PCOS and Graves’ disease / overactive thyroid

[rain_]

Hi Dr Briden,

I noticed there aren’t many studies on period issues and Graves/ hyperthyroidism available compared to Hashimoto / hypo. I’d like to know your thoughts on this.

Some background info:
I‘m 35 yo, normal BMI but have some belly fat since teenage year. My periods have been irregular, 35-50 days cycle, with some occasional absent periods (resulting fewer than 4 cycles per year).

Graves’ and PCOS:
I was diagnosed with Graves’ disease in 2020. Having been on a gradual tapering dose of Carbimazole, my TSH, FT3, FT4 have been within normal ranges since 6 months of taking the medication, other symptoms are also under control except developing thyroid eye disease last year.
I’m now on a low maintenance dose of Carbimazole (1mg daily). Unfortunately my period disappeared for > 1 year (this has happened a few times in my 20s). My endocrinologist ordered blood tests and ultrasound. Ultrasound showed no poly cystic signs in ovaries or other issues. I don’t have hair loss, just a few dark hair on chin and very occasional spots on jawline.

Blood tests (March 2022):
TSH 1.65 mIU/L (normal: 0.27-4.20)
FT4 17.1 pmol/L (normal: 10.80 -25.5)
Thyroid receptor antibodies: 9.1 (normal: <1U/L)

Fasting glucose: 4.0 mmol/L (normal: 3.5-5.4)
HbA1C: 34 mmol/L (normal: 20-41)

Prolactin: 254 mu/L (normal range: 102 - 496)

LH level: 14.4 iu/L
FSH level: 6.4 iu/L

progesterone: 1 nmol/L

testosterone: 2.4 mol/L (normal: 0.29 - 1.67)

SHBG: 21 mol/L (normal: 32.4 - 128)

Serum androstenedione: 9.60 mol/L (normal: 1.1 - 4.3)

——

As I’m not actively trying to conceive and according to blood test, not insulin resistant (my mom is type 2 diabetic so are her siblings and my grandma) , my doctor didn’t offer metformin + Clomid treatment plan whilst the gynaecologist suggested birth control pills which I kindly refused.

So I read your book and started making changes such as improving insulin sensitivity through diet, adding magnesium, omega 3 and reducing inflammatory elements (gluten and cow dairy). In addition, I take selenium from 2-3 Brazil nuts daily due to thyroid eye disease. Around 1.5 months into this regime, my period returned after a long absence (heavy flow 3 out of 5 days). There’re signs of ovulation (cervical mucus), the next cycle seems likely to turn up as expected.

Questions:
In my situation, would I benefit from incorporating additional supplements into my current regime? (such as myo inositol, ubinquinol and NAC mentioned in your book. I have discounted the peony and liquorice combo as it raised my blood pressure when I tried in my 20s.)

Many thanks!