My Hashimoto’s Pregnancy

What’s Inside: I’m sharing my experience getting pregnant and supporting my health during pregnancy with Hashimoto’s Autoimmune Disease. I’m also sharing tips and advice for anyone else on this journey.

I recently gave birth to a beautiful baby girl and have been sharing my journey, tips, and recommendations for a natural pregnancy with Hashimoto’s/hypothyroidism and PCOS. These conditions make getting pregnant difficult as it interferes with ovulation and the health of the baby when the condition is not managed, but we can support our bodies for a healthy pregnancy!

Quick backstory on my journey with Hashimoto’s:

I was diagnosed around 4 years ago and it took me 3 years before that to even get the diagnosis after being bounced around from doctor to doctor who didn’t know why I had all these symptoms like hair falling out, no energy and constant fatigue, and plenty more that even I was overlooking like gut issues… until I got a naturopath to test me properly, diagnosed me, and begin treating me. Since then, I’ve tried plenty of different therapies, healing diets, and lifestyle tools to help me manage the disease and also talk about this at length on my “how I manage my Hashimoto’s” post. It has not been straightforward or easy, so ultimately, making peace with the disease and my body was what really moved the needle for me.

It can be challenging to get/stay pregnant with Hashimoto’s.

My experience getting pregnant…

Beyond Hashimoto’s, I also always suffered with “bad periods”, AKA, PCOS. I personally think it’s all related of course as hormonal issues. That said, what made things challenging for me, was an irregular and very painful period, not knowing when I was ovulating and though we had started trying with me attempting to track on my own… nothing was happening. I was also having some relapses with things like SIBO, parasites and Hashimoto’s antibodies… so I’d frequently pause trying because I always felt I physically wasn’t “there” yet and was mortified to actually get pregnant during these relapses not knowing what danger I’d put the baby in. So it was a mix of physical and mental reasons as to why it was challenging for me. In reality, once I started letting a lot of that go and managing my stress so that certain gut healing and Hashi treatments could work… they did. And I was able to just let go and honestly, we weren’t really planning the pregnancy when I finally did get pregnant!

What I was doing to help my fertility at the time:

• Supporting my foundational health (read my post on this here)
• Trying seed cycling (which I loved – also mentioned in the post above)
• And had been trying acupuncture as well (but had to stop a few months prior due to the cost, I was using this to help regulate my period and it definitely helped).
• I consistently took a prenatal with Methyl-folate AND Inositol which is helpful for PCOS and hormonal imbalances, I recommend Dr. Brighten’s Prenatal which has both of these, or the Thorne Prenatal and adding in the inositol separately.

Pregnancy with Hashimoto’s

I have nothing to compare it to, and I know being pregnant can be like a part-time job for anyone with all the tests and the extra taking care of yourself you need to do – but it felt like a bit more for me having to constantly manage they thyroid. Luckily, my doctor was very on top of it, we checked it every other week and adjust meds as needed with a compounding pharmacy. I also found the glucose testing to be a bit stressful, we had to test it 3x, 3 different ways to confirm I was fine… but I also suspect my thyroid fluctuations had something to do with that as well! Ultimately, I found meditating and trusting my body to nourish my baby was so KEY, vs. nitpicking on every single thing or worrying about my thyroid levels. I had to accept things would fluctuate and trust that being on top of it was the best I could do.

Some nuances with having hypothyroid/Hashimoto’s during pregnancy to note…

My midwives and most providers tended to harp on the TSH alone… which is outdated. My TSH has been suppressed for years and under 0 most of the time because I’ve been on medication. That said, the T3 and T4 markers were what my Naturopath was most concerned with while paying attention to TSH too.

At the beginning of pregnancy, I have to say my antibodies were at the lowest they’d ever been – just a few points from remission and my T3 and T4 were all in good spots within range… but once 2nd Trimester hit, things started moving around pretty drastically and we were concerned the baby was getting too much or not enough depending on the swings. So because of this, we started monitoring more regularly and adjusting medication.

The concern with too little T4 are mental developments, and with too much T3 and T4 in the system, the concern was the baby’s heart. The other major component they’ve been tracking in sonograms are her growth because of the metabolism concern with the thyroid. The placenta can do all sorts of funky things, but ultimately, I had to trust that it was doing right by my baby regardless of what was going on with me, my meds, and lab work… which ultimately is a snapshot in time.

I’ve definitely had more appointments and testing done with the Hashi’s. Mostly, my midwives just liked to check in on it with my naturopath to ensure she was on top of it as well as my constant appointments/check-ins with my naturopath and extra lab work.

Tip: You can use this at-home test kit for your thyroid. It’s easy, thorough, and you’ll have results in 1-week. Use code: FOODBYMARS for $30 off

My general advice if you’re someone with hypothyroid/Hashimoto’s, and looking to boost fertility or get pregnant…

For preconception and fertility in general – go back to basics, make sure your blood sugar is balanced and that will support fertility along with managing stress. Read my fertility tips article where I outline all of this that’s definitely worth checking out before spending the money on treatments and interventions – because in my opinion, without the foundations of health being managed, you’re not going to be set up for success, whatever the treatment/intervention is.

I’d also add that the mental component is much bigger than we realize. Automatically having it in your head that Hashi’s might make you infertile or that you will have a hard time shouldn’t be assumed and can really block you from having a healthy libido and sex life and enjoying the overall process of nurturing yourself and your fertility.

For pregnancy… it’s not a cakewalk for most of us, I’m in a Hashimoto’s pregnancy group on Facebook and many of us have similar challenges that I’ve spoken about. Both with frustrations with providers and then just not understanding why our labs fluctuate so much and our meds with it… but the conclusion I’ve come to is at some point we have to surrender to the process and trust our bodies. It’s normal to worry and wonder but it’s another to stress out so badly about it that we make it worse. The best we can do is get a provider we trust to manage the thyroid and keep up to date with our labs and meds — the body will do the rest, we have to trust that. There are so many women that their pregnancy actually triggers Hashi’s or that don’t even find out they’re hypothyroid until mid-way in their pregnancy since it’s not a common practice to even test women as soon as they’re pregnant for thyroid dysfunction.

We simply can’t predict and worry about everything. The annoying part is, when you have autoimmunity… you’re told your body is broken, malfunctioning, attacking you… I believe it’s much more complex than that and we simply don’t understand it all yet — so I refuse to live in a body that’s “against me“. I had to make peace with it before getting pregnant and have to remind myself when I’m anxious about my thyroid that my body can and will do this.

Common question/concern:

Optimal thyroid levels to get pregnant & what adjustments had to be made once pregnant?

In general, optimal thyroid levels are ideal for getting pregnant (it’s the same). That said, it will likely fluctuate throughout pregnancy, so getting checked as soon as you’re pregnant AND every 4-6 weeks based on your doctor’s recommendation to adjust meds accordingly is best. There’s no one-size-fits-all recommendation I have on adjusting meds because it’s SO unique to your body and your pregnancy, this is why it’s important to keep monitoring and be okay with the dose changing.

I remember hearing a lot of advice to double my thyroid medication as soon as I confirmed I was pregnant with a positive test. I’m glad I instead waited to test my blood because I didn’t need to raise it and in fact needed to lower it a bit. Everyone is different once again, get checked to confirm and take the next steps by staying on top of it with a trusted practitioner. I always recommend a Functional Medicine Doctor, Integrative Medicine Doctor, or Naturopath.

For a more sciency answer…

There’s some conflict on exact levels here but this is what’s ideal and recommended:

• TSH should be around 1; Many though, will have suppressed TSH (I did!) at the time of pregnancy and for most of it due to meds. Some practitioners are fine with this and others aren’t. As a reminder, TSH is essentially the message from your Pituitary to your Thyroid saying to “make more hormones”, it’s not a measure of the hormone levels.
• Free T4 and Free T3 should be in the top half of the reference range
• Reverse T3 would ideally be in the lower half of the reference range
• Antibodies should be as low as possible/close to reference range (TPO is 0-35 IU/mL and TG is less than or = 33 IU/mL)

If testing is a pain in the neck (pun!) with your medical team, you can use this at-home test kit for your thyroid. It’s easy, thorough, and you’ll have results in 1-week. Use code: FOODBYMARS for $30 off

Final thoughts on this…

Obsessing over the levels and creating stress, is just as bad as poor levels in my experience. Blood work/labs are useful but also a snapshot in time. Your body WANTS a SAFE, LOW-STRESS environment to keep your baby safe… give it the chance to by managing that. You do have control over the stress.

Give your body nourishment and peace through this and TRUST. I cannot say that enough.

Try meditation (Love the Expectful App), long walks, breathing, gratitude journals, and I offer you this mantra that I said the entire time… “I trust my body to nourish my baby.”

Recommended Resources

• Expectful App for Meditation >>
• At-home Thyroid Test Kit (use FOODBYMARS for $30 off) >>
• Your Healthy Pregnancy with Thyroid Disease by Dana Trentini >>
• Healing Your Body Naturally After Childbirth by Dr. Jolene Brighten >>
• The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth >>
• The Nourishing Traditions Book of Baby & Child Care >>
• Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition >>
• The First Forty Days: The Essential Art of Nourishing the New Mother >>

Photography by Stephanie Cowan