If you have PCOS and are experiencing symptoms such as stubborn weight loss, infertility, fatigue, hair falling out, depression and anxiety, your thyroid may not be working properly – read more below on the thyroid and PCOS link.
What is the thyroid gland?
The thyroid gland is situated at the front of the throat, below the larynx (Adam’s apple), and comprises two lobes that lie on either side of the windpipe, normally not seen. Part of our endocrine system, this gland secretes hormones to regulate many metabolic processes, including growth and energy expenditure. If the thyroid is overactive or sluggish, the metabolism will be affected, leading to a variety of symptoms that are easily misdiagnosed. Around one in 4 women will experience some form of thyroid dysfunction in their lifetime.
The thyroid regulates many metabolic processes, including growth, energy use and ovulation. Common problems include hyperthyroidism (overactivity) and hypothyroidism (underactivity). Common causes of thyroid disorders are Hashimoto’s disease and Graves’ disease. An enlargement of the thyroid gland is called a ‘goitre’.
Some of the more common hormonal disorders, including PCOS are associated with the thyroid disorders.
The hormones involved in thyroid gland regulation need iodine, which is usally ingested through our food and water. However, the problem facing women today, is the lack of iodine being absorbed.
How do I test for thyroid health?
Problems with thyroid hormone levels can be diagnosed with a simple blood test which can be arranged by your doctor or naturopath. The following levels should be deterimined:
- Thyroid Stimulating Hormone (TSH)
- Thyroxine (T4)
- Triiodothyronine (T3)
- Reverse T3
- Thyroid Antibodies
- Urinary iodine test
The presence of antibodies in the blood will confirm Graves’ or Hashimoto’s disease. Your doctor and naturopath will guide you with the most appropriate treatment.
Nodules and cancers are diagnosed with a variety of different tests, including ultrasound, special x-rays and fine needle biopsies. Your endocrinologist will guide you with the most appropriate treatment.
PCOS cysts and low iodine : thyroid and PCOS link
One interesting link is the relationship between ovarian cysts and low iodine – which is crucial to thyroid gland functioning. Therefore, ask your practitioner to arrange a urinary iodine test to assess your iodine status. This is another way to ascertain the thyroid and PCOS link.
The link between thyroid, PCOS & fertility
An underactive thyroid or having a auto-immune thyroid disorder in conjunction with PCOS will impact on your fertility. PCOS triples your risk for having thyroid autoimmune disease which can exacerbate infertility and greatly increase miscarriage rates if left undiagnosed and untreated.
A number of recent studies have identified a link between PCOS and increased incidence of autoimmune thyroid disease.
A 2013 Italian study (1) in the European Journal of Obstetrics, Gynecology and Reproductive Biology tested for thyroid autoimmune disease in 113 women with PCOS and discovered that 27% had the disease. In addition, 43% of the women had subclinical hypothyroidism which is also linked with increased miscarriage risks if undiagnosed and untreated. The study conclubed that:
“The prevalence of AIT (autoimmune thyroid disease) in patients with PCOS was significantly higher than in controls. No other autoimmune diseases were associated with PCOS. This observation suggests that PCOS patients should be screened for AIT.”
An earlier published study in 2011 (1) also confirms: “Early diagnosis and treatment of hypothyroidism in PCOS may reduce the rate of infertility and pregnancy-related morbidity.”
This study evaluated the thyroid status of 78 PCOS women and compared them to 350 control women of a similar age; the study concluded that: “In this case-control study, anti-thyroid antibodies and goitre prevalence were significantly higher in PCOS patients. These data suggest that thyroid exam and evaluation of thyroid function and autoimmunity should be considered in such patients.”
Sadly, not all doctors automatically test women with PCOS to see if they have elevated levels of thyroid auto antibodies which could elevate risks for miscarriage and IVF failure. So in light of this information, ask your doctor/specialist for a full thyroid panel inlcuding thyroid antibodies.
Despite variances in pathology labs, TSH should be under 2 mIU/ml, with some countries paramaters preferring a reading closer to 1.5 for peak fertility and miscarriage prevention.
If the TSH is high, ensure your specialist will refer you for a thyroid ultrasound too which can pick up early thyroid autoimmune disease before antibodies manifest in the blood.
1. Eur J Obstet Gyne Reprod Biol. 2013 Mar 30. pii: S0301-2115(13)00116-4. doi: 10.1016/j.ejogrb.2013.03.003. High prevalence of chronic thyroiditis in patients with polycystic ovary syndrome. Garelli S, Masiero S, Plebani M, Chen S, Furmaniak J, Armanini D, Betterle C.
2. Arch Gynecol Obstet. 2011 Aug 25. Prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Kachuei M, Jafari F, Kachuei A, Kehteli AH.
Thyroid and PCOS link – find out all you need to know with The Natural PCOS Diet book
If you can associated with the thyroid and PCOS link, The Natural PCOS Diet provides answers to your questions as to what you can do to restore hormone balance and proper functioning of your hormonal system. What’s more, the Natural PCOS Diet comes with a free bonus cookbook, The Natural PCOS Diet Cookbook.
Thyoid gland problems, PCOS and infertility – you need The Holistic IVF Diet Guide to Making Babies
If you are experiencing infertility and have been told you have a thyroid gland problem and PCOS and likely will need to have IVF to conceive, then this book is for you. It’s not just for patients going through IVF, it is for any couple on the fertility journey. You will find detailed, practical information to assist in restoring hormone balance to maximise your chances of having a baby. More information can be found here: IVF Diet Book