I never imagined I would become a go-to Hashimoto’s Dietitian. Health and nutrition has always been much more to me than calories in and calories out. I value low stress, happiness, exercise, being outdoors, hydration, sleep, vitamin/mineral status all as important parts of acheiving the best health possible. I suppose you can say I have always been a little bit of a health “nut” even since I was a little girl and my Mom fed me cucumber sandwiches. Funny thing is I hated hotdogs and soda as well.
Postnatal Thyroid Nutrition
If you are reading this post, you likely have a beautiful healthy baby or are about to! Congratulations!
*This post is not intended for medical advice.*
1 Month Postnatal
First, rest, relax, and enjoy the first few postnatal new baby months.
Focus on nutrient rich foods and supplements. You just had a baby that was depending on your body for nutrients and life. This means you may be a little depleted of your nutrients such as iron, vitamin D, B vitamins, or trace minerals and nutrients. You also need those nutrients and plenty of healthy fats if you are breastfeeding!
Keep up with your prenatal multivitamin, and double check to make sure you are getting a high quality absorbable B complex (this may be contained within the multivitamin). The B vitamins can help ward off postpartum depression and maintain energy during sleepless nights. The B vitamins are also crucial for acheiving optimal iron status. If your multi does not contain B vitamins that are of high quality (aka methylated B vitamins), this is one brand by Designs for Health I often recommend.
For my first month, here is a sample of what I ate to focus on nutrients: Breakfast was either a lot of fresh fruit with natural nut butter OR gluten free oatmeal with nut butter or peanut butter powder (for protein) mixed in and topped with dried cherries. Lunch: smoothie made from frozen fruit (usually frozen cherries), organic whey protein, nut butter OR a veggie omelet. Dinner: varied, but was a lot of
my typical stuff: sweet potatoes, wild Alaskan salmon burgers, broccoli/veggies (that is just one of my easy go-to meals). For snacks, I either had a smaller smoothie, a “mug cake”, veggies/seed crackers and hummus. But, I didn’t have as many snacks the first month. And, my favorite… coffee!
Small amounts of caffeine are fine. However, baby can not truly process caffeine until around 3 months old.
2-3 Months Postnatal
At the end of month 2, headed into month 3 is when you should schedule to have a full thyroid panel done as well as a panel to test your vitamin D and ferritin (iron). 8-10 weeks postpartum is the time when the immune system should shift back to where is was before pregnancy if you have Hashimoto’s or Grave’s disease. This is also around the time when Moms may develop postnatal hypothyroidism if they previously had healthy thyroid levels prior to pregnancy. Therfore, all new Mamas should be screened for hypothyroidism and make sure to get a full thyroid panel that includes a test for free T3 and thyroid antibodies.
It is important to test vitamin D to make sure levels are optimal to promote healthy breastmilk (if you are breastfeeding). Breastmilk does not contain tons of vitamin D, but the thought is that moms who have optimal D promote better levels in baby.
As most of us know, many new moms can become anemic at the end of pregnancy or early postnatal. This is why I recommend ferritin lab testing to check iron status. Optimal iron levels are crucial for acheiving optimal thyroid levels and helping you to rely on less medication if that is your goal.
Once again, I was lucky that my postnatal thyroid labs came back healthy (I still continue to take Nature-Throid). I did not start to notice any thyroid or autoimmune related issues until about 10-12 weeks postpartum I would say. The only thing I began to notice was that the little bumps on my skin returned (autoimmune related I think) and my skin was not so pregnancy “glowy” anymore. I also noticed I became the most tired and exhausted around 5 or 6 months postpartum. I am still working to figure this out. I am almost positive it is sleep related. My hair, fortunately, has remained very thick and healthy after pregnancy. I did not experience any thinning or falling out and I am currently 7 months postpartum as I write this post.
Thinning Hair?
That brings me to my next topic that I get a lot of questions about–thinning hair. Like I mentioned, I did not stuggle with thinning hair pre or postnatal. But, I did have extremely thin hair at the onset of Hashimoto’s and when I also lost weight unintentionally about 12-13 years ago. This was likely when my immune system was likely going crazy, and I was lacking nutrients. Prior to pregnancy, during pregnancy, and postnatally is when I have enjoyed the thickest, best hair. I attribute this to my attention to increasing my nutrients and taking my high quality B complex and vitamin. I have also been working on calming my immune system, and healing for the last few years. In general, this has helped to improve my hair.
I do not recommend generic biotin or “hair supplements”. If anything, you should test your nutrient status and not just guess that is the problem. Or, maybe you need to work on healing your entire body: stress less, address nutrients, ditch gluten, eat well, relaxing exercise, sleep, optimize thyroid hormone, and more.
Breastfeeding Supply and Thyroid
If thyroid levels are not optimal, this can reduce milk supply. If you are suffering from low milk supply, first, I recommend reaching out to a lactation consultant in your area. An IBCLC will best be able to advise you. Then, if you are doing everything they have recommended, test those thyroid labs (FULL panel as always), and check for low thyroid levels.
This concludes the 3-part thyroid and all things pregnancy! I will write further posts explaining the topics that need more explanation like hair/skin/nails, supplements, lab testing, and more.
Thyroid Prenatal Nutrition
Part 2: Thyroid Prenatal Nutrition and Health
My previous post addressed the pre-conception time period, and this post is dedicated to all things pregnancy! Here are thoughts on thyroid health during pregnancy, and if there is anything special to be done for nutrition during pregnancy.
*This post is not a substitute for medical advice.*
Basic Nutrition
Anyone with a thyroid condition should follow all of the standard guidelines for pregnancy nutrition:
- Limit seafood that is high in mercury like white tuna, mackerel, etc (I completely avoided because I am a little paranoid about mercury… I know). Max serving is 6 oz per week, but I prefer less.
- 2 servings of the lowest mercury seafood per week is recommended (or, can consider DHA/EPA supplement which is what I took along with eating some wild salmon)
- Limit caffeine (approx max of 200 mg per day)
- Avoid unpasteurized foods as they are risks for foodborne illness
- Avoid deli meats unless heated above 150 degrees F.
- Monitor foods that contain Listeria by checking this website so you know what to look for and avoid. Frozen vegetables and packaged lettuce made the list last year!
- Eat no raw fish or meat
- Take a 400 mg folate supplement that is well absorbed aka methylfolate (NatureFolate is brand name, 5-MTHF, or methyltetrahydrofolate). I took Prenatal Pro multi that includes the right type of folate.
Special Prenatal Nutrition Considerations for Hashimoto’s
- Ditch gluten if you have Hashimoto’s or Grave’s and have not done so already. Read all about gluten and Hashimoto’s here.
- Iron: Monitor iron (ferritin levels not just hemoglobin/hematocrit) throughout pregnancy. I recommend testing each trimester. Those with Hashimoto’s and hypothyroidism tend to run lower on iron. You may need an additional absorbable iron supplement. I used an iron bisglycinate supplement occaisonally. In addition, make sure to consume plenty of iron-rich foods such as organic red meats (if you eat meat), cooked leafy greens (especially organic spinach), some dried fruit (but, do not go overboard due to sugar), peas/pea products, sardines, poultry, sprouted seeds, sprouted beans, potato, and nuts.
- Vitamin D: Needs are higher during pregnancy. Have your vitamin D tested during the first trimester, and supplement accordingly. If you take a higher amount of vitamin D, I recommend magnesium and vitamin K2 to balance out that vitamin D. Why vitamin D? It tends to run low in those with autoimmune conditions like Hashimoto’s. Optimal levels (50 -70) support the immune system. Lastly, the growing baby can deplete mama of vitamin D. Optimal vitamin D is also needed down the road for healthy breastmilk. Overall, this is mostly to make sure your body does not get depleted of an essential vitamin.
- Calcium: Needs are also higher during pregnancy to help build healthy bones in baby. Calcium is often forgotten for those avoiding dairy and those with Hashimoto’s. Basically, I am saying, “don’t forget your calcium!” even if you do not consume dairy. I got a small supplement in my prenatal multi, but also consumed salmon, cooked leafy greens, white beans, and dried figs. Other non-dairy sources of calcium: almonds, oranges, cooked kale, molasses, and sardines.
- Iodine is controversial for those with Hashimoto’s. Some experts say iodine restriction can improve the autoimmune condition, while others recommend supplementation. This is a tricky guideline for pregnancy since the growing baby needs iodine for proper development. I would never recommend iodine restriction during pregnancy. Here is what I did:
I went ahead took iodine (200 mcg) that was included in my prenatal multi, and this seems like it was a good option. 200 mcg seemed to be a good amount for me (not excessive and not too low). I never experienced any symptoms from taking the iodine.
Lab Testing is Key!
In addition to nutrition guidelines, you will also want to get a full thyroid panel each trimester. This means to make sure you get your free T4 and free T3 tested at each visit. Make sure to get a full thyroid panel done as soon as you find out you are pregnant. This can help to avoid miscarriage (by making sure you levels are in range). Get your progesterone checked at this time as well as your vitamin D and ferritin.
My Experience
My thyroid levels were really wacky the first trimester, and then looked pretty darn perfect (the best I had ever seen) during the second and third trimester. Antibody levels also dropped to the lowest I had ever seen during my pregnancy. My immune system must have shifted for the better. I was concerned about not having enough T4 in the first trimester since I was taking Nature-Throid (a T4 and T3 combination medicine), but my provider reassured me my labs were ok. Most practitioners DO NOT recommend natural dessicated thyroid medicines (the ones containing T3) during pregnancy since the baby needs much more T4. Baby does not produce their own thyroid hormone until approximately 10 weeks gestation, and relies on Mom’s thyroid hormone before then. So, I was nervous continuing to take my Nature-Throid. But, I knew if that is how my body got pregnant, I should continue to take the medicine that made it happen.
Another key is to find a provider that thoroughly understands T4 and T3 hormones.
Feel free to posts questions below! I will leave you with this fun and healthy pregnancy drink:
Infertility and Hashimoto’s
I am excited to publish this 3 part series of blog posts about pregnancy, infertility and Hashimoto’s. This will also relate to those just suffering from hyper or hypothyroidism. I will give more details on the pre-conception period, prenatal nutrition, and postnatal nutrition!
Six months ago, I gave birth to a super cute, healthy little girl. I was very surprised how I glided through the pregnancy and postnatal time period without any major thyroid problems. VERY surprised. I am grateful for that and feel like I lucked out. I had read about thyroid complications postnatally, and many possible dangers during pregnancy. I researched and read as much as I could as soon as I found out I was pregnant, and there is not a lot of clear information out there. But, I did learn a lot, and I am excited to share with you my knowledge! *This blog post is not intended for medical advice.*
Why Many Women Experience Infertility with Thyroid Dysfunction
It’s all about the hormones. If thyroid hormones are low, your body can not produce enough sex hormones to maintain regular menstrual cycles. Or, if you do get regular cycles, you may still not have enough hormone to sustain a pregnancy or conceive.
For me, I noticed my progesterone was always on the low side and I had very irregular (mostly nonexistent) cycles. I figured the chances of getting pregnant were very slim. I was wrong! I had been working to improve my health for about 2.5-3 years and that is what helped my body acheive healthy hormone levels. I also take Nature-Throid.
Many women have low T3 even with no doctor diagnosed thyroid disease. Little (big) things like stress can even cause low hormones. T3 is critical since it is the most “active” thyroid hormone and this is the hormone that “talks” to other parts of the body allowing fertility to run along smoothly.
Know Your MTHFR Status
MTH-what?? Methylene tetrahydrofolate reductase = MTHFR. Certain MTHFR gene mutations can cause fertility problems and very few people know to test this. Yet, an estimated 40-60% of the total population has some type of gene mutation myself included. This topic by itself is a blog post for another day. The reason I bring it up is that I find many with thyroid dysfunction or Hashimoto’s have one of the MTHFR gene mutations.
To oversimplify, if you have one of the gene variants that alters your body’s ability to use B vitamins it will reduce fertility. Your body is less able to create methione which is needed for critical body functions and fertility. The good news is that this is something that is easily treated with various forms and types of B vitamin supplementation. There are other supplements that are often recommended as well (again, more on this subject later). If your B vitamin levels are not healthy, this can set you up for a risk for miscarriage, spina bifida in baby, postpartum depression, low levels of glutathione (master antioxidant) and much more.
Optimize Your Nutrient Status
…and reduce total body inflammation. Take a good quality multivitamin. No brick pills! Capsules and reputable, tested brands only. I took Designs for Health Prenatal Pro throughout my entire pregnancy. Do not simply rely on your vitamins though. Make sure to eat nutrient rich foods. One of the easiest ways is smoothie form. You can add loads of nutrients AND make it taste delish.
I ditched gluten about 2-2.5 years before I got pregnant. I also began following my LEAP MRT plan to reduce inflammation in my body. Lastly, I tested my micronutrients in my body to see how I was doing with my vitamins and mineral stores. Over those two years or so, I got healthier. This made my body run more efficiently, improved my metabolism, and without even realizing, it made my body fertile.
Reduce Stress
Easier said than done.
However, reducing stress helps your body reach higher levels of that free T3 I was talking about. Optimal T3 = more optimal fertility.
I found pole dancing as a sport and fitness activity during this time period when I was trying to improve my health and thyroid levels. Pole dancing was an activity that allowed me to be free and stress free. I loved it, and it was a sport that made me more alive. I used to run and do general workouts, but running was still likely causing some stress on my body. My advice: find a stress reducing activity that you truly love and it will improve your life regardless. Just get out there and do it.
Fertility Basic Checklist:
- Screen for low progesterone
- Get a full thyoid panel including free T3
- Test your MTHFR gene (and/or homocysteine)
- Optimize your nutrient stores
- Reduce stress
Ther are other areas to address, but this is just a general checklist that will be suitable for most thyroid sufferers. Each person is a unique individual, so I never like to recommend a one size fits all approach.
If you would like more information on any of these topics, let me know down in the comments below. This helps me to create future blog posts for you all!
Part 2: Prenatal Thyroid Nutrition — Coming Soon!