Discusses how “normal” TSH can hide underlying imbalance affecting egg quality and ovarian reserve.

1:02 - The overlooked connection: thyroid, adrenals, and ovarian reserve decline

How stress and adrenal patterns influence thyroid function, AMH levels, and FSH trends.

2:15 - What “normal TSH” actually means for egg quality and IVF success

Why the lab range is broad and why fertility outcomes depend on optimal levels, not normal ones.

3:00 - Hypothyroidism and its impact on follicle development, ovulation, and egg quality

How low thyroid hormone slows follicle growth, creates immature eggs, and disrupts ovulation.

3:45 - Oxidative stress, Hashimoto’s patterns, and inflammation affecting AMH and FSH

How inflammation and autoimmune thyroid activity accelerate ovarian aging.

4:28 - When low thyroid function accelerates diminished ovarian reserve (DOR)

Why hypothyroidism can contribute to faster follicle depletion and shortened cycles.

5:10 - How hyperthyroidism and mismanaged thyroid medication disrupt cycles and implantation

The impact of thyroid swings on ovulation, luteal phase quality, and transfer success.

6:02 - Thyroid antibodies (TPO and TG) and their link to low AMH, embryo quality, and miscarriage

How elevated antibodies affect ovarian function even when TSH is normal.

7:12 - Why IVF fails when thyroid antibodies are high despite “normal” labs

Explains the connection between thyroid autoimmunity, failed retrievals, and transfer failure.

8:00 - Functional steps to lower inflammation, improve gut health, and optimize thyroid for conception

Targeted strategies including thyroid-supportive nutrients, gut healing, and lifestyle changes.

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TRANSCRIPTION

[00:00:00] I wanted to bring today's episode to the podcast talking all about the connection with if you're dealing with diminished ovarian reserve, premature ovarian insufficiency, low AMH, and the thyroid. Maybe you've been told your TSH is normal, or maybe it's not normal and you're actually on thyroid medication.

What could be some underlying reasons as to why the thyroid is off why this is so important for, to improve a successful retrieval, improve a successful transfer, and to get pregnant this year. Excited for you to listen. Let's go.

Welcome back. I'm Sarah Clark, founder of Fab Fertile and your host. I believe the functional approach is the first step for anyone on the fertility journey. And my aim is to help you get pregnant naturally. Today, we're digging into thyroid health and how this impacts diminished ovarian reserve and premature ovarian insufficiency.

This episode is for you as if you've been diagnosed with low AMH, diminished ovarian reserve, premature ovarian insufficiency. You want to understand how thyroid health plays a role. You've got irregular cycles. [00:01:00] Maybe you're dealing with unexplained infertility. Maybe you've had a recurrent pregnancy loss.

And you're wondering if the thyroid can be a factor. You've been told your thyroid levels are normal, but you're still having symptoms like fatigue, hair loss, cold intolerance, brain fog, and you want to know what this means for fertility. You've got Hashimoto's or Graves disease and you want to learn how the thyroid antibodies impact ovarian function and egg quality.

You're looking for practical strategies to optimize thyroid function and improve your chances of conception. Thanks so much for listening. I'm so thankful that you're here. Make sure you hit subscribe or follow, and if you know someone else who's on the fertility journey. Please share this podcast with them.

Okay, so I get so many people telling me that their TSH, your thyroid stimulating hormone, is normal. They have gone to the doctors and they said everything is normal, but is it optimal? And a theme we see with diminished ovarian reserve, premature ovarian insufficiency, recurrent pregnancy loss is thyroid dysfunction.

Our whole thesis on this, is it actually early [00:02:00] menopause, or is it your adrenals that impact your thyroid, but that impacts your AMH, your FSH, and your follicle count. It, so the thyroid health plays a crucial role in egg quality, ovarian function, and overall fertility. And we've got to look at the full thyroid panel, including antibodies.

And so I have a whole thyroid guide on this, so send me a message at hello@fabfertile.ca put subject line THYROID and we'll get you that thyroid guide. It talks about the reference ranges when you're looking at the full thyroid panel, which ones to look at. So then you can compare these and see what is being missed.

So we do see it across the board, obviously not every single person, but it's a theme we see and it is continually overlooked. And so hypothyroidism. So maybe you already have hypothyroidism. So typically your REI is going to want to have your TSH below 2 mIU/L. Maybe yours is trending a little bit high.

So they say, Hey, let's take some Synthroid or some levothyroxine. So you're taking it, but that is just a bandaid approach and we need to dig deeper of why the thyroid is off to begin with. And [00:03:00] so making sure that we're looking at the full panel cause you could have either autoimmune thyroid issues or Hashimoto's.

You can have subclinical thyroid issues. So it's not the thyroid, it's the liver or the gut, or you can actually have hypothyroidism. And so we're not opposed to medication. It can be part of the solution, but you've gotta make targeted diet and lifestyle changes.

So with hypothyroidism, so low thyroid function, it could lead to reduced follicular development. So low thyroid hormones can slow down follicle growth leading to immature or poor quality eggs. We see people that have had very low follicle growth and all of a sudden they make all these changes.

The thyroid comes back online, lo and behold, the follicles come back online. Increased oxidative stress. So that's the whole thesis with the adrenals and the thyroid. So hypothyroidism is linked to higher oxidative stress, which can damage egg cells and contribute to chromosomal abnormalities.

So oxidative stress from either from mental, emotional side of things, [00:04:00] environmental toxins, gut infections, food sensitivities, something impacting the, the health of the thyroid and the thyroid is the canary in the coal mine. When that is off, there's other systems in the body to be able to look at that hormonal imbalance.

So hypothyroidism disrupts the balance of reproductive hormones like FSH and LH leading to a regular ovulation and lower egg quality. And then a higher risk of diminished ovarian reserve and premature ovarian insufficiencies. So studies suggest that hypothyroidism, especially when linked to Hashimoto's, may accelerate ovarian aging and contribute to diminished ovarian reserve.

Good news though, there's things we can do, strategies we can take right now to be able to optimize the thyroid. And then we also see hyperthyroidism. So overactive not as much more of a theme of low thyroid. So hyperthyroidism sometimes it's the thyroid medication is managed poorly and it's swinging the thyroid all over the place.

So you need to make sure you're working with your doctor to get it tested typically every six weeks and really optimizing those levels and making sure you're taking the right type of thyroid [00:05:00] because you could just maybe take taking one that's not the right one for you. And so you need to be able to work with someone that understands the functional medicine approach.

And so maybe the overactive thyroid is leading to premature ovarian aging and overactive thyroid can lead to faster depletion of the ovarian follicles, reducing the available pool of eggs. Disrupted ovulation thyroid may cause irregular cycles and ovulation, poor luteal phase support, impacting egg maturation.

Increased miscarriage length. So poor egg quality due to excessive thyroid hormone activity can lead to chromosomal abnormalities and implantation failure. So we see that a lot as a theme with people that have had pregnancy loss, that no one's really dug deeper into the full thyroid panel and making sure that it's optimized.

And then, like we said, we see that autoimmune thyroid side of things, where it's Hashimoto's or Graves. We see more Hashimoto's, but inflammation and egg quality autoimmune thyroid disorders can [00:06:00] increase systemic inflammation, which can harm ovarian function and egg quality. And antibodies and fertility.

So thyroid peroxidase, so TPO antibodies, even in normal thyroid levels have been linked to lower ovarian reserve and higher miscarriage rates. I see so many people that have Hashimoto's and they're doing IVF retrievals and transfers and they look at their antibodies. We like the antibodies below 10 typically and theirs are 100, 200, 300, 400 and they're being pushed and then they have pregnancy loss or they wonder why that the embryo never makes it.

It's just a disservice to people, right? Pushing your body with medication, that can be part of it, but you've got to make the diet and lifestyle changes beforehand to set yourself up for success. When you actually go and do that, you're going to improve the chances of it working. And you want to work with your practitioner, a knowledgable practitioner to be able to monitor your TSH, your free T3, your free T4.

And like we said for the TSH, we like it below 2. So typically [00:07:00] 0. 5 to 2 you got to look for antibodies that can signal an underlying immune dysfunction affecting ovarian health. And you want to consider some nutrient support. So selenium, some Brazil nuts can be helpful, iodine. You got to really work with a practitioner on this.

You got things swinging all over the place. You have to be very careful. So iodine you can use some zinc, vitamin D. We've done many podcast episodes on vitamin D and how that can support thyroid function. It can improve a quality. And then the big piece here is addressing inflammation. So especially if you have an autoimmune issue and you're dealing with diminished ovarian reserve and premature ovarian insufficiency, the conventional approach to an autoimmune issue is typically having you on medication or steroids for the rest of your life.

It does not help to reverse it. Functional medicine and functional nutrition is the best step to actually help reverse that chronic disease. And really get to the root of why it's there in the first place, which can then really help your egg health, the health of the embryo and making sure that it's going to [00:08:00] improve implantation. Work on the gut health.

So we do stool testing, looking at the DNA, the stool, maybe you've got a parasite or a bacterial infection or a fungal infection, something going on the health of the gut. Which can then impact your thyroid. And then when you reduce inflammation, this can impact the thyroid and then that improves overall ovarian health.

And then the big piece here is the stress. So if the adrenals, it's been going on for years, you're in chronic stress, you're burnt out. We've got to nourish everything and bring things back online. So we do the food sensitivity testing we do a food diary for five days. So we can see exactly how food is impacting your health mentally, emotionally.

So you can just eat your regular food. And then we have you do the elimination diet. If you check out the AMH diet that's the elimination diet would tell you how to do it. Taking out the top allergens, systematically reintroducing them over the course of 30 days. And then we have you fast track this with food sensitivity testing.

And so we have you take out [00:09:00] dairy and gluten for 60 to 90 days and really reducing inflammation in your body in a very targeted manner with the diet that's right for you. And if you have a known thyroid issue, just take out gluten 100%. No cheating. Don't mess around. Really, anyone on the fertility journey, we want you to take out gluten 100%.

 So we have you do that elimination diet, then take out dairy and gluten for 60 to 90 days, and then continue on being gluten free. Working on those gut infections. You've got leaky gut, you've, you've taken a bunch of antibiotics and chronic stress and that's impacting the health of your gut, which is highly tied to the health of your ovaries.

Health of the sperm too and then also that genetic piece we were talking about before. So what are those specific diet and lifestyle changes to be able to support that? And then we're looking at your biomarkers and then also the stress side of things with this, right? So we can do perfect gluten free, kick out the parasite, optimize the bacteria.

Minimize the H. pylori, because we see [00:10:00] that you're eating this nice, healthy diet, but you're not actually absorbing the nutrients, but the elephant in the room is often the stress you've been under to be able to procreate depending on where you are in your life, you might've achieved a lot, and now we're throwing everything at this, and it's not about throwing a bunch of medication at it, it's nourishing your adrenals, being able to know in your heart of hearts that this is possible for you.

Being able to look at your numbers, but then also look at your relationships, your social life, your faith, your intuition, that side of things, like what has slipped there. Many times we do this circle of life and it becomes a little lopsided wheel where our relationships, our social life, our place of worship, our, our intuition, we become disconnected from that side of things and we're all stuck over here on the career.

On the doing on the achieving and our heart space has been neglected. And that needs to be looked at too. And then, really meeting your miracle partway. Obviously we believe in miracles, but you've got to take the targeted [00:11:00] action. And if there's something going on, if you're told your thyroid is normal, I encourage you to dig deeper.

Definitely send a message to hello@fabfertile.ca. For that thyroid guide, put thyroid in the subject line and we will send it to you. And I'll give you all the steps you can take right now to improve thyroid health and get pregnant this year. And if you really want, if you would like our help to be able to use testing, work on the mindset side of things and really set yourself up for success.

If you've got that retrieval coming up and you want to ensure it's going to work, you got that transfer. You have those beautiful embryos and you're ready. You want to make sure you're going have the beautiful transfer. you want to improve that actually working. I encourage you to send a message to hello@fabfertile.ca and we can come up with a plan to improve the chances of pregnancy success this year. Thanks again for listening. Take care.

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How to Get Started With Functional Fertility Support

Book your call here to get your personalized plan and options to help improve pregnancy success either naturally or with IVF treatment. 

Check out our Fab Fertile functional fertility program here and learn how to improve AMH levels naturally.  We work with couples that have low AMH, high FSH, diminished ovarian reserve, premature ovarian insufficiency, and recurrent pregnancy loss.

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FAQ - THYROID and Low AMH, DOR and POI

Can low AMH improve if my thyroid improves?

Yes. Studies show thyroid optimization supports egg quality and improves ovarian response, even when AMH stays the same.

Is a TSH of 3 mIU/L okay for IVF?

Technically “normal,” but not optimal. Many reproductive endocrinologists aim for below 2.5 mIU/L before IVF.

Can thyroid antibodies affect ovarian reserve?

Yes. Women with TPO antibodies are more likely to have low AMH and DOR.

Do I need medication?

Not always. Some women improve with nutrition, lifestyle, and addressing underlying imbalance. Others need thyroid medication. It depends on your full picture.

Can thyroid issues cause miscarriage even with normal labs?

Yes. Research links thyroid antibodies and subclinical hypothyroidism to higher early pregnancy loss.

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KEY TAKEAWAYS

• Thyroid function affects follicle development, egg maturation, ovulation, luteal phase strength, and implantation

• Many fertility clinics check only TSH, which misses up to 60 percent of thyroid dysfunction

• Optimal TSH for fertility is narrower than the general lab range

• Thyroid antibodies (TPO, TG) can impact ovarian reserve and IVF success

• Thyroid support improves conception rates in women with DOR, POI, recurrent loss, or repeated failed transfers

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Resources

📩 Get your free Thyroid & Fertility Guide! Email hello@fabfertile.ca with the subject line THYROID to receive your guide and learn how to optimize your thyroid for better egg quality and fertility.

Why Optimizing Thyroid Matters For Low AMH, High FSH and Antral Follicle Count:  https://fabfertile.com/blogs/podcasts/why-optimizing-thyroid-matters-for-low-amh-high-fsh-and-antral-follicle-count?_pos=5&_sid=eddf1bb4a&_ss=r

Can Hypothyroidism Cause Infertility: https://fabfertile.com/blogs/education/can-hypothyroidism-cause-infertility?_pos=6&_sid=eddf1bb4a&_ss=r

Fab Fertile Method https://www.fabfertile.com/what-we-do/

Ultimate Guide to Getting Pregnant This Year If You Have Low AMH/High FSH - https://fabfertile.clickfunnels.com/optinvbzjfsii