Hypothyroidism & Hashimoto’s: Understanding Thyroid Health, Inflammation, and Fertility
The thyroid is a small, butterfly-shaped gland, but its impact on the body is anything but small. Thyroid hormones regulate metabolism, energy, mood, menstrual cycles, and play a critical role in fertility and pregnancy outcomes. At Common Ground Wellness, we see firsthand how undiagnosed or undertreated thyroid dysfunction can quietly interfere with conception, pregnancy, and overall well-being.
There are multiple kinds of thyroid dysfunction, including hyperthyroid and hypothyroid. Today, we will be focusing on hypothyroidism and especially understanding the difference between simple hypothyroidism and autoimmune hypothyroidism (Hashimoto’s).
Hypothyroidism: When the Thyroid Is Underactive
Hypothyroidism occurs when the thyroid does not produce enough thyroid hormone to meet the body’s needs. This can slow nearly every system in the body.
Common Symptoms of Hypothyroidism
Fatigue or low energy
Feeling cold easily
Hair thinning or hair loss
Weight gain or difficulty losing weight
Dry skin
Constipation
Muscle cramps or weakness
Depression, irritability, or low mood
Poor memory or brain fog
Menstrual cycle irregularity
Low libido
Increased risk of miscarriage or infertility
Many of these symptoms overlap with stress, postpartum changes, or hormonal imbalance, making thyroid dysfunction easy to miss without proper testing.
Simple vs. Autoimmune Hypothyroidism: What’s the Difference?
Simple (Non-Autoimmune) Hypothyroidism
This form of hypothyroidism occurs when the thyroid is under-functioning without an immune attack. Common causes include:
Iodine deficiency
Thyroid surgery or radiation
Certain medications
Disorders of other endocrine glands
Inflammation may still be present, but it is not driven by antibodies attacking the thyroid itself.
Hashimoto’s Thyroiditis (Autoimmune Hypothyroidism)
Hashimoto’s is an inflammatory autoimmune condition, meaning the immune system mistakenly attacks the thyroid gland. Over time, this inflammation damages thyroid tissue and reduces hormone production.
Key features of Hashimoto’s:
Presence of thyroid antibodies
TPO (thyroid peroxidase antibodies)
TgAb (thyroglobulin antibodies)
Progressive thyroid damage
Strong association with infertility, miscarriage, and adverse pregnancy outcomes
Importantly, someone can have normal TSH levels while still having elevated thyroid antibodies and ongoing inflammation that impacts fertility.
Why Inflammation Matters for Fertility
Inflammation, especially autoimmune-driven inflammation, can:
Disrupt ovulation
Interfere with implantation
Increase miscarriage risk
Affect egg quality
Create an unfavorable uterine environment
This is why simply “normalizing TSH” is often not enough, particularly in patients with Hashimoto’s or subclinical hypothyroidism.
Thyroid Testing: Beyond TSH
Many people are told their thyroid is “normal” based on TSH alone. However, TSH is not a thyroid hormone; it’s a pituitary signal.
Understanding Key Thyroid Markers
TSH (Thyroid Stimulating Hormone)
Released by the anterior pituitary
Responds to circulating thyroid hormone levels
TSH > 4.0 = hypothyroid
TSH under 2.5 is ideal for fertility and the first trimester
T4 (Thyroxine)
Inactive storage form of thyroid hormone
T3 (Triiodothyronine)
Active thyroid hormone used by cells
Reverse T3
Can block T3 at the cellular level, often elevated with stress or inflammation
TPO & TgAb (Thyroid Antibodies)
Indicate autoimmune activity
Associated with infertility and miscarriage—even if TSH is normal
Recommended Testing
At Common Ground Wellness, we recommend a full thyroid panel, including:
TSH
Free T3
Free T4
Reverse T3
TPO antibodies
TgAb
Iodine (when indicated)
Follow-up thyroid ultrasound if needed
Subclinical Hypothyroidism: The Gray Zone That Matters
TSH between 2.5–4.0
Often dismissed as “normal”
Can significantly impact fertility and pregnancy outcomes
Always test thyroid antibodies in this range
For anyone trying to conceive, this range deserves attention and individualized care.
Treatment Options: A Whole-Body Approach
Conventional & Prescription Support
Levothyroxine (Synthroid®) – T4-only medication
Desiccated thyroid – contains both T4 and T3
Prescription T3 – for those who struggle to convert T4 to T3
Most standard thyroid medications are T4-based. The body must convert T4 into active T3, and many people struggle with this conversion.
Supporting T4 → T3 Conversion
Key nutrients needed for conversion include:
Zinc
Selenium
Copper
Additional supportive therapies:
Inositol (particularly helpful for autoimmune thyroid conditions and fertility)
Low-dose naltrexone (LDN) for immune modulation (when appropriate)
Reducing Inflammation & Creating a Healthy Environment
Healing the thyroid, especially in Hashimoto’s, requires addressing inflammation at its root.
Create a Thyroid-Supportive Environment
Reduce exposure to endocrine-disrupting chemicals
Support liver and gut detoxification pathways
Reference our Toxin Taboo educational module in our online fertility courses for guidance, or download the free Fertility Detox Guide to get started
Nutrition Matters
An anti-inflammatory, balanced diet
Adequate protein, healthy fats, and complex carbohydrates
Many individuals benefit from a gluten-free diet, particularly with Hashimoto’s
Our Philosophy at Common Ground Wellness
Thyroid health is not just about lab numbers; it’s about creating an internal environment where hormones, immunity, and inflammation are in balance. Especially for those on a fertility journey, addressing thyroid dysfunction early and comprehensively can be life-changing.
If you’ve been told your labs are “normal” but your body says otherwise, we’re here to help you dig deeper. Schedule a consultation today to get started.
*Medical Disclaimer
The information provided in this blog is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Thyroid conditions, fertility concerns, and autoimmune disorders are complex and highly individualized. Always consult with a qualified healthcare provider before making changes to your medications, supplements, or treatment plan. Do not discontinue or adjust prescribed thyroid medications without medical supervision. Common Ground Wellness encourages collaborative care and personalized treatment guided by appropriate testing and clinical evaluation.
