How I Managed Hashimoto’s During Pregnancy

hashimoto's pregnancy

This was the last picture taken of me before I gave birth to my daughter May 2016.


One of the most frequent questions I receive these days is, “How did you manage your thyroid while pregnant?” This is a poignant question because pregnancy and post-partum is infamous for sending the thyroid awry whether or not you have Hashimoto’s disease.


my back story…

I was diagnosed with Hashimoto’s at age 19 (10 years ago) and have been on some form of thyroid hormone replacement since then. In our community, we tend towards anti-medication but in the case of many autoimmune diseases, supporting the body through medication AND dietary and lifestyle changes is a true holistic approach.


My body requires supplemental hormone because the disease has significantly destroyed my thyroid prior to diagnosis and dietary changes. Once thyroid tissue is destroyed through autoimmunity or radiation, it will not produce the necessary thyroid hormone required for optimal metabolic function. This requires supplement through medication and it is incredibly important to adhere to your doctor’s advice regarding medication while pregnant.


A quick note on which thyroid medication I take:

I am one of the rare people who has a severe autoimmune attack to porcine thyroid hormone (Armour, Naturethroid, for example). In fact, the last time I took it, I launched into a 12-month long flare that ended during pregnancy. You will also likely find autoimmune disease remission during pregnancy as the immune system down regulates to protect the body from seeing your baby as an invader.

Instead, I do best on a synthetic combination of T4 (Tirosint) and T3 (liothyronine). Yes, I’ve tried compounded medication with a functional practitioner and my numbers do not stabilize well. No, I have not tried and will not try to go off my medication. Tirosint is a great option for those of you looking for additive-free synthetic thyroid medication. Ask your insurance if they will cover it.


My story with infertility is long, and I won’t be talking about it here. Instead, let’s start with conception to keep this focused. 


I went into pregnancy in the middle of that autoimmune flare mentioned above. Women with Hashimoto’s do have an increased risk of pregnancies not being carried to term (I don’t like the word “miscarriage”). As a woman with Hashimoto’s, I knew I needed to be an educated self-advocate during pregnancy and beyond.


I did not let these statistics scare me though. Sure I had my moments of worry like most moms, but I trusted and supported and loved my body extra during this time. When I needed to calm my mind, I used prayer, meditation and journaling to comfort me.


I am sharing with you the process I put into place the moment I found out I was pregnant in August 2015 to best ensure a healthy mom and a healthy baby.




I found out I was pregnant in Hawaii on our way from moving from Chicago to Austin. I didn’t have an OBGYN in Austin let alone a general practitioner.


The day I found out I was pregnant, I called my health insurance company from our Kauai Airbnb to get the number of a gynecology group in Austin under our plan. I knew they may not be the perfect fit, but I needed to establish care as soon as possible so I could get my thyroid tested immediately.

But what if I don’t have diagnosed Hashimoto’s? Should I still get my thyroid tested?

My answer as a thyroid patient is YES. If you have suspected Hashimoto’s or hypothyroidism or have a family history, get your thyroid tested early in the first trimester. There is absolutely no risk to you to get this done but it can be risky to NOT know what your thyroid is doing in those formative weeks.

In fact, some thyroid experts advocate thyroid testing for every pregnant woman.


The office requested I only schedule my first appointment between 8 to 10 weeks pregnant, but I had done enough research on early pregnancy and Hashimoto’s to know I needed to get in sooner.


I was able to schedule my first appointment for 6 weeks. I would have preferred 5 weeks but they did not have availability. I requested a blood thyroid panel including TSH, free T4, free T3. I even got to see my baby as a little dot on a quick ultrasound (and hear her heart beat) during that appointment.


Backing up, I had a full panel done around the time of conception and knew my TSH, T3, and T4 were normal even though my antibodies were high from the flare. Just four weeks later at 6 weeks pregnant, my TSH increased from 1.0 to 9.0 and my T3 and T4 dropped.


The increased demand on your thyroid during the first trimester is no joke. If you have a damaged thyroid due to Hashimoto’s, your thyroid may not be able to keep up with this increase demand. Test early, test often, and test fully.


Test early, test often, and test fully.


We increased my thyroid dosage by about 50% to stabilize my numbers. At this time, I was only on T4 and not T3. In fact, during pregnancy, I could not find a practitioner to prescribe me T3 since it has not been studied in pregnant women. You may have a different experience with that depending on your practitioner. I got on T3 within a few weeks of giving birth. Even without supplemental T3, I was able to keep my T3 in the 50% range and had bounds of energy throughout pregnancy.





Many thyroid patients will agree that finding the right practitioner, one knowledgeable in full thyroid panels and optimal levels (not just “in range” levels) is a necessity. Pregnant women especially must feel they are in good care with their medical team. Your OBGYN, midwife or general practitioner will likely be the one in charge of monitoring your thyroid while pregnant. 


You’ll likely encounter a physician who doesn’t believe in testing T3. I did several times (endocrinologists are notoriously the worst about this ironically). I essentially “fired” those physicians but not before providing information on why testing T3 is so important for their thyroid patients. This topic is worthy of more than just a quick paragraph here.


Rather than having an endocrinologist follow my thyroid throughout pregnancy, I trusted my gynecologist. We worked together to establish a plan of care that included frequent testing, monitoring of symptoms, and extra care to ensure that Grace was growing adequately. Since mothers with unmanaged Hashimoto’s can have babies with low weight as well as an increased risk of pre-term labor, we wanted to monitor closely.


How I Self-Advocate with Physicians

Whenever I move to a new city or visit a new doctor, I am very clear about a few things. I tell them I am a seasoned thyroid patient, I know how to read my lab numbers, and I know when I need a change in medication. I have lived this and researched it for a decade, and I would like to be treated that way.


The only physicians who have responded negatively to this are endocrinologists so I refuse to see them anymore. Am I being harsh about endocrinologists? It may seem that way. But over ten years, I’ve had the exact (it’s eery) same experience with over a dozen of them. It angers me to see so many thyroid patients often poorly managed by these specialists.


Being this upfront may not be easy, especially in a world where we believe medical practitioners are above us. Remember, no one knows you better. Trust yourself, your experiences and your intuition. Your doctor is your teammate not your boss.





My doctor felt most comfortable testing my thyroid every 4 to 6 weeks throughout pregnancy to ensure stabilization. I informed her at my first appointment at 6 weeks that I tend to have a volatile thyroid that struggles with stress and hormonal changes (so prevalent in pregnancy and post-partum!)


This is another instance of self-advocacy in the hierarchical medical model. Speak up for yourself. Don’t be complacent with your physician. You know your body way better than they do. They know textbooks, they know previous patients. They do not know you. Help them get to know you.


Thankfully, I only had to adjust my medicine once during pregnancy in the first trimester and was able to maintain that dosage throughout. Your doctor needs to be well-informed on the thyroid ranges for pregnant women as they do differ from non-pregnant women. For example, the TSH range is quite a bit tighter than for non-pregnant women, and it also changes slightly the first to the second trimester.


Most providers will want your TSH below 2.5 for the first trimester and below 3.0 for the second and third trimester. My TSH stayed around 2.0 throughout my pregnancy, about twice as high as when non-pregnant. I was not concerned with this number after researching the increased demand on the thyroid. It makes sense my pituitary was sending out a “produce more thyroid hormone” signal to my thyroid.


That being said, be aware of your hypothyroid symptoms even if your numbers are in range, especially if they are at the higher end of the range. For example, I could barely walk up the stairs my first trimester. This symptom (what I call “stair fatigue”) is a classic hypothyroid symptom for me. I knew I needed to give the increased dosage a couple weeks to kick in before my symptoms would reside though. Once the meds kicked in, my fatigue quickly dissipated.


It’s important to know your body in this way. Get a sense of what it feels like to be hypothyroid and to feel well. Note those hypothyroid symptoms so that if and when they appear, you can get yourself to your doctor for testing.




I started the autoimmune protocol in 2014, about 18 months before getting pregnant. In fact, it was key in helping me reverse my infertility diagnosis. I didn’t use pregnancy as an excuse to go wild on cravings though. If there’s ever a time in your life to treat your body with respect, it’s during pregnancy and post-partum.


The nutritional and energy demands of a woman’s body during this time are astounding. I made a pact with myself to stick as closely to the principles of the autoimmune protocol as possible during pregnancy and post-partum. Note that I said the principles of the protocol and not the elimination phase of the protocol.


For me, this meant including foods I knew I tolerated well such as soaked organic white rice cooked in broth, dark chocolate, seed spices and treats like store-bought coconut milk ice cream. This allowed me to focus on nutrient density while still having fun with food and listening to my body.


I would be lying if I said I ate “perfectly healthy” my entire pregnancy. I am not a diet perfectionist by any means. My food choices stem from my intuition, my mood, the social setting and frankly what’s in my fridge. While I ate dark chocolate most days, I also never skipped a meal. I had three balanced meals each day that included protein (a must!), leafy greens (folate!), starchy veggies (glucose!) and fats like avocado or coconut. I wish I still ate like that post-partum!


I personally do not believe in attempting low carb and ketogenic diets during pregnancy. I only mention this because they are trending hard right now. I am so happy for all the people these diets heal and bring happiness. If you naturally eat low carb (and you’re being honest with yourself about it being natural), then continue to listen to your body.


But if you are truly craving sweet potatoes, dried mango or a bowl of freakin’ cereal, then YOU get to decide if you eat that or not. Not a diet guru. In fact, I had gluten-free cereal several times during pregnancy. I also distinctly recall eating a bowl of rice with coconut aminos at 3 am because I woke up craving it and was starving (2nd trimester hungry, if you know what I mean).


My pregnant body craved SPECIFIC foods like citrus, mango, berries and sweet potatoes. And I don’t blame this on being a “sugar-burner” (so many opinions on that terminology, by the way). These are common food cravings for pregnant women for good reason – our bodies demand all of that folate, vitamin C and glucose they’re asking for. WE’RE BUILDING A HUMAN. Be easy on yourself but also treat your body with respect and let that be reflected on your plate, with your sleep, your stress management, your movement and your relationships.



It is my goal one day to provide a more inclusive guide of managing autoimmune disease during pregnancy. Until then, I hope this article provided you with some helpful, actionable information to protect your thyroid health during pregnancy. 




Hypothyroid Mom is an excellent resource for additional information on fertility and pregnancy. Dana Trentini is also the author of Your Healthy Pregnancy with Thyroid Disease. You can also order your own full thyroid panel with a coupon code on her website.


Looking for post-partum support? I found Dr. Jolene Brighten’s book Healing the Body Naturally After Childbirth helpful.


I also have written an article on Balancing Hormones for Fertility. You can read more about my story of reversing infertility here.


Disclaimer: I am not a medical practitioner, and I will not be able to answer specific questions regarding your health state. I am here for emotional support and to provide hope. The information in this article is based on my personal experience and research. 


Balancing Hormones for Fertility



Hormonal Balance Enemy No. 1: Estrogen Dominance


When discussing the basics of hormonal balance, it’s important to explain the purpose of our two main sex hormones: estrogen and progesterone. These two girls are responsible for maintaining a healthy menstrual cycle and pregnancy, yet they are frequently imbalanced with each other causing those annoying and painful PMS symptoms, infertility, and miscarriage.


Many of us walk around with imbalanced estrogen and progesterone. This imbalanced ratio can come in many forms. You may be in the normal range for both progesterone and estrogen but low-normal for progesterone and high-normal for estrogen, leading to estrogen dominant symptoms. Or you may be low in progesterone and normal or high in estrogen which is very common in a stressed autoimmune-diseased body, if you have low body weight, or if you suffer from adrenal fatigue. Heck, you can even be low in both progesterone and estrogen and STILL be estrogen-dominant! As you can see, it’s a tight rope to walk when balancing these two uber-important hormones, which is why working with your doctor or a functional medicine doctor can be incredibly helpful in tracking your progress towards hormonal balance.


Estrogen dominance is on the rise in both pre-menopausal and menopausal women. We pick up estrogen from our modern day environments quite easily, especially in our food choices (i.e. non-organic meats and produce sprayed with herbicides and pesticides, soy products, and conventional dairy to name a few) and the over-use of the birth control pill which can both cause estrogen-dominance symptoms and cover up existing dominance. For menopausal women, it’s even more difficult to fight estrogen dominance because as we age progesterone naturally decreases by up to 75% while estrogen may only decrease by half that amount or less! This is why hormone replacement therapy (HRT) has become incredibly popular as a treatment for menopausal symptoms such as mood swings and hot flashes.


To help combat estrogen dominance, make some environmental and lifestyle changes such as switching from plastic containers and water bottles to glass ones, buying only organic meat and produce (and peeling any non-organic produce if that’s all you can afford), and avoiding conventional cosmetics that contain xenoestrogens (toxins that mimic estrogen in the body) such as parabens. You may also need to work with a practitioner who can prescribe the proper amount of progesterone to raise progesterone levels, decreasing estrogen dominance symptoms.


Progesterone can be a very protective and health-promoting hormone for women. It is also incredibly vital for a healthy pregnancy and increased levels have to be maintained to promote the growth of the fetus. Low progesterone in pre-menopausal women can be caused by several factors including stress, poor diet, history of birth control pill usage, anovulatory cycles (where a period can exist without ovulation leading up to it), and defects in the corpus luteum (which releases progesterone during your menstrual cycle and helps prevent miscarriage in early pregnancy).


Estrogen can get a bad rap especially when talking about its dominant nature. It is after all responsible for growth. Growth of our uterine lining, growth of our hips and breasts, and even growth of healthy, thick hair. There are 3 main estrogen components commonly tested in salivary and serum blood tests on hormone panels: estrone (E1), estradiol (E2), and estriol (E3). When in healthy balance, estriol comprises about 70% of estrogen, while the remaining 30% is divided somewat equally between E1 and E2. Not only is it important for these 3 estrogen components to be in balance with each other, but they also must balance with our progesterone levels. Want to learn a lot more about estrogen dominance? I love this article for its comprehensiveness. 



What about all those other glands?



While researchers don’t understand exactly how overactive or underactive thyroid affects fertility, they do know that both conditions can affect ovulation, healthy growth and development of a fetus, ability carry a full-term pregnancy, and has  been associated with an increased risk of stillbirths. Thyroid function is especially important to monitor before conception for women with a history of thyroid disorder or those with a family history. Make sure that your thyroid is in tip-top shape prior to conception and advocate to have it monitored consistently throughout pregnancy to ensure the health of your baby. If you are trying to conceive but have abnormal menstrual cycles or suspect you aren’t ovulating, make sure to get a full thyroid panel done to check for underlying disorder. 



If you’ve been in the health and wellness sphere for longer than 3 seconds, you know all about the dreaded adrenal fatigue. It’s the real deal and certainly not a fabricated disorder made up so that supplement companies have something tangible to target. Many, many, many (x 100, if we’re talking numbers) people in our modern day world suffer from some level of adrenal fatigue due to chronic stress. This stress can be either mental or physical (or worse, both) in nature and leads to a pretty nasty cycle of hormonal imbalance.

In short, a common way the adrenals affect our estrogen and progesterone balance is like this: our adrenals are responsible for producing a hormone called cortisol. Cortisol helps our body respond to stress by adjusting vital body functions such as metabolism, blood sugar, and immune activity. It is also is on the same “pathway” as progesterone, which is one of the precursors of cortisol in addition to pregnenolone and cholesterol. Progesterone also is at the fork of another pathway that results in estrogen, which is also made by DHEA. If our body is in a constant stress response, it prioritizes balancing life-or-death functions such as metabolism and insulin response rather than fertility and menstruation. That means our body shuttles progesterone to the production of cortisol leading to low progesterone levels, estrogen dominance and potentially anovulatory cycles or amenorrhea.


HPA axis

The HPA axis is too complex of a subject for this article. If using a top-down approach, one could really start with the hypothalamus-pitutary-adrenals trifecta of feedback cycles and hormonal production. Here’s a short article explaining how HPA axis dysfunction can negatively impact fertility and ovulation. To quickly sum it up, low body weight, over-exercising, and emotional stress can wreak havoc on hormones for years until properly addressed.




Natural Ways to Restore Hormonal Balance

Note that the majority of supplements are poorly studied in well-controlled research. Many of these compounds have been used in Traditional Chinese Medicine for hundreds, possibly thousands of years. They may or may not work for you, but either way it is important to work with a qualified practitioner such as a naturopath, TCM doctor, or functional medicine practitioner to ensure accurate dosage and safety. Supplements tend to be more gentle and work more slowly than prescription-based hormonal therapy. 


DIM for lowering “bad estrogen” and increasing “good estrogen” also balancing testosterone levels

– Used in weight lifting community as a fat loss supplement successfully because of its effect on estrogen activity

– May help restore fertility caused by estrogen dominance

-Verdict: anecdotal and case study evidence suggests DIM can have a powerful and quick effect on estrogen and testosterone levels in the body. Be sure to source a soy-free product such as 


Vitex (chasteberry) for increasing low progesterone

-In studies, Vitex seems to relieve PMS and PMDD symptoms, but studies have not consistently proven its efficiency as a fertility treatment.

-It is often recommended to women with low progesterone levels to ease menopausal symptoms, prevent miscarriage, and increase fertility by naturopaths and Chinese medicine doctors

-Verdict: Unknown. Some studies have shown effects only after taking Vitex for at least 7 months.


White Peony, Shatavari, and Schisandra (FemCo by Standard Process)

– White Peony is often used in Traditional Chinese Medicine (TCM) to stimulate circulation in the pelvic region, reduce the size of painful uterine fibroids, and reduce symptoms of PCOS by decreasing testosterone levels.

– Schisandra is an adaptogenic herb also often used in TCM to treat fertility issues by decreasing the stress response of the body and improving liver function. 

– Shatavari is recommended by ayurverdic, TCM, and  naturopathic doctors to increase overall fertility by boosting libido and acting as a “cleanser” for the reproductive system in both women and men.

– Verdict: this may be a helpful combination as it addresses common estrogen-dominant issues such as poor stress response and liver function (which is responsible for clearing excess estrogen out of our system).


Seed Cycling to balance hormones throughout the cycle

– It can’t get much more “granola” than literally eating different seeds during different times of the month to help balance your hormones so that the follicular phase and luteal phase have the correct balance of estrogen and progesterone. Supplementation of fish oil and evening primrose oil is also recommended.

– Verdict: Unknown. I have not found any “good science” on seed cycling and whether or not it truly makes a significant difference in hormonal levels. At worst, you’re getting in some healthy seeds high in minerals, vitamins, and omega-3s!



Common Western Medicine Ideas

Hormone creams

Many believe hormone creams to be more fast-acting and effective than compounded hormones, but it’s also harder to regulate exactly how much hormone you are receiving through the skin barrier.

Compounded hormones

Medical and functional medicine doctors may prescribe compounded hormones to increase deficient hormones such as in the case of menopause or peri-menopause women with estrogen or progesterone deficiency.

You will need to get lab values tested or record any new symptoms of too much or too little hormone such as changes in breast tenderness, weight, mood, water retention, skin health, and energy, so your doctor can adjust accordingly.

Tend to take several months to regulate hormones enough that glands can pick up where they left off.

Birth control pills

Highly unlikely to be prescribed by a functional medicine doctor for hormonal imbalances, but a common go-to by western medicine docs. The pill overrides your body’s need to produce its own estrogen and progesterone and can mask deficiencies in either hormone.

Some doctors believe amenorrhea must be treated this way. Give them the pill and they will be sure to get a period. This is probably true but it’s what I call an artificial period; rather it is not your body’s own natural hormone production creating your monthly cycle.

Birth control pills are becoming more and more recognized for their poor effects on post-pill hormonal health.

Ignore it – they say there is “no medical need for a period” and well… health effects usually aren’t deathly unless that hormonal imbalance leads to hormonally-driven cancers such as breast and ovarian.

Some doctors (and even some ill-informed patients) will proclaim that it’s no biggie if you don’t get your period. There’s no medical need for one! Well, they’re right in a sense. You aren’t going to die in 3 weeks if you don’t get your period like if you didn’t have access to food. It’s not required for respiration, kidney and liver function, or to keep your heart from stopping. But what these doctors and patients fail to recognize is the chronic and long-term effects hormonal imbalances and deficiencies can wreak on a woman’s sensitive body.

The risk of osteoporosis increases especially for white women under the age of 30.

Mental health can be affected by hormonal imbalances. I think our mental health IS a medical necessity. Hormonal issues commonly caused anxiety and depression in women that can continue for years before treated by balancing hormones.



Listen Up! Your body is trying to tell you something. 

Women tend to me the more intuitive of the genders. We must use this intuition to make accurate and evidence-based observations about our hormonal health. That may mean charting your cycles in a variety of ways.

  • Write down the first day of your period every month.
  • Chart your morning basal body temperature before you get out of bed in the morning using a mercury thermometer. As little as .1 degree increase in body temperature can indicated ovulation is occurring,  notifying you of your most fertile days.
  • Chart your symptoms. Is your luteal phase getting shorter and shorter (i.e. are there less and less days in between periods?) Are symptoms such as breast  tenderness, bloating, and cramping worsening? This may indicate rising estrogen levels and are often signs of estrogen dominance.
  • Advocate for your body. Do you having a feeling that you’re not ovulating or that you are experiencing estrogen dominance? Make an appointment with your physician and ask to receive the proper testing!


Getting Ready to Conceive?

Aim to get omega-3’s in your diet as often as possible. My favorite way to do this is with wild salmon, oysters, shrimp, mackerel, and anchovies. If you tolerate flax and chia seeds, they are also good sources of omega-3’s, but not autoimmune-protocol friendly nor do they have as good of an amino acid profile as seafood. Omega-3s

Get your thyroid tested. Ensure your thyroid hormones free T3, free T4, reverse T3 and your pituitary hormone TSH are well within normal range. If you have Hashimoto’s, it is now conventionally accepted (albeit not by all conventional doctors) that many people feel best with a TSH in the bottom 25% of the range and T3 and T4 in the top 25% of the range.

Take prenatal supplements full of methylfolate (NOT FOLIC ACID), B vitamins, zinc, magnesium, calcium, vitamin C, DHA, and vitamin D. You may also want to be on a probiotic and cease any supplements after conception that may affect hormonal levels like DIM or Vitex until you can talk to your doctor about their safety. 

Relax. I have a theory that the more you try to get pregnant, the less likely it will happen. While there’s no scientific evidence behind that, give it a thought in relation to your perspective about your own fertility. Just as we can self-sabotage a job interview if overly-anxious, we can also affect our body’s ability to conceive. Sex should not be a chore, but a loving activity between two committed partners who both have parenthood goals. It’s easy to feel under pressure once you hit a certain age, but remember you have 12 times a year to try and most women DO get pregnant eventually.

Don’t fear fat. Take this point from two angles: the fear of eating fat and the fear of having fat on your body. I’m sure you have heard many times over that being underweight can negatively impact fertility. It’s the truth, ladies, no matter how much you don’t want to hear it. I’ve experienced it and so have thousands and thousands of other women. We like to think we are the exception to this loose rule (i.e. “I can exercise 7 days a week, eat 1,200 calories a day, fit into size 00 pants and still have a baby!”  but for many women our bodies prefer having a little extra cushion for the labor pushin’. Some estimates suggest women have at least 18% body fat when trying to conceive (although there are athletically lean women who conceive with less body fat, it is inherently less common). Are you stuck in gym rat mode, suffer from irregular menstrual cycles and just can’t seem to get pregnant no matter what you try? Are you way too focused on your bikini bod and gym goals to the detriment of your sex hormones? Then I suggest finding a way to back off the fitness regimen. This is going to require you to re-work your mind and recognize that your body will try its hardest to work with you on your pregnancy goals as soon as you give it some loving too. If having a six-pack or cellulite-free legs is more important than having a child, well then you have just stated your priorities without even realizing it. Harsh words but they’re coming from a gal with a lot of experience in this area. You’ll have plenty of time (once the kids are in college?) to get back to your 90-minute gym sessions!



Coping with Infertility & Loss 

This subject is worth a series of blog posts on its own, but I think it’s important to address in the real-world context of chronic disease and infertility. For some women, health conditions prevent you from conceiving which can be a world-crushing realization. Or those health conditions may even prevent you from carrying to full-term. The inability to conceive your own blood-born children is a deep, deep wound that may takes years to heal. If this applies to you, you must go as easy on yourself as possible. What if it were happening to your best friend? What would you say to her to make her feel better?

Children are a gift to this world, but there are other ways to reap the benefits of this gift if you cannot conceive. Adoption is always an option. I also am particularly fond of mentorship programs such as Big Brothers Big Sisters or finding a career where you can make a valuable difference in a child’s life such as becoming a child and family psychologist, occupational therapist, speech therapist, teacher, or sports coach. These can all be rewarding and different ways to affect a child’s future in the absence of fertility.

Find hope. For nearly a decade when I didn’t think pregnancy was a possibility, I went through many emotional ups and downs about how I would feel if I were unable to have my own children. Initially, I put the thought on the back burner and focused on other things going on in my life since I was in my early twenties and not nearly mature enough to mother a child. Once I met my husband and realized I wanted to spend my life with him, the idea reared its head in a very ugly way when I felt like I would be doing him a disservice if I couldn’t have children. My obsession with infertility caused such an immense amount of stress on my body that I truly believe it prevented me from healing my adrenal fatigue and autoimmune disease faster than I did. Once I had started the autoimmune protocol and my hormonal health began to rebound, I had a renewed sense of hope that children could be in our future. I also reminded myself about what countless doctors had told me despite 7 years of amenorrhea: you will be able to have children but right now your body doesn’t want them. A harsh truth but the fact that it was in the realm of possibility really fueled every decision I took to continue healing my body. So take the advice of a girl who has been through the same thing, do not give up on your fertility. Right now may not be the best time to produce a healthy child, but focus your energy on healing, remain open-minded to a life with or without children, and remind yourself of all the women who have had “miracle” children and have walked in the same shoes as yourself. 

A Serious & Honest Look at Why Periods are So Important for Health

Periods… I’ve always wondered why they are called that. They aren’t the “end” of something. Menstruation should be a never-ending cycle until we start winding down our reproductive capabilities in our 4th and 5th decade of life. But why are more and more women in their teens, twenties, and thirties going to their doctors with menstrual irregularities and hormonal symptoms? I wanted to explore this topic a little deeper with you guys in my typical bulletpoint article style flecked with sarcastic commentary meant to lighten up a pretty heavy (no pun intended) topic!


First, I will say when I lost my period after going off birth control in 2009 I was not upset. I historically was riddled with cramps so bad they required prescription-strength pain relievers and usually a day or two off school or work. There was something amazing about going through life never worrying about if I would start bleeding in the middle of a meeting, but that joy wore off pretty quickly once I stopped feeling like a woman. My weight dropped dramatically, my breasts went from a full C to a AA, and I lost my ability to cry. Seriously, I could NOT cry and my mood was the same all the time. Even puppies living in sad conditions could not make me shed a tear, and if you know me at all you know I am incredibly passionate about animal wellness. I just didn’t feel like myself but some androgynous creature floating through life with this fantastic benefit of never having to wear a bra (that part I miss). 



  • Why getting a period is a sign of health
    • I know we all gripe about it, oh approximately every 4 weeks, but if you have a regular and healthy menstrual and ovulation cycle, consider yourself fortunate. It likely means that you have a lot of your health ducks in a row. Of course there are many people in a diseased or malnourished state that still get their periods as their bodies have a different threshold of perceived threat to a fetus, but overall when your brain and endocrine system are synced up, it’s likely that you’re doing something right. That is if you don’t have any hormonal imbalances hiding behind your regular monthly cycle such as estrogen dominance or anovulation (lack of ovulation).



In order to truly appreciate the beauty of the female reproductive cycle, I think you need to understand the orchestra of hormonal harmony your body must create before the blood bath begins… 



What happens to hormones during a menstrual cycle

  • Day 1 of your cycle starts on the day you begin  your period which usually lasts anywhere between 3-7 days for most women
  • During the follicular phase before ovulation progesterone is staying stable but estrogen, is rising and peaking up until ovulation. Initially, your libido may be non-existent but it often ramps up towards ovulation as your body prepares for making babies.
  • As estrogen rises, another hormone, the follicular stimulation hormone (FSH), is also rising and signaling to your body to start readying those eggs for release
  • Luteinizing hormone (LH) rises and peaks dramatically, stimulating ovulation and the release of an egg which will travel to the fallopian tubes.
  • After ovulation, progesterone rises steadily (along with another smaller surge of estrogen) and drops off before your period begins again. Generally around ovulation, women tend to feel their “best” – breasts start to become fuller, mental clarity is highest, and you will probably perform better in the gym too! But the closer we get to our next period, the more bloated and tired we feel and the more carbs we crave due to a drop in serotonin (one of your mood-boosting neurotransmitters) and a rise in cortisol. You may also feel HOT! No, not sexually attractive, but physically overheated. One of the best indicators of a successful ovulating cycle is an increase of about ½ a degree in body temperature that is sustained during weeks 3 to 4.


That’s a lot of hormonal ups and downs and you can see how a typically healthy individual is already on a hormonal roller coaster each month! Now throw in autoimmune disease, thyroid dysfunction, adrenal burnout, and inflammation, and you have got yourself a party. A party of screaming drunk girls fighting over who copied who’s statement coral lipstick trend.


But what if you aren’t one of the lucky ones with predictable cycles or heck, you can’t even remember the last time you had one?!


Common Causes of Irregular or No Cycles

    • STRESS
      • Emotional: Difficult life stressors such as moving, break ups, the onset of new disease symptoms, a death in one’s family, etc can be enough of a stressor for the body to put a stop to potential fertility. Our cortisol production is part of the HPA axis which is the feedback loop between the hypothalamus, pituitary, and adrenals. When one of those systems goes awry, it can affect the stimulation and production of another gland’s master hormones such as FH and estrogen. This can happen fairly quickly and you can go from a lifetime of normal periods and the next month (or months and years) of amenorrhea (lack of periods) unless the cycles have been regulated. Unfortunately our bodies are very good at prioritizing certain functions over others so if you’re constantly revving the sympathetic nervous system (“fight or flight”) and not spending enough time in a relaxed state, your production of cortisol is likely going to be high. High cortisol generally results in low DHEA (commonly seen in the first stages of adrenal fatigue) which is like the first stop on the production line of female hormones before you make a baby. Breakdowns with cortisol and DHEA can mean that your body shuttles its energy towards staying alive rather than making lives.
      • Physical: Most of my readers know this well! Chronic autoimmune disease that has not been addressed from a gut health perspective is a constant underlying stress on the body. We think of sitting in traffic and paying overdue bills as typical life stressors, but I would count those more under the “Emotional” stress category. Physical stressors such as a leaky gut, low-level infection, chronic inflammation, active autoimmune disease, and endocrine imbalances are the physiological stressors we cannot see or tangibly address each day but they are big contributors to a lack of menstruation or ovulation. These physical stressors shuttle your body’s energy towards keeping those systems functioning – if you have low thyroid function, your body is obviously not going to be able to support the stress of pregnancy or carry your child to full-term (although that does sometimes happen but it can result in an exhausting pregnancy and possible birth defects!)
    • Malnutrition
      • Poor absorption of nutrients is very common in those with autoimmunity due to increased intestinal permeability and funneling of energy towards other processes
      • B vitamin deficiencies may lead to anemia and both can affect the regularity of your menstrual cycle
      • New research has been exposing a link between low Vitamin D levels and irregular periods but further studies need to explore this in a controlled human subject design
    • Low body weight
      • Yes, those thin, lithe models you see in magazines and the perfectly dressed petite girls on the beach wearing crop tops and jean shorts with not a hint of cellulite…. They’re probably not getting their periods. Yes, I said it. What we as a culture deem as healthy, vibrant, and beautiful usually is a cover-up for some serious female hormone issues. It’s sad. It really is. How the media has turned the curviness, roundness, and fullness that should be a female’s body (unless by pure genetics you are one of those lithe individuals who still gets her period every 28-32 days) into something that needs to be “fixed”. I wish I had a percentage I could give you for how many young American women are walking around with diet-induced amenorrhea, but if my social circle is an indication then my guess is over 50%. Not at any one point in time, but I would not be surprised in the least if over half of young American women have experienced disruptions in their menstrual cycle due to the diet and exercise choices they make so they can be thin and fit into our socio-cultural definition of beauty. It’s disturbing. What’s covering up this problem even more is the overuse of hormonal birth control which overrides your body’s production of female hormones with man-made versions that tell your brain it does not need to do its job anymore. I know MANY women walking around on low calorie diets, exercising their butts off (literally) for 60-90 minutes a day, who religiously take their birth control and have no idea that once they go off the pill, it’s likely their body has “forgotten” how to make its own estrogen and progesterone. More on that in a little but there’s some food for thought in the meantime.
    • Premature ovarian failure affects up to 1% of the female population under 40 years old, according to recent research. It usually results in irregular or absent cycling and some menopausal-like symptoms such as decreased libido, hot flashes, vaginal dryness, and painful sex. There’s no solid cause for premature ovarian failure but it has been linked to X-chromosome genetic diseases, chemo and radiation treatment, autoimmune ovarian disease (where your body produce antibodies directed at your ovaries), and inflammation. It affects fertility greatly, but instance of women conceiving do occur through hormonal support designed to stimulate ovulation.


Okay, Alaena, get off your soapbox of sarcasm and tell me how I can fix this darn mess?


Ways to Support Regulation Of Menstruation

  • Cease birth control: When you were put on birth control by your gynecologist (oh, say around 17-19 years old), you were probably sold on lighter, less painful periods, clearer skin, and the freedom to sleep with whomever you want without the risk of having a baby with that frat guy Jim from the glow-in-the-dark bubble party last Saturday. It’s very freeing in that way! You can even control WHEN you have your period! Oh, huge tropical vacation coming up? I’m just going to skip that week of placebos and be blood-free for 6 weeks straight! Sounds wonderful, it really does, but what about when you want to start having children? Or if you just are curious if your body is even capable of menstruating without pharmacological assistance at a $10 price tag? What doctors DON’T do when they put you on the pill is tell you how it can affect your cycle once you go off of it. It is not uncommon for women to not start a natural period for up to 6 months after going off or even years (like in my case). YEARS. That was the scariest situation I have gone through in the past decade, and that is saying a lot considering my health journey has been a little rough. What’s even worse is that when you do go off the pill and don’t get your period, what does your doctor suggest you do? Go BACK on the pill to “regulate” it. If you ever get that advice, run. Run fast. And knock down the display of NuvaRings on your way out the door.
  • Eat a nutrient and calorie-rich diet: It isn’t folklore that a diet high in fat and calories (as long as they come from the right foods in the absence of a sedentary lifestyle) is an excellent way to support natural hormone production. If our bodies view us as starving, which they do when we are cutting calories while exercising vigorously, it is not going to set itself up for carrying a fetus who is going to need a good amount of our nutrient store to develop healthfully. Particularly, Omega-3 rich foods are useful for contributing to a healthy menstrual cycle. My favorite sources include wild salmon and other fatty fish, high quality soy-free egg yolks, flax and chia seeds (if tolerated), fish eggs, and basil (in higher amounts). Don’t count calories – how many times do we have to hear that before it clicks? Not only is counting calories stressful (hey cortisol, what’s up?) but it can limit our intake of the vitamins and minerals our bodies are craving. It’s OKAY to crave carbs sometimes – just get them from potatoes, sweet potatoes, white rice, carrots, parsnips, and other starchy vegetables rather than cereal and pizza. You’re still a good person if you eat carbohydrates. I promise.
  • Reduce stress: I think I mention this in every article I have written for the blog, but it is the root of many hormonal imbalances. You need you find a way to calm down. Oh, you think you’re calm? Next time you’re getting ready in the morning for work, stop for a second and let yourself hear and feel your heart rate. I have a feeling you’re going to be like “Why does my heart think I’m running up the stairs and I’m only brushing my teeth?” It’s unfortunate but most of us live in hectic, schedule-filled states that don’t allow much breathing room. My favorite stress reduction techniques are going for long walks, meditating (the Headspace App is amazing!), coloring, painting, and playing with animals. If going to CrossFit is your “stress reduction” then please remember that your “stress reduction” is actually spiking your cortisol…


Well, that was about as brief of an article I could write on a monster of a topic! But I have been wanting to address health of the reproductive system for a long time since I have such a long history with it. I spent my entire twenties back and forth between doctors trying to figure out why I wasn’t “normal” anymore, and I’m really glad I never took “you just aren’t” as my answer! Remember, the body is amazing at prioritizing what it sees as most vital for survival, but you can tweak it’s to-do list by supporting your hypothalamus, pituitary, thyroid, and adrenals by leading a low-stress lifestyle focused on eating nutrient-rich whole foods, making plenty of time for playing in the sunshine, and developing a strong social circle of people you can rely on when stress gets the best of you!