.png)
Every woman dealing with infertility is on her own journey. If you’re just taking the first steps, you might be hearing from your doctor that you don’t need testing yet. But we believe in using data and knowing rather than guessing.
We see our all of our patients as individuals and we treat them with personalized protocols, but there are
5 hormone imbalances we see all the time:
Low vitamin D
Low morning cortisol
Subclinical hypothyroidism
Flat-line cortisol
Estrogen/progesterone
These are all imbalances are all easy imbalances to identify and early treatment can make a big difference in how you feel and how long it takes to get pregnant.
1. Low Vitamin D: Vitamin is a bit of misnomer here, as vitamin D behaves much more like a hormone than a vitamin. What exactly does that mean? Vitamin D goes way beyond bones and has broad reaching effects on the immune, cardiovascular, and reproductive systems. You need vitamin D to absorb calcium, which keeps bone and teeth strong. Where does vitamin D come from? About 10% of your vitamin D is taken in through the diet and the rest must come from sun exposure (sans sunscreen) or supplementation. Sun exposure can be tricky for those of us who spend a great deal of time indoors, are good about wearing sunscreen, or live north of the 45th parallel. Even fortified sources of vitamin D, such as milk and other dairy products require the sun for conversion into the active form of Vitamin D.
Many patient who aren’t taking vitamin D (and even many who are!) have low Vitamin D. My recommended dose for most patients is 2000-4000 IU/day (a bit more than the RDA of 800 IU/day). Remember, you can become toxic with fat-soluble hormones like Vitamin D (also Vit A/K/E) so it is important to be tested, especially if you are taking higher than recommended doses.
2. Low Morning Cortisol: Cortisol production should be highest in the morning and lowest at night, looking like a ski slope. Unfortunately, nearly all of my patients have suboptimal or low AM Cortisol. Symptoms of low morning cortisol are fatigue, excessive caffeine intake, depression and even insomnia. If this feels like you, get tested!!!
3. Subclinical hypothyroidism: This is rampant! American College of Endocrinology tells us that women with a Thyroid Stimulating Hormone (TSH) more than 2.5 are at higher risk for miscarriage and infertility even though the upper limit cut off for TSH in most labs is 4.5. Rather than only use this criteria during a woman’s reproductive years, we use the cut off of 2.5 for women of all ages. we also look at free T4 and free T3, but if that TSH isn’t optimal, we’re going to treat! Unfortunately, TSH levels are often only checked when someone has had a recurrent miscarriage or other fertility issues arise.
4. Flat-line Cortisol: Whenever I have a patient who sees her lab result showing a flattened cortisol curve, they almost always says “Well yeah, that’s exactly what I feel like!” and it’s validating for her to know it’s not all in her head. Our adrenal glands aren’t meant to be stimulated as constantly as they are (thanks to our go-go-go lifestyle, exposure to screens, and overuse of stimulants like caffeine), so eventually they go into a pseudo-hibernation mode and put out just enough cortisol to keep us going. Why is cortisol important? Well, if you are chronically stressed, fatigued and rely on caffeine to get you through your whole day, this will stress other parts of your hormonal system. This can lead to irregular cycles, low progesterone, and disrupted thyroid hormone activity.
5. High Estrogen, Low Progesterone: Our environment keeps our bodies swimming in chemicals that mimic estrogen. Also, many women are on birth control pills or implants which suppress eggs being released from our ovaries. No egg = no Progesterone. With this suppression of progesterone from anovulatory cycles, we end up with too much Estrogen + low Progesterone = PMS, breast tenderness, acne, menstrual migraines, endometriosis, and so many other symptoms that my patients suffer from. We can also see this pattern in patients who chronically miscarry in the first trimester.
So consider asking your doctor to test you for these basics (especially the Vitamin D and the Thyroid) or finding a Naturopathic doctor to help you dig into these imbalances. Test, don’t guess!
Are you ready to kickoff your fertility journey?