The question
Dear Dr. Sher,
I have a diagnosed Hashimoto‘s disease with high thyroid antibodies >1500. We tried naturally for a while but nothing happend. I am 33 and my husband is 34 yeras old. I recently tested my NK cell acitivation via blood K-562 target cell test and the results show high toxicity starting with 12,5:1 = 21,3% (range <12% for fertility), so all other rations are high, too. However my TH1 is low (below normal range) and TH2 is normal. I am wondering if in this case steroids make sense and if so which one prednisolone or dexamethason?
My sister had a similar problem with high toxicity but normal TH1 and TH2. She got pregnant only when using dexamethason combined with intralipid and granocyte. Prednisolone with Intralipid was not successful in suppressing her nk cell activation/toxicity.
Best, Anna
Answer from Dr. Geoffrey Sher
Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss. The condition is 5-10 times more common in women than in men.
In most cases hypothyroidism is caused by damage to the thyroid gland resulting from of thyroid autoimmunity (Hashimoto’s disease) caused by damage done to the thyroid gland by antithyroglobulin and antimicrosomal auto-antibodies. The increased prevalence of hypothyroidism and TAI in women is likely the result of a combination of genetic factors, estrogen-related effects and chromosome X abnormalities.
While being the main cause of hypothyroidism TAI is more often present independent of coexisting clinical or hormonal features of hypothyroidism. Regardless of whether or not hormonal or clinical evidence of hypothyroidism is present or whether a woman with Hashimoto’s disease is successfully treated with thyroid hormone supplementation, women who have thyroid antibodies are often afflicted with reproductive dysfunction (infertility and early or late pregnancy loss).
We reported on the fact that 47% of women with TAI (regardless of the absence or presence of clinical hypothyroidism) have CTL and activated NKa cells and that such women often present with reproductive dysfunction. We also reported that appropriate treatment with IL and steroids, often results in viable pregnancies in such cases.
The fact that almost 50% of women who harbor antithyroid antibodies do not have activated CTL/NK cells suggests that it is NOT the antithyroid antibodies themselves that cause reproductive dysfunction. The activation of CTL and NK cells that occurs in half of the cases with TAI is probably an epiphenomenon with the associated reproductive dysfunction being due to CTL/NK cell activation that damages the early “root system” (trophoblast) of the implanting embryo.
Geoffrey Sher MD
702-533-2691
General information only, not medical advice for your own situation. For that, book a consultation.