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. The most common form of thyroid disorders are autoimmune related and include conditions, such as Graves’ and Hashimotos, which occurs in the majority of patients.
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. 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:
- 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, such as 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.
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. Sinha and colleagues found that 22.5% of women with PCOS had hypothyroidism compared to 8.75% in controls and TPO 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 thyroiditis (HT), elevated TSH, anti-TPO, and anti-Tg levels in PCOS patients. 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. 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.
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, such as hashimoto’s.
Soy is a phytoestrogen, which means 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.
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. 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.
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. Sugary foods and drinks raise insulin levels. Avoiding sugar as much as possible is important.
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 of 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.
Tip of the day
Go on an end of summer adventure. Summer is coming to a close, make the most of it by planning an active outing with your family. Hiking, canoeing and camping are just a few options your family may enjoy.
Self-analyzation can lead to depression. We need to keep our attention focused on Christ.
“I do not understand my own actions. For I do not do what I want, but I do the very thing I hate.”
~ Romans 7:15