Natasha Dunn

Did you know thyroid issues are more common in women who have polycystic ovary syndrome (PCOS) than in women who don’t? According to the Rotterdam criteria, 5-10% of women of reproductive age will have PCOS.

Thyroid disorders and PCOS are two of the most common endocrine disorders in women.   They both also result in similar symptoms which can be very confusing, so lets take a look into each of them.


What is PCOS?

PCOS is an increase of androgen levels circulating in the body. High levels of these male hormones can prevent ovulation and affect your menstrual cycle.  With PCOS your ovary produces too many partly formed follicles in the lead up to ovulation.

PCOS is associated with insulin resistance and levels of insulin in women with PCOS can be similar to people with diabetes. This causes the production of excess androgens which affects normal functioning of your ovaries.


What is subclinical thyroid disease?

This includes subclinical hyperthyroidism and subclinical hypothyroidism, which is usually caused by a change in thyroid simulating hormone (TSH).

Subclinical hypothyroidism is commonly associated with PCOS and this occurs when TSH concentrations are raised and T3 and T4 concentrations remain normal.


Symptoms of PCOS vs Subclinical Hypothyroidism

PCOS Subclinical Hypothyroidism
Irregular or infrequent periods Weight gain
Infertility Breathlessness
Pre-diabetic/type 2 diabetes Dizziness
Mood changes Dry Skin
Anxiety/depression Palpations
Acne/facial hair Loss of appetite
Weight gain Constipation


Singla, R et al, 2015 reported women with PCOS had a 22.5% increase risk of also having subclinical hypothyroid.

Singla, R et al, 2015 also reported women with PCOS had 27% higher levels of thyroid antibody to that of the control group. We actually see this very commonly in clinic and frequently test our PCOS and thyroid patients for antibodies. You can read our expose on subclinical hypothyroidism here


Recommended Dietary Approaches


Foods to Include and Why

  • Oily fish such as salmon, mackarel, herring and cod are rich in omega-3 fatty acids which help to lower cholesterol and body fat
  • Nuts such as cashews and almonds,are a good source of monosaturated fats, vitamin B, E, fibre, folic acid, and magnesium. The fibre in the nuts can help reduce cholesterol and insulin levels.
  • Apples, grapefruit and other citrus are a great source of fibre and antioxidants to help reduce insulin requirements
  • Artichokes, bitter gourd, cabbage, spinach, lettuce, kale, zucchini squash, celery and parsley, these are not only a good source of fibre and vitamins A, C, iron and potassium but they also lower blood glucose levels and aid in weight loss (high fibre foods keeps you fuller for longer)
  • Rolled oats, whole grains, legumes, barley, chickpeas, lentils, brown rice these are all rich in fibre, magnesium and folate and help control insulin levels and weight due to having a low glycaemic index (GI)
  • Garlic and onions have an effect on controlling insulin levels


Foods to Avoid and Why

  • Refined carbohydrates and high intake of carbohydrates as your body secretes higher levels of insulin causing your liver to produce very low-density lipoproteins (VLDL) which increase triglyceride levels
  • Due to increased risk of heart disease due to higher levels of LDLs, it is recommended your diet is low in saturated and trans fats so aim to substitute these fats with unsaturated fats such as flaxseeds, walnuts, avocados and nut butters
  • High glycaemic food (GI) such as fresh mashed potatoes, fatty foods, fast foods, white rice, unrefined white flours, pretzels, donuts, scones, and alcohol these cause weight gain and increase LDLs and cholesterol leading to heart disease.

Lifestyle changes

  • Incorporate at least 30 minutes exercise into your daily routine as exercise improves insulin sensitivity in skeletal muscle and fat tissue. Exercise also reduces body weight, lowers blood pressure, lowering triglyceride levels and increasing high density lipoproteins (HDL) levels
  • Reduce stress levels with a technique that works for you




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Cooper, D, S and Biondi, B 2012. Subclinical thyroid disease. “Lancet” 379: 1142-54.

Huang, R., Zheng, J., Li, S., Tao, T., Liu, W 2014. Subclinical hypothyroidism in patients with polycystic ovary syndrome: Distribution and its association with lipid profiles. “European Journal of Obstetrics & Genecology and Reproductive Biology” 177: 52-56.

Singla, R., Gupta, Y., Khemani, M., Aggarwal, S 2015. Thyroid discorders and polycystic ovary syndrome: An emerging relationship. “Indian Journal of Endocrinology and Metabolism” 19, 1, 25-29.

The optimal diet for women with polycystic ovary syndrome?, 2005. Kate Marsh and Jennie Brand-Miller, British Journal of Nutrition, February 94: 154-165

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