PCOS And Your Thyroid: How Nutrition Plays A Role
Thyroid disorders and polycystic ovary syndrome (PCOS) are two of the most common (and perhaps overlooked) endocrine disorders in women. Although hypothyroidism and PCOS are very different, these two conditions share many similar features. Here’s what you need to know.
About the Thyroid
Located in the base of your throat with a butterfly shape, the thyroid gland regulates the rate at which your body converts food for energy, functioning as a thermostat to control the body’s metabolism and other systems. If working too fast (hyperthryroid) it tends to speed up your metabolism. If it works too slowly (hypothyroid) this tends to slow down your metabolism, resulting in weight gain or difficulties losing weight.
All cells in your body rely on the hormones secreted from your thyroid to function properly. In addition to controlling the rate at which your body converts carbohydrates, protein, and fats into fuel, thyroid hormones also control your heart rate and can affect your menstrual cycle, thus affecting fertility.
Statistics show one in eight women between the ages of 35 and 65 have some form of a thyroid disease (1). The most common form of thyroid disorders are autoimmune related and include conditions like Graves’ and Hashimotos, which occurs in the majority of patients.
Thyroid Hormones
The main thyroid hormones that the thyroid gland produces are triiodothyronine (T3) and thyroxine (T4). These hormones are synthesized from the amino acid tyrosine and the mineral iodine.
Signs and Symptoms of Hypothyroidism
According to the American Thyroid Association, hypothyroidism has a large variety of symptoms, many of them similar to PCOS (1). When your thyroid hormone levels are too low, your body’s cells cannot get enough thyroid hormone, slowing down your body’s systems. For example, the body makes less heat causing you to feel cold. Hypothyroidism doesn’t just cause symptoms; it can make other conditions worse. Symptoms of hypothyroidism usually appear slowly over several months or years. In general, the lower your thyroid hormone levels become and stay low, the more severe your symptoms will be.
Here’s some of the most common signs and symptoms:
Diagnosing Hypothyroidism
To really diagnose hypothyroidism, your doctor should do the following:
- Evaluate your symptoms, medical history, risk factors, and family history
- Perform a physical exam
- Check these blood tests:
TSH: measures how much T4 the thyroid is being asked to make. An abnormally high TSH test may mean you have hypothyroidism. Relying on TSH alone is not sufficient to make an accurate diagnosis and one reason why so many people with hypothyroid are misdiagnosed.
T4 tests (Free T4, free T4 index, total T4): assesses the amount of T4 your thyroid is producing.
Thyroid peroxidase antibody (anti-TPO) (TgAb): checks for thyroid antibodies and to detect autoimmune thyroid conditions like hashimoto’s.
T3 and Reverse T3 (rT3): assesses the amount of T3 your thyroid is producing and its ability to convert T4 to T3.
According to the American Thyroid Association, saliva tests for detecting thyroid disease are not accurate (1).
PCOS and Thyroid Disorders
It has been reported that hypothyroidism and autoimmune types of thyroid are more common in women with PCOS as compared to the normal population (2,3).
Sinha and colleagues found that 22.5% of women with PCOS had hypothyroidism compared to 8.75% in controls (3) and TPO antibodies have been shown to be present in 27% of patients with PCOS versus 8% in controls (4). More recently, a study published in Endocrine Research demonstrated a higher prevalence of Hashimoto’s thyroiditis (HT), elevated TSH, anti-TPO, and anti-Tg levels in PCOS patients (5). The researchers suggest an increased estrogen and estrogen/progesterone ratio seem to be directly involved in high anti-TPO levels in PCOS patients.
Both genetic and environmental factors are believed to be contributing to thyroid disorders in PCOS. Hypothyroidism is known to cause PCOS-like ovaries and overall worsening of PCOS and insulin resistance (1, 6).
Hypothyroidism can increase testosterone by decreasing the level of sex hormone binding globulin (SHBG), increasing the conversion of androstenedione to testosterone and estradiol, and reducing the metabolic clearance of androstenedione (1,5).
Medical Treatment for Hypothyroid
Hypothyroidism can’t be cured but it can be treated by replacing the missing thyroid hormone with synthetic thyroxine pills, which must be taken daily for life. Medications can treat hypothyroidism but not always its symptoms.
Nutrition and Thyroid
Functional medicine involves finding the underlying causes of the thyroid dysfunction or autoimmune response. For example, what is causing the body to attack itself, which is what happens with autoimmune conditions like hashimoto’s.
Soy
Soy is a phytoestrogen. This mean it can mimic estrogen although it does so very weakly and nowhere close to being as powerful as estrogen. Eating large amounts of soy can inhibit the activity of thyroid peroxidase (TPO) and cause the thyroid to be inflamed.
If you have a thyroid disorder, you may want to limit your intake of soy. Examples of soy foods include tofu, soy milk, and foods that are meat-alternatives. Be sure to read labels for hidden sources of soy. Watch out for the ingredient soy protein isolate which is found in many bars, protein powders, cereals, and processed food.
Gluten
Gliadin, the protein found in gluten is very similar to the hormone produced by the thyroid gland. The result is that the body thinks it has plenty of thyroid hormone and stops working as it should.
While there is a lack of scientific research to support it, gluten is linked with worsening (or causing) autoimmune disorders. Markers of autoimmunity, such as antihistone, have been reported to be elevated in PCOS women (7). If you have a thyroid disorder, especially an autoimmune one, it may benefit you to try a gluten-free diet to see how your symptoms respond.
Sugar
Hypothyroidism can worsen insulin resistance. A study published in Human Reproduction showed that women with the highest TSH levels (hypothyroidism), tended to have the most severe insulin resistance, regardless of weight status (6). Sugary foods and drinks raise insulin levels. Avoiding sugar as much as possible is important.
Iodine
The thyroid must have iodine to make thyroid hormone. The main food sources of iodine include dairy products, chicken, beef, pork, fish, and iodized salt. Pink Himalayan and sea salt are not rich sources or iodine. Keeping thyroid hormone production in balance requires the right amount of iodine. Too little or too much iodine can cause or worsen hypothyroidism. Discuss with your doctor before taking iodine supplements and use with caution and only under supervision of a health care provider.
In addition, it’s important to eat a healthy diet that includes a variety of fruits and vegetables to provide adequate amounts of vitamins and minerals such as selenium, zinc, chromium, and magnesium to keep your thyroid functioning properly.
Do you have PCOS and diagnosed with a thyroid disorder? Please share your experiences with us below:
Sources
1.HYPOTHYROIDISM: A BOOKLET FOR PATIENTS AND THEIR FAMILIES. A publication of the American Thyroid Association (ATA) www.thyroid.org accessed on July 14, 2015.
2.Rajiv Singla, Yashdeep Gupta, Manju Khemani, and Sameer Aggarwal. Thyroid disorders and polycystic ovary syndrome: An emerging relationship. Indian J Endocrinol Metab. 2015 Jan-Feb; 19(1): 25–29.
3.Sinha U, Sinharay K, Saha S, Longkumer TA, Baul SN, Pal SK. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India. Indian J Endocrinol Metab. 2013 Mar; 17(2):304-9.
4.Garelli S, Masiero S, Plebani M, Chen S, Furmaniak J, Armanini D, Betterle C. High prevalence of chronic thyroiditis in patients with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2013 Jul; 169(2):248-51.
5.Arduc A, Dogan BA, Bilmez S, Imga Nasiroglu N, Tuna MM, Isik S, Berker D, Guler S. High prevalence of Hashimoto’s thyroiditis in patients with polycystic ovary syndrome: does the imbalance between estradiol and progesterone play a role? Endocr Res. 2015 Mar 30:1-7.
6.Mueller A, Schöfl C, Dittrich R, Cupisti S, Oppelt PG, Schild RL, Beckmann MW, Häberle L. Thyroid-stimulating hormone is associated with insulin resistance independently of body mass index and age in women with polycystic ovary syndrome. Hum Reprod. 2009 Nov;24(11):2924-30.
7.Hefler-Frischmuth K, Walch K, Huebl W, et al.Serologic markers of autoimmunity in women with polycystic ovary syndrome. Fertil Steril 2010;93:2291–4.
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Comments (32)
Danielle
July 23, 2015 at 7:06 pm
I’m 25 years old and when I was 12 I had my first menstrual cycle. When I was 13 it stopped completely. Found out that I had pcos and they put me on birth control pills to regulate things. I was on them until 2010. My fiance and I were trying to convince and could not. Later in 2010 I was sent to a endocrinologist and was diagnosed with hypothyroidism. They put me on synthroid and metformin ( which is for pcos). And it seemed to work well for the pcos until my cycle stopped again in a year. It’s off and on and it has taken a toll on me. I believe that I had both pcos and a thyroid disorder when I was 13, but being too young, the Dr decided to wait until I was older. With the thyroid problem, it is extremely hard for me to loose weight and once I do and get to a small goal amount, it all comes back and then some. Both disorders cause infertility and we have been trying for five years now and aren’t going to give up. If there is something extra to help with both disorders to help conceive, please let me know.
Aimee
July 29, 2015 at 7:07 pm
I have PCOS and now hypothyroid. I can honestly say this is the worst I’ve ever felt. Working to get pat the fatigue and weight gain. Started cleaning up my diet gluten free, dairy free, yeast free. Tough but hope to see results. Great article! Thank you.
Mary
January 6, 2016 at 7:08 pm
Hi I’m Mary I have PCOS and low thyroid.I recently had my thyroid test done its low causing me to be sluggish fatigue all the time much more in mornings my joints.its like I never get enough sleep.my sugar has been dropping lately.my periods are heavy unexpected no regular schedule I’m 49 the doc said I’m in perimenopause too.
An
January 25, 2016 at 12:35 pm
Interested in trying this. Unfortunately, I can’t stand any drink mix -ins. Is it available is pill form, or could it be put into a gel cap? Or possibly tasteless in something like yogurt, smoothie, etc? Looking for an alternative to metformin as my stomach can’t take it. Thanks! 🙂
Angela Grassi
January 26, 2016 at 12:35 pm
Thanks for your comment on the PCOS nutrition Center Blog. Ovasitol is a tasteless powder that should be taken with meals and should be dissolved in your favorite hot or cold beverage.
Other forms of inositol are available but none that compare to the combination of myo and DCI in Ovasitol.
Gurpreet kaur
March 30, 2016 at 2:47 am
I have pcos and thyroid. I am a mother of 1year old daughter. Post delivery my weight has increased rapidly. My tsh levels have increased and pcos is worsening. Can u please help ?
Gina
October 24, 2016 at 7:35 pm
I am 35 and have both POCS and hypothyroidism. I have been unable to lose weight despite extremely clean eating and daily exercise. I have been prescribed birth control for the POCS but that made me gain a lot of weight. So I stopped taking the birth control. My thyroid medicine is armour and cytomel, and aside from high antibodies my thyroid is mostly under control. i am not sure what else to do and feel hopeless. I have had hypothyroidism since i was 25 and have been able to stay a healthy weight. For some reason, now that i have POCS nothing works. It has been 1 1/2 years of hard work with no effort.
Angela Grassi
October 25, 2016 at 7:38 am
Gina, a big reason a lot of women struggle to lose weight is due to insulin. Metformin can help but there are some other aggressive insulin sensitizing supplements like Ovasitol and NAC (both in our supplement store) that can help. As always, focus on getting labs into normal ranges with lifestyle changes rather than focusing on a number on a scale.
Jennifer Post
March 2, 2017 at 4:48 pm
I was recently diagnosed with Hashimoto’s. Is this different than hypothyroidism and is it curable? I was told it was curable with a clean diet, but I get conflicting information.
Angela Grassi
March 2, 2017 at 5:38 pm
Hi Jennifer!
Sadly, Hashimoto’s is an autoimmune disorder and does not go away but can be managed.
Jennifer phanton
March 10, 2017 at 6:05 am
So I’m a 37-yr old female who had a thyroidectomy 15 months ago. I found out, when having my thryroid removed only made things worse, that I have PCOS and Hashimoto’s. I’ve always battled weight, depression, lethargy, no menstral cycle or irregular ones, acne, low blood sugar ironically combIned with high insulin, issues ovulating, and miscarriages (3 pregnancies and I’ve miscarried them all). I’ve read the article and my question is, what do I do now that I no longer have a thyroid but my PCOS remains and I feel worse now? I can’t be on Metformin as it causes my blood sugar to crash all the time. My allergist says I’m allergic to Gluten and I must admit I haven’t been able to cut Gluten from my diet. I also eat a lot of sugar so that doesn’t help. When I try to eat healthy I feel sick, it isn’t until a few days later when I finally break and eat junk food that I actually physically feel better. So I feel like I’m damned if I do and damned if I don’t. What do I do? I’ve considered HRT. But beyond that I’m at a loss. My allergist says nothing will get better until I cut Gluten out. But if I’m giving myself thyroid meds then how does Gluten even matter at this point? How do I still have PCOS when I’m regulating my own thyroid hormones?
Angela Grassi
March 13, 2017 at 8:36 am
If you have an allergy to gluten, eating it will cause more inflammation and make your PCOS symptoms worse. If you need support in making changes to your eating to reduce gluten and sugar, we can help. Many women get good results with Ovasitol helping to reduce cravings for sweets and carbs: http://www.pcosnutrition.com/product/ovasitol/
Arshiya
May 24, 2017 at 6:03 am
Hiiii …I’m Arshiya I’m 28 years old I have hypothyroid and pcos I have two kids after my second delivery my weight has increased a lot from 60 kg to 75 kg unable to loose weight my skin has become so dark and excess hair fall I am on metformin since 3 months but result , my periods are irregular if I periods once in 6 months bleeding is only for two days
Please help me
Diana
October 6, 2017 at 6:04 am
Hi I’m 29 I have had a pacemaker since I was 18mons. I was diagnosed with PCOS when I was in highschool later had a daughter after graduation, after 7yrs had another daughter now I have had hives out of nowhere and feeling sick not knowing what was wrong went to have blood work done came back my thyroid was low the heart doctor says I have to go and have more blood work done for my thyroid today. I don’t know what to do, how is all this going to mean on my health? Pacemaker, PCOS, and thyroid smh…..
Susan
October 13, 2017 at 7:05 am
Hi im 45…was diagnosed with just “hypothyroid” slow thyroid at age 25…for 20 years ive been feeling like crap even on thyroid meds…over time i developed lots of chin hair, a nice happy trail, puss filled bumps under my armpits and irritabilty and a bright red facefinally within the last few years came diagnoses of: HS disease, PCOS and hoshimotos…all 3 in one! Im constanrly having ovarian cyst that rupture but are said to be small, irregular periods lower back pain..lots of flatulence…now i need a radioactive iodine thyroid scan to view how thyroid is working…im an inhorbalanced nightmare lol…any chance to feel better and shrink cyst with change of diet? Thank you!
Angela Grassi
October 25, 2017 at 10:59 am
Hi Susan, Yes, there is help for you! Diet and lifestyle can make a huge difference. We offer nutrition counseling if you are interested contact us at info@PCOSnutrition.com
madeeha
January 18, 2018 at 2:49 pm
Hii i am madeeha
when i was 14 i was suffering from hypothyroidism and there were many irregular periods . I stopped taking the medicine. During that period i gained a lot of weight . At the age of 18 i was diagnosed with pcod . It was a three months course after which now i have almost lost 10 kgs . And my periods are also regular. Now i am taking 100mg thyroxine regularly everyday . My question is that, in future does this will effect my fertility and pregnancy and what changes will happen.
Angela Grassi
January 23, 2018 at 8:33 pm
An optimal thyroid level is important for fertility and a healthy pregnancy. Regulating your thyroid now, will help when you are ready to start trying for a baby.
Diane
February 5, 2018 at 1:26 pm
I am 54, was diagnosed with pcos in my 20’s after experiencing a 75# wt gain in just 4 yrs. Went through infertility treatments to no avail, went on metformin at age 37, lost 50# without really trying, and got pregnant naturally at age 39. Healthy baby, but gained all of the wt back I’d lost, had gastric bypass at age 48, lost 90#, kept it off for 3 yrs, Went through a great degree of stress in the past few yrs, slowly gaining weight though continuing to eat healthy. Have gained 20# just in the past 7 months along with other symptoms which I related to stress and perimenopause, hair loss, brittle hair, mood swings, carpal tunnel syndrome, etc. Just has a check up and discovered I now have hypothyroid. I’m at my wits end. My body fights me at every turn. It wants to keep my weight at its highest no matter what I do. Very discouraged, esp as I age. Heart disease and diabetes run strong in my family.
Angela Grassi
February 8, 2018 at 9:40 am
Diane, You are not alone in your struggles with weight. We do provide personalized nutrition coaching to help you reduce your risk for disease and take control over PCOS. If you are interested, please contact us at info@PCOSnutrition.com
Deepika
February 11, 2019 at 2:13 pm
Hey! Why didn’t you described PCOS with hyperthyroid ? I have PCOS & hyperthyroid from years. Fed up of taking medicines, diagnosis. I am 28. Can’t gain weight, hair loss,thin hair, acne,pimples, fatigue,no menstrual,mood swings, digestion problems……hell life. I was 20, when I was diagnosed with PCOS and thyroid…
Angela Grassi
February 13, 2019 at 1:41 pm
Hi Deepika, Thanks for reminding us to write a post about hyperthydroid. Hypothyroid affects most people with PCOS.
Nathalie M.
February 28, 2019 at 10:29 pm
Hi. I have veen diagnosed with Pcos and have thyroid nodules and a bit low t4 but everything is fine and there is nithing wrong with thyroid. My hormones are inbalanced high elevated dhea , elevated testosterone and i believe it was also androgenes. I also have been diagnosed with leaky gut and fibromyalgia and have water retention in hips legs and osteoarthritis in hips and low back. Need a new hip when im +/- 55 years old. I also have allergies and gluten lactose intolerant and have a histamine problem. I thought i had menopauze and thyroidproblems but docters blamed all of it to fibromyalgia so they didnt test me. Once i asked for a bloodform and then I checked a bunch of hormones myself on the form , edited it and thats how i found out. I have been adviced to go on a vegan diet without soy and to take the pill. I am not taking any chemicals because i am allergic/sensative to chemicals.
Helen
May 28, 2019 at 1:58 pm
I was diagnosed with PCOS when I was 16 and have had about one period each year since then. At 27 I was diagnosed with thyroid cancer and had the whole thyroid removed. I have since had a baby and am still exclusively breastfeeding. Any recommendations on what I should be eating?
Lisa Truitt
August 4, 2019 at 10:40 am
I think mineral deficiencies as well as toxicities are at the root of PCOS and hypothyroidism and that PCOS and hypothyroidism go together. I think that the two always go together though often the hypothyroidism is subclinical and doesn’t show up on tests.
Further I think think that the primary deficiencies are iron with that being number one, iodine, vitamin d3, retinol form vitamin a, and sometimes b12. Excessive levels of copper, and heavy metals like cadmium, arsenic and mercury can also be involved.
I base this conclusion on several years of research and self experimentation.
I find it too much to be coincidence that the comprehensive list of symptoms of iron deficiency are EXACTLY the same as hypothyroidism right down to the less mentioned ones like dysphasia, insomnia, brittle nails and hair, apathy, breathing problems/shortness of breath etc.
women need to Econ’s educated that the vast majority need iron supplementation. Reference the blood journal article is the rda for iron for women too low? Google it to read it. They found that it took 50 mg of iron a day for 90 percent of menstruating women to have adequate iron stores and 25 for non menstruating women.
For years I went on and off iron even though I felt human and my symptoms basically the full battery of hypothyroid/iron deficient symptoms greatly resolved or headed towards that as long as I kept up my iron supps because of the brainwashing of fear or too much iron. I learned recently that the national association of medicine and science or something like that set the no observed adverse affects level for iron at around 60 mg per day. That means that that level and below is not going to hurt most people. Unless they have hemochromatosis they are not going to be harmed. The liver secretes Hepcidin which regulates iron absorption. If you need more you absorb more.. Twice I have been tested and my ferritin iron stores were very low. When I deal with that I get better and better.
I also have tested very high androgens and have had a lot of PCOS symptoms. That gets better also when I lower inflammation and get all my thyroid nutrients. I do cod liver oil for a and d and omega 3s for anti inflammatory effect, juicing, iron, iodine, selenium a broad based high potency multi, vitamin d3 etc
Cut out all high glycemic inflammatory foods. I’d highly encourage people to try this and see what happens. It’s given me my life back.
Michelle
February 7, 2020 at 7:10 pm
I have PCOS and went vegetarian three years ago. (Before that I did not eat pork or beef, but did eat chicken and fish.) I just realized I started gaining weight gradually over the past three years even doing the same things (exersizing and eating healthy.) Also I have developed hypothyroidism and heart issues. I think that I am not getting enough protein probably and it’s all connected. Thanks for the info.
Angela Grassi
February 10, 2020 at 2:35 pm
That’s great that you noticed how protein helps you.
Kristin
February 29, 2020 at 2:23 am
I have pcos and hypothyroidism. I wish that I could find a doctor that would help manage both together.
Ka
May 2, 2021 at 8:11 am
I have been diagnosed with Hashimoto. I take synthroid. Dont know if its working. I’m balding, overweight. Struggle to lose. Dont know what to eat. I have suffered with facial hair pretty much all my life. Did electrolysis in my younger years, didnt likw results. In 2017, I had a hysterectomy due to the complications of fibroids. Both ovaries were covered in cysts. I guess I didnt ask the right questions. Now my dictor tells me Im prediabetic. I took 1st shot of Moderna and I suffered. My inflammation was terrible! I need someone to help me understand what’s wrong with my body. Please help.
Angela Grassi
May 4, 2021 at 10:01 am
You may want to check with your doctor to see if your synthroid dose is sufficient.
Soma Chowdhury
May 19, 2021 at 8:15 am
I have Hypothyroidism since 13 years and PCOD since 9 years.
I had problem with ovulation due to which I was not having periods, along with that weight gain, hair fall and acne was a challenge.
Taken Birth control hormonal pills for 6 years, started getting regular periods, acne was gone but hairfall not yet stopped.
I have stopped with OC and started doing Seed Cycling and taking care of my diet and exercising daily. Weight is under control.
I would like to know if I may have Dairy Curd.
Angela Grassi
June 12, 2021 at 2:53 pm
Yes, as long as it doesn’t bother you.