid disorders ©
  3. 3. 3 22/06/2012 WHAT IS THE THYROID? The thyroid is a butterfly shaped gland acting in concert with the Hypothalamic pituitary axis Toregulate all the metabolic and endocrine function of the body via a feedback mechanism i.e. growth & sex ©
  4. 4. 4 22/06/2012 WHERE IS IT LOCATED? located in the anterior (front ) side of the oesophagus between the carotid and arteries in the neck wrapped over the trachea. Due its location abnormalities can be easily observed to give an early indicator of fertility issues ©
  5. 5. 5 22/06/2012 WHAT DOES IT DO? Itregulates all endocrine activity through hormones Principally by controlling the energy and growth hormones which in turn Control metabolism and fertility. The parathyroid which regulates Vitamin D, calcium, magnesium, phosphate, (bon es and kidney excretion ) ©
  6. 6. 6 22/06/2012CONSEQUENCES OF DISORDER Although menstrual irregularities are common, ovulation and conception can still occur in hypothyroidism, if treated. Subclinical hypothyroidism may be associated with ovulatory dysfunction and adverse pregnancy outcome. Thyroid autoimmunity increases the miscarriage rate, and thyroxine treatment does not protect. In males, thyrotoxicosis has a significant but reversible effect on sperm motility. ©
  7. 7. 7 22/06/2012 HPA HORMONES The hypothalamus via its two lobes (anterior and posterior pituitary creates the following hormones: oxytocin, Trophic hormones of the anterior pituitary includes thyrotropes that produce TSH and gonadotropins that produce Prolactin, FSH and LH. Via an ERK mediated pathway in females only. ©
  8. 8. 8 22/06/2012 HPA HORMONES Also produced are: ADH ( vasopressin/ regulating kidneys ) Somastatin ( growth & TSH inhibiting ) Corticotrophins (ACTH - insulin) Dopamine Growth releasing hormones (GRH) ©
  9. 9. 9 22/06/2012 FEEDBACK MECHANISM Recentlya sperm protein (SP22) directly affecting TSH and androgen synthesis has been found in the male pituitary. Thelevel of all hormones is regulated within the body by a feed back mechanism ©
  10. 10. 10 22/06/2012 THYROID HORMONES TSH, T4, T3, thyroglobulin, thyroid peroxidase and antibodies Conversion of TSH to T4 @ 20% takes place in the thyroid – the rest in the body overall Calcitonin – vitamin D – calcium absorption ©
  11. 11. 11 22/06/2012 CONVERSION Deiodination is the most important pathway of thyroid hormone metabolism not only in quantitative terms, but also because it accounts for most of the circulating T3 (~ 80%) in humans IODINE ©
  12. 12. 12 22/06/2012 IMPACT ON FEMALE FERTILITY Thyroid dysfunction may cause short luteal phase, failure to sustain a fertilized egg, and loss of early pregnancy. Over 50%of hypothyroid patients have menstrual irregularities and one third of subfertile patients have thyroid disease. Pituitary hormones such as TSH, prolactin, or growth hormone act synergistically with follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to usher the follicles into the growth phase. About 46.1% of infertile patients with hypothyroidism exhibit hyperprolactinaemia. Which impairs pulsatile secretion of gonadotrophin- releasing hormone (GnRH) and causes ovulatory dysfunctions ranging from inadequate corpus luteal progesterone secretion when mildly elevated to oligomenorrhea or amenorrhea and polycystic ovaries when levels are high. ©
  13. 13. 13 22/06/2012IMPACT ON MALE FERTILITY Male reproduction is adversely affected by both thyrotoxicosis and hypothyroidism. Erectile abnormalities have been reported. Thyrotoxicosis induces abnormalities in sperm motility, whereas hypothyroidism is associated with abnormalities in sperm morphology ©
  14. 14. 14 22/06/2012 IMPACT ON MALES the participation of triiodothyronine (T3) in the control of Sertoli and Leydig cell proliferation, testicular maturation, and steroidogenesis is widely accepted, as well as the presence of thyroid hormone transporters and receptors in testicular cells throughout the development process and in adulthood. But even with data suggesting that T3 may act directly on these cells to bring about its effects, there is still controversy regarding the impact of thyroid diseases on human spermatogenesis and fertility © ©
  15. 15. 15 22/06/2012 LONG TERM CONSEQUENCES FOR MEN An increase in SHBG is a consistent feature associated with thyrotoxicosis, and leads to an increase in circulating levels of total T4 and reduction in the metabolic clearance rate of testosterone. However, the plasma level of free testosterone is usually maintained within the normal range, which is in keeping with the lack of clinical consequences of the noticeably elevated levels of total testosterone found in thyrotoxicosis . Peripheral conversion of androgen to estrogen is enhanced in thyrotoxicosis, probably due to changes in peripheral blood flow rather than a direct effect of thyroid hormones on the aromatase complex. An increase in the production rate of estrogens is also observed in some men with thyrotoxicosis, ©
  16. 16. 16 22/06/2012 INFERTILITY STARTS IN CHILDHOOD Thyroid failure in the pre-pubertal period is associated with testicular enlargement as well as alterations in sexual hormones. Hypothyroidism initiated in infancy may occur in association with macroorchidism without virilization. The longer the hypothyroidism persists, the greater is the degree of damage to the testes. When adequately treated with thyroid hormone, however, boys with congenital hypothyroidism progress through puberty normally and at the appropriate time. ©
  17. 17. 17 22/06/2012ONTARIO & THYROID ISSUES Itis widely recognised that sub clinical hypothyroidism is endemic in Ontario for which there is conventional remedy But Leaving this condition to worsen actively promotes diseases such as cancer, diabetes and infertility as the only available drug has a poor efficacy level. ©
  18. 18. 18 22/06/2012 STANDARD PARAMETERS Thyroidfunction is measured in blood- work as being @ between 0.35-5.5 Itis ignored by conventional medicine as there are no drugs to treat But even a small deviation from the mean can have a huge effect on fertility hormones. ©
  19. 19. 19 22/06/2012 LONG TERM CONSEQUENCES Controlled ovarian hyperstimulation leads to important increases in estradiol, which in turn may have an adverse effect on thyroid hormones and TSH. When autoimmune thyroid disease is present, the impact of controlled ovarian hyperstimulation may become more severe, depending on pre-existing thyroid abnormalities. Autoimmune thyroid disease is present in 5-20% of unselected pregnant women. Isolated hypothyroxinemia has been described in approximately 2% of pregnancies, without serum TSH elevation and in the absence of thyroid autoantibodies. Overt hypothyroidism has been associated with increased rates of spontaneous abortion, premature delivery and/or low birth weight, fetal distress in labor, and perhaps gestation-induced hypertension and placental abruption. The links between such obstetrical complications and subclinical hypothyroidism are less evident. Thyrotoxicosis during pregnancy is due to Graves disease and gestational transient thyrotoxicosis. All antithyroid drugs cross the placenta and may potentially affect fetal thyroid function. ©
  20. 20. 20 22/06/2012 IVF/CancerA brief discussion on the thyroid hormones show why IVF can have such devastating consequences on the female body Last year I had 5 ladies who had had IVF and consequently within a short time period developed cancer. ©
  21. 21. 21 22/06/2012 hypothyroidism Thisis traditional described as having a T3 IN EXCESS of T4 However any loss of libido, weight gain, fatigue, menstrual irregularities are early warning signs Hashimoto’s ©
  22. 22. 22 22/06/2012 hyperthyroidism Hyperthyroidismis traditionally measured as a TSH below 0.35 Earlywarning signs are blood clots, rashes, heat intolerance, high appetite and weight loss Graves disease ©
  23. 23. 23 22/06/2012 Subclinical conditions Any of the typical symptoms associated with disease are present Golden opportunity treat successfully with plants Avoids a lifetime use of thyroxine which only puts T4 into the body. Pre cursor to many diseases including fertility issues ©
  24. 24. 24 22/06/2012PLANTS & MICRO MINERALS Zinc selenium chromium Bladderwrack, coleus, withania, myrrh, reis hi, licorice, ginger, nettle Lemon balm, chickweed, nettle, all heal Vitex, paeony, red clover, ©
  25. 25. 25 22/06/2012 Fertility Impacted also by: Stress Lifestyle Takes two to tango Alcohol Toxins – pcb’s Excess weight ©
  26. 26. 26 22/06/2012 CAUTIONS PLEASE NOTE IT IS ADVISED, THAT ANY PLANTS MENTIONED IN THIS TALK, ARE ONLY USED UNDER PROFESSIONAL GUIDANCE. BOTANICAL MEDICINE AS SUPPLIED BY A PROFESSIONAL IS NOT AVAILABLE OVER THE RETAIL COUNTER. It is not advisable to self treat A professional: will recognise all the issues within the body Select herbs that will impact positively on these issues without causing problems in order to co exist with orthodox drugs, ©
  27. 27. 27 22/06/2012 SUPPLEMENTS There are some specific supplements beneficial in infertility such as zinc Retail supplements are not allowed by law to have a medical effect at the suggested dose and thus the doses maybe inappropriate Always consult your professional practitioner first before purchasing ©
  28. 28. 28 22/06/2012 References & Evidence base www. Pubmed, Science directIhave a full list of references for those who are interested – if you would like either to email me or put your name down tonight I will send them to you. ©
  29. 29. 29 22/06/2012 Thank youMORWENNA GIVEN WWW.MEDICUSHERBIS.COM © 2012