5 Things Women With PCOS Should Know About Hypothryoid

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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 are 5 important things women with PCOS should know about hypothyroid.

Hypothyroidism is Very Common in PCOS

Hypothyroidism, and in particular, Hashimoto's thyroiditis, is more common in women with PCOS than in the general population.

Hashimoto's is an autoimmune condition in which the body is attacking itself.

Sinha and colleagues found that 22.5% of women with PCOS had hypothyroidism compared to 8.75% in controls and thyroid antibodies have been shown to be present in 27% of patients with PCOS versus 8% in controls. More recently, a study published in Endocrine Research demonstrated a higher prevalence of Hashimoto's and elevated TSH (indicating hypothyroid) in PCOS patients.

Thyroid and PCOS are Interconnected

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.

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.

An increased estrogen and estrogen/progesterone ratio seem to be directly involved in high thyroid antibody levels in PCOS patients.

The Thyroid Affects Your Whole Body

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 (hyperthyroid) 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, affecting fertility.

TSH Alone Not Enough

TSH alone is not a reliable test to determine your thyroid functioning. 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.

Other thyroid tests include:

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.

Iodine Plays a Big Role

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 caution and only under supervision of a health care provider.

Sources:

HYPOTHYROIDISM: A BOOKLET FOR PATIENTS AND THEIR FAMILIES. A publication of the American Thyroid Association (ATA) www.thyroid.org accessed on July 14, 2015.

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.

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.

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.

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.

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.

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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