Can hypothyroidism affect fertility in a 39-year-old woman?

Question

Hello doctor,

I am 39 and have been dealing with hypothyroidism for six years now, but my symptoms keep getting worse even though my labs are supposedly normal. I am taking Levothyroxine 125 mcg daily, but still feel exhausted all the time, am gaining weight despite eating healthy, losing hair in clumps, and my periods are super heavy, lasting nine to 10 days.

My TSH is 3.2mU/L, which my endocrinologist says is fine, but I read online that the optimal range is one to two. My free T4 is 1.1 ng/dL, and free T3 is 2.8 ng/dL. I also have positive TPO antibodies at 450 IU/mL, indicating Hashimoto's thyroiditis.

I tried asking about T3 medication like Cytomel, but my doctor said it is not necessary. The worst symptom is brain fog. I cannot concentrate at work and constantly forget things.

My cholesterol is 245 mg/dL, and my triglycerides are 189 mg/dL, even though I exercise regularly. I have also been trying to get pregnant for the past year with no success, and the fertility doctor thinks hypothyroidism might be affecting ovulation.

Should my TSH be lower when trying to conceive?

I am also wondering about switching to natural desiccated thyroid instead of synthetic. I am really frustrated because I do not feel like myself anymore, and nobody seems to take my symptoms seriously.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

It sounds like you are experiencing significant ongoing symptoms of hypothyroidism (when your thyroid gland does not make and release enough hormone into your bloodstream) despite taking Levothyroxine and having labs that are considered normal by standard reference ranges.

Your fatigue, weight gain, hair loss, heavy, prolonged periods, brain fog, and elevated cholesterol are all consistent with insufficient thyroid hormone activity. Your positive TPO (thyroid peroxidase antibodies) confirms Hashimoto's thyroiditis (an autoimmune disorder in which the immune system mistakenly attacks the thyroid gland), which can progressively reduce thyroid function over time.

While your TSH (thyroid-stimulating hormone) of 3.2 mU/L falls within the general reference range, many specialists consider a TSH closer to one to two optimal, particularly for symptomatic patients and women who are trying to conceive, because higher TSH can impair ovulation and early pregnancy outcomes.

Some patients continue to have symptoms on Levothyroxine alone, possibly due to inadequate conversion to the active T3 (triiodothyronine) hormone. In those cases, doctors sometimes consider combination therapy with T3 or a trial of natural desiccated thyroid, although responses vary and should be closely monitored.

Given your ongoing fatigue, brain fog, heavy periods, and infertility concerns, it may be reasonable to discuss adjusting your thyroid dose to target a lower TSH, evaluating free T3 more closely, and exploring whether combination therapy or desiccated thyroid might improve your symptoms.

Regular monitoring of thyroid function, cholesterol, menstrual cycles, and reproductive hormones is necessary, and addressing these issues can improve energy, cognition, fertility, and overall quality of life.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.