Hypothyroidism and PCOS: The Overlooked Link and What You Can Do About It

Polycystic ovary syndrome (PCOS) is a complex hormonal condition that affects over 5 million women in the US of reproductive age and it doesn’t just impact your period and fertility. Because hormones control so many of the body’s functions, PCOS can cause a wide range of symptoms, like irregular menstrual cycles, weight gain, fatigue, acne, mood swings, hair thinning, and even excess body hair growth. Basically, when your hormones are out of balance, everything can feel off. 

If you’re dealing with these symptoms, there’s a good chance your doctor may give you a diagnosis of PCOS but there’s something else to consider. Another endocrine condition, hypothyroidism, shares many of the same symptoms and sometimes even overlaps with PCOS. In fact, it’s not uncommon for women with PCOS to also have hypothyroidism, which can make symptoms feel even more intense. 

That’s why I’m dedicating this blog post to breaking down the relationship between PCOS and hypothyroidism, and sharing how to support both conditions naturally with a holistic approach. Let’s get into it! 

Are Hypothyroidism and PCOS Related?

Yes, hypothyroidism and PCOS are related, but they’re not the same thing. While both are hormonal disorders with overlapping symptoms, they affect the body in different ways. The tricky part? They can often occur together and even make each other worse. 

Here’s the deal: around 22-30% of women with PCOS are also diagnosed with hypothyroidism most often with Hashimoto’s thyroiditis, which is an autoimmune form of hypothyroidism. So, if you have PCOS, it’s worth looking into your thyroid health, too. 

Hypothyroidism happens when your thyroid gland, that little butterfly-shaped gland in your neck, slows down and doesn’t produce enough thyroid hormones. And, since your thyroid plays a major role in digestion, metabolism, energy, mood, fertility, and your menstrual cycle, this slowdown can really throw your body off. It often leads to imbalances in important hormones like thyroid-stimulating hormone (TSH), estrogen, progesterone, insulin, and cortisol. 

PCOS, on the other hand, starts in the ovaries. It seems to be triggered by elevated androgen (male hormone) levels, and is often tied to insulin resistance and chronic inflammation. But, the two conditions can look a lot alike. 

Symptoms that PCOS and hypothyroidism often share include:

• Irregular or missed periods
• Weight gain (or trouble losing weight)
• Fatigue and low energy
• Hair thinning or hair loss
• Depression or anxiety
• Infertility

So, while PCOS and hypothyroidism aren’t identical, they’re absolutely related, and if you’re managing one, it’s super important to be aware of the other. 

Can Hypothyroidism Cause PCOS?

While there’s no solid evidence proving that hypothyroidism causes PCOS, the two are definitely connected, and they can really confuse your body. 

Here’s what we know: when your thyroid hormones are low (AKA hypothyroidism), it can throw off your lots of other hormones, too! This can lead to problems with ovulation and the imbalances may prompt PCOS-like symptoms. So yes it’s totally possible to have hypothyroidism that presents like PCOS, even if you technically don’t have both conditions, but it does not cause PCOS. 

But it can work the other way around. Some research suggests that women with PCOS are actually more likely to develop thyroid issues. Why? Because, PCOS often comes with chronic inflammation, insulin resistance, and estrogen dominance all things that can put extra stress on your thyroid and increase your risk of developing hypothyroidism down the line. 

That’s why it’s so important to work with your doctor and get tested for both PCOS and hypothyroidism. Treating one without the other can leave you stuck in a frustrating cycle, where you’re doing everything “right” but still don’t feel like yourself. Getting the full picture of your hormone health is the first step toward real, lasting relief. 

How to Tell the Difference Between Hypothyroidism and PCOS

Since hypothyroidism and PCOS share so many overlapping symptoms, it can be really tricky to know what’s actually going on with your body. That’s why it’s super important to get the right tests and a clear diagnosis from your doctor. 

To check for thyroid disorders like hypothyroidism, your doctor is likely to order a blood test to look at key thyroid hormone levels:

• TSH (thyroid-stimulating hormone)
• Free T3
• Free T4
• Thyroid antibodies (TPO and TG)

If you have higher levels of TSH but  Free T4 is low, that’s usually a sign of hypothyroidism. If your thyroid antibodies are also elevated, it may point to Hashimoto’s, an autoimmune condition. Your doctor might also recommend a thyroid ultrasound to check for enlargement or other structural changes to the gland. 

To test for PCOS, your doctor will look at different hormones through a blood test (be sure to ask for a Comprehensive Functional Lab Test), including:

• FSH (follicle-stimulating hormone)
• LH (luteinizing hormone)
• SHBG (sex hormone binding globulin)
• DHEA-S
• Testosterone
• Insulin levels

An ultrasound might also be done to check for polycystic ovaries, which are one of the key diagnostic markers for PCOS. 

Because the symptoms of PCOS and hypothyroidism look so similar, getting tested for both conditions is essential. It’s the best way to figure out what’s really going on and to create a treatment plan that actually works for your body. 

How to Treat PCOS and Hypothyroidism

If you’ve been diagnosed with both PCOS and hypothyroidism, don’t worry. Take a deep breath, you’re not alone, and there are ways to support both conditions at the same time. With the right lifestyle changes, you can start feeling better, balance your hormones, and take back control of your health. 

Eat a gluten- and dairy-free anti-inflammatory diet. 

When you’re managing both PCOS and hypothyroidism, your diet becomes one of the most powerful tools in your healing journey. Especially since almost 80% of women with PCOS and hypothyroidism also deal with insulin resistance, which makes it harder for your body to turn glucose into energy, and instead stores it as fat. 

I always recommend trying a gluten- and dairy-free anti-inflammatory diet for 30 days that focuses on lean protein, healthy fats, and fiber-rich foods. This whole-food approach is amazing for stabilizing blood sugar, boosting energy, and supporting both thyroid and ovarian function. And the bonus? Even a 5-10% reduction in body fat can seriously improve symptoms of PCOS. 

The goal isn’t restriction, it’s nourishment that helps your body and hormones thrive. 

Want support with this step? Dive into my blog where I break down how to reverse PCOS naturally with diet, or join us inside The Cysterhood app for hundreds of PCOS-friendly recipes, grocery lists, and meal plans tailored to your carb tolerance and healing goals. 

Practice low-impact, slow-weighted exercises. 

Never underestimate the power of slow, intentional movement when it comes to managing PCOS and hypothyroidism. While high-intensity workouts can be helpful in some cases, they also have the potential to spike cortisol levels (your body’s primary stress hormone), which may worsen hormonal imbalances, fatigue, or weight retention in both conditions.

For many people with PCOS or hypothyroidism, low-impact, slow-weighted workouts can be a gentler, more sustainable option. These types of exercises help build lean muscle, support insulin sensitivity, and reduce inflammation…all of which are key when metabolic rate or thyroid function is compromised. Strength-based movement also supports better joint stability and energy regulation, which is especially helpful if you struggle with fatigue or muscle weakness, common symptoms of hypothyroidism.

Some of my favorite PCOS-friendly workouts? Think strength training with light weights, yoga, walking, swimming, and pilates. And, if you’re looking for an easy way to get started, The Cysterhood app is packed with effective workout routines designed specifically for women with PCOS, so you can build a fitness routine that supports your healing journey. 

Manage stress and sleep. 

One of the most common (and sneaky) symptoms of PCOS and hypothyroidism is elevated cortisol, your stress hormone. When cortisol is high, your body stays stuck in fight-or-flight mode, which can throw your entire hormone system out of balance. The good news? You can absolutely bring those levels down with some intentional lifestyle shifts.

Start by focusing on stress relief and sleep, two powerful tools for healing. Aim for 7 to 9 hours of quality sleep every night to give your hormones time to reset. And during the day, practice calming habits that work for you, like deep breathing exercises, meditation, a peaceful walk outside earlier in the day, or journaling your thoughts and feelings…anything that keeps you away from your screens! Even a few minutes a day can make a big difference. 

If sleep has been tough, try skipping that afternoon cup of coffee (I actually recommend cutting caffeine altogether if you have PCOS) and instead wind down with screen-free activities before bed. Read a cozy book, light a candle, sip on a calming hormone-balancing herbal tea (like our Testosterone Relief Tea.), and give your body the rest it needs to support healing your cortisol levels from the inside out. 

Add helpful natural supplements to your routine. 

Even if you’re eating a super healthy, balanced diet (go you!), sometimes your body still needs a little extra support, especially when you’re managing both PCOS and hypothyroidism. That’s where supplements come in to give your body the boost it needs to heal, balance hormones, and feel its best. 

Some of my go-to nutrients for this combo include magnesium glycinate, omega-3s, B6, and B12. These all help with energy, stress, hormone balance, and inflammation, major players in both PCOS and hypothyroidism. You can find these in the dosages for women with PCOS in OvaFit’s Metabolism Plus supplement kit.

But the two supplements I always recommend to my Cysters? Ovasitol and Berberine Advanced. 

Ovasitol is a science-backed blend of myo-inositol and d-chiro-inositol in the ideal 40:1 ratio. It helps improve insulin sensitivity, supports ovulation, and even assists in thyroid hormone conversion (hello, energy and mood!)

Berberine Advanced is another powerhouse, especially if you’re dealing with insulin resistance. It promotes stable blood sugar levels, supports a healthy metabolism, and can aid in weight loss, all of which can help reduce PCOS symptoms and support thyroid health. 

When you combine the right supplements with lifestyle changes, you’re giving your body the tools it needs to thrive naturally.

What to Eat with PCOS and Hypothyroidism

High-Fiber Cruciferous Vegetables

Adding high-fiber veggies to your meals is a simple (and powerful!) way to support hormone balance, especially when you’re managing PCOS and hypothyroidism. These veggies help your body naturally detox excess estrogen while giving your liver and gut the love they need to keep things running smoothly. I like to make veggies 1/2 of my plate, I call it the PCOS Plate Method.

If you’ve been diagnosed with hypothyroidism, it’s best to cook your cruciferous veggies first to make them easier on your body. Lightly steaming or sauteing them can make a big difference! 

Some go-to hormone-loving veggies to add to your plate:

• Broccoli
• Cauliflower
• Brussel sprouts
• Kale
• Arugula
• Spinach
• Zucchini
• Asparagus
• Bell Peppers
• Cucumbers

Low-Glycemic Fruits

Fruits are a delicious and powerful way to support your PCOS and hypothyroidism healing journey. They’re packed with essential vitamins, antioxidants, and fiber that help fight inflammation and keep your hormones happy. And here’s the best part: when you focus on low-glycemic fruits, you can also help reduce insulin resistance and balance your blood sugar levels. 

Some of my favorite fruits to enjoy daily include:

• Berries
• Apples
• Pears
• Cherries
• Kiwi
• Pomegranate
• Citrus Fruits

These fruits are sweet, satisfying, and gentle on blood sugar, perfect for adding to smoothies, oatmeal, or just enjoying as a snack! 

Healthy Fats

Not all fat is bad fat, especially when it comes to healing your hormones! In fact, healthy fats are essential for supporting hormone production, reducing inflammation, and keeping your blood sugar stable (which we know is a must for managing insulin-resistant PCOS and hypothyroidism). 

The key is choosing the right kind of fats: natural, nourishing, and anti-inflammatory. Some of my go-to healthy fats to add to meals include:

• Avocados
• Olives
• Olive Oil
• Nuts and Seeds
• Fatty Fish (salmon, sardines, mackerel – for omega-3s)

Try sprinkling them into salads, blending them into smoothies, or drizzling them over roasted veggies. Your hormones will thank you! 

Lean Protein

Making lean protein the 1/4th of your plate is one of the most effective ways to support balanced blood sugar and healthy thyroid function. That’s because protein plays a big role in transporting thyroid hormones throughout the body, and let’s be honest, our PCOS bodies need that kind of support! 

My favorite lean protein sources include:

• Organic Chicken or Turkey
• Wild-Caught Fish
• Grass-Fed Beef
• Pasture-Raised Eggs
• Lentils and Legumes

Pair these proteins with fiber-rich veggies and healthy fats, and you’ve got a hormone-loving meal your body will thrive on. 

Whole Grains

When dealing with insulin resistance, cutting back on processed and refined carbs is one of the best things you can do for your hormones. Foods like white bread, pasta, pastries, and sugary cereals might taste good in the moment, but they spike blood sugar, increase inflammation, and can throw your insulin even more out of whack. 

Instead, reach for nutrient-dense whole grain complex carbs that are gluten-free and rich in fiber, so they won’t cause those dreaded blood sugar spikes and crashes. I try to make complex carbs 1/4 of my plate, but if you want to take your PCOS journey to the next level, you can find your Carb Tolerance Range, which we teach in The Cysterhood app.

My go-to whole grains for PCOS and hypothyroidism are:

• Quinoa
• Sweet Potatoes
• Brown Rice
• Gluten-Free Oats
• Buckwheat Noodles

These complex carbs are not only gentle on your blood sugar, but they also give you lasting energy and support hormone balance. 

Herbal Teas

Sipping your way to hormone balance? Yes, please! Adding just one or two cups of herbal tea to your daily routine can do wonders for calming inflammation, supporting your thyroid, and easing those stubborn PCOS and hypothyroidism symptoms. And, if you’ve been hanging out with me here at Ovafit for a while, you already know I’m obsessed with the power of herbal teas! 

If you have hypothyroidism, especially alongside PCOS, you might be dealing with frustrating symptoms like fatigue, weight gain, hair thinning, mood swings, and irregular cycles. One common connection? Elevated androgen levels, which can get even more out of balance when your thyroid hormones are low.

That’s why I often recommend our Testosterone Relief Tea, a soothing herbal blend specifically designed to help lower excess androgens, gently support hormone balance, and promote more regular cycles. This tea is made with research-backed herbs like spearmint and chamomile, which are known for their calming, hormone-supportive properties. When you combine that with thyroid-friendly habits, Testosterone Relief Tea can be a simple, comforting way to support your overall hormonal health—one cozy sip at a time.

Find natural relief for hormone-disrupting conditions like PCOS and hypothyroidism today!

Your hormones run the show, so when they’re out of balance, it’s no surprise that you might not feel like yourself. If you’ve been diagnosed with PCOS and hypothyroidism, I know how overwhelming it can feel navigating symptoms and treatment options. We’re here to help you take that stress off and provide you with resources and information to get control back of your health!

At Ovafit, we’ve created the only line of NSF-certified supplements designed specifically for women with hormonal conditions like PCOS and thyroid disorders, so you can start feeling like you again. 

• Berberine Advanced – This natural GLP-1 booster helps improve insulin sensitivity, reduce inflammation, support weight loss, heal your gut, and bring your hormones back into balance. 
• Ovasitol – Our signature 40:1 blend of myo- and d-chiro-inositol is clinically shown to support ovulation, stabilize insulin levels, and improve hormone function. 
• Testosterone Relief Tea – A soothing herbal blend made to naturally lower androgen levels and ease symptoms like acne, hair loss, and mood swings. 
• MetaMulti – A daily multivitamin tailored for women with PCOS to help fill nutrient gaps and support hormone health from every angle. 

Ready to take the next step in your healing journey? Let’s do this together with natural tools, your body will thank you for!