Coaching in the Grey Zone: Thyroid & Fertility in Hashimoto’s- When Lifestyle Isn’t Enough
One of my favorite parts of our mentorship program is seeing the coaches build confidence in their decision-making.
It's a big reason why we decides to make our Thyroid training on April 29th free - we want you to have the most complete thyroid picture available outside of a one-on-one appointment.
A Case Study from This Week's Calls
I was thinking about our calls this week and one of the clients a coach in our group is supporting. This scenario is all too common, and I am so glad that this client has this Coach in her corner. For my coaches reading this, I want you to have confidence to guide your clients through situations like this. Situations where women feel dismissed, confused or powerless - and show them that they are anything but .
Fertility, Hashimoto's and “It’s not that bad- yet”
This is a woman with whom this coach has worked with, on and off, for years. She has a history of autoimmune hypothyroid activity. They have made tremendous strides, but as of late, this client is feeling burned out- she’s going through a stressful period of life, and really putting a lot of pressure on herself to get pregnant and start a family with her new husband.
Because this coach knows her stuff, she suggested the client get updated labs to check what systems may need support to a) feel better in the now and b) support those fertility goals knowing the thyroid history
The results came back:
- TSH: highest it's ever been ( 6.3 … for reference, optimally we want to see this at a 1-2.5) , this hormone produced by the pituitary gland and regulates production of thyroid hormones. TSH reflects demand- when it’s high it signals the body needs more thyroid hormone
- Thyroid Antibodies: back up, signaling Autoimmune activity against thyroid tissue- impacting thyroid function and causing active destruction occurring against the thyroid gland.
- Cortisol: high at an 18, we don’t always love to rely on serum cortisol alone as it’s transient however with how this client was presenting (aka WIRED and stressed) - it serves as confirmation of her stress load .
Want to know exactly how to understand labs like this?
Save your spot for the thyroid webinar
Back to that big goal : Fertility.
Unfortunately, a familiar story: the client’s doctor was dismissive…
“this isn’t bad enough yet - come back if you can’t get pregnant “
sadly, not a unique situation in our medical system.
This coach and client duo had done the things to lower autoimmune activity, help the thyroid produce enough hormones and convert them, get everything nice and shiny and ready for the body to use.
- They have done the work to improve mineral status
- They've gone through gut health protocols
- She's put in work over the years to have ovulatory cycles
- Her food quality is on point
And she still isn't pregnant. She's been dismissed And those thyroid markers are just getting worse.
So now what?
The Right Call : And the Coach Already Knew It
Mere and I had the exact same reaction: help this client get to the right providers so she can get on thyroid medication. Because there ARE providers who are out here who can help and are up to date on thyroid health & fertility care.
When I said that out loud, I could see the coach's sigh of relief — her shoulders relaxed and she smiled to herself a little — because she had the right instincts.
If you have ever doubted your decisions as a coach, especially in the functional health landscape, I'd bet it's stemmed from seeing something on social media, or from another provider or coach who has painted a black-and-white picture of health.
What others may have missed in this case is the context of what this client has tried, the timelines, the trends, the goals, and her mental state.
They may have suggested another GI map to make sure digestive health was fully supported , a new supplement for those antibodies...
But the bigger issue is this: she is a human being with a life and a body that said, in biofeedback and in black and white on her labs, that it needed more.
Read this blod post on the connection between thyroid and fertility
What's Actually Happening in the Body
When we see elevated antibodies alongside a high TSH but normal thyroid hormones, the gland is being destroyed. The body is still able to compensate. It's just a waiting game until it isn't.
Thyroid medication can stop that destruction. The hormones increase antioxidant status and protect the thyroid gland from further damage.
Especially in this case, because the coach and client had been laying the foundation for years — good nutrition, sleep, supporting the gut and liver. They had done the root cause work and the appropriate comprehensive testing.
This client's body has so many tools to do its thing, be resilient, and get pregnant. It just needed a little nudge from one more tool. In this case, thyroid medication.
Where Coaching Doubt Comes From
This coach knew what to do- her doubts came from external sources. Sources that say if you recommend or support medication, you are "missing" some root cause that lifestyle and nutrition could fix.
Black and white sells because it's easy to market.
Supporting true health, though? That lives in the grey.
The grey is the nuance. The context of an individual's history, goals, passions, bottlenecks, fears, and lifestyle.
The functional health space often leans into the idea that a "natural" approach is always better:
- Don’t take antibiotics ever — it will ruin your gut
- Allergies? Skip the cold and flu meds and take quercetin and bromelain
- Not producing enough thyroid hormones? Take selenium and thyroid glandulars
A Multi-Faceted Approach — Including Medication When Needed
Hear me out: I DO firmly believe in supporting the whole body via a multifaceted plan that leverages nutrition, lifestyle support, nutraceuticals, supplements, and mindset. That is how we truly transform and heal.
That's why the complete picture matters: the complete picture of labs, but also of history, lifestyle, and diet. And when it comes to the thyroid, the fitness industry is partly to blame for why it takes such a beating. Most coaches just try to Band-Aid it. We're not about that.
I'm passionate about this because I've been there. In 2019, I remember sitting on the platform between sumo deadlifts feeling puffy, fatigued, and like my improvement season was falling apart before it even started. My digestion was a mess. My hair was falling out.
That journey of having to advocate for myself in doctor's appointments, having to fight for the right labs, consulting coaches who gave me advice that wasn't targeted (i.e., just take some selenium and call it a day) . That's what makes me so passionate about coaching and functional health. About integrating functional health coaching with the performance and physique space AND the conventional medicine space. Because it all goes together, and I'm tired of people not getting the full picture.
Sometimes the interventions are simple:
- Cut the alcohol
- Correct the nutrient deficiency
- Support the gut
Other times, it's about looking at the other systems that are influencing the thyroid — the liver, adrenals, immune system, gut, toxins — and digging deeper to identify where the root cause is stemming from, so we can make targeted interventions that actually move the needle.
In this thyroid training, we're helping you make these calls with confidence
Moving the needle may also mean thyroid medication. Like it did for the coach and client on our call this week. They had done the work — the natural things. This client had made life changing improvements to her digestion, hormones, and physique with those tools. And now, to get pregnant and start her family, she needed that final tool for support.
That's what good coaching is: helping someone leverage every resource available to them.
Come to the Webinar
Coaches, we have a cool role here: To be the person in our client's corner who refuses to let them settle. To see the bigger picture when they can't.
In this case, we're talking about helping someone start a family. Bringing a human into this world. That is a big, freaking amazing goal- and this woman felt so incapable of it after being dismissed at a doctor's appointment.
Because this coach bothered to ask, and reminded her client that her health and goals are worth fighting for, that story gets to have a different ending.
And here's the thing: supporting that thyroid doesn't just help her get pregnant. It helps her BE the mom she wants to be. Present. Energized. In her body. That's what's on the line when we let this stuff go unaddressed — and that's exactly what we'll be getting into at the webinar. PS it's free.
The stress of navigating all of this alone, with 5,000 tabs open and no clear answers, is exhausting. It keeps the body stuck in fight-or-flight, which is its own roadblock to healing. That's why having a coach who actually gets it matters so much.
Come to this webinar to learn how to be that coach. Come to understand the full thyroid picture , what the labs are really telling you, what raw materials the gland needs to function, and how to spot when lifestyle support alone isn't enough and it's time to refer out. Come because your clients deserve someone in their corner who sees them as a whole person, not just a TSH number.
Mere and I have been there — in our own health, and with our clients. We built this because we kept seeing the same gaps. We don't want that for you or the people you serve.
And we can't wait to see you there!
Sarah & Mere
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