Thyroid Hormone and Its Relationship with PCOS
Polycystic ovary syndrome (PCOS) and thyroid disorders are two health concerns that, although they seem disparate, share an intricate and delicate relationship. This blog post will delve into the extensive body of knowledge available about the connection between PCOS and thyroid function, with an aim to clarify some of the confusion surrounding these complexities.
Background
PCOS is a common endocrine disorder affecting reproductive-age women worldwide. It is characterized by hormonal imbalance, irregular menstrual cycles, and the development of small cysts on one or both ovaries. Despite the abundance of studies on PCOS, its relationship with thyroid dysfunction remains a nebulous area.
Thyroid dysfunction, on the other hand, is a disorder characterized by an overactive or underactive thyroid gland, which can lead to hyperthyroidism or hypothyroidism respectively. The thyroid is a butterfly-shaped gland at the base of the neck responsible for regulating metabolism, growth, and development, among other things.
What Does the Research Say?
While diagnosing PCOS, it is crucial to exclude disorders that mimic its phenotype, one of which is thyroid dysfunction. However, the current literature does not specify the precise tests or cutoff values needed to differentiate these two conditions. This area of ambiguity is a clear testament to the necessity for further research.
Many experimental and clinical data indicate a relationship between thyroid function perturbations and PCOS, although direct and clear-cut evidence remains elusive. One aspect to consider is the impact of thyroid function, particularly elevated thyroid-stimulating hormone (TSH) levels and subclinical hypothyroidism, on women with PCOS.
It appears that these thyroid abnormalities may amplify the risk of cardiometabolic complications in women with PCOS. This includes increased susceptibility to conditions such as heart disease, hypertension, and diabetes. Moreover, it has been noted that thyroid disorders may exacerbate reproductive outcomes, especially in patients undergoing fertility treatment.
Looking Ahead
A crucial concern for women with PCOS is fertility. While thyroid medications are commonly used to manage thyroid disorders, no concrete evidence exists to support their efficacy in improving fertility and cardiometabolic risk in women with PCOS.
On the brighter side, certain interventions such as lifestyle modifications, the use of metformin (a common medication used to treat type 2 diabetes), and vitamin D supplementation show promise in improving thyroid function across the general population. However, it is essential to note that these interventions need further exploration and validation in the context of PCOS.
Conclusions and Recommendations
The coexistence of PCOS and thyroid disorders might identify a group of patients with a heightened reproductive and metabolic risk. Therefore, it is critical to routinely screen for thyroid function and thyroid-specific autoantibodies, especially in women with PCOS. This becomes even more crucial before and during pregnancy.
In summary, the relationship between PCOS and thyroid dysfunction is complex and multifaceted. While we have some knowledge, there are still gaps that need to be filled. Until then, heightened vigilance, regular screening, and appropriate management of these conditions remain our best tools in the quest for optimal health and wellbeing of women affected by these disorders.
Palomba, S., et. al. Front. Endocrinol. Sec. Reproduction. Volume 14 - 2023 | doi: 10.3389/fendo.2023.1251866
Studies like this show how important optimizing thyroid hormone is for metabolic improvement with regard to insulin resistance, diabetes, PCOS, obesity, heart disease. . . .the list goes on and on. Jason & Rita...aka Dr. De Leon and Dr. Gillespie.
