How Can You Tell the Difference Between PCOS and Hypothyroidism?

It’s so easy to fall into the trap of self-diagnosing online. Why pay money to see a specialist when you can Google symptoms? Some conditions may look similar to your experience, but only a health care provider can define them with certainty. This is often the case with polycystic ovarian syndrome (PCOS) and its impacts on weight, abdominal discomfort and more. What are the differences between PCOS and hypothyroidism?

What is hypothyroidism?

Understanding the differences requires foundational knowledge of each illness. Primary hypothyroidism is when the thyroid doesn’t create enough hormones or is underactive. Hyperthyroidism is the opposite, when the thyroid is overactive and produces too much.

A well-functioning thyroid plays a deceptively significant role in overall health. It influences heart, muscle and lung wellness while managing energy and metabolism. Ideally, the thyroid should always pump hormones because the body uses them to support healthy processes. Its range of influence means symptoms are all over the place and can include, but are not limited to:

• Fatigue
• Low immunity
• Weight fluctuations
• Mental health issues
• Muscle concerns
• Irregular menstrual cycles
• Skin and hair dryness

What Is PCOS?

PCOS is a common condition with unknown origins and manifests as hormone imbalances. Medical experts have theorized potential causes for years, ranging from genetics to insulin resistance. It could be due to high androgen levels — a hormone hindering ovulation. People with PCOS often skip ovulation because of these imbalances.

Cysts, or fluid-filled sacs, develop on the ovaries when this occurs. Ovarian cysts range in size, which means symptoms vary drastically. The most concerning side effect for most individuals with PCOS is fertility issues. A large cyst could lead to other symptoms, though they are not present in all individuals:

• Pelvic pain
• Abdominal pressure or bloating
• Back pain
• Fever
• Vomiting
• Hirsutism, or excessive hair growth
• Painful, inconsistent menstrual cycles

Individuals with PCOS may or may not also have polycystic ovaries. The former is a metabolic, endocrine condition, while the latter describes ovarian qualities outside of typical characteristics, including if they are too large.

What Are the Differences Between PCOS and Hypothyroidism?

The average person may be unable to tell the difference between these two without a professional’s knowledge because there are overlaps with symptoms. Self-diagnosing incorrectly could lead to serious ramifications and hospitalizations. In the most unfortunate cases, you may have both, making matters even more confusing.

The main variances between them are the anatomy the condition relates to, the diagnostics process, treatment options and long-term risks.

Anatomy

One apparent distinction between PCOS and hypothyroidism is what part of the body it’s related to. The thyroid gland is in the neck near your voice box and windpipe, and if it’s the source of failure, doctors will diagnose it as primary hypothyroidism.

The thyroid’s ability to perform is determined by the pituitary gland, located in your skull. It serves as the control panel for the thyroid, adjusting its hormone generation as needed. If the pituitary gland isn’t working properly, this is called secondary, or central, hypothyroidism. Shortcomings in either reflect throughout the body.

Similarly, PCOS symptoms are felt all over but relate to specific organs that are not the thyroid or pituitary gland. PCOS primarily happens in the ovaries, but other influential regions include the adrenal glands and endocrine pancreas.

The adrenal glands are near the kidneys, and if they are the reason behind excess androgen, you may have adrenal PCOS. The endocrine pancreas produces insulin, and PCOS may develop if it makes too much.

Diagnoses

Diagnosing thyroid concerns is relatively straightforward. Most doctors only need to order a thyroid function test and review blood work to see how present the hormones are. Doctors typically look for low levels of the thyroid-stimulating hormone (TSH) and thyroxine (T4). An underactive thyroid may lead to other diagnoses, such as Hashimoto’s disease. Thyroid testing can happen as early as the infant years.

Meanwhile, diagnosing PCOS is more involved, and it has to wait until the individual is of reproductive age. Doctors may conduct a pelvic exam to see how healthy your reproductive organs are. This involves an internal and external examination to identify pain points, tenderness and other symptoms.

A follow-up ultrasound will find if cysts are present. This also helps doctors because it shows the size of the ovaries and the thickness of the uterine lining. Blood tests are another aspect of this, much like with hypothyroidism, but they look for different hormones. Many professionals believe insulin resistance is a cause, so doctors may look at everything from blood glucose to cholesterol.

Treatment and Management

The other primary difference is the treatment. Unfortunately, there is no set cure for PCOS, so endocrinologists prescribe ovulation-inducing or birth control medications, among other strategies for management. This varies widely from patient to patient, as untreated or severe PCOS may cause other conditions requiring unique care. However, many will recommend lifestyle changes, such as regulating diet and activity.

Hypothyroidism isn’t curable, either. However, management is simpler and more consistent. Usually, this involves daily hormone adjustment medications, like levothyroxine. Some individuals may prefer to seek home remedies until they receive medical treatment. Some of these include:

• Seaweed: Contains high iodine levels to help hormone production
• Brazil nuts: Has high selenium if amounts are low
• Ashwagandha: Reduces stress levels
• Gotu kola: Increases energy levels by stimulating thyroid functions

Long-Term Risks

Be sure not to neglect either condition and treat all symptoms seriously. Ignoring hypothyroidism could lead to more severe conditions, including myxedema, which may cause coma or heart failure in the worst-case scenarios. Most cases of hypothyroidism are not life-threatening unless they get to this point.

Untreated hypothyroidism also impacts muscles, joints and nerves. As these bonds weaken, you may experience constant fatigue, pain or numbness in the limbs. Poor management could make these side effects irreversible, so prompt medical attention is crucial before the situation is beyond a health care expert’s control.

Concerns for people with PCOS include diabetes, high blood pressure, endometrial cancer, sleep apnea and nonalcoholic fatty liver disease. Many of these relate to weight gain and insulin management, while other risks are because of uncontrolled hormone imbalances that have persisted for too long.

Is There a Link Between the Two Ailments?

The biggest similarity is both conditions impact metabolism and endocrine operations. If the body doesn’t have the right hormone recipe, it doesn’t know the best ways to process food and convert resources into energy. This is what can lead to inconsistent side effects.

Researchers have hypothesized potential links between PCOS and hypothyroidism. Hashimoto’s disease and PCOS frequently share a common bridge — polycystic ovaries. This is why symptoms blur together, especially when evaluating menstrual cycles and weight fluctuations.

Another commonality is varying luteinizing hormone and follicle-stimulating hormone (LH-FSH) ratios. Individuals without either condition produce LH-FSH in equal proportions. People with PCOS and Hashimoto’s are likely to produce LH two to three times more than FSH, impacting ovulation and throwing off someone’s whole cycle.

What are the other overlaps health care providers notice?

• High thyroid peroxidase in people with PCOS aligns with enlarged thyroid glands
• Elevated TSH production leads to rapid fat cell creation
• Potential connections to autoimmune diseases
• Slower heart rates

Knowing the Signs

If you are learning what the differences are between PCOS and hypothyroidism, then you are one of many experiencing anxiety and pain. The best way to tell a difference is to receive advice from a licensed medical professional. Always take their insights seriously while trusting your awareness of your body. Every questionable feeling is worth looking into, whether the life disruption is large or small. You’re not alone, and with attentive medical care, relief is available.

Beth Rush is the beauty editor at Body+Mind, and has much experience writing about how readers can create personal care routines that impact their sense of self in positive ways.
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