This is an article that I have wanted to write for a while now. You see, there is a close link between PCOS and hypothyroidism. And the symptoms of both can overlap and look similar. You may also be doing all of the right things to manage your PCOS and not see any results because you may have an underlying thyroid issue that you need to address first.
So, let’s unpick this a little bit and work out what the link is and how you can have your thyroid checked and sorted out, if necessary.
What is the thyroid?
The thyroid is a butterfly-shaped gland in your neck. It is also one of the biggest endocrine glands in the body. So, what does it do? Well, it’s main job is to control the rate of metabolism, or how quickly (or slowly) your body uses energy. It is also involved in making proteins and it controls the body’s sensitivity to other hormones (1).
So, if your thyroid gland is overactive, you tend to be slimmer, have a higher heart rate, trouble sleeping, mood swings and anxiety (2). An underactive thyroid makes you gain weight and feel generally more sluggish. Women with PCOS are more prone to hypothyroidism so let’s have a look at that in a little more detail.
Hypothyroidism
The thyroid gland is controlled by another gland in the brain – the pituitary gland (that’s important because the pituitary may be the link between PCOS and hypothyroidism, which we’ll talk about in a little bit). If you thyroid doesn’t produce enough thyroid hormones, it is underactive. Let’s have a look at some of the symptoms (3):
- Weight gain
- Slow movements, thought and speech
- Pins and needles
- Breathlessness
- Dizziness
- Palpitations
- Dry/gritty eyes
- Hoarse voice
- Difficulty swallowing
- Hair loss especially outer third of eyebrows
- Dry skin
- Muscle and joint pain
- Carpal tunnel syndrome
- Loss of appetite
- Constipation
Mmmm, I can see some overlap with PCOS there, particularly with regard to weight gain and hair loss.
PCOS and Hypothyroidism
Okay, so now that we know a little more about Hypothyroidism,
let’s have a look at the link between hypothyroidism and PCOS.
One study has found that 22.5% of women with PCOS also had subclinical hypothyroidism. That’s a high percentage of us! Now, the pathway connecting PCOS and hypothyroidism isn’t clear yet but what is pretty well established is that women with PCOS may also have be at a higher risk of developing hypothyroidism (4).
Hypothyroidism, PCOS and Sex Hormone Binding Globulin
Now, there is something else that we need to consider. We know that women with POCS tend to have lower levels of SHBG. This is problematic because SHBG picks up free testosterone in the blood and helps to make it inactive. So, the less SHBG you have, the more free testosterone you have to make your PCOS symptoms worse.
Here’s the thing, it is our thyroid hormones that increase the levels of SHBG. So, if you do have a sluggish thyroid, you will have a harder time getting your PCOS under control (5).
What to do now?
Now that we know that there is this strong link, what should we do about it? Well, there are a couple of things.
It’s really important that we all have our thyroid function monitored. My doctor runs blood tests every two years or so to monitor my general health and PCOS and thyroid function is included in this.
Treatment for Thyroid Disorders
If you suspect that you may have a thyroid disorder or your blood work shows an anomaly in your thyroid hormones, there is medical treatment available. Your doctor will guide you on this.
Diet
Once again, we come back to the cornerstone of PCOS Diet Support. Your diet can impact on your thyroid health, as well as your PCOS. Here are some suggestions to support your thyroid function and improve your PCOS:
Avoid soy – Soy products contain phytoestrogens that have been shown to increase the risk of developing subclinical hypothyroidism(6). Soy can also cause delayed ovulation which is why I don’t recommend soy products as part of a good PCOS Diet.
Give up Gluten – I’ve written about gluten before and I don’t think it has a place in a PCOS friendly lifestyle. Well, according to Chris Kresser, gluten can also impact on your thyroid health. There is a protein in gluten (gliadin) that is very similar in structure to a thyroid hormone. So, if you have a gluten sensitivity, your body not only attacks the gliadin, it can also attack your thyroid in an autoimmune response.
Avoid sugar – Research has shown that hypothyroidism can make insulin resistance worse. And, eating sugar or highly refined carbs causes your body to release more insulin. Remember that all of this insulin is also causing your ovaries to release more testosterone. So, by avoiding highly processed and sugary foods, you are managing your PCOS and supporting your thyroid function (7).
Summing it up
So, to sum it all up:
- We’ve established that women with PCOS are 22.5% more likely to have some type of thyroid dysfunction. This can make our PCOS symptoms worse and much harder to manage.
- I highly recommend that you have your thyroid levels checked at least every two years.
- Following a good PCOS diet will not only help to manage your PCOS, it will also support your thyroid health.
Do you suffer from hypothyroidism? I’d love to hear what things have worked for you and whether or not you have seen an improvement in your symptoms. Please leave me a comment below!
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42 Responses
I have hashimotos and pcos. I suffered from being overweight through all of my adolescent years and my 20’s. Nothing worked for me except incredibly strict dieting and intense workouts every day that were not sustainable long term. Finally I tried the Keto diet which worked for me. I lost about 50 pounds without working out, just by changing my diet. My pre diabetes went away and I was feeling so much better. I do still take synthroid and liothyronine because the weight loss wasn’t changing my thyroid levels even though we kept checking at every 10lb loss mark.
After reading this article it makes sense why Keto works with thyroid and pcos. The diet is eliminating most gluten sources, refined carbs, and sugar. I need to get back to being strict Keto because I definitely feel better eating this way.
My wife has hypothyroid and PCOS- we have tried gluten free diet, eating salad, oats, green vegetables, no oil, no sugar. But it affected her B12,Iron significantly lower, while her Platelets increased upto 418. She is now worried too much. What is the best suggestion for diet vegeterian.
I have had PCOS forever but with no weight problem. (I’m 49) Three years ago I decided to go vegetarian and since then have packed on pounds despite eating well and developed hashimotos. I am on thyroid medication and levels are better now, but still feel sluggish and having major heart palpitation issues. Since my issues started when I went vegetarian I’m really wondering about my diet. I don’t think I get enough calories and probably not enough protein. Don’t want to go back but thinking I might have to try it to see if things improve.
Do not give up. I had thyroidectomy, have Hashimotos and PCOS. Please look at your T3 in your blood tests. It should be in the upper quadrant of the norm at 7am fasting and about 50% of the norm in the evening. If it’s not, everything will go to hell because only T3 is the hormone that participates in your metabolism. If you maxed out on your T4 dose, meaning they can’t increase it because it is in the norm, then your body is not converting T4 to T3 well and you need additional T3. I asked my dr to take extra Cytomel (T3) only 5mcg with my Synthroid 125mcg. It made such a huge difference that I cried for 3 weeks over losing 10 years of my life feeling like crap and also crying I guess from happiness I found the way to have a much better life. No more feeling cold at night, no more having muscular issues in building stamina or running a flight of stairs, no more joint pain or brain fog… Also I lost 23lbs in 4 months without much trying and I’m going for another 50 with very moderate exercise and 1800kcal diet. I started painting again, working and living my life. Hang on there!
THANK YOU SO MUCH FOR YOUR POST! I have Hashimoto’s, and had a thyroidectomy for Thyroid cancer and I have PCOS. I’ve been struggling for years and could find no help. Here I am again at my wits end and waiting on my endocrinologist to set up a video visit. I was thinking I needed T3 added to my Synthroid, but now I’m positive I do!!! Do you mind if I ask …. did you have to fight your doctors to add the T3? Seems like I can never get my endo to listen and I’m miserable. I feel the same way now as I did before my thyroid was removed. I really appreciate you post!!!
Hi Tarryn I was diagnosed with pcos in my early 20,s I’m now in my early 30’s and have been diagnosed with hyperthyroidism, your article mostly talks about hypo- I am currently takin a break from prescription medication and gone the natural route for now with food mainly a strict paleo diet , i really don’t know how to manage with this my pcos I haven’t had a flare up in years and have had 29-30 day cycle since I did the pcos diet years ago is there anything I like u would recommend I should be doing ok terms or prescription medications methamizole has bad side effects for women who don’t have children , your article definitely was one I needed to read !!
Hi
I am a 27 year old and I was diagnosed with hyperthyroidism almost 9 years back when I was in school. Back then, my thyroid was very high, now however with medicines, it is controlled.
I just found that I have PCOD/PCOS, when my periods became very erratic 2 months back. They were delayed by 2 weeks in 2 months.
Currently my thyroid is controlled, however the TSH was very low, while T3, T4 were fine.
I visited my Obgyn and Thyroid doctors and they suggested a lifestyle change with 45 minute exercise. They also gave me some multivitamins, D3 and apcod sachets (15 days) and asked me to lose weight. In the past one year, I have lost 9kgs. But have scope for shedding some more kilos. My question is,
1) can I do intermittent fasting that is 16 hours long with thyroid and Pcod
2) is it possible to completely eradicate these 2 diseases from my body?
Thanks so much!!
I have pcos and thyroid problem for over 10 years now ive had two children but ive started spotting a lot my doctor tells me its normal was just wondering if anyone else is suffering with this and if so how they manage it thanks
I’ve had may of the same problems other women here seem to have had. I only learned I had PCOS and Hypothyroid this year after six years of weight gain, pain and poor health despite trying everything from years anorexia to years of body building. I’ll be starting medications soon and I hope they do help. I’ve been on a keto diet for a bit over a month now but recent tests have revealed that my body is for some reason not absorbing any of the proteins, fats or vitamins I’m taking in and I’ve developed several other conditions because of it all such as anemia and muscle deterioration. I don’t know how many years this may take to fix and I have been very scared that I would have to fully give up on my dream to become a mother some day (way in the future, my mum got me at the age of 51 so it doesn’t seem bad to me to start a bit late on that end), but seeing other women who have worked through it and having found really great doctors I am finally feeling optimistic again. I would absolutely agree that the main takeaway is that people with these problems have to just be extra careful about what we put in our bodies. It’s not really fun but it’s all manageable.
I have both thyroid and pcos. I’ve had it from the age of 16 but the doctors I use to go to never mentioned it to me, but when I moved houses I changed my gp and this is when I was diagnosed with thyroid and pcos, this was at age 22. For 6 years I didn’t know I had either and I was putting on drastic amount of weight. Even now I’m struggling to lose weight as having both are the cause to me putting double the weight. I am now on a Cambridge diet and it is helping me lose weight slowly. I have been told it will take longer for me to lose weight due to my health. It is also getting harder for me to start planning for a family as I am now 27 and wanted at least 2 children by now. I would suggest keto or Cambridge diet for better results in weight loss. Hope it helps the other women out there with my story.
Hi there thank you for the article. I suffer from both PCOS & hashimotos. I find it difficult to lose weight even when I’m very strict with food and exercise use 4times a week and if u lose weight I can put it all back on with one cheat meal. Also my fluid is terrible also can put on 3-4kgs in fluid. I’m gluten free and have been for a long time. The only way I can lose weight is running but I feel like my thyroid burns out and then I put on weight and my hair falls out again. Running is good for my pcos but I think my thyroid hates it. I also do bike classes at the gym. What type of exercise makes both my pcos and thyroid problems happy?? Any help is so appreciated!!
The exercise is too stressful for Hashimoto’s. Find a functional medical practitioner. Also, with Hashimoto’s, it’s a given that there’s some serious stressor that triggered the situation. What happened around 16? Anything in particular, or was it a re-triggering of an earlier trauma? I don’t know, but it helped me. So I’m passing along that looking at ways to reduce stress are also important. I know it can be a huge struggle, but you have gotten this far..
Hi, thanks for the article. My doctor is looking into PCOS for me and the blood test came back saying I have an under active thyroid. yay me. Now I am on meds and once that is all figured out we will then again discuss PCOS because my ultra sound came back fine. I deff think I have PCOS as well and I hope my doctor doesn’t just write it off as thyroid only. I have had most of these symptoms including added hair to my neck and chest, irregular periods and more since I was a young teen and my thyroid has always been tested and has only recently been a problem. I also started puperty at 6. Should I still try talking to my doctor about the PCOS or just wait it out? (im 25 if that matters)
I have hypothyroidism and pcos and i am taking medication for both. However even with diet control and excercise i cannot seem to lose weight. Fortunately i got pregnant without any hassle or even trying to.. so im wondering what kind of activity is going on in my body. My dr. Said my hormones are imbalanced but i get regular periods. I just dont know why i cant lose weight. Appreciate some advice
Thirty years ago I was given a radical hysterectomy because of pain in my abdominal area. Doctors thought I had endometriosis but suspected cancer. Post op they told me that’s my appendix was very scarred so they removed that and tests showed no cancer but my ovaries were swollen, but that can be normal however they were removed along with my womb.
About 12 years later I went on a Vegan diet for
2 years. I mostly ate Soy everything. Tofu, soy milk and cheese.
My outer brows disappeared, walking became difficult, I was dropping things and my speech became slurred because my tongue was swollen. Friends thought I
May have suffered a stroke. I was diagnosed with Hypothyroidism. I was placed on large doses of thyroxine. My thyroid has since atrophied. Last year I had a parathyroidectomy, I don’t know if this is related. I have become a Pescatarian since my Thyroid was removed. Post op I suffered badly from Chronic fatigue syndrome. I had difficulty walking, sometimes breathing, and even chewing food. Fortunately After some months I emerged okay. For the past 3 months I have been on a Keto diet. Reading many stories I have seen that some people have restored their thyroid levels to normal. It is probably too late for me but perhaps worth some investigation? Thanks
My thyroid has always been in “normal” range so my doctor said it was fine, but when my hair started thinning really bad and I was still struggling with my energy levels my new doctor tested my thyroid and had a different conclusion. Even though my T3 was in “normal” range it was on the low end which my doctor explained meant that my liver wasn’t properly converting T4 into T3, which was causing hypothyroid symptoms. She put me on a small dose of Naturethroid because it has both T4 and T3 in it. She said a lot of thyroid meds only have T4 but if your body can’t properly convert it then it’s not going to help someone like me. Since taking Naturethroid combined with following the guidelines on your site I feel like a new person. My hair started growing back, I can make it up the stairs without breaks, I’ve started working out. I really didn’t understand the link before, so I’m so glad you wrote this post.
Amazing, Nicole. Well done on seeing a new doc and pushing through. I’m so glad that you’re starting to feel so much better!
Thank you for this post. I just got back from a gynae appointment / discussion about my pcos and pre hypothyroidism. I refused to go onto thyroid medication until I have had a chance to make then necessary lifestyle changes: food intake / relationship change, and exercise. And couldn’t understand how these two couldn’t be linked?? Thank you for this article, and for all the beautiful women out there that I know share my struggle.
I have pcos and i had thyroid cancer and now my pcos is getting worse and im following the pcos diet and it’s not helping me at all so i will have to live with this pcos and no thyroid glands this suck for me
I know exactly how you feel. I was diagnosed with PCOS when I was in my early 20s and Thyroid cancer in mid 30s, I just had my thyroid removed a few months ago and managing all of my symptoms is really hard. Best of luck to you.
Have you tried other things like massage, or a good accupunture lady? I found real temporary pain relief from essential oils and later accupunture. No I’m not selling anything. I just ache with pcos. One medical Dr writes that having accupunture once a week with ladies with pcos helps regulate hormones.. I’m over an hour away so they suggested 2 wks. One time I had energy to spare! One time I must have been resetting, I was exhausted afterwards. Keep searching.. It’s not all diet controlled.
Hi,
I have Pcos from 2013 and have been on different medication from past 2 years. I never had hair loss before but from past two months hair thinning is getting worst. Also, I have severe acne on my face and sometimes on body parts. I am more concerned about hair loss because my skin has been acne prone from so long. Doctor suggested me to check thyroid. But My wait has been reduced 2-3 kgs instead of gain. Is there any chance that I can have hyperthroidism? Should I go for the test? Please suggest.
I just had my thyroid checked and the numbers look much better than they used to (when I was doing everything ‘right’ in an attempt to lose weight), but I still feel like something has to be to blame for all this extra weight that piles on even working out didn’t fix.
I was treating the PCOS at the time. I was spending 2 hours a day, 6 days a week in the gym (1h cardio, 1h strength each day 3x a week with a trainer), on a strict diet and 2 weekly meetings with the R.D. (which tripled my caloric intake to 1600 cals a day) and it took 13 months to lose 30 pounds. That is just insane. I quit working out because I was working so hard I ended up in a wheelchair and needed surgeries to get out of it…yet, here I am, 70 pounds heavier than when I stopped working out like that…tho I am still legend in that gym, which is kinda cool.
Now I don’t take the pill, I have been found to be within ‘normal’ range for TSH, T-3 and T4 I have a high stress, low movement job, and I still gain. It’s like a steady march toward death for me. I guess there’s nothing you can really do to help, I just needed a moment to vent to some ladies that might understand.
Have you tried Yoga Asans and Pranayam?
Hey its not lyk dat!! I too suffer the same!! Stress is also a big thing, dnt take so much of stress!! Jst have a control on what you eat!!
I’m not sure when these were written! But I hope you are doing ok! That sounds like thyroid too me. Also maybe your adrenals need some work.
These “normal” ranges kill me. Only people with thyroid problem, know how much a little change in range feels. I’m ok when tsh .05-1 and T3 5.45-6 , everyone is different, and any change in my levels I feel it big time!! Even though the doctors say your “normal “ range, they have no clue
Hi – when I was 14 I got diognoised with an under active thyroid. And the doctors put me on medication which really helped me feel better, but when I was 18 they said that I must have grown out of it as I didn’t have an under active thyroid anymore and tested me for PCOS again and said I had that.
I am certain that I have a thyroid problem but the doctors keep Fobbing me off and saying I don’t. My doctor said my blood test came back normal but the endocrine department can do more further depth tests. So I went to the hospital and saw endocrine. But he said to me to take metformin which really doesn’t agree with me and to come back in 6 months. In the last 6 months I have probably put on another stone and haven’t had a period.
I know my body and I know I have a thyroid problem. I just don’t know how to get them to listen to me.
I saw an endocrinologist who put me on medication for hypothyroidism. It helped a little but I still felt very tired. He kept telling me my levels were normal. I asked for a copy of my results which included the actual numbers the lab sent him in the report. I did my own research and it turned out that I was the bottom of the “normal” range for a 55 year old woman. That was very upsetting because at the time I was only 29! I went to someone else and he doubled my dose, rechecked my blood work after being on the new dose for a bit and told me I was now within “normal” range for a 29 year old woman. I immediately felt better after the increased dose but the proof was in the new numbers. My suggestion is to get the results and check your own numbers to prove to yourself whether your endocrinologist is doing right by you.
I literally feel the same!havent had a period at times for about a year and in this time it’s when I put on the most weight last 2 years I’ve gained 1.5 stone while having a really active job. I feel so low constantly and just can’t cope with the mood swings any more. No combined pills agree with my body making me bleed 3/4 weeks with about 24 hour breaks which makes me feel tired 24/7 so stopped taking pills. Really don’t want the coil as heard some horror stories and don’t like the idea of having a permanent object inside my body after having a really bad experience with the implant. Really feel alone in this. After numerous times at doctors they just say it’s my pcos and it would be a good idea to loose a little weight to ease symptoms but healthy eating and excercisimg doesn’t help me loose weight it just puts my weight at a stop and doesn’t change. I really need help and just don’t know what to do anymore:(
Hi,
I’ve diagnosed by PCOS a year ago when I had severe Hairfall. I had extended periods of 40 or so, but I wouldn’t miss cycles as such. My testosterone levels were slightly elevated but I had that taken care of by bcp and aldactone.But my Hairfall hasn’t reduced one bit. What do you think might be the cause of it. My hair growth is controlled.I exercise regularly both cardio and yoga. I still don’t get what I’m missing.My TSH levels come back normal.
Can you please tell me if I’m missing something?
Please. I’m only 22. I’ve put off my plans to pursue my masters in science for this reason. I really want to get better.
Sounds like thyroid! How is iron? Your ferritin should be 60-100 , don’t let them tell you 9-50 is normal range, that’s crap
Hi Tarryn and Team,
Thank you for this article. I’m currently going through this.
Having followed your dietary advice with great dedication,
I started to see weight actually coming off nicely.
The last couple of months I’ve been pretty much ‘knocked flat’ energy wise and have lots of those symptoms mentioned. I’m
Currently having blood tests done as the hypothyroidism showed up when having other things checked out.
Have you any dietary advice regarding helping calm symptoms down?. It’s
been a crushing blow to have gained weight through no fault of my own, seeing all hard work being undone once more. Many thanks, Donna
I’m sorry to hear that Donna! Here are some suggestions http://hypothyroidmom.com/a-7-step-plan-to-boost-your-low-thyroid/
Thank you for that, I appreciate it a lot.
I’m sure I’ll read it a few more times too.
I’m intrigued by the natural T3 mentioned, where would we find this?
Many thanks, Donna.
Hi,
I watched this very good dvd yesterday with Barbara o’neill (misty mountain) about hormonal imbalance. She is all about natural healing and I can highly recommend her DVDs.
To sum it up she said to:
Eliminate –
Contraceptive – big no no.
Meat – eat organic!
Plastic – stay away from plastic and use glass.
Chemicals (use natural products for cleaning home etc)
Coffee – because of the caffeine
Sugar
Eat –
Cabbage
Cauliflower
Brussel sprouts
Chia seeds
Flaxseed
Vitamin b6,9,12
Recommended cream to use – Anna’s Wild Yam Cream – 1/3 teaspoon – alternate spot – not applied during menstruation
Exercise
Hydrate – drink a lot of water
Stay positive
Hope any of this helps!
I have PCOS and hypothyroidism, I’ve been taking Yazz 24+4 and Euthyrox to manage both. 3 months ago my doctor told me that my blood results showed toxic TSH levels, so I quit Euthyrox for a while. He told me that sometimes thyroid glands can regain its function but it’s quite rare. I’ve been on the medication for more than 5 years now.
I’ll have my blood checked again soon but I think the hypothyroidism is back. Because I haven’t been feeling really well and I blame my irregular thyroid levels.
Having irregular hormones can do crazy things to you, especially when PCOS is hand in hand with hypothyroidism. It’s the worst combination. Thanks to a proper diagnosis I was able to regulate my bodily functions and mood for at least 5 years now, but during this time I had two cysts removed from my each breast. I’m suspecting it’s the side effect of Yazz. I’m not sure what’s the prolonged side effects of Euthyrox but if I have another cyst growing in me, I thought I’ll go crazy. But this last August I just found out that I’m harboring another cyst in my left breast. It’s on constant monitor now, but it’s not good to have irregular masses growing in your body. It’s my breast today, it could be my uterus or God knows where. I’m really scared.
We have a family of women full of hormonal imbalances and breast cancer, so I’m not in a great position. When I finish my doctoral studies I will seriously commit to working out, I just don’t have the time for it now. I’ve been eating according to PCOS diet and still I gain weight and feel bloated. I think what I need is a strict work out and a stress free life.
This might be a silly question, but does avoiding soy include avoiding soy sauce? I read somewhere that fermented soy is ok but would you just avoid all soy if you suffered from hypothyroidism?
http://wp.me/p7s75y-l
This us my blog entry about my PCOS, and how the doctors once telling me I had minor thyroid issues. After traveling the world for a while, starting out of the fast food and over processed food businesses, I can’t home to a normal reading after blood work was redone. Ever since, I haven’t had problems, and work to keep it that way. Some may think I’m idealistic or crazy, but I believe it can be reversed.
I have PCOS and hypothyroidism. It never occurred to me that they could be linked, because my mom also has hypothyroidism (but not PCOS.)
I’m taking Levothyroxine to manage my hypothyroidism. I’m not sure if it is that, the Spironolactone I’m also taking, or the dietary changes that I have made that are making the difference, but I am slowly making my down the weight scale. From my top weight I’m down about 30 pounds so far.
I haven’t seen a huge amount of improvement in my other symptoms, but I’m hoping continued dedication to slow weight loss will bear fruit in the long run.
This is so reassuring to hear! I also have hypothyroidism alongside PCOS; I actually had the diagnosis for my thyroid problem as part of my blood tests for PCOS. It’s amazing how you just assume your sluggish/tired feeling is the norm.
I’m also taking levothyroxine and spironolactone – my thyroid function is showing normal after a tricky few months of getting the dosage right, so it’s provided the ultimate motivator to sort out my exercise regime and diet!
I have PCOS and hyperthyroidism. Likewise, my doctor said they could be affected by each other, but my mom had hyperthyroidism but her period was really regular.
I’m taking pills for both PCOS and hyperthyroidism. In fact, there’s no significant change in my weight yet, but it seems there is no change in my symptoms. I’m not afraid of hyperthyroidism since I know how to control it, but I worried about my PCOS.
Before all of these I was somehow beautiful and self-confident. But now it’s gone. Sometimes a common mirror can suddenly depress me, because I cannot stop thinking about what I looked like in the past. Taking pills often makes me stressful. But if I stopped it, everything would become abnormal again.