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www.drbrighten.com/labs that are all about preconception labs that you should be thinking about if you do have an autoimmune thyroid condition. But I think every woman should be looking at these things. So you definitely want to get a full screening panel done. And the reason for that is we know that if you have elevated anti­TPO antibodies (those are the most common antibodies in Hashimoto’s that we see elevated, that’s the immune system basically tagging, flagging the cells in your thyroid to tell the T­cells to come over and destroy them, so it’s not a good scene), but I know some people they ask… “Well my thyroid labs are normal but I have elevated TPO antibodies.” Well, elevated TPO antibodies are associated with a 2 to three­fold increase in miscarriage. So if you have anti­TPO antibodies but the rest of your thyroid looks fine, you’re still at risk for a miscarriage. And if there’s an autoimmune condition taking place then there’s inflammation, and inflammation is not good for pregnancy. It will disrupt the HPA axis, (what the brain is saying to the adrenal glands), and if we think about it, you have your thyroid, your adrenal glands, and your ovaries… They’re like a 3-­legged stool. And if any one of those gets off they all start to falter. The thyroid is really in tune with the sex hormones and with the adrenal glands. So if your thyroid levels are off, and you don’t have adequate thyroid hormone, then we can see that you don’t get signaling to your ovaries to produce progesterone the way that you should be. In a lot of autoimmune thyroid patients we will see estrogen dominance taking place. As this estrogen rises up, so does a protein called thyroid binding globulin. And that will bind your excess thyroid hormone, (well I’d say just your thyroid hormone, it doesn’t even have to be excess), which can then make it problematic because then it will then cause higher levels of estrogen again. We’ll see dysregulation in cortisol levels, and all of this, in a woman without autoimmunity will lead to difficulty with conception and retaining a pregnancy. But the other thing that’s really special about the thyroid and why you should always screen for it before you become pregnant, is that it’s been well­-recognized and The American Thyroid Association actually put out a publication, anybody can Google that autoimmune thyroid and pregnancy and look at American Thyroid Association, it’s a huge document. And so for any woman listening right now (or reading this), if your doctor’s pushing back on you about your thyroid, this is a good document to download and take with you. Because what they stated in there, is that any woman who has a TSH above 2.5 (that’s the thyroid stimulating hormone, what the brain says to the thyroid gland.) Any woman with an elevation above 2.5 should absolutely be on levothyroxine (that’s a synthetic T4.) And they actually recommend that you just start on fifty micrograms and you get those levels down, especially if the woman is already pregnant. So to me in my mind if any woman who wishes to conceive shouldn’t have a TSH greater than 2.5 because she’s at risk for a miscarriage, which I should say miscarriage alone can trigger autoimmunity in women. But in my mind we aren’t supposed to let a woman who wants to have a baby go above 2.5. Why are we letting all other women go well above 2.5 and have symptoms? That’s just not my practice but it’s something that I just wanna make that point, that if you wanna become pregnant your doctor will medicate you if you’re above 2.5 on your TSH. But if you don’t wanna become pregnant and you’re a 3, they’ll just kind of let you go with that.  ]]>

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