Being proactive about your adrenal and thyroid health during pregnancy is incredibly important for the health of both you and your baby.
The adrenal glands play an important role in the endocrine system and the physiological changes of normal pregnancy. Thyroid hormones are crucial for normal development of your baby’s brain and nervous system. So, taking steps to support these two parts of the body is incredibly important!
What role do the adrenals play?
The adrenals are responsible for sending the hormones such as cortisol and adrenaline into the bloodstream during times of stress. They make hormones such as DHEA and aldosterone, and they also make hormones that your body then uses to make other hormones such as testosterone and estrogen.
The adrenals are also part of the HPA axis. The pituitary, hypothalamus, and adrenals constantly communicate with one another throughout the day. When the body perceives stress – emotional, mental, physical, environmental, etc. – the hypothalamus tells the adrenals, via the pituitary, to work harder to put out additional cortisol, and it tells the pituitary to produce more TSH. This tells the thyroid to slow down, and sometimes it can actually cause TSH to lower, causing the thyroid to produce excess thyroid hormones.
As you can see, supporting the adrenals is foundational to hormone balance!
What role does the thyroid play?
The thyroid is a gland that produces hormones, including T3 and T4. It plays a major role in the growth and development of the human body. It helps regulate many functions including temperature, metabolism, and heartbeat.
If the body needs more energy in certain situations – such as during pregnancy – the thyroid gland produces more hormones.
Why is the thyroid’s role so important during pregnancy?
During the first trimester, your baby depends solely on your supply of thyroid hormone, which comes through the placenta.
The AAF states that because of various biological and demand-related changes that happen during pregnancy, there is a 20% to 40% increase in the thyroid hormone requirement as early as the fourth week of gestation.
At around 12 weeks gestation, your baby’s thyroid starts to work on its own, but it doesn’t make enough thyroid hormone until 18 to 20 weeks of pregnancy.
What happens if the adrenals are overworked during or after pregnancy?
Chronic stress can lead to chronic cortisol output from the adrenals.
This constant cortisol output can eventually weaken the endocrine system, immune system, digestive system, liver, and brain. It can also cause the thyroid to slow down (aka hypothyroidism) and in some rare cases, it will speed up (aka hyperthyroidism).
When the adrenals become too taxed and cortisol levels are out of balance, this can lead to postpartum thyroid disease such as hypothyroidism, hyperthyroidism, Hashimoto’s, and Graves’.
Symptoms of Adrenal Imbalance Can Include:
Low blood pressure
Clenching or grinding your teeth
Hair loss
Insomnia
Waking up in the middle of the night with difficulty going back to sleep (outside of your baby waking you)
Feeling keyed-up and having trouble calming down
Craving salty foods
Chronic low or middle back pain
Chronic fatigue
Afternoon headaches or headaches after exercising
Anxiety
Panic attacks
Dizziness when you stand up
Getting upset or angry easily
Nutrient deficiencies
Digestion issues
Symptoms of Thyroid Imbalance Can Include:
Chronic fatigue
Anxiety
Thinning or loss of outer third of eyebrows
Depression
Weight gain
Feeling cold
Irritability
Hair loss or thinning
Weakness and aches in muscles and joints
Itchy and dry skin
Difficulty concentrating
Brain fog
Constipation
Heavy or irregular periods
Puffy face
Hoarseness of the voice
Muscle weakness
Elevated cholesterol
Slowed heart rate
Low blood pressure
Insomnia
Brittle nails
Muscle loss
Low libido
Lack of motivation
Digestive issues
Low vitamin D
Low B12
Weak immune system
Low ferritin (or anemia)
Diminished appetite
Low basal body temperature
Frequent infections
Lump in throat
How do you test for thyroid imbalance?
It is very beneficial to have a thyroid panel test done prior to conception to see how things are going.
If levels are less than optimal, I’d suggest taking a few months to work on thyroid health before trying to conceive. Pregnancy is taxing on the thyroid gland, so it is important to walk into pregnancy with your thyroid as healthy as possible.
Click here to see a full list of testing to talk to your doctor about optimal thyroid lab numbers and steps you can take if they are too high or too low.
It’s also very important to know that thyroid levels change during pregnancy! TSH levels actually decrease during a normal pregnancy due to the cross-reactivity of the hormone HCG with the TSH receptor.
The Endocrine Society recommends that TSH levels be maintained between 0.2-2.5 mU/L in the first trimester of pregnancy and between 0.3-3 mU/L in the remaining trimesters.
Here are 20 steps you can take to support your thyroid and adrenals during pregnancy:
1. Eat three regular meals throughout the day. Make sure to include a mix of healthy fats, pastured meats, and complex carbohydrates.
I know this is a simple step, but it is incredibly important for balancing blood sugar and providing essential nutrients throughout the day.
Skipping meals or going too long in between eating can put a strain on the adrenals and lead to blood sugar imbalance. As a bonus, eating meals that support blood sugar balance can help against the effects of morning sickness and nausea.
2. Remove processed foods from your diet. Processed foods can increase inflammation, irritate the gut, and are generally devoid of nourishing nutrients. They are not the building blocks for healthy eggs or babies.
Here is a short list of foods to choose instead:
Pastured meats and eggs
Organic meats
Wild seafood (here’s more info about which ones to avoid)
Raw or cultured organic dairy (organic raw milk* from a trusted source or non-homogenized, whole yogurt, kefir, sour cream, etc.)
Fruits and vegetables (choose organic when possible)
Bone broth or meat stock
Healthy fats (butter, ghee, lard, tallow, coconut oil, olive oil, etc.)
Spices and herbs
Soaked grains (if you can tolerate grains)
Soaked nuts, seeds, legumes and lentils
Lacto-fermented vegetables, fruits and beverages (like raw sauerkraut, cortido, chutney, and kombucha – you might need to introduce these slowly if you weren’t eating them prior to conception)
Honey, maple syrup, and organic sugars in moderation
Lots of filtered water!
Here are some whole foods to avoid (Keep in mind, this is not a complete list. Talk to your practitioner about what’s right for you.):
Various mold-ripened and soft cheeses (click here for more info)
Raw egg whites
Certain kinds of fish should be avoided or limited (here’s more info about which ones to avoid)
Here are some recipe ideas.
When it comes to your diet, it’s a good idea to simply do the best you can. Be mindful about what you’re putting in your body and source your food from reputable places.
*If you’re not comfortable with raw, pastured dairy, then pasteurized and non-homogenized can be a good option. Of course, talk to you practitioner about what’s best for you.
3. When you wake up, drink a glass of water with 1/4 teaspoon of Celtic sea salt. Throughout the day, have a pinch of sea salt with each glass of water and use it to season your food. The 80+ minerals in Celtic sea salt can help nourish the adrenals and endocrine system, and are also helpful for protein digestion, carbohydrate digestion, and cellular metabolism.
If you take medications in the morning, talk to your practitioner about taking this step. If you need to delay the water and sea salt until later in the morning, that is fine.
If you prefer, I have a fantastic recipe for a healthy electrolyte drink.
4. Eat breakfast within one hour of waking. It’s important to nourish the body on a regular basis throughout the day. While intermittent fasting has its place, now is not the time for that.
Waiting too long to eat in the morning can cause your blood sugar levels to decrease, leading the adrenals to produce excess cortisol. It can also cause morning sickness to worsen.
5. Spend more time outdoors. Getting fresh air and being in nature helps reduce the stress response in the body. Going for a daily walk outside is a great way to get outdoors. If you struggle with sleep, getting natural light outdoors is especially helpful. It helps to set your internal circadian clock.
6. Don’t try and do everything by yourself. Ask friends and family for help. Help is not just important after baby arrives, it’s incredibly important as you prepare for baby too!
Ask a spouse, partner, friend, or neighbor for a hand before over-exerting yourself.
7. Diffuse essential oils throughout the day to help you feel more relaxed. If you can’t diffuse the oils, put a drop or two on the soles of your feet or on your spine twice a day to help lower stress levels.
This study found that inhaling lavender essential oil can decrease cortisol levels.
Here is a list of oils to avoid when pregnant or nursing.
8. Do low-impact exercise like walking, pilates, gentle yoga or stretching. High impact exercise puts strain on the adrenals, especially if the body is already fatigued. Low impact exercise can decrease the risk of gestational diabetes and need for Cesarean section.
9. Rest one day a week. Lack of rest and a do-it-all mentality can eventually lead to health issues and strain on the adrenals. Taking a day off for rest each week is very important for your fertility or your pregnancy.
Here are some examples of things that might be restful:
Leave one day completely open on the calendar
Take one day to be technology free (this can have a huge impact on cortisol levels!)
Go outside
Read a book
Take an epsom salt bath
It’s ok to not be productive. God set the example by taking a day to rest, so I order my week that way too!
10. Quit caffeine. I know, this seems like a big one. But caffeine can cause the release of cortisol, which can overwork the adrenals can create an imbalance in the HPA-axis overtime which isn’t ideal during pregnancy.
In addition, the American College of Obstetricians and Gynecologists (ACOG) states that there has been research on whether caffeine increases the risk of miscarriage or preterm birth, but the results are unclear.
For those two reasons combined, I recommend cutting out caffeine during pregnancy as the best health practice.
11. Eat as many fresh, organic vegetables as possible at all three meals with some healthy fats. There is no limit on non-starchy vegetable intake.
Many of the nutrients in vegetables are fat-soluble, which means they must be eaten with healthy fats in order for our bodies to utilize them.
Cooked vegetables are usually easier to digest than raw, so eating mostly cooked vegetables is preferred. You can add cooked vegetables to soups and stews, or use them while stir-frying or roasting, etc.
12. Have a regular sleep schedule. Sleep is completely free and one of the most impactful game-changers when it comes to supporting the adrenals and thyroid. Aim for 8-9 hours per night.
13. Consider taking prenatal supplements. Talk to your practitioner about the right prenatal nutrients and possible supplements for your body.
Here are some various prenatal supplements that I use at my practice (As always, please talk to your practitioner about what’s right for you):
Cyrofood or Catalyn – a good food-based multi-vitamin
Cod liver oil – an excellent source of vitamins A and D (it should be stopped at week 39)
Desiccated liver – for iron and blood building (omit if you eat liver 2-3x a week)
Cataplex B – for carbohydrate metabolism and adrenal support
Folate – eat liver, cooked dark leafy greens, and soaked/cooked lentils throughout the week to up your folate consumption
Prolamine Iodine – iodine is very important for brain development and IQ.
Before considering supplementation, remember, a nutrient-dense diet overall is paramount!
14. Eat a diet rich in nutrients – especially vitamins A, D, E, and K.
Here are some examples of important nutrients to get in throughout the week:
Vitamin A: Cod liver oil, liver, butter, and egg yolks from grass-fed animals
Vitamin D: Cod liver oil, lard, butter, and egg yolks from grass-fed animals
Vitamin K2: Butter, egg yolks, and organ meats from grass-fed animals
Choline: Liver, egg yolks
DHA: Cod liver oil, liver, butter, egg yolks
Zinc: Red meat, shell fish
Cholesterol: Seafood; dairy foods, eggs, and meat fats
This article walks through all of these nutrients and explains why they are necessary during pregnancy.
I recommend reading about Weston A. Price’s research when it comes to facial structure and the development of the teeth. In short, eating nutrient-dense foods plays a huge role and can actually help save money at the orthodontist down the road (I wish I’d know this when I was having kids!).
Not everyone loves the flavor of liver, so desiccated can be a good option.
15. Drink plenty of filtered water each day. Drinking 1/2 your weight in ounces is a good goal. Hydration is really important for the endocrine system. Without the right amount of water, the body can’t transport necessary nutrients and hormones to the cells properly.
Hydration is also particularly important during pregnancy in order to form amniotic fluid, produce extra blood, build new tissue, carry nutrients, enhance digestion, and flush out wastes and toxins.
16. Take an epsom salt bath a few times a week. When you’re stressed, the first mineral get depleted in the body is magnesium. Soaking in a bath with 1 cup of epsom salts for 20 minutes can be very helpful to relax the body.
17. Sit down to eat each meal and eat slowly. Don’t eat on-the-go, when you’re stressed, driving, etc. I know that can be tough in today’s fast-paced world! Eating slowly ensures the body is properly digesting the food and you’re able to soak up all the beneficial nutrients in the food.
Here’s an entire article to help you understand the importance of eating in a slow and relaxed state.
18. Incorporate light breath work into your daily practice. This is a fantastic way to practice intentional relaxation, which automatically lowers cortisol.
Andrew Huberman has a fantastic video explaining a physiological type of breathing that reduces stress and anxiety. It consists of double inhale followed by an extended exhale.
This type of breathing works so well to relax us because it off-loads a lot of carbon dioxide at once.
19. Don’t go low-carb. I don’t recommend a low-carb diet during pregnancy because your body needs the healthy carbs to sustain both you and baby.
You also need those carbs so the liver can convert fT4 to fT3 (fT3 is the thyroid hormone that goes to every cell of the body!).
Here’s a short list of carbs that are good choices:
Potatoes, all kinds (with butter)
Root vegetables
Fruits – apples, pears, berries, etc.
Soaked and cooked beans (kidney, navy, white, etc.)
Fermented sourdough or other soaked grains (if you can tolerate grains)
Beets
Peas
Soaked and cooked quinoa and oats
Raw and cultured dairy (here’s a list of cheeses to avoid)
20. Include protein at each meal. Get these proteins from grass-fed meat, free range poultry, wild seafood, pastured eggs, etc.
Further resources for pregnancy include:
Mama Natural – (I highly recommend checking out her birthing course!)
Lily Nichols
Weston A. Price
Nourishing Traditions Book of Baby and Childcare (I wish I’d had this book when I was having kids!)
Vitamins for Fetal Development
Podcast: How to Have a Healthy Pregnancy
Disclaimer: The purpose of this post is to give an overview of how to support the body during pregnancy from a holistic perspective. Due to biochemical individuality there are many ways to support thyroid and adrenal function when pregnant. This information is not intended to take the place of your doctor’s advice.
This article was written by Theresa Meacham and Carrie Vitt, FNTP.
