Desiccated Thyroid Prescription for Hypothyroidism and Hormonal Imbalance in Ottawa

Thyroid hormone prescriptions are used to help support the treatment of conditions that require additional thyroid hormones. The desiccated thyroid is an alternative option for thyroid medication which contains both forms of the thyroid hormone: T3 and T4. The main difference between this and standard thyroid medication is that the standard prescription contains T4 only.

The Impact of Thyroid Hormone in the Body

T4 is the inactive form of the thyroid hormone, meaning it must be converted to the active hormone T3 in the tissue where is it to be used. Desiccated thyroid may help individuals who have felt little improvement in their hypothyroid symptoms even though blood levels of the thyroid hormone appear in the normal range from previous treatments. Desiccated thyroid contains both T4 and T3, so the T3 content will directly stimulate the receptors for thyroid hormone in the body to help, providing relief from symptoms of hypothyroidism. Common considerations for hypothyroidism:

1. Genetics: Individuals with a 1st degree family member who has been diagnosed with hypothyroidism is much more likely to develop hypothyroid themselves. 

2. Gender: Women have a significantly higher-risk of developing hypothyroidism 

3.Estrogen Imbalance: Conditions which increase the estrogen levels in the body can slow down thyroid function. A common example is pregnancy, where the estrogen levels are necessary to support a healthy pregnancy. The effect of the high levels of estrogen can in some cases push the patient in to a hypothyroid state.

4. Radiation or Surgery: Radiation to destroy the thyroid gland or its surgical removal is sometimes medically required. The body is unable to produce thyroid hormone following such a treatment and will require constant supplementation with thyroid hormone. 

5. Fertility: Thyroid hormones are required to support pregnancy, healthy development of the baby and reduce complications during pregnancy. A lack of thyroid hormone can increase the risk of miscarriage and cretinism in the baby.

Treatment Options for Low Thyroid Hormone

1. Desiccated Thyroid: Providing extra T3 and T4 can help reduce the symptoms of hypothyroidism and treat the condition. This is obtained through a prescription from a registered healthcare provider that has prescribing rights.

2. Clinical Nutritional Supplements: Specific nutritional supplements have been studied and shown to help improve the function of the thyroid gland, protect it from oxidative stress, support healthy conversion of T4 to T3 in the body.

3. Diet & Lifestyle: The dietary and lifestyle choices we make can also significantly affect our body's hormone production. Particularly specific types of exercise and dietary habits can help support healthy hormone production.

4. Botanical Medicine: herbal remedies can also stimulate the production of the hormones from the thyroid gland and support healthy conversion of thyroid hormone from T4 to T3 in the body.

Thyroid hormone plays an incredible role in fertility and pregnancy. Having hypothyroidism or symptoms of hypothyroidism even though you are taking medication may suggest that your thyroid is still not working in the optimal range for fertility.

 

What is a normal TSH for Fertility?

 

In general, having a thyroid stimulating hormone (TSH) below 2.0 uIU/mL. If TSH is higher than 4.5 the risk of miscarriage significantly increases. Having a TSH above 2.0 may make it harder for you to conceive

 

How does Thyroid Hormone support Fertility?

 

Thyroid hormone stimulates the production of leukemia inhibiting factor (LIF) in the microenvironment of the uterine lining. LIF is crucial to support healthy implantation and pregnancy. A deficiency in thyroid hormone would lead to a decline in LIF and a significant reduction in chances of implantation. It also helps in the production of matrix metalloproteinases (MMP), fetal fibronectin and integrin to support the production of the extravillous trophoblasts (part of the placenta that causes implantation to occur). Thyroid hormone also regulates follicle development, ovulation, and hormone production from the ovaries

 

Thyroid Autoimmunity and Infertility 

 

An elevation in thyroid antibodies, specifically anti-thyroglobulin antibody and anti-thyroid peroxidase antibody can decrease fertility, independent of the TSH levels. They may cause a subtle shift in the amount of thyroid hormone that is circulating in the blood and they can also damage the zona pellucida of the follicles/eggs. The zona pellucida helps to protect the eggs from damage from external chemicals, oxidative stress, toxins, and inflammation. A deficiency in Vitamin D has also been associated with an increase in thyroid antibodies, as Vitamin D has an important role in modulating immune system function. Treatment with thyroid hormone in the presence of thyroid antibodies seems to significantly reduce the risk of miscarriage. In one study treatment with thyroid hormone had a miscarriage risk of 33% and the group without any thyroid hormone treatment had a miscarriage risk of 52%. 

 

Thyroid Hormone requirements in Pregnancy 

 

The increase in production of estrogen during pregnancy leads to an increase in thyroxin-binding globulin. Thyroxin-binding globulin attaches itself to thyroid hormone and makes it unavailable for use in the body. Additionally, the increased excretion of iodine during pregnancy pushes the thyroid gland to a potentially hypothyroid state. To anticipate this push towards a hypothyroid state, it is important to have a sufficient amount of thyroid hormone before trying to conceive. As such, the TSH during the first trimester should be maintained at 2.5 or lower, in the second trimester at 3.0 or lower, and during the third trimester at 3.5 or lower. 

 

Thyroid Hormone with Assisted Reproductive Technologies (IVF, IUI, and ICSI)

 

The medications used during the controlled ovarian hyperstimulation (COH) phase create a hormonal imbalance similar to pregnancy, a very quick and significant rise in estrogen levels in the body. In fact, research has found that the amount of estrogen in the body during the first trimester is significantly higher in Women who conceive immediately after IVF compared to Women who conceived naturally. This significantly reduces function of the thyroid gland. In anyone who has thyroid antibodies, the freeT4 and TSH should be checked before going for IVF or IUI and at least every 30 days in the first trimester. If TSH goes above 2.5 it should be treated with thyroid hormone to reduce the risk of miscarriage. Thyroid hormone should also be used to keep the TSH below 2.5 prior to starting any fertility treatments, especially if the thyroid antibodies are elevated. 

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