Hey, it’s Dr. Aumatma, host of Egg Meets Sperm, where we bring you all the vital information you need to support your fertility journey holistically. In this episode, I’m joined by Dr. Amie Hornaman, aka the "Thyroid Fixer."

Dr. Amie is an expert in thyroid health, and we dive into how optimizing thyroid function can make a huge difference in fertility. She's not your ordinary doc – she's your guide to a vibrant, kick-ass life in the world of medicine and alternative health. Dive into her chart-topping podcast, "The Thyroid FixerTM," where people from all corners of the globe gather for health secrets and wisdom. Dr. Amie is the mastermind behind The FixxrTM Supplement Line, and let's be real, these supplements are game-changers. Designed to tackle weight loss hurdles, fatigue, low libido, hormone imbalances, and more, they're your secret weapon for a life upgrade. Here's the deal: Dr. Amie knows the frustration of feeling misunderstood in the medical world. She's been there. During her NPC figure competition days, her own body played tricks on her, leading to endless misery, misdiagnoses, and bad treatments. That's when she decided to be the hero she wished she had. She's not just another functional guru; she's your partner in health. Dr. Amie takes your hand and guides you to answers nobody else has given you. With personalized treatment plans and a sharp focus on optimizing your thyroid and hormones, she sees you as a unique individual, not just a set of lab numbers. She dives deep into all the factors causing thyroid issues and symptoms, and guess what? She fixes you up so you can be the badass human you were born to be.

We explore the key role of the thyroid in regulating hormones, why so many women are told their thyroid is "normal" when it’s not, and how to identify and treat underlying thyroid issues like Hashimoto's and Graves' disease. If you’ve been struggling to conceive or want to better understand the thyroid's impact on fertility and pregnancy, this episode is packed with essential insights.

Topics covered:

• Why thyroid health is crucial for fertility
• The connection between thyroid function and sex hormones
• Identifying hidden thyroid issues: T3, T4, Reverse T3, and antibodies
• How Inflammation and Stress Affect Thyroid Health
• Natural ways to optimize your thyroid for fertility success

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IG: @dramiehornaman

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 Hey, it's Dr. Amatma, host of Egg Meets Sperm, and this is the best podcast to get all of the vital information that you need to support your fertility journey holistically for you and your partner, because fertility takes two. Hey, welcome back. I'm your host, Dr. Amatma, and I'm going to introduce you today to the thyroid fixer.

Her name is Dr. Amy Horniman, and she is not your ordinary doctor. She is a guide to Your vibrant kick ass life in the world of medicine and alternative health. Today we're gonna dive into all of the things that are so crucial for thyroid function and how they impact your fertility. So join me as we get into a really great conversation about What is happening with the thyroid, how to address it, and what we can do to optimize our fertility by optimizing thyroid health.

Dr. Amy, great to have you here today. Welcome. I'm very excited to dive into thyroid health. Let's kick it off with why thyroid is so important to fertility. Absolutely. Well, we have to start with the thyroid being the master gland and that pretty much runs the show of the body. So from your metabolism to the regulation of other hormones, regulation of your blood sugar, really even dictating whether or not you go to the bathroom every day, it comes back to thyroid function.

So if we're dealing with a thyroid gland that isn't working so well, maybe it's under attack, it's sluggish, it's hypo, low and slow. That's going to have that downstream effect on sex hormones, progesterone, estrogen, testosterone. And then, yeah, we can throw in DHEA, pregnenolone, throw all the sex hormones in the mix.

When the thyroid's off, we start seeing this dysregulation of the sex hormones. We're in very young, adults, young women, we might see a drop in progesterone where she actually looks like she's headed into perimenopause or menopause. Progesterone is very important for fertility. We might see this estrogen dominant state or a low or high testosterone state, all of which, and you've had other guests on here talking about hormones, all of those sex hormones are really important for fertility.

So when the thyroid is off hypo when it's just not working right, we'll see that sex hormone dysregulation. The other thing is the actual ability to get pregnant and development of the fetus. Very much dependent on thyroid hormones, specifically T4, but we have to bring in T3 as the active thyroid hormone as well.

What we'll see when a woman is, let's say she's undiagnosed hypo and she's had three, four or five miscarriages, or she's just really struggling with fertility. So we see that on both ends, the, the actual. Fertility aspect and then the holding of the pregnancy aspect that we see really just thrown off.

And it's a frustrating struggle for the woman, as you know, and it's coming back to the thyroid. It's like, Oh, if we just. Optimize the thyroid. Got her out of that hypo state. Calm down the inflammation of the thyroid. Calm down the autoimmune attack that was going on. All systems would start to work together.

So I know that was kind of like three answers in one, but it, it, it comes back to the thyroid gland being the master gland and having such control over the body. Yeah, absolutely. And it has so many interconnections with all the different functions that then impact the sex hormones, fertility in general, the ovaries, as well as pregnancy outcomes.

So thank you for sharing that, that stage is setting that stage for us. Big overview. Yeah, exactly. Exactly. Uh, so why do so many women get told that their thyroid is normal? And I'm putting this in quotes because Like, oh my God, what is up with this? Right. I mean, you and I have seen so much of this. So a woman comes in, she's, like I said earlier, struggling with fertility, maybe a couple of miscarriages.

She, but you know, my doctor tested my thyroid and told me that I was totally normal. And then we say, okay, let's see those tests. She breaks out a TSH, thyroid stimulating hormone, and it's within normal limits. Again, air quotes. She is correct that that TSH was normal. But here's the problem. That does not tell us the whole picture of the thyroid.

TSH is a pituitary hormone, is not a thyroid hormone. We have to have to have to go deeper and look at free T three. T3 is the active thyroid hormone. So it helps to kind of say that T3 is your gas. That's what actually gets to the cell, turns on the cell, connects with the cell, and gives you a metabolism and blood sugar regulation and the sex hormone regulation and fertility.

We have to measure that active thyroid hormone free T3. We also want to look at free T4. Now T4 is inactive. It's an inactive thyroid hormone, but it's the most abundant thyroid hormone that your thyroid gland produces. So we want to look at how much of that inactive thyroid hormone do you have in your body?

Is that adequate enough? And then we want to look at reverse T3, which is That's the brakes. So essentially reverse T3 is a beautiful thing. It was built into our bodies to protect us. It's a survival mechanism. If you are in a state of crisis, trauma, you're in the ICU, the ER, that reverse T3 will go up to basically say, Hey, this person doesn't need to get pregnant, burn fat, feel good.

They just need to survive. But what if that reverse T3 is high? When you're walking around trying to live life, when you're trying to go to work and take the kids to school and get pregnant or get pregnant again, right? We don't want that reverse T3 elevated because it's putting your body in survival mode.

Very important test to look at. And then of course we want to see if you have Hashimoto's. That's going to be the TPO and the TGA antibodies. We want to see if you have that autoimmune hypothyroidism where your body just attacks the thyroid gland. Good. Thanks. But it's an invader. It thinks it's a bad guy.

Your body's just confused and it goes out and attacks your thyroid gland. Now, when it's being attacked. It's obviously not going to work at a top level. It's not going to be working at a hundred percent when it's getting attacked every day. So that's going to play a role in low thyroid hormones as well.

We want to check everything. And that's the big problem when women come to us and they're like, Hey, I was told my thyroid is totally normal. I'm fine. Well, are you or aren't you? We don't know unless all of those tests are done. Yeah, absolutely. So, um, what are all of the tests? We want to know almost every doctor tests TSH, but then T3, T4, free T3, free T4, um, TPO and TGA, those are the antibodies to the thyroid.

How frequently do you, oh, sorry, and I don't, I forgot, a reverse, which you said is super important. Um, how important are like TSI antibodies? How often do you see those elevated? And like the whole that hyper thyroid situation, how often do you see that happening? It's much more rare. We see way more Hashimoto's and low hypothyroid function than we see hyper normally when I'll when I get a patient that has.

Graves disease. So that is the, it's kind of the flip side to Hashimoto's. So with Hashimoto's, we have the destruction of the thyroid gland and the down regulation, like not enough thyroid hormone is produced. So that's where we'll see that all those low and slow symptoms, low gut motility, low metabolism, low mood, low brain function.

The other side is Graves. That's where we'll test the, the TSI. Antibodies and that's hyper. That's where you're losing weight. You can't sleep. And if you've ever seen anyone with thyroid eye disease, they kind of have those bulging eyes. That's Graves disease. Now, what I see is the pendulum swing. I'll see women who, yeah, they might be graves for a hot minute.

But their symptoms are all that of being hypo. They're like, wait a minute. I'm not losing weight. I'm gaining weight. I can't go to the bathroom every day. I can't get pregnant. I can't think I can't. So they're swinging to the other side, going into Hashi. In that case, we just have to look at that person as an individual, treat the whole picture.

But it is kind of interesting when you test TSI, especially if someone has any kind of, or in the past has any kind of hyper symptoms, we want to check that. And so that like fluxing between hyper, hypo, hyper, hypo, what, what's your, um, assessment about what's happening in those women? Well, it's still all autoimmune, right?

So we know with autoimmune, there's that genetic predisposition. There's usually leaky gut involved and there's a trigger, a stressor. What woman isn't under stress, right? I don't care what age you are, you're, you're under some kind of stress and hormonal fluctuations equals stress. So normally post pregnancy is when we'll see a lot of autoimmune conditions come up.

And kind of turn on because that pregnancy, I'll be at natural and something you want and something you want to go through is a huge stressor on the body. And I think as women, we tend to forget that because it's just, it's built into us, right? It's biological. We're built to, to reproduce, but it's such a huge stressor on the body because of the hormone fluctuations that occur.

So same thing. I mean, you can be in, maybe you're trying IVF, maybe you're trying hormones for fertility. Maybe you're trying all these different things or even just. Trying period to get pregnant. That's a stressor. And so that's where we'll see huge fluctuations in autoimmune conditions come up. We'll call them autoimmune flares or that autoimmune gets activated.

That's where we'll see someone who does have both sets of antibodies, the TSI and the TPO and TGA. Kind of swing back and forth where they might experience a few hyper symptoms like, uh, you know, they're not sleeping really well. They're kind of more anxious than depressed, but yet they still have all of these hypo symptoms over here that they're complaining about.

So in terms of supporting women with hypo, hyper, the fluctuations, what, uh, strategies do you find most useful in helping women have better thyroid function? Absolutely. So yeah, at the end of the day, it doesn't matter whether, you know, if you have Hashimoto's or not graves, or you're just deemed hypo, or you're looking at your numbers and you're like, Hey, wait a minute.

These are a little bit low, even though they're in the normal range. First and foremost, cross the board, cross the board. We have to take down inflammation, inflammation. And this is, it's so cliche. You know, you've probably heard many, many, many interviews, practitioners talk about inflammation to the point where you're like, Oh, here we go again, more inflammatory talk.

But if you think about it, when the body is in that inflamed state, Number one, you're going to get more destruction of the thyroid gland. So let's take Hashimoto's, for example, I love using analogies for people to understand you have these little soldiers and those soldiers, like I said earlier, are confused.

So they go out and they attack your thyroid. Now, whenever the body is in this inflamed state, right? When you think of inflammation, you think high alert red. Oh my God, we're at war. The, the, the, uh, So those soldiers go out and they beat up your thyroid gland even more. It's like two attacks a day. Let's bring in some new troops.

Let's send them all out at once. This is war, right? So when you're in that inflamed state. Your body can't heal and not only can it not heal, it's going to get worse and the whole situation gets worse. So what we end up seeing from that inflammation is more destruction of the thyroid gland, less thyroid hormones being produced.

So those are going down the toilet. We're just not having enough T3 and T4 in the mix. The person is suffering because they don't have those thyroid hormones on board. Obviously, they can't get pregnant amongst a list of all these other symptoms. If we can take down that inflammation now, how do we do that?

The best, my favorite supplement for autoimmune is black cumin seed oil. Black cumin seed, when you look at the studies, oh my God, it's so amazing. Reducing antibodies, lowering inflammation, even helps improve insulin resistance, which would be kind of my part two of what causes inflammation. You walk around with high insulin and high blood glucose all the time because you're eating the standard American diet, you're eating too much sugar, you're eating processed food, you're eating garbage, you are going to be inflamed.

That insulin, that high insulin, insulin resistance, high glucose number, whatever you want to call it or whatever bucket you want to put it in. is causing a ton of inflammation in your body, and that alone can trigger the autoimmune attack. Not to even mention the gluten, which we know, gluten, and again, here's another eye roll from the audience.

I get it. You've heard over and over and over again to go gluten free, and you've either said, I can't go gluten free, it's too overwhelming, to which I call BS because there's plenty of gluten free Alternatives out there or right. I mean, there's, they're everywhere. Not that they're the best, but they're, they're good stepping stone.

They're a nice little crutch for those transitioning to the gluten free, but you have to know the why. So it, I'll either hear, yes, it's too hard. I can't do it or I just don't know why I'm doing it. There's not enough motivation to continue being gluten free. They'll say, well, I'm not celiac. So why am I doing this?

Here's the why that gluten molecule looks like your thyroid gland. So it's no different from soldiers at war. The enemy comes in and the enemy colors and they go, Hey. There's enemies coming in. We got to go to war. We got to go out. We got to fight. We got to battle. Same thing. When you eat gluten, your body thinks, because it looks like the thyroid gland in molecular structure, your body thinks that the enemy's coming in.

It's time for war. So it literally goes out. And again, you get that further destruction of your thyroid gland when you eat gluten. It's also causing a lot of inflammation. So we have that whole tie in together with the gluten, the processed foods, the inflammatory foods, high insulin levels, high glucose levels, just making the whole situation worse.

And that, those simple steps of lowering the inflammation, going gluten free, doing all the things, getting your insulin under control, that's enough to calm the system down to let the body heal. Now that's not to say you might. We can't say that's all you need. Maybe you do need some intervention, thyroid hormone replacement, whatever, but my God, that's the first step.

And that's a huge step to take. Yeah, absolutely. I love that starting point of very simple things that people can do. If they know that they have thyroid issues, or even if they don't know they have thyroid issues, right? Right. You have all the symptoms, your doctor says your thyroid's normal. You can still try to get rid of gluten from your diet and see if your symptoms improve.

So, you don't need a diagnosed thyroid condition to actually make some of these changes. Right. You really don't. So why is it so important for women to pursue and, and receive appropriate treatment before conceiving through pregnancy and postpartum? Absolutely. I'm very passionate about this. I'll get into the why.

So first of all, pre conception, the ability to get pregnant to improve your chances of fertility to improve your fertility overall is dependent on proper thyroid hormone balance. So when we're looking at those. numbers. If we're seeing a couple numbers that is really subclinical or low thyroid function, especially in the functional medicine world, because remember, we're looking at you from an optimal standpoint.

We're not going by those standard lab value ranges that are on your labs. So you could go out, you could get all the labs done that we just talked about today. You can look at whether or not it's flagged red or whether there's an H or an L next to it. And you might look at it and go, Oh, well, I'm normal because you fall within those normal limits.

So the first thing to mention is we want you optimal. So as we're looking at your labs from an optimal standpoint, we really want to get those thyroid hormones into the optimal ranges because that's where your body is going to function the best. And that's going to give you the best chance at at conception.

I mean, that's so, so hard on a woman. It's so hard. So let's, Let's balance out the thyroid hormones before conception, improve fertility overall. Then as we get pregnant, you're carrying the baby, the baby is developing. This is where my story comes in. So my stepson is 11, nontest, nonverbal autistic. And when I.

Look at mom, I see thyroid, I see the thickened neck, I see the weight fluctuations, and I know she had trouble conceiving, she had multiple miscarriages, they went to a fertility specialist, they went to a genetic specialist, so there's, there was already something going on with her body. Now, I don't know what they looked at, what they didn't look at, but I just see, you know, the baby's brain development is so dependent on proper thyroid hormone.

Balance specifically, and this is where T3 comes into play a little bit more. This is where iodine, I mean, that's why a good prenatal always has a little bit of iodine in it. Yep. Absolutely. So I'm good. I want to ask you a couple of questions about that. So I've heard a lot of OBGYNs say, Oh, you only need T4 in pregnancy because T3 doesn't cross the, the, um, placental barrier.

Mm hmm. Mm hmm. What are your thoughts on that? Well, here's the thing. So we have to look at mom and remember that reverse T3 that we talked about in the beginning. It's also important to note that T4 is inactive. It has to convert over to become the active thyroid hormone T3 in that conversion process.

If you kind of picture it as like two roads, two roads to choose to go down, we hope that that T4 chooses the path to convert over into T3. That's good. If it chooses the other path, it's going to convert into reverse T3 and put your body into survival mode. So the problem with just giving a woman T4, T4, T4, and not testing her reverse T3 is you could be actually putting her body into survival mode.

So then if she's not getting enough of the thyroid hormone, There's no way that the baby is going to develop properly because her body is in shutdown. So that I would say, you know, while we do weigh a little bit heavier on the T4, um, therapy during pregnancy, we still have to be testing all the tests. We still have to be looking at the mom's free T3 level and, you know, you don't want to overdose or with T3.

We're not trying to make mom hyper and then, you know, have issues with the pregnancy, but you want her optimal. It's, it's the whole picture. It's getting all the hormones optimal. And then the body, our bodies are so smart. Or the body will know what to do with the developing fetus. It will give the baby what it needs to develop in a proper way.

But if mom doesn't, if mom's not optimal, how can the baby be optimal? Right. Yeah. That's a beautiful explanation because I feel like all too often women are getting these messages that are so different from the functional medicine world. So I appreciate that insight. Um, Another question that came up for me is the iodine story.

Yeah. Uh, and there is a lot of debate in the thyroid thyroid world about iodine. Um, let's just focus on it specific to pregnancy because It's a crucial period of time where iodine is a necessity. Is there an optimal dose of iodine that women should be getting? Is there such a thing as too much iodine during pregnancy?

And are there symptoms from either too much or too little? Absolutely. So iodine, uh, he, just like you said, huge controversy. You can find 50 percent of the functional medicine community says Absolutely not. No iodine if you have Hashimoto's or have a thyroid problem and the other 50 percent recognize it's benefit.

We have to find that happy ground. So I'm all for, I am a proponent of iodine. I believe that it's very beneficial to the body, very beneficial, like we mentioned, to the baby's developing brain. When you look at the studies of iodine and fetal development, it's, it's huge. That is why it's in. Every prenatal, like good prenatals will have iodine in them.

So that's what I like to go by. In dosing wise, you know, if I had just had a regular hypothyroid patient, you know, she's paramenopause, menopause, not worried about getting pregnant. None of that. We can increase her iodine for just to bring down the reverse T3 to improve thyroid function, to help with our energy, to help with hair loss, fibrocystic breasts, all of that.

But with a. With a pregnant woman, I'm going to stick with the iodine that is in the prenatal. Now, how will she know if she's getting too much or too little? You really kind of, you can't tell about the too little. You're not going to notice that like, Hey, I'm not getting enough iodine. Like you would like vitamin D like, Oh, I'm really sluggish and I have brain fog and maybe you're low in vitamin D.

You're not going to notice that with iodine, but you are going to notice if you get too much. You will basically feel hyper and I've had some patients take too much and you know, they're reporting, they're like, Oh my gosh, my heart rate's a little bit increased. I'm sweating all of a sudden, you know, I didn't sleep last night, but it's an easy fix.

You back off, you listen to your body and you back off, take a couple of days off from it, let it clear your system and then add it back in at a lower dose more slowly just to assess your tolerance. But iodine is so fantastic. Thank you. Binding. It's a detoxifier and it binds to the halides. That are actually toxic to your thyroid.

So chlorine, fluoride, oh my, oh my God, like it helps excrete those out of the body. So you can see why it's so imperative for all of us, but especially during pregnancy and during fetal development. Absolutely. Thank you again. That's good with them. Uh, Is there, oh, let's talk about thyroid health, specifically in the postpartum period.

You hinted at this earlier, where you said a lot of women during pregnancy will develop kind of this autoimmune scenario and autoimmune scenario. It often doesn't get caught in my, from what I've seen in the, until their postpartum, right? So during pregnancy, they're like, Oh, you're fine. You're fine. It's fine.

And then postpartum is where we start to see not only the, the, dysfunction in the hormones, but also all of the symptoms. Right. So, um, I'm curious what you think is happening from that, like pregnancy to postpartum period where, um, just like a lot more possibilities of autoimmune thyroid conditions popping up and And like, I feel like a lot of women are even postpartum ignored with the thyroid because they're like, it's postpartum.

You're not sleeping. That must be what it is. And the reality is you have a major gland that's just not functioning anymore. Exactly. And you know, so many women get the tag of postpartum thyroiditis to which I say, yeah, that's called Hashimoto's. So postpartum thyroiditis is just another way of saying like, Hey, after.

You gave birth your thyroid crapped the bed and isn't working very well, but why so we have to go back and we have to look We have to test everything that we just talked about We have to check to see if that Hashimoto switch did turn on Because pregnancy pregnancy perimenopause menopause are the three big times in a woman's life Where she will notice autoimmune conditions Conditions turning on.

So it's like the little, the switch flips to the opposition. Pregnancy is a big one. Like we said earlier, it's a huge stressor on the body. Those hormonal fluctuations that occur huge stressor on the body. So. If, if you get the diagnosis of postpartum thyroiditis, please make sure that you're testing your TPO and TGA antibodies because it's very possible that those have raised, they're now being flagged high and you have Hashimoto's.

Now, in my world too, I like those antibodies at zero. Any antibody is a soldier. It's a soldier that's attacking your thyroid. So my argument is, okay, well, this is a soldier. This time of testing, you have 20 soldiers, but they're not flagged yet because the standard lab value range goes up to 40. Oh, but you still have 20 soldiers.

So are we going to wait until you're 20 pounds heavier? Miserable. Can't take care of your baby because you can't get out of bed. Can't even think straight, which is part of pregnancy. You know, postpartum anyways, like you said, like you're already dealing with all of these, these symptoms that just Come after pregnancy.

Now you add on low thyroid function and those symptoms 10 X and now it becomes unbearable. Why don't we catch that early on and actually start with intervention and treatment so that the woman can regain her life a little bit, like be able to take care of herself and her baby. To the utmost that she possibly can, you know, fighting through the sleepless nights and all of the things that come with it.

I mean, we can still at least empower her and her body to be more resilient and stronger to make it through that post pregnancy state. I think it's important to test and to treat early. Yeah, absolutely. I agree wholeheartedly. I think that all too often, um, the women that are being told you're fine, it's normal, it's not a big deal.

Um, but it does, it ends up being a big deal. And to your point, like we don't need to wait till it's a big deal. Let's deal with it now so that it doesn't become a problem, uh, in the future when it's going to be a lot harder to treat and a lot harder to turn around. Right. Yeah. Yeah. Love it. Love it. Love it.

Thank you so much for being with us and all, all of your wisdom that you shared today. Uh, where can people connect with you? Yeah, absolutely. So you can listen to my podcast, the thyroid fixer podcast on all podcast platforms. And Dr. A was a guest on mine as well. And you'll also find, I do have an episode in there that speaks specifically to.

Postpartum thyroiditis being Hashimoto. So you can kind of dive into that a little bit. And then all social media I'm on social media is Dr. Amy Horniman, and you can go to my website, Dr. Amy Horniman. com as well. Love it. Thank you. We're honored to have you. And for those of you listening in, we'll see you again very soon.

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