PCOS and Hashimoto’s Thyroiditis by Michelle T. Bickford
Hormone imbalance begets hormone imbalance. If you are reading this, then you probably know this fact. However, did you know that having PCOS makes you 3x more likely to have Hashimoto’s thyroiditis? 
What is Hashitmoto’s Thyroiditis (Hashi)? How is it related to PCOS?
Hashi is an autoimmune disease in which your body attacks its own thyroid gland. Over time, the thyroid becomes unable to provide the body with enough hormones for proper function. When a person is deficient in thyroid hormones, they are called hypothyroid. Hashi is the leading cause of hypothyroidism. It is difficult to determine who will have active Hashi since it is a result of both genetic and environmental factors.
Hashi increases your risk of thyroid cancer, other autoimmune diseases, vitamin and mineral deficiencies, and many other issues that can impact your health. PCOS and hypothyroidism are inter-related since each is a symptom of the other. Each has similar impacts on female physiology, and hormones. However, the exact connection seems to be unknown.
What do we know? Women are 5 to 10 times more likely to develop Hashi due to estrogen’s apparent promotion of autoimmune diseases. PCOS and hypothyroidism have many similar symptoms such as insulin resistance, high cholesterol, irregular periods, ovarian cysts and higher free testosterone. Some PCOS patients see their symptoms improve with proper treatment for their hypothyroidism. Ideally, every PCOS patient should be screened for Hashimoto’s thyroiditis, and resulting hypothyroidism, just in case a thyroid hormone deficiency is driving or aggravating your symptoms.
Where is your thyroid, what does it do and how does it work?
The thyroid gland is located in the base of your neck. Go ahead, touch your neck above the collarbone just below your “Adam’s apple,” there is a butterfly shaped gland. The wings wrap around your throat. It secretes various hormones in the presence of thyroid stimulating hormone (TSH), which is secreted by your pituitary gland by sensing amount thyroid hormone in the brain. The most important hormones secreted by the thyroid that you need to know about are T4, and T3.
The thyroid is considered the controller of your metabolism, which can be defined as your body’s ability to use its energy efficiently at the cellular level. The “energy” is the hormone called T3, and every cell in the human body has a receptor for it. In an effort to sustain optimal energy, the thyroid releases T3 for immediate use, and T4, a storage hormone that is not useable unless the body changes it into T3.
The deficiency in T3 at the cellular level causes symptoms in every area of the human body. There are over 300 symptoms of thyroid disease, and its symptoms overlap with so many other diseases as we saw with PCOS.
How is Hashimoto’s thyroiditis and hypothyroidism diagnosed?
Hashimoto’s is diagnosed through lab testing of thyroid antibodies (TPOab and TGab). The presence of these antibodies welcomes you to the Hashi club.
To determine your thyroid function, and if you are deficient in hormone or hypothyroid, you need to run these tests: TSH (Is your brain screaming for hormone?), Free T4 (Is there enough storage energy?), Free T3 (Is there enough available energy?), Reverse T3 (We will discuss soon).  You can read more about these tests and their values in this article.
What treatments are there for hypothyroidism?
There are many treatments for hypothyroidism, and which one is best for you is dependent on your personal situation, and individual needs. The basics are these medications: synthetic T4, synthetic T3, and natural desiccated thyroid.
The first line of defense for the ordinary doctor is synthetic T4. If a patient finds relief on this medication, and his or her lab values goes “into range.” The patient will take a pill a day for the rest of his or her life with routine testing every 6 months or 6 weeks after a dosage change. If this is not effective due to a patient’s inability to effectively convert T4 or for whatever reason, there are further options!
Remember earlier, we discussed that T4 had to be turned into T3 before it could become useable energy. There are many things that can interfere with this process and some individuals do not readily convert these hormones. Faulty conversion may become Reverse T3, blocks energy (T3) from getting to the receptor site on the cell. With these issues, you have to be more creative and go beyond just T4 only treatment. It also demonstrated why FULL thyroid labs must be run (FT4, FT3, RT3, TSH and thyroid antibodies).
Some doctors will add synthetic T3 to the T4. Some patients have such faulty conversion that they cannot take T4 at all and need only T3. Other patients prefer natural desiccated thyroid, which is made from pig thyroid and has T4, T3 and “other” thyroid hormones that may be more significant than previously perceived. Others compound their medications. These patients go to a special pharmacy, and have custom medications created which contain their own unique amounts of medicine and fillers with either synthetic or natural thyroid hormone. (Great article on various treatments.)
Where do you find good thyroid doctors?
Unfortunately, it can be difficult finding a doctor who is willing to go beyond synthetic T4. Similar to doctors writing prescriptions for the pill to mask symptoms of PCOS; physicians write thyroid patients prescriptions for high cholesterol, and anti-depressants, and on and on. Please do not settle for subpar treatment.
You can find a list of good thyroid doctors on the ThyroidChange website, and also great tips on how to find other doctors within your communities. This website is run by thyroid patients seeking to educate others of available treatment options and advocate for international access. Make sure you read the wealth of information that we have gathered. Please sign our petition for better care, Like us on Facebook, and Follow us on Twitter because as you have learned, our causes are related, and we need to advocate for our future generations.
Michelle T. Bickford is NOT a doctor. She is a Hashimoto’s thyroiditis patient, a thyroid patient advocate, and Co-Founder of ThyroidChange. Please use this information to have an educated discussion with your physician regarding your health.