If you have Hashimoto’s Thyroiditis or Graves’ Disease you are genetically more likely to develop other auto-immune conditions of the GI tract such as an inflammatory bowel disease (ie: Crohn’s Disease or Ulcerative Colitis). Another GI disorder caused by the immune system is Primary Biliary Cirrhosis which is an auto-immune attack on the biliary ducts in the liver and the progression of the disease will result in cirrhosis and liver failure.

Thyroid patients are also more likely to be afflicted by Pernicious Anemia which is caused by an immune attack on the stomach. This causes the stomach to produce less of a chemical essential for Vitamin B12 to be absorbed by the GI tract. Patients suffering from Pernicious Anemia have Vitamin B12 Deficiency which can result in Anemia. Pernicious Anemia is treated by regular IM injections of Vitamin B12.

Another common GI disorder mediated by the immune system is Celiac Disease or Gluten Sensitivity. Patients having auto-immune thyroid disorders are also at a higher risk for having Celiac Disease or Gluten Sensitivity. This condition is related to an auto-immune attack on cells of the intestines resulting in sensitivity to consuming gluten. Gluten Sensitivity and Celiac Disease may result in bloating, abdominal discomfort and fatigue. If you have poorly explained GI symptoms and are suffering from an auto-immune thyroid disorder it may be important to have a Celiac Panel ordered by your doctor to see if you have positive anti-bodies markers for Gluten Sensitivity.

As you can see GI symptoms may be directly or indirectly related to a thyroid disorder. If you have thyroid auto-immunity or you are a thyroid patient suffering from a thyroid imbalance and you are experiencing GI symptoms you need to address them with your physician.

If you have Hashimoto’s Thyroiditis or Graves Disease you need to know that your genes could be playing a role in making you more vulnerable to having these auto-immune thyroid conditions, but the environment and exposure to environmental deleterious factors are also very important.

Iodine of course has been talked about as an important trigger of auto-immune thyroid disease and thyroid imbalance. Various types of infections, including viral infections have also been shown to trigger and promote auto-immune thyroid disease. Several medications including Amiodarone, and even smoking and stress can be additional factors that can promote immune attacks on the thyroid.

Well conducted research has shown that Hepatitis C virus infection can also promote immune attacks on the thyroid. The research has shown that both thyroid imbalance and thyroid anti-bodies are much more common in patients with Hepatitis C virus infection than in normal people. In fact, nearly 10% of patients with Hepatitis C have a thyroid disorder and positive thyroid anti-bodies. The reason is that the Hepatitis C virus shares some molecular similarities with the thyroid and this may make the immune system mistakenly attack the thyroid gland in response to the presence of foreign molecules coming from the virus. The virus could also be infecting the thyroid cells and that could trigger the attack of the immune system on the thyroid gland.

Alfa-interferon is a medication widely used to treat infections and cancer. This medication is also used to treat chronic Hepatitis C. It also happens that the medication Interferon can also trigger an auto-immune thyroid disease. So patients with Hepatitis C virus who are already pre-disposed to having an auto immune thyroid disease and are taking Alpha-Interferon are at higher risk of having an auto-immune thyroid condition. It has been estimated that thyroid disorders may occur in as many as 20-40% and a significant thyroiditis may occur in 5-10% of patients treated with Alpha-Interferon. Interferon can cause both Hashimoto’s Thyroiditis and Graves Disease. If a person has positive anti-thyroid antibody prior to being treated with interferon, the risk of having a significant thyroiditis becomes quite high. Interferon treatment can even trigger an auto-immune thyroiditis in people without thyroid anti-bodies. So if one has a genetic vulnerability to auto-immune thyroid disease, the use of interferon therapy makes the likelihood of having an auto-immune thyroid condition become more significant. Interferon can also cause a thyroiditis not mediated by the immune system but instead by a destruction of thyroid cells. This medication can directly destroy thyroid cells and makes thyroid hormone pour in our system. This ends up causing hyperthyroidism. Often the hyperthyroidism is followed by hypothyroidism as in Silent Thyroiditis. This is interpreted as a direct toxic effect of the medication.

What makes a person be at risk for thyroid disease and thyroid imbalance is a genetic predisposition. However environmental factors including infections, external radiation, and defects in the cells, medications, stress and exposure to toxic chemicals are more and more recognized as culprits in thyroid disorders. Other risk factors are being a female, older age and iodine deficiency.

Toxic chemicals such as insecticides, herbicides, and fungicides can disturb the function of the thyroid gland in different ways and trigger thyroid imbalance. Not only can these chemicals be toxic to the thyroid cells themselves but they can impair the uptake of iodine by the thyroid cell and can make thyroid hormone become inefficient in doing its job in the cells. In fact, animal research has shown that pesticide exposure to DDT (dichlorodiphenyltrichloroethane) and Amitrole can result in goiter and hypothyroidism. Herbicides and Fungicides have also been shown to cause low-grade hypothyroidism. An earlier research evaluated Danish greenhouse workers that were exposed to pesticides. This research showed indication of increasing frequency of hypothyroidism among the exposed workers.

A more recent research study from the University of Nebraska Medical Center has evaluated the occurrence of thyroid disease among women in Iowa and North Carolina which were enrolled in the agricultural health study in 1993 – 1997. These women were female spouses of private applicators of the chemicals. The women were questioned about their overall pesticide exposure, the number of years they worked on a farm and whether they have mixed or applied any pesticides during their lifetime, about the duration of such activities and about the herbicides and insecticides and fungicides that they were exposed to. They were subsequently questioned about their medical history including thyroid disease a few years later. The results were striking. Out of 23,569 spouses who were evaluated, 12.5% provided a history of diagnosed thyroid disease. 6.9% had hypothyroidism and 2.1% had hyperthyroidism. The increased frequency of thyroid disease has to do with the exposure to organochlorines (Aldrin, DDT, Heptachlor, Lindane and Chlordane) as well as the exposure to fungicides: (Benomyl and Maneb/Mancozeb) and the exposure to the herbicide, Paraquat.

Polycystic Ovary Syndrome (PCOS) is a very common hormonal disorder affecting nearly 7% of women in their reproductive years. In Polycystic Ovary Syndrome, there are slightly high levels of male hormones, problems with ovulation, irregular menstrual periods, infertility, as well as several metabolic abnormalities. One of the most significant metabolic abnormalities is insulin resistance, meaning that insulin does not work efficiently in our organs. High insulin levels, glucose intolerance, and early diabetes are common consequences of insulin resistance. A significant number of women with Polycystic Ovary Syndrome are overweight or obese. Women with Polycystic Ovary Syndrome also have high levels of inflammation chemicals produced by fat tissue.

Research had previously shown that women with Polycystic Ovary syndrome have a higher tendency of having Hashimoto’s Thyroiditis, which is the most common cause of hypothyroidism. Hashimoto’s Thyroiditis may share genetic susceptibility with Polycystic Ovary Syndrome, explaining to some extent, the association between Hashimoto’s Thyroiditis and PCOS. An interesting common feature of both PCOS and Hashimoto’s Thyroiditis is that both are associated with high levels of inflammatory chemicals in the blood.

Fairly recent research conducted in India and published in the European Journal of Endocrinology has looked at how common Polycystic Ovary Syndrome is present among girls, whose age ranges between 13 and 18 who had evidence of Hashimoto’s Thyroiditis and compared the results of the frequency of PCOS in girls without Hashimoto’s Thyroiditis. The study used extensive studying of the girls, including evaluation of insulin resistance and meticulous hormonal testing. This research showed that nearly half of the girls with Hashimoto’s Thyroiditis had PCOS, as compared to slightly less than 5% in girls who did not have Hashimoto’s Thyroiditis. The study has also demonstrated that girls with Hashimoto’s Thyroiditis have more marked insulin resistance than the girls who did not have Hashimoto’s Thyroiditis.

The association between Hashimoto’s Thyroiditis and PCOS is quite interesting but cannot be explained with any certainty at the present time. However, if you have Hashimoto’s Thyroiditis, you need to be aware that you may have PCOS or you may be developing features of PCOS in the future. If you have been diagnosed with PCOS, then your physician needs to be alert to the possibility of Hashimoto’s Thyroiditis and the possibility of occurrence of hypothyroidism in the future.

Hypothyroidism affects many reproductive aspects in women. It can cause irregular and heavy menstrual periods, miscarriages, and infertility. Mild or sub-clinical hypothyroidism is diagnosed when thyroid hormone levels (T4 and T3) are normal but TSH, the most sensitive test to diagnose hypothyroidism, is slightly high. Hypothyroidism is quite common among the general population and affects as many as 7-8% of women in their reproductive years.

Previous research has demonstrated that among women suffering from infertility, there was a higher percentage of mild hypothyroidism than in the general population, suggesting that mild hypothyroidism can cause inability to conceive. A recent research studied the outcome of assisted reproduction technology with IVF women who had suffered infertility and who also were diagnosed with mild hypothyroidism. Half of the patients were treated with thyroid hormone to correct the mild hypothyroidism and half of the patients were given a placebo (not a real medication). When women became pregnant, either thyroid hormone treatment or the placebo was continued throughout the pregnancy. The success pregnancy rate among the women who received thyroid hormone treatment was 51.9%, compared to 18.8% in women who received placebo. The women who were treated with thyroid hormone also had a significantly lower miscarriage rate than the women who did not receive thyroid hormone treatment.

So, if you have an infertility issue, it is quite important to have your thyroid anti-bodies checked and thyroid testing performed by your physician to make sure you do not have mild hypothyroidism, which can predispose you to infertility. Also, if you do have mild hypothyroidism, it is quite important to have your underactive thyroid corrected with appropriate thyroid hormone treatment prior to trying to get pregnant and prior to undergoing IVF. The reason why hypothyroidism, even mild, can affect the ability of the person to become pregnant, is the fact that thyroid hormone affects estrogen and progesterone levels.