Mais conteúdo relacionado Semelhante a The thyroid and fertility (20) 1. 22/06/2012
THE THYROID
AND FERTILITY
Morwenna Given
Medical Herbalist
BA MA (Oxon) BSc m.OHA
RH
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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
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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
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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
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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 )
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CONSEQUENCES 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.
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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.
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HPA HORMONES
Also produced are:
ADH ( vasopressin/ regulating kidneys )
Somastatin ( growth & TSH inhibiting )
Corticotrophins (ACTH - insulin)
Dopamine
Growth releasing hormones (GRH)
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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
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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
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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
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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.
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IMPACT 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
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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
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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,
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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.
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ONTARIO & 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.
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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.
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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.
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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.
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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
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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
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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
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PLANTS & MICRO MINERALS
Zinc selenium chromium
Bladderwrack, coleus, withania, myrrh, reis
hi, licorice, ginger, nettle
Lemon balm, chickweed, nettle, all heal
Vitex, paeony, red clover,
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Fertility
Impacted also by:
Stress
Lifestyle
Takes two to tango
Alcohol
Toxins – pcb’s
Excess weight
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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,
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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
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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.
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Thank you
MORWENNA GIVEN WWW.MEDICUSHERBIS.COM
© 2012
