November 8


How to improve fertility when you have Hashimoto’s

When you are experiencing infertility as well as Hashimotos is can be frustrating. Here is what to focus on to improve your fertility and Hashimoto's.

By Amy Vespa, MS - Integrative Clinical Nutritionist

November 8, 2021

minutes read time


Many women struggle with fertility issues especially when Hashimoto’s is present. But it is very possible to get pregnant with Hashimoto’s! If you are hoping to conceive there are a few important areas to focus on that can improve your chances of getting pregnant and having a healthy pregnancy. After reading this article you will understand how Hashimoto’s affects infertility, and what you can do to improve your fertility.

Hashimoto’s and infertility are common especially before Hashimoto’s is in remission and thyroid numbers are normal. 

Irregular cycles

Hypothyroidism can cause an irregular menstrual cycle. This means that ovulation is also irregular. Typically, a woman ovulates every 28-32 days and is fertile for about 3 days during her cycle, with about a 10-25% chance of getting pregnant depending on age. When ovulation is irregular it is difficult to know when your most fertile days are without tracking your cervical temperature and ovulation symptoms (To know more about this, check out the FAM method.)


Polycystic ovary syndrome causes irregular ovulation and increased androgen (the “male hormone”). Symptoms of PCOS include irregular periods, hirsutism, and cysts in your ovaries. It can impact fertility because eggs are not being released regularly, which decreases chances of getting pregnant. Many women with PCOS have elevated TSH and low progesterone. Elevated TSH means that the thyroid is not producing enough T3 (hypothyroidism) which slows down metabolic processes. 

Low progesterone 

Progesterone is necessary for preparing the uterus for pregnancy as well as helping regulate blood pressure, supporting mood and reducing anxiety, protecting bone health, and supporting pregnancy. Progesterone is produced when an egg is released in the ovary, so when there is a lack of ovulation progesterone is not created. (Some is also created in the adrenal glands). 

Decreased progesterone has a few effects:

  • it increases thyroid binding globulin levels (TBG)
  • it caused a decrease in thyroid peroxidase (TPO) which helps make T4 and T3
  • means estrogen is increased which can have similar symptoms to hypothyroidism (hair loss, weight gain, fatigue, headaches, low libido, depression)

Low progesterone can be caused by:

  • blood sugar issues
  • nutrient deficiencies (such as B6, magnesium, zinc)
  • inflammation
  • stress

What to do to improve your Hashimoto’s AND fertility at the same time

Focus on lowering inflammation

When you begin your Hashimoto’s healing journey, one of the first things to do is figure out your food triggers. Which foods are causing symptoms and making you feel worse? A food/mood journal is a good way to see the patterns, and doing a trial of eliminating the most common triggers can help (gluten, dairy, soy, eggs, nuts, peanuts, shellfish, sesame). Finding your trigger foods will help lower your antibodies and reduce the inflammation they cause.

After eliminating your triggers, focus on increasing anti-inflammatory foods. Anti-inflammatory foods are:

  • fruits and vegetables
  • beans and legumes
  • green tea
  • fish oils from flax, hemp, chia seeds
  • Supplements such as NAC, resveratrol, quercetin, cucumin

Manage stress

Stress is a factor in most health conditions, especially hashimoto’s and infertility. (SOURCE) Stress causes HPA axis dysfunction (formally called adrenal fatigue), which basically means that our response to stress is out of whack. This causes inflammation, nutrient deficiencies, increased cortisol, etc.

Helping your body manage stress and be able to truly calm down is crucially important. What does it mean to manage stress? It means that while eliminating all stress is impossible, our reaction to stressful events can change AND learning how to fully calm down after a stressful event.

When we encounter a stressor (at work or school, busy days, tense moments, worry about the kids, news, etc.) we go into fight-flight mode which allows us to focus and react how we need to. Afterwards, we should naturally go back into rest-digest mode which allows our body to go back to focusing on daily functions calmly. However, our minds alone can keep us in fight-flight mode by constant thinking, ruminating, worrying, etc. This is chronic stress.

Teaching your body and mind to calm every day will help rebalance your body. Try one of these powerful ways of calming:

  • walking outside
  • meditation
  • vagus nerve toning
  • talk therapy
  • hatha yoga
  • getting creative (journaling, art journaling, knitting, painting, crocheting, cooking, etc.)
  • taking a nap when you feel like it!

Balance gut health

As with stress, strong digestive health is important for feeling good every day. If you are experiencing digestive issues, such as bloating, pain, gas, irregular bowel movements (less than 1 bm per day) then look at strengthening digestion:

  • find food triggers
  • enjoy anti-inflammatory foods that make your gut feel good
  • increase fiber and hydration
  • drink bone broth daily
  • eat probiotic foods (lacto-fermented sauerkraut, kefir, miso, kombucha, etc.)


Visit your doctor to test your progesterone levels. If you find that your levels are low you can look into the cause (blood sugar issues, nutrient deficiencies, inflammation, stress) and your doctor might consider a progesterone cream to increase your levels, especially during the luteal phase of your cycle. 

In a nutshell

Hashimoto’s and infertility are commonly linked because of irregular cycles, PCOS, or progesterone/estrogen imbalance. When you have Hashimoto’s and are hoping to get pregnant focus on optimizing your chances by:

  • finding food triggers (to lower antibodies and reduce inflammation)
  • increase anti-inflammatory foods daily
  • really, really focus on managing and reducing stress (more info in our other article)
  • make sure your digestion is feeling good
  • ask your doctor about your progesterone levels

This was a lot of information and we know it can be confusing to put it all together to figure out what will work for you. We do this every day, so we can help you put the pieces together much more quickly. Book a no cost 20-minute call to see how we can help your Hashimoto’s, thyroid health, and fertility!


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