Does PCOS Increase My Chance Of Getting Hashimoto’s Disease?

If you're a woman who has been diagnosed with the autoimmune disorder Hashimoto's disease, you may already know that you have an increased chance of developing another autoimmune disease, such as lupus or type 1 diabetes.

What you may not have known, however, is that many women who have Hashimoto's disease will also be diagnosed with PCOS and vice versa.

Here's what you should know about the connection between Hashimoto's disease and PCOS before creating an individualized treatment plan with your healthcare provider to treat and manage both conditions.

What is Hashimoto's disease?

The thyroid is a small gland that is shaped like a butterfly and located at the bottom of your neck. It's responsible for making hormones that help other systems in your body function as they should, including your heart rate, reproductive system, and metabolism.

When your thyroid produces too many or not enough thyroid hormones, other systems in your body could stop working properly.

If you have been diagnosed with Hashimoto's disease, your body's immune system attacks your thyroid as it would an invader. Often, this can prevent your thyroid from producing an adequate amount of thyroid hormones, specifically thyroxine (T4), which is also called hypothyroidism.

As a result, hypothyroidism, or an underactive thyroid, could lead to the organs and systems in your body slowing down and cause symptoms, such as:

• Fatigue

• Weight gain

• Changes to your menstrual cycle

• Hair loss

• Muscle weakness

• Brain fog

• Depression

• Constipation

• An enlarged thyroid gland (goiter)

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a condition that affects how a woman's ovaries function. It is particularly common among women of childbearing age.

The three main indicators of PCOS are:

• Irregular menstrual cycles: This is a result of your ovaries not releasing eggs regularly, also known as ovulation.

• Excess androgen: PCOS can cause high levels of "male" hormones in your body like testosterone, which can cause physical signs, including facial or body hair.

• Polycystic ovaries: Your ovaries may become enlarged or produce fluid-filled sacs, called follicles, that will surround your eggs.

While its name includes the word "cyst," PCOS does not mean that your ovaries grow actual cysts.

What causes PCOS?

You may be diagnosed with PCOS if you experience one or more of these indicators. No one knows what exactly causes PCOS, but factors that could be the cause include:¹

Insulin resistance

Your pancreas creates a hormone, called insulin, that helps your body use sugar and produce energy.

When your body doesn't respond properly to the effects of insulin, your blood sugar levels will inevitably rise and your body will continue to make more insulin.

As a result, excess insulin can increase your body's production of androgens, which can make ovulation more difficult.

Heredity 

You may be more likely to develop PCOS if it runs in your family.

Low-grade inflammation

If you have PCOS, your white blood cells may be producing substances to fight off infection. This could be encouraging your ovaries to make androgens, which can contribute to cardiovascular problems over time.

Excess androgen 

Your ovaries produce too many androgens, which can lead to many symptoms, including facial hair growth.

What are the symptoms of PCOS?

The symptoms of PCOS may vary from person to person. While one woman may experience certain symptoms, another woman may experience completely different ones.

Common symptoms of PCOS² include:

• Irregular periods or not having a period at all

• Weight gain

• Trouble getting pregnant

• Thinning hair or hair loss

• Excessive hair growth, especially on the face, chest, buttocks, and back

• Acne-prone or oily skin

• Mental health disorders, such as anxiety or depression

What's the connection between Hashimoto's disease and PCOS?

If you have been diagnosed with PCOS, you may be at a higher risk of developing Hashimoto's disease.

A study performed by German physicians³ who examined the medical records of 827 women with PCOS realized that many of them had also been diagnosed with thyroid disease, specifically Hashimoto's disease.

It's estimated that Hashimoto's disease is up to three times more likely to develop in women with PCOS than in women without it.

Interestingly, women who have both PCOS and Hashimoto's disease are less likely to have high levels of androgen, such as testosterone, unlike women who have PCOS without Hashimoto's disease.

While the reason for this is unclear, it's suspected that the immune system's response to the thyroid gland not only suppresses thyroid hormone production, but also androgen production.

What symptoms do Hashimoto's disease and PCOS share?

While Hashimoto's disease and PCOS are two distinct conditions that may seem unrelated to one another, they share many of the same symptoms; this can make them difficult to diagnose by examining their symptoms alone.

Some of the symptoms that both Hashimoto's disease and PCOS share include:

• Weight gain

• Depression

• Irregular menstrual cycles

• Hair loss

• Fatigue

• Impaired libido

How is Hashimoto's disease diagnosed?

When you experience one or more symptoms of Hashimoto's disease, such as fatigue, hair loss, or weight gain, your doctor may perform a series of tests to check if your thyroid is working properly.

This is done through a physical exam in which the doctor will feel your neck and throat to check for abnormalities to your thyroid, such as nodules or a goiter.

In addition, they will review your medical history and run some tests, including blood tests to check your thyroid-stimulating hormone (TSH) levels. 

How is PCOS diagnosed?

There is no one specific test that can diagnose a woman with PCOS. If you're experiencing one or more signs of PCOS, your doctor will likely discuss your symptoms, medical history, including the regularity of your menstrual cycles, and perform a pelvic exam on you.

Additionally, your doctor may recommend a series of tests to check your insulin and hormone levels, including:

• Blood tests

• A transvaginal ultrasound

If your doctor diagnoses you with PCOS, they may recommend follow-up testing, such as:

• Glucose intolerance blood test

• Cholesterol blood test

• Blood pressure check

• Mental health screenings, such as for anxiety and depression

• Sleep apnea screening

How to treat PCOS when you have Hashimoto's disease

The primary treatment plan for women with PCOS is to address their specific concerns and symptoms. This will involve working closely with your healthcare provider to find the combination of lifestyle changes and medications that work for you.

These could include:

• Encouraging ovulation with medications, such as Clomiphene, Letrozole, or Metformin

• Managing unwanted hair growth through medications, such as birth control pills, Eflornithine Cream, or electrolysis

• Losing weight to reduce insulin and androgen levels

• Exercising regularly to maintain a healthy weight and lower blood sugar levels

If you have both PCOS and Hashimoto's disease, getting your thyroid levels under control could minimize some of your symptoms of PCOS as well.

For instance, weight gain and depression are a symptom of both conditions. However, if your thyroid levels are regulated, it may be easier to lose weight and improve your mental health, which could make treating your PCOS symptoms easier. 

When to speak to your doctor

If you experience one or more symptoms of PCOS or Hashimoto's disease, it's important to schedule an appointment with your healthcare provider right away. Seeking professional medical care sooner rather than later can help you address the source of your symptoms and find relief.

Because PCOS and Hashimoto's disease share many of the same symptoms, managing one condition could help the other improve.

Preparing for your doctor's appointment in advance can help make your appointment and diagnosis go smoothly. Here are some tips to keep in mind:

• Write down the symptoms you're experiencing, when they started, and their frequency

• Write down all of the medications you're currently taking

• Note the date of your most recent menstrual cycle

• Write down any questions you may have about your symptoms, diagnosis, or treatment

The lowdown

Hashimoto's disease is a condition that entails your body attacking your thyroid, which can result in an underactive thyroid. PCOS is a disorder that causes irregular periods, ovarian dysfunction, and high androgen levels.

While no one knows exactly what causes either of these disorders, it's suspected that if a woman has one, she is more likely to develop the other.

The good news is that a combination of lifestyle factors and medications can help treat the symptoms of both, including weight gain and hair loss. For this reason, it's important to work closely with your doctor to manage both disorders.