The PCOS-Thyroid Connection

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in reproductive age women, yet only 50% of women with the disorder are properly diagnosed. PCOS is a complicated condition that carries a genetic component, and affects hormones, metabolism, digestion, and reproduction. Common signs and symptoms include irregular cycles, weight gain, fatigue, insomnia, acne, facial hair, and mood changes.

To be diagnosed with PCOS, you need at least two of the follow three:

1. Irregular cycles meaning periods typically occur more than 35 days apart. This is due to irregular or absent ovulation.

2. Elevated androgen hormones which may present as acne, hair loss, or excessive hair growth on the face, chest, or back. Androgen hormones like DHEA-S and testosterone can also be measured via a blood or urine test.

3. Polycystic ovaries seen on ultrasound performed by your OB/GYN. This change develops because elevated androgen hormones prevent follicles from fully developing enough to release an egg during ovulation. As a result, multiple premature follicles develop.

    

What is Hashimoto’s?

Hashimoto's thyroiditis, the most common cause of hypothyroidism, is when the immune system attacks the thyroid. The thyroid is a butterfly-shaped gland in the neck that produces hormones responsible for regulating metabolism, body temperature, and growth.

Signs of hashimoto's include weight gain, fatigue, depression, constipation, dry skin, hair loss, and sensitivity to cold. One 2013 study found that 22.5% of women with PCOS had hypothyroidism compared to 8.75% of those without PCOS. Additionally, Hashimoto's antibodies were found in 27% of patients with PCOS compared to 8% of those without PCOS

What makes hashimoto’s and PCOS so closely similar is the presentation of irregular cycles and polycystic ovaries. Unmanaged hashimoto’s can lead to elevated prolactin, a hormone that affects fertility by inhibiting FSH and LH, two hormones responsible for triggering ovulation. Without ovulation, polycystic ovaries develop, and can further contribute to PCOS symptoms.

Check out this post about thyroid health and fertility to learn more about thyroid hormones and how you can test for hashimoto’s. I recommend completing thyroid testing annually, as thyroid health is easily impacted by our lifestyle, stress, and environmental toxins.

It’s also important to note, when completing thyroid testing you should discontinue any supplement with biotin for 72 hours prior to testing. Biotin is a vitamin found in multivitamins, prenatal, and hair supplements that may interfere with results.

Ways to support thyroid health

LOVE YOUR LIVER (& GUT)

Hashimoto’s decreases sex-hormone binding globulin (SHBG), the protein responsible for binding excess hormones. Lower SHBG leads to higher levels of testosterone and estrogen, two hormones that are often already elevated with PCOS. High estrogen can then lead to higher thyroid antibody levels, and the cycle continues. By improving liver and gut health, you can support your body’s ability to metabolize hormones and restore hormonal balance.

• Eat fiber-rich foods including beans, apples, pears, berries, avocado, and whole grains to promote daily bowel movements.

• Eat probiotic-rich foods including kimchi, sauerkraut, and non-dairy yogurt to encourage a healthy gut micro-biome. This is especially important if you have been on antibiotics or the birth control pill. You may also consider a high-quality probiotic. Click here to shop my favorites.

• Eat liver-loving foods like beets, lemon, garlic, leafy greens, cilantro, artichoke, and broccoli.

• Reduce processed foods and sugar which are known to increase inflammation in the gut.

• Limit your alcohol and use of NSAIDs, like Advil, as these can be harsh on the liver.

   

COOK YOUR BRASSICAS

Brassicas include broccoli, cauliflower, kale, collard greens, turnips and brussels sprouts. These foods contain a chemical called goitrogens that are known to inhibit the thyroid's ability to produce hormones. By cooking these foods you can inactivate the goitrogens, making them safer to consume in those with hypothyroidism.

CONSIDER GOING GLUTEN FREE

Studies show improvement in thyroid antibody levels in those with Hashimoto's who follow a gluten-free diet. This is because the gluten protein has a similar structure to thyroid tissue, meaning a women whose immune system mounts a response and attacks the thyroid will mount a similar response to gluten. A high gluten diet will lead to a greater inflammatory immune response and can exacerbate thyroid dysfunction.

EAT YOUR SELENIUM

Selenium is a mineral needed to convert T4 (the inactive thyroid hormone) into the active form, T3. This mineral also helps protect the thyroid form oxidative damage. Eating just two to three brazil nuts per day can provide your daily selenium needs of 200mcg.

CONSIDER SUPPLEMENTING WITH OVASITOL

Inositol is a vitamin-like compound found to support hormone balance and regulate menstrual cycles. Ovasitol is a 40:1 combination of myo-inositol and d-chiro-inositol, which is the same ratio found naturally in the body. Recent studies have found better outcomes when these two forms of inositol were taken together compared to taken individually. Myoinositol has been found to reduce thyroid stimulating hormone (TSH) and thyroid antibody levels while increasing thyroid hormone production. It takes six months to see noticeable change with Ovasitol, so being consistent and patient is key. Click here to shop.

REDUCE YOUR ENVIRONMENTAL TOXIN EXPOSURE

Environmental toxins greatly influence our thyroid and hormonal health. Everything from our household cleaners to our personal care products to makeup and sunscreen. Knowing what is in your products is so important, but can be very overwhelming. I recommend starting with the products that come in contact with your skin, things like body lotion, soaps, laundry detergent, and sunscreen. Use the Environment Working Group’s “Healthy Living” app to scan products to determine which are non-toxic. The EWG ranks products on a scale of 1-10, based on safety and efficacy. I recommend choosing products that rank 4 or less. For more information on environmental toxins and hormone disruptors, check out my environmental toxin guide on Instagram!