By Breea Johnson, MS RD
In a previous blog posting, I recommended that women with PCOS (Polycystic Ovary Syndrome) get screened for autoimmune thyroid disease as research has shown that women with PCOS are three times as likely to also have an autoimmune thyroid disease. The autoimmune thyroid diseases are Graves Disease and Hashimoto's Thyroiditis. In both cases, immune system antibodies attack the cells of the thyroid gland which can lead to the gland’s eventual destruction - producing symptoms which can include weight gain or loss, depression, anxiety, rapid heart rate, and in some cases infertility. While most Reproductive Endocrinologists routinely test for Thyroid Stimulating Hormone (TSH) which can determine an over-active thyroid gland (hyperthyroidism) or under-active thyroid gland (hypothyroidism), autoimmune thyroid disease needs to be tested by determining levels of antibodies that the immune system is producing such as anti-thyroid peroxidase antibodies (anti-TPO) or anti-thyroglobulin (anti-TG)antibodies.
In addition to the higher incidence of autoimmune thyroid disease in women with PCOS, a recent study showed that infertile women suffering from PCOS with anti-TPO values that exceeded the upper level of normal were significantly more likely to be resistant to Clomid compared to Clomid responders and Metformin responders. They went on to conclude that elevated anti-TPO levels (an indicator of autoimmune thyroid disease) are associated with poor treatment response in infertile women who suffer from PCOS.
So, why is it so common to see PCOS and Thyroid Disease together? There is no definitive answer, but there are connections. Both the thyroid gland and the ovaries are part of the endocrine system. Insulin resistance, which is very common in women with PCOS, is also associated with thyroid function as studies have found that increased levels of TSH correlate with an increase in insulin resistance (read more about the insulin resistance and PCOS connection in a previous blog). There also may be specific nutritional deficiencies that PCOS and thyroid disease have in common.
While the research is still limited in the area of infertility, thyroid disease and PCOS, there is a link between all of them and getting tested and screened for both PCOS and thyroid disease may be beneficial in your fertility journey. Nutrition also plays a large role in the treatment of PCOS and thyroid disease including helping to lessen insulin resistance. To book a nutrition consultation at Pulling Down the Moon, call (312) 321-0004 or visit www.pullingdownthemoon.com.