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PCOS and A Sluggish Thyroid: Fight This Combo With A Holistic Approach

In this Article:
PCOS and hypothyroidism

Tiredness, constipation, brain fog, infertility, weight gain, depression… sound familiar? Polycystic Ovary Syndrome or PCOS and hypothyroidism have more links than you might imagine, from signs and symptoms to causes and treatments. When we look below the veneer, we see that PCOS and hypothyroidism affect one another markedly. This means it is critical we look at both conditions to tailor a successful treatment plan.

Let’s take a look at your thyroid, similarities between PCOS and hypothyroidism, what testing is appropriate, and what can be done to improve both challenges in one fell swoop.

Know Your Thyroid

This small gland sits at the base of your neck and is made up of two lobes, the right and left. The functions of your thyroid gland are controlled by the pituitary gland, which is, in turn, controlled by your hypothalamus. Both are located in your incredible brain.

What Does Your Thyroid Do?

This gland releases powerful hormones, vital for maintaining your health and wellbeing. It flames the spark of your energy furnaces, which helps release energy for all of your metabolic processes. To cut a long story short, your thyroid gland is the metabolic engine of your body. That’s why when we have hypothyroidism — or a sluggish thyroid — everything other than the aging process slows down. We feel tired, foggy brained, our ability to burn fat takes a back seat, our mood can plummet, even our fertility can stagnate.

PCOS and Hypothyroidism: What’s The Connection?

The evidence shows us that hypothyroidism is more common in women with PCOS. And I believe that there are such important links that a sluggish thyroid ought to be considered in every suspected and diagnosed case of PCOS.

Let’s take a look why.

Both conditions can cause:

  • Fatigue
  • Depression
  • Menstrual irregularities
  • Increased miscarriage rates
  • High cholesterol
  • Weight gain
  • Increased sweating
  • Pain
  • Irritability
  • Infertility (including ‘of unknown cause’)
  • Recurrent miscarriage
  • Scalp hair loss
  • Trouble losing weight
  • Low FSH (follicle stimulating hormone) levels
  • Low sex hormone binding globule (SHBG)

PCOS is known as a diagnosis of exclusion. This means all other causes of a woman’s signs and symptoms need to be ruled out prior to this diagnosis. As you can see by the list above, hypothyroidism should be assessed thoroughly before a PCOS diagnosis is given. However, with a mainstream approach, it rarely is.

Interestingly, SHBG results in more free and active hormones like estrogen, and testosterone (one of the diagnostic criteria for PCOS). According to Evanthia Diamanti-Kandarakis − co-author of Insulin Resistance and Poly Cystic Ovarian Syndrome: Pathogenesis, Evaluation, and Treatment, p325, “Decreased SHBG [sex hormone binding globule] and increased free testosterone levels and altered estradiol [estrogen] metabolism have been described in hypothyroid patients, whereas PCO [polycystic ovaries] has been detected in 36.5% of hypothyroid patients.”

What this means in English is that hypothyroidism may enhance the signs and symptoms of PCOS. And polycystic ovaries, one of the three diagnostic criteria for PCOS, is more common in hypothyroidism.

PCOS And Hypothyroidism: What Tests Should Be Conducted?

Testing For PCOS

The Rotterdam criteria for the diagnosis of PCOS requires at least two of the following:

1) High levels of testosterone
2) Irregular or absent periods
3) Polycystic ovaries on ultrasound

You can learn more about this in this article PCOS Diagnosis: An Expert Outlines How To Test For PCOS.

As you can see, each of these can also occur in hypothyroidism.

Testing For Hypothyroidism

Women with PCOS are more likely to suffer from both hypothyroidism and thyroid autoimmune conditions. While that’s not great news and might feel overwhelming, it can also be a blessing as it helps to answer why you may be struggling to get the answers you need and the help you deserve. This is why a holistic integrative approach is critical.

An appropriate thyroid blood panel includes:

Thyroid Stimulating Hormone (TSH)
Reverse T3
Thyroid auto-antibodies

The results of these tests must be interpreted by a holistic health expert. Because what is suggested as ‘normal’ by the average pathology laboratory is not what the research shows to be true.

A Successful Treatment Plan For PCOS And Hypothyroidism

While medications are commonly incorporated as the main approach for both of these conditions, this is simply not the best path. What is?

Let’s take a look now.

There are similar challenges and potential causes between PCOS and hypothyroidism. So identifying commonalities helps to tailor the right program. It is important to get to the heart of the causes to successfully navigate the path to a healthier you.


It is super important to set up a sleep routine, with a regular time to rise. While some people claim four hours of sleep is sufficient, I would suggest this is merely for survival not optimal health. Some of my friends need coffee in the morning before it is safe to mumble a good morning (Sam and Erin, I’m looking at you!)

One night of poor sleep has been shown to reduce insulin sensitivity, as does longer term deprival. Insulin resistance has links to both PCOS and hypothyroidism. And of all the strategies for optimal health, a good book just before a snuggled sleep in a comfy bed has to be one of the best!


Did you know the number of bacteria, viruses, and fungi that live in your digestive system outnumber the cells in your body by at least 9-1? These bugs play more of a role than we can imagine, although science is starting to glimpse the marvel of our inner colony. The foods we choose help our digestive ecosystem to flourish, or falter. Lots of healthy fiber and nutrient-rich produce assists our good gut bugs to thrive. And this helps to improve the insulin levels and inflammatory markers so important for our hormonal balance. Poor choices, however, result in a less than ideal digestive makeup and adversely impact our health.

Other than digestive issues, there are a raft of reasons why food is critical for both PCOS and hypothyroidism. Let’s look at which foods can lead to improved insulin sensitivity, reduced inflammation, and enhanced thyroid function.


* Low glycemic index foods. Refined sugar is not our friend.
* Anti-inflammatory foods and spices, like berries, turmeric, oily fish and olive oil.
* Nutrient rich foods.

To produce our active thyroid hormones we need:

  • Iodine (think seaweed, cranberries and navy beans)
  • Magnesium (in spinach — my fav!, pumpkins seeds and avocado)
  • Selenium (from tuna, mushrooms and eggs)
  • Zinc (eat spinach, kidney beans and peanuts)
  • Omega three fats (include oily fish, flax seed and walnuts)

To improve our insulin sensitivity and inflammation, important for both PCOS and hypothyroidism, we need:

  • Magnesium (as above)
  • Antioxidants (berries, pecans and even a little dark chocolate!)
  •  Omega three fats (as above)


A little or short-term stress is ok, usually. It’s what our body is designed for. However, as cave women stepped into modern life, chronic and low-grade stress shuffled into our days like the sneaky stalker it is.

The hormonal changes that underpin PCOS appear like the twin of stress. Stress also impacts negatively on our thyroid function.

What can you do?

  • Rest and relax. It may take some dedication and practice, but I know you can do it!
  • Exercise. Those endorphins are great stress busters, and exercise also helps to improve  your hormonal balance.
  • Eat healthy foods. The types that come from the ground and the fields, not a packet.
  • Laugh. Not that shallow, polite giggle. No, here we are looking for a regular and hearty, prolonged belly laugh. Those ones that leave your cheeks aching and your tummy tired.
  • Sleep!
  • Supplement… and that brings us to…


Do I believe you can be healthy in this day and age without supplementing

Not a chance!

Between the pollution found lurking around every corner, to our altered diets, increased stress, mass farming and medication consumption, each requiring increased nutrient intake to address it, I absolutely believe we all must supplement with high-quality, pure, bioavailable, food-based and natural supplements.

Weight Loss

Yes, PCOS and hypothyroidism can cause weight gain. Yet, shedding excess body fat can help both conditions as well. The approaches already suggested throughout this article will help, as will a tailored holistic program, informed by the right tests and expert recommendations.

Natural Therapies

Many women find relief and support with natural therapies. Whether this is through massage, acupressure or Chiropractic, what relaxes and aids in healing your body is beneficial and worthwhile.

Massage is a therapy I love, both as a practitioner and a patient! Defined at RMTAO, massage therapy is “the manipulation of soft tissues of the body including, muscles, connective tissues, tendons, ligaments and joints.”

According to “Acupressure is an ancient healing art using the fingers to gradually press key healing points, which stimulate the body’s natural self-curative abilities.” Developed over 5,000 years ago, this therapy is used worldwide.

As a chiropractor, it would be remiss of me not to mention my wonderful profession. Movement of the spine is, according to Nobel Prize Laureate, Dr. Sperry, the main nutrient for the brain. By correctly adjusting the spine and extremities to improve and normalize function, we can positively impact function and overall body and mind balance.

PCOS and hypothyroidism can be addressed and you can feel and function much better. A holistic, thorough and expert plan is the right approach.

Dr. Rebecca Harwin
is a leading natural health and PCOS expert, and has worked with thousands of women, men and children to improve their lives. Holding three University degrees, she is the author of 23 books, including her Amazon bestseller titled, Conquer Your PCOS Naturally, and three courses. Dr. Harwin is a contented wife and stepmom of one 17-year old, a greyhound, two cats and three hens.
Dr. Rebecca Harwin

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Medical And General Disclaimer for
This article is intended for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. strongly recommends that you consult a medical practitioner for implementing any of the above. Results may vary from person to person.

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