Polycystic ovary syndrome (PCOS) and thyroid disorders are two of the most common hormone disorders in women. 

At Root Functional Medicine, we often see women presenting with BOTH of these conditions. Is there a connection?

In this blog, we’ll discuss the relationship between PCOS and thyroid conditions (Hashimoto’s in particular) and what you can do to start feeling better. 

What is PCOS?

PCOS is an inflammatory condition that affects your hormones and menstrual cycle. Some studies report that PCOS affects up to 15 percent of women (1). Although some women with PCOS have cysts on their ovaries, it is not a requirement for diagnosis. 

Most women with PCOS have higher levels of androgens, i.e. “male” hormones, and insulin resistance. Symptoms of PCOS may include period irregularities, acne, infertility, hair loss, unwanted hair growth, and mood disturbances.

What is Hashimoto’s?

Hashimoto’s is an autoimmune disease in which your immune system mistakenly attacks your thyroid, a butterfly-shaped gland in your neck. 

Hashimoto’s is the most common cause of hypothyroidism in the United States, and women are 10 times more likely to have Hashimoto’s than men (2). In fact, up to 9 percent of pregnant women develop Hashimoto’s after pregnancy. Read more about autoimmune disease after pregnancy here.

Symptoms of Hashimoto’s include period irregularities, dry/thinning hair, fatigue, sensitivity to cold temperatures, mood disturbances, and more.

PCOS and Thyroid

While researchers aren’t quite sure how these two conditions are related, it is clear that there is a bidirectional relationship. For example, women with PCOS are three times more likely to also suffer from Hashimoto’s thyroid disease than the general population (3, 4). 

At the same time, polycystic appearing ovaries can be a clinical sign of hypothyroidism. This is why your doctor should rule out hypothyroidism before diagnosing PCOS (5). 

PCOS and thyroid conditions also share common characteristics, like period irregularities, increased insulin resistance, and dysregulation of the immune system.

PCOS and thyroid

What Can You Do?

PCOS and Hashimoto’s thyroiditis are both inflammatory conditions. In functional medicine we focus on treating root causes to reduce inflammation in the body. So, whether you have PCOS, Hashimoto’s thyroiditis, or both, here are a few ways you can start healing.

Improve Your Gut Health

Your gut plays a large role in balancing sex hormones, like estrogen, reducing overall inflammation, and creating a healthy environment for friendly gut bacteria to thrive. So, healing the gut is essential in treating the root cause of PCOS and Hashimoto’s.

Here are a few ways you can start improving your gut health at home:

  • Eat a variety of fiber-rich foods. 
  • Include probiotic-rich foods as tolerated (kombucha, raw sauerkraut, kimchi, etc.)
  • Limit foods high in added sugar.
  • Limit gut irritants, like excessive caffeine and alcohol.
  • Spend time in and around nature/plants.

Sometimes, women require more interventions to truly heal their gut. This is where working with a functional medicine practitioner to guide you through a personalized treatment plan is key.

Balance Your Blood Sugar

Women with PCOS and/or Hashimoto’s thyroiditis can both benefit from balancing their blood sugar levels.

Insulin resistance is a hallmark feature of PCOS. Insulin is a hormone responsible for lowering your blood sugar levels after a meal. If you have insulin resistance, your cells do not properly respond to insulin. This causes your blood sugar levels to remain elevated for longer than normal, which can worsen inflammation and PCOS symptoms.

insulin resistance 

Likewise, some studies indicate a relationship between insulin resistance and Hashimoto’s thyroiditis as well (6). 

To balance your blood sugar and reduce insulin resistance, include a protein, fat, and high-fiber food in all of your meals and snacks. Try to limit processed carbohydrates and foods high in added sugar (like soda, sweets, and pastries) that excessively raise blood sugar levels.

Balance Your Lifestyle

Your lifestyle has a tremendous effect on your health, especially with PCOS and thyroid conditions. 

Use these tips to rebalance your lifestyle:

  • Aim for 7-8 hours of sleep per night (read our blog on insomnia here).
  • Find a healthy way to reduce stress, like meditation, yoga, therapy, or breathing exercises.
  • Move your body in whichever way you most enjoy. Exercise is important for overall health, but avoid vigorous or stressful exercise, as this may do more harm than good in these conditions.

Sometimes we try so hard to be healthy that we end up ignoring our body’s cues. Make sure to listen to your body, and be kind to yourself! 

Eat an Anti-Inflammatory Diet

By now you probably know that chronic inflammation creates havoc in the body. Since PCOS and Hashimoto’s thyroiditis are both inflammatory conditions, following an anti-inflammatory diet is crucial.

An anti-inflammatory diet is rich in colorful, non-starchy vegetables, fatty fish (like salmon), nuts, seeds, and colorful fruits! Including a variety of healthy fats, like extra virgin olive oil, avocados, and coconut oil is helpful, too. Follow us on Instagram @rootfunctionalmedicine for quick and easy anti-inflammatory meal ideas!

Seeking Help for PCOS and Thyroid Conditions 

PCOS and Hashimoto’s are complicated conditions that may require blood tests and personalized advice from a functional medicine doctor or dietitian. 


At Root, we offer a 3-month PCOS nutrition program that includes personalized blood work (with hormone and thyroid testing), a PCOS specific meal plan, and coaching with a registered dietitian. Click to learn more about our PCOS Nutrition Coaching Program or our other functional medicine treatment plans.


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