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July 17, 2023 11 min read

Do you, or someone you know, battle with Polycystic Ovary Syndrome (PCOS) and hypothyroidism (underactive thyroid gland) concurrently? You might be wondering about the possible connection between these two seemingly distinct conditions. Despite appearing unrelated, a growing body of evidence suggests that there may be, indeed, a link between PCOS and Hypothyroidism. But how are they connected? And what does it mean for people who struggle with both? Well, read on!

What is PCOS?

Polycystic Ovary Syndrome, better known as PCOS, is a hormonal disorder occurring during the reproductive years of women. This condition is marked firstly by the development of numerous small sacs of fluid, or cysts, on the outer edges of the ovaries. Each of these cysts contains immature eggs, also known as follicles. Unfortunately, these follicles have a tendency to fail in regularly releasing eggs—a key function of a healthy reproductive system.

A diagnosis of PCOS typically includes having at least two of the following symptoms: irregular menstrual periods, high androgen levels, or polycystic ovaries. Women with PCOS may experience few and far-between periods, seeing fewer than nine in a year, with these periods occurring more than 35 days apart. Some women might even experience a complete absence of menstruation. When menstruation does occur, periods often last longer than usual.

Moreover, excessive androgen—a hormone present in higher-than-normal amounts in those with PCOS—can result in distinctive physical signs. These include abnormal hair growth or hirsutism (excessive facial and body hair), severe acne, and even what's classified as male-pattern baldness. Meanwhile, the ovaries might be larger than is typical and fail to function properly due to the presence of immature egg-containing follicles.

Another factor to consider is weight. Symptoms tend to be more severe in individuals living with obesity. That said, aside from weight, the exact cause of PCOS remains unknown. Early diagnosis and appropriate treatment can help manage the symptoms and lower the risk of long-term complications such as type 2 diabetes and heart disease.

Is hypothyroidism more common in women with PCOS?

While PCOS has many implications, what may not be as well-known is the linkage between PCOS and thyroid disorders, specifically hypothyroidism and Hashimoto's thyroiditis (autoimmune thyroid disease).

Research has continually pointed towards an increased prevalence of these thyroid disorders in women with PCOS. For instance, a study from India in 2013 noticed that as many as 22.5% of women with PCOS suffered from hypothyroidism as opposed to 8.75% of women without PCOS. Another report from the National Institutes of Health in 2015 echoed this, revealing that 22.1% of women with PCOS had Hashimoto's thyroiditis compared to just 5% of the general female population.

Hashimoto's thyroiditis is an autoimmune condition where the body mistakenly launches an attack on the thyroid gland, causing hypothyroidism. In women who suffer from PCOS, the incidence of Hashimoto's thyroiditis is a staggering three to four times greater as compared to women without PCOS. This high frequency also extends to other thyroid-related disorders like subclinical hypothyroidism, goiters, and autoimmune thyroiditis, as reported by BioMed Research International.

To understand these connections, researchers delved into the medical charts of 827 women with PCOS who were visiting an outpatient fertility clinic. According to their study, published in 2018 in Experimental and Clinical Endocrinology & Diabetes, the incidence of thyroid disorders, particularly Hashimoto's thyroiditis and related hypothyroidism, was found to be significantly higher in women with PCOS.

Can your PCOS get worse due to hypothyroidism?

The escalating of PCOS signs is commonly brought on by an underactive thyroid, known as hypothyroidism. This can lead to an uptick in issues such as insulin resistance, which hampers the body's ability to use insulin to regulate blood glucose, thereby escalating the likelihood of type 2 diabetes. Hypothyroidism also contributes to hyperandrogenism — an overproduction of the male hormone, testosterone.

These consequential hormone imbalances amplify typical PCOS symptoms. For instance, the increase in testosterone can incite the occurrence of male-pattern hair loss, troublesome acne, and hirsutism, which is characterized by unusual hair growth on the face or body. Notably, the excess testosterone level disrupts the maturation of follicles — sacs responsible for egg development in the ovaries. This disturbance can lead to irregular ovulation or the failure to release a mature egg, further compounding the PCOS condition.

Not to forget, hypothyroidism can result in the swelling of the ovaries and the development of cysts, another typical sign of PCOS. Reading between the lines, one sees how managing thyroid health is crucial for those dealing with PCOS.

Does hypothyroidism complicate PCOS?

Hypothyroidism can complicate PCOS in several ways. Firstly, both conditions are linked to hormonal imbalances, disrupting your menstrual cycle and making it harder for you to conceive if you're trying to get pregnant. Additionally, hypothyroidism can worsen some of the symptoms associated with PCOS, such as weight gain, fatigue, and mood swings.

Furthermore, hypothyroidism has a tendency to intensify and complicate certain PCOS symptoms while introducing others not typically associated with the condition. For instance, the presence of hypothyroidism may lead to bradycardia, essentially a slowed heartbeat. Facial swelling, often referred to as "moon face," and the development of a goiter—an enlarged thyroid gland— are other complications that can surface.

Hypothyroidism may also affect the effectiveness of certain treatments for PCOS. For example, some medications used to manage PCOS symptoms rely on proper thyroid function to work optimally. Suppose your thyroid isn't functioning properly due to hypothyroidism. In that case, these medications may not be as effective in alleviating your PCOS symptoms.

In essence, the intersection of hypothyroidism and PCOS can exacerbate the already challenging symptoms of the latter while adding some unique disturbances typically not documented in standard PCOS cases. Recognizing the dynamic influence of the thyroid gland, therefore, can be a critical facet in managing the overarching health of individuals grappling with PCOS.

What's the connection between hypothyroidism and PCOS?

If you have hypothyroidism and PCOS, there are some key connections to be aware of.

Thyroid autoimmunity

Imbalances and diseases of the thyroid often have a bearing on autoimmune responses. Hashimoto's thyroiditis, a common cause of hypothyroidism, is one such example where thyroid peroxidase (TPO) antibodies are found in increased levels. Additionally, hypoechogenic thyroids—a certain ultrasound pattern indicative of thyroiditis—are frequently observed in women suffering from this condition.

Interestingly, these trends echo in women with PCOS as well. Research indicates that PCOS sufferers tend to show more hypoechogenic thyroids compared to those without the syndrome. Furthermore, elevated levels of thyroid antibodies, like TPO, are common in women with PCOS, and an enlarged thyroid gland, or a goiter, is also frequently noticeable.

These overlapping patterns hint at a possible susceptibility for women with PCOS in manifesting autoimmune diseases. Although further research is needed to fully comprehend these relationships, current indications do emphasize the criticality of regular thyroid monitoring in managing and mitigating risks associated with PCOS.

Polycystic ovaries

One major link between PCOS and Hashimoto's thyroiditis is the condition known as polycystic ovaries. In simple terms, "polycystic" means many cysts are present. These cysts are actually tiny sacs filled with fluid in the ovaries which contain immature eggs.

In PCOS, these small sacs can't grow and mature as they should, mainly because of high levels of male hormones, also known as androgens. On the other hand, people with hypothyroidism have less thyroid hormone in their bodies. This deficit leads to a sequence of changes in the body, including alterations in a hormone called prolactin. It's important to understand that these changes stem from lower thyroid hormone levels, particularly when another condition called hyperprolactinemia occurs, which results from high prolactin levels.


Hashimoto's thyroiditis and ensuing hypothyroidism are frequently linked with raised levels of a hormone named prolactin—famously acknowledged as the breastfeeding hormone. High levels of prolactin can hamper ovulation and can also contribute to the formation of additional ovarian cysts owing to the surge in immature follicles. It's also worth noting that prolactin levels are generally elevated in individuals with PCOS.

Weight gain

The level of thyroid-stimulating hormone (TSH) tends to be higher in individuals who carry excess weight. While the specifics of this relationship are not entirely understood, it is believed that the intricate interactions of inflammation markers and possibly a hormone known as leptin are involved. What is certain is that increased TSH levels trigger the accelerated multiplication of fat cells or adipocytes. Similarly, individuals with PCOS are often more prone to being overweight.

LH-FSH Ratio

Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are two key hormones secreted by the pituitary gland, a small pea-size organ located at the base of the brain. Its job is to manage your menstrual cycle.

In the case of individuals with PCOS, the ratio of LH to FSH tends to be higher when compared to individuals who do not have PCOS. In a similar vein, studies have discovered that this same ratio, LH to FSH, is also higher amongst those with Hashimoto's thyroiditis.

Is hypothyroidism difficult to diagnose in women with PCOS?

Identifying hypothyroidism in women battling PCOS can indeed be a tricky business, oftentimes leading to a sense of frustration and confusion. The root of the challenge lies in the crucial role the thyroid gland plays. As a regulator of metabolism and hormonal balance, any irregularities can topple this delicate internal balance. The challenge arises when trying to differentiate between PCOS and hypothyroidism, given the overlap in their symptoms.

They both exhibit common signs such as fatigue, weight gain, hair loss, and irregular menstrual cycles. This overlap can often lead to either a misdiagnosis or a delay in the correct identification, adding to the distress of those seeking to understand their health issues.

Further complicating matters, diagnosing hypothyroidism in women with PCOS might necessitate more rigorous medical testing. Conventional thyroid function tests, such as measuring the levels of thyroid-stimulating hormone (TSH), might not provide an accurate reflection of the thyroid's condition in these individuals. Hormonal imbalances associated with PCOS can skew the results, thus requiring doctors to consider additional tests for an accurate diagnosis.

Consider this: The pituitary gland produces TSH, which regulates the release of thyroid hormones T3 and T4. Elevated TSH levels might suggest hypothyroidism, indicating that the pituitary gland is exerting itself to stimulate an underperforming thyroid gland. However, a high TSH level on its own does not confirm hypothyroidism. An accurate diagnosis also requires successive T3 and T4 tests, along with an anti-TPO test, to check for an autoimmune disorder like Hashimoto's.

Given this, diagnosing hypothyroidism can prove elusive, and women with PCOS are frequently subject to misdiagnosis. This highlights the importance of conducting comprehensive tests for an accurate diagnosis and the subsequent targeted treatment.

How to manage hypothyroidism and PCOS

Managing hypothyroidism alongside PCOS begins with a comprehensive understanding of how these conditions interlink and influence one another. Here are a few key strategies:

Take thyroid hormone replacement

The thyroid dysfunction hypothyroidism is commonly managed with thyroid hormone replacement therapy. They work by increasing the levels of thyroid hormones in your body, which helps alleviate symptoms of thyroid dysfunction. You can effectively manage your hypothyroidism and improve overall thyroid function by taking levothyroxine as your doctor prescribes. There are several different types of thyroid hormone replacement. These include:


Levothyroxine is a synthetic form of thyroxine (T4), a hormone naturally produced by the thyroid gland in our body. This medication requires a prescription and is typically taken once daily, ideally on an empty stomach, for better absorption. As with any medication, it's crucial to take levothyroxine exactly as directed by a healthcare professional.


Liothyronine is a synthetic hormone that's used to replace or supplement the body's natural thyroid hormone, triiodothyronine (also known as T3). It is used less frequently than levothyroxine (which replaces the thyroid's T4 hormone) but can be instrumental in situations where individuals cannot convert T4 to T3 effectively. Like all medications, they should be taken as directed by your healthcare provider, often once daily, and their dosage should be tailored to the individual's needs based on regular monitoring and testing.

Natural desiccated thyroid

Natural Desiccated Thyroid (NDT) is a natural approach to treating hypothyroidism, often preferred by many for its holistic origins. Unlike synthetic options, NDT is derived from the dried thyroid glands of animals, typically pigs, and contains a mix of both T4 and T3 thyroid hormones. This combination is believed to closely mimic the natural hormone mix in human bodies, potentially improving hormone balance more effectively. NDT is often favored as a treatment option for patients who continue to experience hypothyroid symptoms on synthetic T4-only medication. 

NDT displays a notable versatility, presenting in both prescription and over-the-counter versions. In the U.S., Armour Thyroid and NP Thyroid are well-reputed brands often prescribed due to their consistent results and dependability.

Alternatively, for those seeking a more readily available option, VitaliThy offers an excellent choice. VitaliThy, a natural desiccated thyroid you can buy online, takes pride in its carefully curated formulation, free of common allergens such as lactose, gluten, eggs, fish, and shellfish, making it a safe bet for people with dietary restrictions.

Adding to its appeal, VitaliThy stands out in its commitment to cleanliness and simplicity. This NDT supplement is devoid of any artificial flavors or colors, aligning well with the goals of those who prefer a clean lifestyle or wish to avoid unnecessary additives in their health supplements.

Be sure to receive optimal treatment for PCOS

The therapeutic approach to PCOS is multifaceted and hinges largely on individual factors, including age, symptom severity, overall health, and future pregnancy plans.

For those desiring future pregnancies, management strategies often entail medication to induce ovulation. Certain drugs can assist the ovaries in routinely releasing eggs. However, these come with certain risks, including the potential for multiple births and ovarian hyperstimulation, manifesting as hormones being released excessively by the ovaries. This could result in symptoms such as abdominal bloating and pelvic discomfort.

For those who don't have immediate pregnancy plans, treatment options commonly encompass the following:

  • Contraceptive pills. Such medicines regularize menstrual cycles, draw down androgen levels, and can alleviate acne.

  • Diabetes medication. Frequently applied to reduce insulin resistance in PCOS, this could also aid in reducing androgen levels, decelerating hair growth, and contributing to more consistent ovulation.

Other supplements and medications

Metformin, a medication typically used to manage type 2 diabetes and regulate blood sugar levels, is frequently recommended for patients dealing with PCOS due to its ability to tackle insulin resistance. Research indicates that treatment with metformin for six months led to normalized TSH values in patients diagnosed with both PCOS and Hashimoto's, although it didn't significantly alter free T3 and free T4 levels. While more studies are required, metformin is potentially a promising treatment option considering its role in managing both thyroid functionality and PCOS-related insulin resistance.

Another potentially beneficial supplement for insulin-resistant PCOS and for those grappling with Hashimoto's and hypothyroidism is Myo-inositol. Evidence suggests that its effectiveness is comparable to drugs like metformin, with the added advantage of having minimal side effects for most individuals.

Get enough iodine

The formation of thyroid hormones relies heavily on the supply of iodine. Primary food sources rich in iodine include dairy, chicken, beef, pork, fish, and iodized salt. To ensure the stable production of T3 and T4 hormones, it's crucial to maintain optimal iodine levels. Both an excess and deficiency can trigger or exacerbate hypothyroidism. It's particularly important for women with PCOS who are diagnosed with, or susceptible to, hypothyroidism to be mindful of their iodine consumption. This conscientious approach can help lessen the effects of hypothyroidism and consequently mitigate any potential impact on their PCOS condition.

Healthy lifestyle changes

Maintain a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Regular physical exercise also aids in keeping your weight in check and improves insulin resistance – a major concern in PCOS.

Stress management

Chronic stress can negatively impact both PCOS and hypothyroidism. Practices like yoga, meditation, or any relaxation techniques can help manage stress levels.

Regular monitoring

Keep track of typical PCOS symptoms like irregular menstruation, acne, hair loss, and weight gain. If these symptoms worsen, it could indicate a need to adjust your hypothyroidism treatment.

Remember, both PCOS and hypothyroidism are lifelong conditions that require ongoing management. Following these steps while staying in close consultation with your healthcare provider can help you minimize symptoms, improve your overall health, and enhance your quality of life.

Conclusion: PCOS and hypothyroidism may coexist

Wrapping up, it's clear that PCOS and hypothyroidism share a relationship. Although these conditions may appear as distinct entities, the connection between them is undeniable. As individuals living with these conditions well know, the symptoms can often overlap, making diagnosis and treatment a complex task. However, our understanding of these conditions continues to grow, with research ever-evolving in ways that can help us navigate these complexities.

First and foremost, if PCOS and hypothyroidism coexist, managing hypothyroidism adequately is essential. Strategies such as maintaining a healthy lifestyle, regular monitoring, stress management, and ensuring adequate iodine consumption become critical steps in this journey. In addition, taking thyroid hormone replacement therapy faithfully is a potent way to manage hypothyroidism effectively.

Traditional therapies like levothyroxine have paved a successful path in this regard, but for many people, natural desiccated thyroid (NDT) supplements like VitaliThy offer a promising alternative. NDT supplements are derived from animal thyroid glands, providing a balanced mix of T4 and T3 hormones that the human body naturally produces. This holistic source, coupled with a clean ingredients list free of allergens and artificial additives, makes NDT a popular treatment choice. Moreover, you can buy this desiccated thyroid online.

So, whether you're exploring treatment options for the first time or looking to switch up your existing treatment, it's worth considering NDT supplements like VitaliThy for their natural origin and meticulously chosen ingredients. 

Wojciech Majda
Wojciech Majda

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