Irregular Periods? It Could Be Your Thyroid

Thyroid as a cause of irregular periods.If you came to me for help with irregular periods, I would think very carefully about your thyroid.

It wouldn’t matter if you already had another diagnosis such as PCOS or hypothalamic amenorrhea. It wouldn’t matter if your doctor had vaguely said at some point that your blood test was normal. I would still think about thyroid. Why? Because underactive thyroid (hypothyroidism) is a common reason for irregular periods.

3 ways underactive thyroid causes irregular periods:

  1. It elevates prolactin, which suppresses ovulation.
  2. It impairs insulin sensitivity, which increases your risk of PCOS. (See 4 types of PCOS.)
  3. Most importantly, it robs your ovaries of the cellular energy they need to ovulate.

 Tip: Cellular energy (ATP) is the energy your cells use to do everything. It’s made by tiny organelles in your cells called mitochondria and requires a healthy amount of thyroid hormone.

Cellular energy, mitochondria, and thyroid hormone are critically important for ovaries. Why? Because ovaries to have to bring a healthy follicle (egg) all the 100 days to ovulation, and then still have enough energy to grow a 4 cm corpus luteum in one day, and make progesterone.

All of that requires energy. Lots and lots of energy. All of that requires thyroid hormone.

Your doctor may have missed a thyroid problem

Your doctor may not have tested for thyroid at all. Or maybe she did test, but only with a blood test called TSH or thyroid-stimulating hormone, which not a great test.

Under current guidelines, your doctor cannot diagnose underactive thyroid until your TSH is greater than 4.5 or 5 mIU/L. Yet according to a 2002 statement by the American Association of Clinical Endocrinologists, your doctor could consider diagnosing underactive thyroid when your TSH is only 3 mIU/L. Subsequent studies have found that keeping TSH below 2.5 is associated with better outcomes for fertility and pregnancy, and better outcomes for periods.

Ask your doctor to take a second look at your thyroid. For example, ask her to consider that you have thyroid symptoms such as fatigue, dry skin, depression, hair loss, and elevated cholesterol. Ask her to consider that you have a direct family member (mother or sister) with thyroid disease and that you may, therefore, require further investigation. Finally, ask her to test you for thyroid antibodies (also called anti-TPO antibodies), which are an important marker of thyroid disease (even when TSH is normal).

Natural treatment for thyroid

If you do have an underactive thyroid, then that is what you need to treat to get your periods back. You can take standard T4 medication (thyroxine), or a combination T4 plus T3 prescription such as desiccated thyroid.

Beyond just taking thyroid hormone, you can support your thyroid with natural treatment. That usually means correcting the autoimmunity that underlies most cases of underactive thyroid.

  • Eliminate wheat gluten to reduce thyroid autoimmunity.
  • Supplement selenium to reduce autoimmunity. A safe dose is 100-150 mcg per day.
  • Maintain healthy intestinal bacteria to reduce autoimmunity.
  • Supplement magnesium to aid with the production of thyroid hormone
  • Take the herbal medicine ashwagandha (Withania) to aid with the production of thyroid hormone.

117 thoughts on “Irregular Periods? It Could Be Your Thyroid”

  1. dear Dr Briden
    my daughter is 14 years old is having periods every two weeks lately. What should we look at..? What could be the cause ? She has food allergies and doesn’t eat most of the foods like eggs, dairy, fish, gluten, nuts.
    We don’t know what to do with this period issue now!
    thank you

  2. Hi Lara,

    Would you generally say that Atpo on the higher end (for example 31) indicates an Auto Immune disease or possibly the inflammatory kind of PCOS? Especially when also high Androstendiones are present?

    Thank you so much for your valuable informations!

    Best wishes,


  3. HI!
    I just devoured your Hormone Repair Manual. It was great! I am writing to you since I’ve been diagnosed with hypothyroidism last August but just began taking Levothyroxine for just 6 weeks. I am 52 but having my periods monthly except this month of March. The period just came today at 42 days. My cycles were in average 30 days so this delay is new to me. Could it be the Levothyroxine? I haven’t been doing anything else different than that. Hard to tell if is actually menopause related, thyroid or both.

    Ive been in keto/low carb since November and carnivore (just January) trying to get thyroid hormones back to normal without taking meds but it didn’t help much. Thats why the doctor recommended me to try Levothyroxine .25. I dont take any other pill, just supplements recommended in low carb lifestyles and some for thyroid like Zinc & Selenium and Ashagwanda, etc.

    As your book says, if I still have periods, I want to do everything I can to keep them coming as longer as I can. Any advice to make sure my periods keep coming and make sure it is not related to this med? Thanks, 🙂

    • the shift in your cycle could be the thyroid medication, perimenopause, or the carnivore diet. My guess would be the carnivore diet because of the timing — ie. with ovulation disruption, you count back 3 months to identify the disruptor. Which is not to say the diet would do that in everyone, because some women are fine. And I’m not anti-keto. I’ve just observed that a low-carb diet can disrupt periods (and cause hypothyroidism).

      Mainly in young women, but sometimes in older women, if they’re sensitive. See my blog post Have you lost your period to a low carb diet?

      ps. the main thing to know about your thyroid diagnosis is whether you have thyroid antibodies or not– see the thyroid section in Chapter 8.

  4. Hi Lara! I planned on including Ashwadandha as a daily remedy, however, yesterday I just read that Ashwagandha strongly promotes the production of male hormones. Is that true? Because I “suffer” from high male hormone values and I definitely don’t want them to increase them…

  5. Hi , thank you so much for your book I loved it!
    I’m currently TTC for the past 6 months
    My latest labs show TSH 2.75 and TPO antibodies of 200
    My Dr says this is all normal and shouldn’t affect me getting pregnant … would you say I should get a second opinion and do you think getting on medication could help me?

    • Hello, I am not a doctor or anyone in the medical community at all but my mom has Hashimotos and you might consider looking into the work of Izabella Wentz, a.k.a. the Thyroid Pharmacist. If I recall right, on her website she likes to see antibody levels below 35. She has a lot of information on her website and has written some books as well. She also suggests eliminating gluten and supplementing with selenium. I hope this is of some help!

  6. Hi Lara,
    quick question please 😊. I am a healthy 26 year however I have an under active thyroid currently taking Eltroxin 100mg daily. I was on the pill for almost 10 years. I had a copper coil inserted last April and have nerve looked back 🙌🏽💯. I am having very long cycles between 30 and 40 days. My prolactin level is normal and so are my androgen levels according to my GP. I have no intention of planning a family in the next couple of years but is there any actions I should be taking in the meantime to help resolve any issues that may arise down the line 🙈.

    • do you know if you’re ovulating with those cycles? Because a 35-day cycle is normal if it’s ovulatory.
      I discuss in Period Repair Manual

  7. Hi Lara,
    I just started taking the ashwagandha, and this naturopath told me “As for ashwagandha, it has some helpful properties, but also has some negative effects such as promoting serotonin and stimulating the cholinergic nerves, which when energy levels are low such as with hypothyroidism, can overstimulate and stress/kill the cells. You can see these findings on PubMed,” Can you shed some light? I don’t know why increasing seratonin would be a bad thing. I mean people are going to say something negative about every herb. But this made me anxious about taking it. I have hashimotos and a lot of anxiety/depression already so being told this didn’t help.

    I have 2 other questions. Can ashwagandha balance estrogen and progesterone? My pms and periods are terrible, and I find it ignites this terrible anxiety/depression that I now am having trouble getting rid of.
    Thanks for all that you do. And thanks for answering my last question.


  8. Hi Lara, How much Ashwagandha would you recommend ? Can a person take this on their own or should they take on the watch of a practitioner. I’ve read some info online regarding ashwagandha possibly causing heart issues in certain people. So I’d like to try, but I’m concerned about it’s safety. What’s your feedback, thanks so much, love your website.


  9. Hi Lara! I am halfway through the latest edit of your book and I just felt compelled to thank you for such great effort! I wish I had that knowledge at my fingertips a decade earlier, albeit I feel very lucky to come across it today. Thank you for sharing your wisdom with the world and please keep at it. Best, E

  10. Hypothyroid is hereditary in my family, but I had such awesome changes after I went paleo that I resisted taking levothyroxine after a nutritionist told me I’d have to take it for the rest of my life.

    I had PCOS but paleo resolved it, and in 2015 I started having irregular periods again. I went back to strict paleo, supplements, etc and nothing that worked before (including ovasitol) worked this time. I finally decided to go to one of the hormone clinics to check to see if all of the crazy things happening were perimenopause — and the blood test showed my thyroid was underactive, but not horribly so (which made me feel pretty good about the lasting results of my lifestyle changes).

    The doctor wanted me to take the levothyroxine and I told him I didn’t want to take that stuff, asking him instead for the Armour or some other option. (He actually got upset that I didn’t follow his advice to the letter — he couldn’t write a prescription for that anyway at the hormone clinic — I would have had to go to his office in order to get a prescription, which is actually what I think he wanted me to do! My cholesterol was high too, and I think he wanted me on the pharmaceutical train, which I refused.) Anyway, the hormone clinic sells the NatureThroid and it’s cheap. He prescribed 1/2 grain per day, which I also take with Vitamin C in hopes of lowering my cholesterol.

    Interestingly enough, my estrogen was normal but they didn’t measure progesterone (which I am writing in on my next blood test) but my testosterone was only 7. I had one pellet inserted for that and didn’t really notice any benefit from it. I think I will probably see a different doctor there for the thyroid issue, and get labs done every six or so months so that if something does get out of whack, I will know about it. I really don’t want to go through perimenopause or menopause feeling miserable.

  11. Hi Lara,
    Love the blog! I’m almost 30 and have always had irregular periods since I was 16. Started the CP at 20 which helped with onset of adult acne but body couldn’t handle the hormones at all (break through bleeding if I missed timing by ten minutes!). It also made me gain weight and depressed. Been off CP for 18 months now and still having trouble regulating, Testo is 0.1 too high, 25plus cysts both ovaries, only three cycles this year. Recently found out my TSH 4.47 and FT4 14.0 are both high but this has only occurred in last two years (prx TSH was 1.6). I am trying to work on the PCOS with diet, peony and licorice as well as magnesium but why would my TSH increase so significant so quickly?? Any suggestions would be great! Cheers Lou

    • Do you know if you are positive for thyroid antibodies? Autoimmune thyroid (the most common kind of thyroid disorder) can flare up quite quickly. I would say that treating that is priority for your periods.
      You also need to know if you have insulin resistance, or not?

  12. Dr. Lara, I’ve read that Hypothyroidism can result in low basal body temperatures. Would ovulation tracking using BBT still be accurate for such a scenario?

  13. Hi Lara, I’ve never missed a period until the most recent one. As per the blood-work I had an elevated TSH of 4.87 mIU/ml (This was always ~2.5 earlier) and elevated prolactin of 36.71 ng/ml. Should I stick to addressing my thyroid to ovulate again or also look at ovulation boosting herbs like Vitex? My LH isn’t elevated – 2.65 mIU/ml. Thanks!

    • Bot the high TSH and prolactin do suggest that your thyroid is underactive. Which may explain your new symptom of irregular periods. YEs, best to speak to someone about thyroid treatment

  14. Hi Lara,

    So do we want 0 thyroid antibodies?

    I had anti-thyroglobulin abs <20IU/mL
    Anti-thyroidal peroxidase abs 41U/mL

    There is hypothyroid in my family and I am having symptoms (hair loss, forehead acne, cold hands/feet, slight constipation etc) but also have gut problems too

    • No, thyroid antibodies do not need to be zero. A low level can be clinically insignificant. Or significant in the presence of symptoms

  15. Hello, I have a few questions. I got tested a year ago and my TSH was 7.43. The doctor did not want me to go on medication. 6 months later is dropped to 7.2, then 6 months later to normal at 0.43. My T3 & T4 are normal. I stopped taking BC 1 year ago when my TSH was out of range. I recently in the last month start taking iodine. My period for the last 2 x was irregular at 22 days then 30 days. I currently am 2 weeks later and was suppose to get it on 5/28 and its 6/16. I been having cramps like I was gonna get my period by had not. 2 days I had light brown blood but no period. I am afraid to test a preg test b/c I dont wanna baby right now b/c I am overweight at 168 which I should be 120-130.

  16. Hi Dr. Briden,

    I wish you were still practicing in Canada- I would book an appointment in a heartbeat. Two things:

    1- Thank you so much for writing the Period Repair Manual. I have read and re-read it and it is my period bible and I talk about it to all of my female friends.

    2- Would a thyroid disorder (which impedes menstruations) cause me to have the same symptoms as PCOS? (hair loss, hirsutism, acne on chin and neck, difficulty losing weight)?

    I had a blood test done recently:
    – ANA positive
    -TSH normal (therefore, they did not test for T3/T4/thyroid antibodies- they apparently only test these if there are irregularities with TSH)
    – LH normal
    -prolactin normal
    – testosterone low-normal
    – insulin/glucose normal

    My ultrasound also shows cysts, but as you mention in your book, that’s not uncommon…

    Thanks so much for taking the time to read this and for your thoughts!
    Warm hello from Canada!

  17. Hi Dr. Briden,

    What’s considered an irregular period? If it comes every 25-28 days, would you say that’s irregular? Thanks for your help!

  18. Hi Lara! First of all I loved your book the Period Repair Manual. I have been without a period for three years since going off the pill and have recently been diagnosed with hypothyroidism. I have been taking medication for about 5 months now and am anxious to get my period back. Any thoughts on what I can do to help it come back sooner besides take my meds? My levels are good. Last time they checked my TSH level was .92 and that was over three months ago. Thank you!

    • Now that your thyroid’s treated, your period should come back within 6 months or so. You might just need a bit more time. You’re not vegetarian or low-carb, are you?

      • No I’m neither. However I have dabbled with carb cycling in the past and was a heavy exerciser. I eat plenty fats, carbs etc now and am trying to moderate exercise. Thanks for your prompt response

  19. Thanks for this article. I’m currently trying to conceive and have been unsuccessful for the last six months. My RE ordered a blood panel and my TSH is 2.5 and antibodies are 283. I don’t feel like I have any symptoms of thyroid disease and my periods are very regular with some light spotting a week before my period is due. Is my antibody number something to be concerned with? My RE said she would be concerned if the number was much higher. She prescribed synthroid to help reduce the TSH number. I’m concerned that the antibodies might mean bigger problems down the road. Thoughts?

  20. I have been trying to help my daughter navigate the issues of PCOS…she was not having periods, estrogen and progesterone were extremely low, testerone and dhea was elevated, she was insulin resistant, hypothyroid and losing her hair. Her gyn just put her on the pill, but after a lot of research I knew that wasn’t the answer . She stopped the pill and started a regimen of Ovasitol (inositol supplement), saw palmetto, spiroloctone, magnesium, and stayed on levothyroxine. She responded quite well and had a bit of weight loss, is not currently insulin resistant, her hair loss slowed, skin cleared etc. The problem is now she is bleeding far too frequently, usually only has 5 to 10 days off and starts bleeding again. She had a Pap smear, which is normal and an ultrasound, doctor just says she has to go back on the Pill, but she really doesn’t want to go that route. Her TSH dropped too low so she went from 75mg to 50mg of levothyroxine. Is there anything else that could be causing her to bleed way too often now? Don’t know if she should take a lower dose of Ovasitol? Are there other gyn tests that should be run to be on the safe side? Thanks for any input

    • The overdose of thyroid hormone could have caused her frequent bleeding. It would take a cycle or two for that to sort itself out.

      • I agree – I’m going through that now. My TSH 4 months ago was 6.8 and my free T3 and free T4 were both towards the lower part of the normal range. I started on Naturethroid and have been building up my dosage as per the protocol on the Stop the Thyroid Madness website (and with my doctor’s consent), but an immediate effect it had on me was shortening my menstrual cycle to, like, 15-18 days. I just had my thyroid panel checked again and my TSH is down to 0.26 while my free T3 and free T4 are moving up into the upper part of the normal range.

        The Stop the Thyroid Madness book says that no matter how low the TSH goes, to stick with the protocol until hypothyroid symptoms subside, but if hyperthyroid symptoms occur, to back off the dosage a bit. Then let things settle. I got further confirmation to not panic over the now-low-TSH value from the J. of Family Practice, June 2006 issue which explains how very small increases in free T4 will signal the pituitary to throttle back sending out TSH, and this can happen when on thyroid hormones. Makes a lot of sense.

        As I understand it, you don’t want to stay that low (that is, with TSH that low) too long, but just long enough to build the free T3 and free T4 in the body and then stay at the maintenance dose of thyroid hormone needed to keep them there. I imagine that my menstrual cycle will settled down once I’m at that point. My doctor is aiming for my free T3 to be as close to the maximum of the normal range as possible and for my free T4 to be towards that end too. However, she will also do a urine thyroid test later to see how my free T3 and free T4 levels are there too, since blood levels of these hormones do not tell you what is actually getting into the cells. The urine test shows how much of the thyroid hormone is making it into the cells.

        • Hmmm. Well, I don’t agree with staying on an overdose of thyroid hormone if it’s to the point that it’s disrupted your ovulations and your periods. Perhaps the Stop the Thyroid Madness stuff is aimed more at post-menopausal women. Young women are different.

          • The Stop the Thyroid Madness (STTM) book and website are for women of all ages, and they do not mention this issue of shortened menstrual cycles – I learned about that upon reading up on hyperthyroid symptoms. What STTM advocates is dosing according to symptoms, not TSH value, since the latter is a poor and unreliable indicator of thyroid function. Their protocol involves increasing the natural desiccated thyroid (NDT) hormone until either (ideally) your hypothyroid symptoms subside or (less ideally) you begin to experience “hyper” thyroid symptoms (anxiousness, shakiness, sweating, rapid heart rate, etc.) and then back off a bit.

            Here is where I’m confused, because my hypothyroid symptoms, especially the low/limited energy and fatigue, weak muscles, poor mood, zero libido, dry skin, etc., have continued as I’ve increased my NDT dose, while the ONLY “hyper” thyroid symptom I’ve experienced so far has been – and this happened from the get-go…at the lowest 1/4 grain NDT dose – the suddenly shortened menstrual cycle.

            I am wondering if the pathways affected by the thyroid hormone are different for the sex hormones as compared to other organs (including the brain) that utilize the thyroid hormone, so that it may be possible that taking the thyroid hormone immediately over-activated the sex hormone response but the other sluggish pathways that affect my energy and mood require higher dosing and/or more time to improve/resolve?

            I am also bringing up my ferritin levels at present. I was losing my hair in gobs until I started to take iron supplements last May. My ferritin level came back at 55 ng/ml (15-150 reference range) recently, an improvement since being at 23 last May (8 months ago), and I’ve heard that women feel tired/fatigued if ferritin drops below 50, so I’m expecting to feel better any day now! My serum iron levels have been fine.

            There is clearly a dance between these various factors to get the right outcome. I appreciate your feedback and perspective to shed more light on how to proceed with thyroid hormone dosing in light of these conflicting outcomes (“hyper” periods while otherwise still having “hypo” thyroid symptoms). Thanks, Dr. Briden!

    • Common reasons for elevated reverse T3: insulin resistance, under-eating, low carb diets, stress, and other factors. The best treatment is to correct the underlying reason. Sometimes T3 is helpful.

  21. Is it a bad idea to take NAC, Alpha liopic, Inositol and Berberine (in recommended dose) together. as supplement ..can that be too much ?

  22. I know this is an old post but I’m hoping you can help me out. I have read your book and have slowly been getting better through the advice from your book and seeing a local naturopathic doctor. It wasn’t until seeing her that she informed me my thyroid was on the low side (TSH 3.14, t3 total 104 and t4 free 0.98) and that my progesterone is a little on the low side (5.59). I was getting my period every 28 days however after trying red clover supplement I missed a month and now get my period every 27 days.
    I was wondering if you ever heard of cranial sacral therapy for treatment for thyroid and pcos problems?

  23. Hi Lara, I was wondering if iodine and selenium can have a detoxing affect on your hormonal system causing frequent (2-3 weeks) periods? I had a really bad case of adrenaline fatigue and started to take a supplement with only 75mcg of iodine and a 100 of selenium, yet my otherwise normal periods (well, every 4 weeks but spotting for many days beforehand) turned into no- symptom pain free but frequent periods. Could this be a detoxing effect? Please let me know your thoughts. I stopped taking the supplement for now. Thanks so much!! (Btw, my daughter is Lara too!)

      • By the numbers, yes. But 8 years ago I was diagnosed with Hashimitos and after changing my diet at eating gluten free and clean it went back to normal. My periods have been regular in their own way- 3rd week alway spotting and 4th week period. Could this be an estrogen detox symptom? Shall I carry on taking it? Thank you Lara!

        • In theory, even a small dose of iodine could flare up thyroid antibodies, then therefore disrupt periods. If you were my patient, I would probably test thyroid antibodies and thyroid function again before continuing with iodine.

  24. Dr. Briden,

    Would you suggest starting selenium if you haven’t had your thyroid antibodies tested yet? I have read that selenium can lower them, which is great, but I want an accurate reading to know for sure if I have autoimmune thryoid. Also, is there a low dose 100 mcg soy and gluten free brand you like? Most come in 200mcg. Thank you for your help!

    • Low dose selenium is generally safe to take even if you don’t have thyroid antibodies. Sometimes I ask my patients to take the 200 every second day

  25. Dr lara,

    I could really really use your help! I was diagnosed with Hashimoto’s and hypothyroid (tsh 4.97) in august 2015. I was started on armour thyroid. I got pregnant 3 weeks later. I have been really struggling with acne. Ive always had acne but had it under control with antibiotics for years which im sure contributed to the autoimmune… but once i started the thyroid medication it got worse and even more cystic and severe once i increased my dosage in second trimester… i am at a loss of what to do. I have very very oily skin and acne has always been an issue but not usually cystic. I figure i have high testosterone bc of the oily skin. Not sure if you think i may have pcos… i was on the pill then mirena iud which caused terrible acne then the pill for a month again before going off of all birth control. I had my period every 32 days never skipping a month once stopping the pill. I did have one ovarian cyst rupture but doc said mirena has chance of causing a cyst. Other than that ovaries and all were normal and i ovulated each month no issues… could i still have pcos? Or is it possible to have high testosterone without pcos? How do you recommend treating the acne after i have the baby and am done breastfeeding next month? It is seriously depressing me and idk what to do. If the thyroid meds r causing my acne to be worse im even more scared and want to go off of them!!!

  26. Great post. I’d love your advice on my situation. Im 41 and My periods are not happening monthly. I’m very very irregular. This has been going on for several years. I have two children and had two healthy pregnancies. I am overweight and have been for at least 10 years, but recently lost 25 lbs. My GYN has me taking Provera several times a year to induce a period. I started spotting in late January 2016 and told my gyn doctor. She ordered an ultrasound and labs and my TSH is 2.8. She said everything is normal? She didn’t share the other lab values? I may need a endometrial biopsy if my endometrium doesn’t thin after my next period. Nectar I have a thick endometrium, I’m on Provera again to force a period. She mentioned I may have PCOS but I’m not convinced. I think the reason for missing periods is hypothyroidism? I’m seeing my primary doctor in a week for further lab testing. What labs should I request? Thanks so much!

    • Are you insulin-resistant? That is the most important question in your case. The test is “fasting insulin” or “HOMA-index IR” or “glucose tolerance test with insulin”.

      You may also have a thyroid issue, but TSH of 2.8 doesn’t look too bad.

    • I’m reading Leah Anderson’s post of February 20, 2016 and just want to highly recommend the Stop the Thyroid Madness book and website ( Thousands of mis-diagnosed and mis-treated patients compiled what they have learned. They recommend a thyroid panel and, in the presence of hypothyroid symptoms, if your free T3 and/or free T4 are in the middle to low end of the “normal” range, then hypothyroidism is likely. TSH is a poor indicator, as Dr. Briden has pointed out, and can be very low for a variety of reasons while the thyroid is struggling. If the thyroid isn’t working right, you also have to look at the whole train of endocrine organs, including the adrenals (note that high chronic stress results in the adrenals stealing progesterone in order to make cortisol which throws off the sex hormonal balance) and pancreas (hence the connection also to insulin resistance). The hypothalamus-pituitary-ovary axis (all endocrine organs) can become dis-regulated and throw off your menstrual cycle. It’s all rather complex, but you can get clues from hormone testing (saliva & blood tests) and keeping track of your symptoms with your cycle (such as it is).

  27. Hi, Lara
    Could you help me get a better idea of what to think of my condition. I’ve been diagnosed with subclinic hypothyroid a few years ago (it’s been rising from 3,5 up to 10, sometimes it’s 8 or 9, other times I saw a drop to 4,9 after a herbal fasting.. Antibodies are pretty low, as low as 38 (normal up to 115) and 13 (normal up to 34.
    free T3 is on lower of ‘normal’ 3 (2,38 to 4) and T4 is 1,25 (normal 0,8 to 2,10)
    So this does not look like Hashimoto and does not look autoimmune, does it? My weight is stable, I don’t feel weak but maybe just a little slow thinking, skin is and always was not so good, and gets better rather after menstruation, I guess I really am not ovulating most of the time but I only now understand how and why I’ll be checking that from now on.. as I managed to get pregnant just naturally one day (I am 33, it was the first time!) I am not on pills, but sex was not too often (libido – none, but that’s rather psychological matter I guess.. as there was never any, but anxiety where arousal should be)

    I lost that pregnancy at 12th week and seems it froze at 8 weeks. It might well be due to my subhypo condition which I was not paying much attention, esp since I got pregnant inspite of it, and havn’t heard any serious precautions from my therapist.. still.. this subhypo might well be the reason for a miscariage I guess.. and still I just hate the idea of synnthetic hormones (do they supresss the natural hormone production, in your oppinion? I heard million times it does and it’s a one way train more or less.. Do you think I should not even try get pregnant again unless I fix TTH, with synthetic hormones or any other way.. Do you know if I can rather stimulate it with acupuncture and homeopathic ‘drugs’? Again this is really confusing as there’re two opposite camps on this question.. From what I’ve read by now on your super useful site, is I should probably start taking selenium daily (I only had some in my natural pregnancy vitamins and none before that)..

    I’ll greatly appreciate any advice how to look at my condition and what is possible.
    Thank you so much in advance for your help and also for the great work you’re doing here (I am absolutely amazed with the work you also do in comments)

    Liubov (from Moscow (!) -)

    • Hi Liubov, With a TSH for 3.5-10 (!), I would call that clinical hypothyroidism. (Not subclinical.). It is almost certainly affecting your periods and your fertility.

      When my patients have a similar situation, I encourage them to take some form of thyroid replacement, and that could be desiccated thyroid or thyroxine (prescription thyroid hormone). Thyroxine is natural or “bioidentical” T4 hormone and can be very helpful. Sometimes T3 hormone is also necessary.

      It is possible to treat the thyroid naturally at the same time as taking thyroxine. That way, the day might come when you can come off it again. In answer to your question, yes, thyroxine does suppress thyroid to some extent, but that effect is usually reversible.

      • Hi and thank you so much for answering!
        Indeed it was subclinic when diagnosed, but also because I have no complains about energy levels or my weight, now there’s this serious matter of recent miscarriage added, but even for that I can’t be sure it’s caused by my hypo condition or rather chromosomal. Have you ever seen healthy pregnancies with hypo moms on no thyroxine? Or healing naturally without taking it? These are two very important questions for me, but your answer sounds a little like my condition is really serious and I’d better realize it and stop playing around with natural solutions, is that right?

        After reading your articles I figured first it could make sense for me to try add iodine, selenium and zinc for a couple of months to make sure it’s not plain defficiency manifesting
        I am confused – my T3 and T4 are within normal, antibodies are low.. hair, weight and skin pretty okay, I got pregnant in September just naturally… which must indicate I am not hopeless at all, so why then do this condition call for more T4?

        Thank you so much and if this is taking too much of your time, could I ask for a skype or mail consultation with you?

        Thanks again!

    • Liubov’s case is a classic example of hypothyroidism. Her TSH is high (a strong indicator) AND her free T3 and free T4 are both in the lower part of the normal range. Her free T3 was “3” in a range from 2.38-4, so the midpoint of that range is (2.38+4)/2 = 3.19. Her free T4 was “1.25” in a range from 0.8-2.1, so the midpoint of that range is (0.8 + 2.1)/2 = 1.45. For many women, they only find the clue in the free T3 and/or free T4 value, but in Liubov’s case, it’s very clear since her TSH is also high. I learned this from the Stop the Thyroid Madness book and website (

      Miscarriages are common if there is insufficient progesterone, and so the hypothyroid condition is a flag bringing attention to the poor health of the endocrine system, which includes the adrenals (which can steal progesterone to make cortisol to support the body’s needs) and other glands that regulate the female cycle. The Stop the Thyroid Madness book explains the additional testing that needs to be done to fully address hypothyroidism, which includes adrenal and hormone testing. Hope this may be helpful! I do appreciate your website and information, Dr. Briden! Thank you. I hope Liubov is doing better now!

  28. Hi Dr Lara,

    My PCOS symptoms have really ‘flared up’ over the several months and I’ve been desperately trying to get to the bottom of it. Living in the Middle East there is little regard for female health until you are trying to get pregnant so I really have to be my own advocate at finding the root of the cause (all I was offered was anti-androgenic BCP).

    Your book has been so empowering in allowing me to better understand my situation, and I am about to see my doctor to get full bloodwork done. Currently my symptoms include: polycystic ovaries, very light, irregular periods with spotting throughout my cycle; hirsutism; hair loss; anxiety & depression; sleep problems; oily face skin (which previously was so dry I have used medicated moisturizers my whole life). My doctor very quickly brushed me off in my last appointment when I said I suspected an underlying thyroid issue as an unrelated ultrasound last year showed that I have goitre, I have also lost about 6 ½ kg this last year (BMI 18.9 now) with no exercise and the same diet, my hair and nails are extremely dry and brittle, and I find it extremely hard to concentrate. Last year I had only had my TSH tested which was 1.69 miU/L, but I am now going to get a full Thyroid test as your book indicates.

    I guess my questions here are 1) Do you think my suspicions of hyperthyroidism are valid? 2) The above article makes the connection between Hypothyroidism but what are your thoughts on the role Hyperthyroidism plays in PCOS?

    I’d so appreciate your insight, thank you!

  29. Dear Laura,

    I doubt a doctor’s prescription. He quickly decided that I have the PCOS insulin resistance type because I guess it’s easier to automatically prescribe the Pill or a steroid treatment. however, he ignored the set you talked about: TSH of 2.8, cholesterol a bit above the normal and high prolactin. Interesting enough prolactin was high pre-ovulation, but then when tested on the 5th day of my cycle was normal. He didn’t take all these things into consideration… Secondly, I also wanted to ask you if with an insulin resistance test 94ml insulin at the 2nd hour was normal or indicates pre-diabetes.

  30. Hi Lara, I’ve recently discovered your blog and it’s a treasure for us women! You’re incredible because you try to answer to most comments. I’ve recently been trying to uncover the root cause of my recurrent acne (completely disapears between ovulation and the start of the period, and then skin gets really oily and spotty between the start of the period and ovulation – skin likes high progesterone?), heavy irregular periods (they stop and restart again for a bit more a couple of days later), and extremely low energy and mood swings.

    I’ve recently uncovered that I have Hashimoto’s and subclinical hypothyroidism.
    FT3 4.03 (4.00-8.30)
    FT4 14.79 (9.00-20.00)
    TSH 4.024 (0.27-4.70)
    Anti-Tg 28 (<4)
    Anti TPO normal
    As far as I understand, my problem is ft4 conversion to ft3. Also, only Anti-Tg is elevated, could this be indicative of iodine deficiency? I've never consumed iodized salt or seaweed in my life (until very revently). The skin patch test disappears in less than 5 minutes.

    I did a blood test to check cycle day 21 progesterone and estradiol:
    Estradiol 192.45 (43-180)
    Progesterone 19.90 (1.00-24)
    Could the ratio of 103 be a little too low and a slight estrogen dominance could be causing these issues? My mom had endometriosis and fibrocystic breasts. I took the pill for 10 years, quit 3 years ago and my health has been going downhill since.

    My vitamin D is 55, cholesterol is normal, I'm not anemic, fasting blood sugar is around 95. I don't eat gluten or cow dairy.

    For the last month I've been taking 320mg of iodine from kelp, 200mg selenium, 1-2g vitamin C, 25mg chelated zinc, and priobiotics. Am I on the right track?

    My theory is that the iodine deficiency caused estrogen dominance, which then started interfering with the t4 to t3 conversion. I also suspect high cortisol because I inherited weak adrenals from my mom, which would also interfere with the conversion. Would it make sense?

    I guess my main question is: does it look like an iodine deficiency and could it be the reason for elevated anti-Tg? Should I continue taking kelp?

    Thanks so much for reading, and I really hope you will reply. I'm a fellow blogger and I know how time consuming replying to everyone is, but if you help me out, I'd be over the moon. After being letdown by doctors a hundred times here in Europe, I'm trying to uncover it all on my own. Thank you!

    Vita xxx

        • Vita i have hashimotos and am subclinical hypothyroid as well… i think my thyroid meds are causing acne for me! Have you started on medication or no??

          • Amber, I didn’t start any medications because I actually managed to heal myself. I first took mastic gum to kill h. pylori and wild oregano oil and Saccharomyces Boulardii to kill candida, which completely sorted out my digestion. Next, I discovered I have pyroluria, which requires zinc, b6, and evening primrose oil supplementation. I also take b complex in addition to b6. These things have sorted me out completely. No more period ptoblems (no cramps or heavy periods anymore), no more depression or fatigue, I can exercise again, and my digestion is perfect. Thyroid issues were just a symptom of low zinc and b vitamins. Zinc is needed to convert FT4 to FT3 and also to produce stomach acid, that’s why I had gluten intolerance, h. pylori, and candida. I believe Pyroluria was the route cause of everything in my case. Good luck in your journey, don’t give up! P.S. Most acne is linked to low zinc and high copper. Pregnancy increases copper and lowers zinc. Please, please, please look into zinc supplements.

          • That is great! I have hasimotos with high antibodies but am working on my gut health as well to hopefully reverse it! I have candida, leaky gut, sibo, and bacterial overgrowths in my gut. No h pylori thank goodness. How long did it take you with this supplementation to get better and tsh to go within normal range??? Also, my doc recommended a b vitamin bc i am deficient but they cause me to breakout more so i cant take it.. i have done the zinc for the first part lf my pregnancy and it didnt help at all 🙁

          • Perhaps because you were taking prenatal multivitamins? They often have massive amounts of copper (4 times more than regular multivitamins), which would mean that zinc supplementation is useless. Zinc and copper are antagonists. There is an amazing book called “Why Am I Always So Tired?” about all of this. I can’t take anything with copper, it breaks me out and gives me anxiety and depression at the same time, plus have to be careful with copper in food. Also not all zinc is the same. A lot of it is formulated with copper, which is awful. Most women already have too much copper, especially after a pregnancy. Life Extension makes a great Optizinc without copper. Regarding b complex, I took a regular b complex in the past and it was rubbish. Now I take an enzymatic b complex, which basically has all the active forms of b vitamins and it’s amazing. Also regular b complex has folic acid, while what you need is folate. Country Life has the best enzymatic b complex ir seems. I haven’t tested my TSH yet, but judging by how I feel, it should be back to normal. It took me around a couple of months to recover completely once I found what exactly I needed.

          • I am not taking a prenatal because it made me sick and my acne terrible! I have been taking folate instead of folic acid and the b complex i have i believe is active forms my functional dr recommended… but still wary of breakouts! You sound knowledgable id love to talk with you more. Do you have an email or facebook we could talk on?

  31. Does this profile mean hypo or hyper?:

    Reverse T3 24 reference range 8-25 ng/dL

    Thyroid paroxidase antibodies <10 reference range 0.0-34.9 IU/ML

    TSH 3.88 reference range 0.35-4.94 uIU/ML

    Free T3 3.8 reference range 1.7-3.7 pg/mL

  32. What is the minimum dose of Ashwagandha to get results? Also, is it ok to use with a blend of Rhodiola rosea Root Extract, Eleuthero Root Extract, Schizandra Berry Extract, Licorice Root Extract?

  33. Doctor Lara I am not overweight at all I have the hirsutism around my chin area and breast area, I get acne on my chin and forehead, I am hypoglycemic and it gets worst before I start my period and sometimes after my cycle just for a couple of days. I get the sugar cravings only when I’m about to start . I am dairy free, gluten free and hardly ever eat sweats. I have bad mood swings, (almost suicidal) they go away when I start my cycle sometimes though. What testing should I do. I have your book but there is so much to cover and so many places that my symptoms fit in that I don’t know what to test for. I have been to so many naturopaths and they all give me different things and half of them never heard of PCOS very frustrating. I was on the pill and spirolactone for almost 12 years I have been off it for 2 years. I work out 4-5 times a week but don’t see results especially around my waist area. Please help guide me.
    I bought a saliva testing on ZRT and going to do it on the 21st. I am currently self-medicating myself I have gone to about 5 naturopath and this last one I went seems to be helping but then yet it has been only 3 days of taking food enzymes probiotic etc.
    I am currently on glutamine VITEX, magnesium (calm), saw palmetto, cod liver tablets, and dulce liquid for thyroid and waiting for my next supplements that she prescribed.
    I get hypoglycemia almost every day 2.5 hours after I eat, in the morning only and I read that in your book how your energy should be the highest in the morning.
    Please let me know if you can help so far you seem to be the only one that knows about PCOS which per and endocrinologist 10 years ago is what I have and prescribed me the pill and spirolactone which is a disgusting pill if you read up on it. Im am also getting hot flashes in the middle of the night.
    My biggest concern is my sugar dropping and my mood swings.
    I want to take DCI and I bought it but im so overwhelmed with so many things im taking.
    Please HELP!

  34. Hi Lara I know this is an old post but I will appreciate if u can answer to my question. I have some of the symptoms of hypothyroidism like high cholesterol and hair loss I also get my TSH test and it was 3.4. I bought ur book and I found it very helpful and you suggest ashwagandha for thyroid problems so Im thinking to start taking it but I have found some information on Internet that this plant increase testosterone levels and is used for male with low spearm count but as pcos suffer I already have testosterone high so you would still recommend it ? Thank you so much for your answer and for all the info u share with us.

  35. Hi Lara, thanks a lot for this post.
    I have Pcos and high TSH 3.8, and They definitely influence one another.
    I have done diet changing, exercise, taking supplements for almost 6 months, however, I didn’t see any changes on my period, technically still no period.
    Now this month my lh 9.22, fsh 6.38, Tsh 2.8 (by taking medicine), BIM 17.5 ( I tested IR, and seems I’m lean PCOS with IR)
    Do you think it is still possible for me to restore period? and I’m also doing acupuncture, is it good for me?
    I also bought your book, great book.

    • Is your BMI 17.5? That’s probably too low to get a period. You may need to re-introduce starch to your diet (if you’ve restricted it). Also, with a thyroid diagnosis, you should test for “thyroid antibodies” and “gluten antibodies” and perhaps treat to correct autoimmunity. Please see the Thyroid section in Chapter 10.

  36. Hi Lara! I’m really worried about this stuff… My mother had problems with her thyroid when she was a teenager. My sister has Hashimoto and takes Eutirox since her first pregnancy.
    On the other hand, I took the pill for nearly 5 years and suddenly stopped taking it because I bacame scared to develop blood clots (I was taking Yaz). Also my cholesterol were increasing (280) even with my super healthy vegan diet!
    That was on September 2014… By now I haven’t had any periods! My hair is falling and its super thin. That makes me so depressed! 8 months have passed, and still nothing.
    I’m starting to feel there is something wrong with my thyroid, but I don’t want to take any pills, I’m sick of medications!

    What can I do? 🙁

    Thank you for everything!

    • Probably best to speak with your doctor about some possible blood tests. Be sure to tell her about your family history of thyroid disease.
      Chapter 10 of my book includes a section: “How to speak to your doctor”.

  37. Hi, are there any potential problems with taking supplements to support thyroid (selenium, ashwagandha, iodine, etc) if there isn’t a thyroid issue? My tests are all normal (TSH 2.13, FreeT4 1.1, FreeT3 275), but I have many sx (cold extremities, bluish tint to hands and lips on occasion, extreme temp sensitivities, very dry skin, anxiety, brittle thinning hair, acne, high cholesterol despite eating well and weighing 110 lbs, mom has hypothyroidism)… many of which could possibly indicate a thyroid problem. So I am interested in trying something natural to see if it would help, but don’t want to mess anything up further if this issue isn’t actually thyroid related. Thanks!!

  38. Hi Lara! I know this is an older post and my question is very long, but I have a question about some symptoms im having and what you think, because even though this isn’t exactly a pregnancy post, I still need help.. because NO doctor I’ve been to will give me any help or answers.. Recently I’ve been diagnosed with hypothyroidism (TSH was 4.0) and PCOS (I’ve read your articles on both and how they can vary and how PCOS isnt a disease per se) but anyways, they told me my chances of pregnancy were not the best in the world due to that. My husband and want a baby, but we aren’t “not trying” or trying either, if you know what I mean. It’s okay with us either way right now but I’ve not been worried about it or thinking about it so I know it’s not all in my head because I mostly accepted that I wouldn’t be able to get pregnant until I got my problems under control due to how many things the thyroid and my blood sugar controls (I have hemacromatosis as well). The part that has me a bit concerned is that out of nowhere I started having VERY sharp pains in my breasts for about 4-5 days now, very intense hunger no matter how much I eat I seem to always be able to eat more. My period is 1 month and 8 days late and I have been exhausted. I stay exhausted no matter what. My skin has broken out with a lot of acne consistently for 4 weeks now, which normally ONLY happens 2-3 days before my expected period. This all started happening a bit over 3 weeks ago. More intense now and all very unpleasant. It seems like really REALLY awful PMS symptoms & like my thyroid problems increase by 1,000… but I’ve always had these symptoms (the PMS ones) for about 3 days then I have my period, even though it’s late, that part has never been wrong until now. I’m not able to see a doctor right now due to work and I lost my insurance (lost it as soon as I was supposed to get my medicine but they cut it off before I got any), so any real explanations would be greatly appreciated because doctor/test/hospital bills where I live are outrageous. I’m so confused and I just would like some insight as to what could be causing it all to get the painful for me and last this long and what I can do to help it, since you really seem helpful and to know what you’re talking about. Thank you so much!

    • If it helps you any with your answer, I’ve never been on birth control, I don’t do drugs, drink, etc. And I was wondering how will I ever be able to tell if I could be pregnant in the future because everything is so screwed up or if I am now? I’m not entirely sure what the symptoms im having mean or if they are even related to that. But again, thanks for reading and I hope to hear from you!

  39. Lara I know this is an old post but I’m really wondering about my thyroid function and what this post says concerns me. I have brittle hair, hair loss, fatigue, chronic constipation issues, no period since 2012 on the pill, (was on it 7 years) but I’m also very thin and have had a high level of stressful/trumatic events in the last two years. I have a family hx of thyroid dysfunction and in 2011 did have thyroid antibodies in one test I had. I had my thyroid looked at again recently as I feel i fit the picture and the GP said my Thyrotropin was 3.130 (and yes, that its not out till its above 4). The other thing is despite normal prolactin apparently I have for a long time had very tiny amount of colostrum that can be expressed from my breasts at different times. (I am a midwife though so this may be just knowing how and being clucky as iv heard other midwifes can do the same despite no children). I would really appreciate your input as I’m not familiar with these studies etc and would like to have a baby. thanks

  40. I was diagnosed with PCOS about 4 yrs ago after experiencing amenorrhea for about 6 months. I have also had recurrent miscarriages in that time – all pregnancies not lasting beyond 10 weeks.

    As expected, my thyroid has been checked a number of times; each time “they” say that it’s normal.

    In the last 10 yrs, I’ve completely lost the outer half of my eyebrows – which I’ve read is a sign/symptom of hypothyroidism….I have other symptoms as well, such as fatigue, thin/brittle nails, sluggish metabolism, etc. and it’s driving me crazy that I can’t medically “prove” that my thyroid is causing me problems, when I truly feel that it is.

    As for the PCOS, they did check many of my hormones on more than one occasion throughout the years – FSH, LH, Prolactin, Estrogen, Testosterone, etc. I can’t recall my lab values, but I do remember being told that my testosterone was elevated, which makes sense as I have been experiencing hirtuism (I’m practically growing a beard).

    I don’t believe that it’s been shown that I have insulin resistance, as I’ve always been told that my fasting glucose is normal as well. That said, I feel I have “issues” with blood sugar, in that I don’t seem to process sugars well, and often battle symptoms of low blood sugar (faint, cool, shaky)… there’s something not right with that, though I’m not sure exactly what’s going on. I also seem to react poorly to gluten and dairy (gut pain, bloating, gas, loose stools). I’m not sure if that is related.

    Do you have any advice on how to get doctors not only to take my concerns seriously, but to also orders tests that will actually find what’s wrong with me? I’ve been through 2 specialists, and 3 doctors – for example, each time I ask for a reverse T3, they say “we don’t do that”.

    And, are there other things I should be asking them to check?

    I appreciate your help.

    • The most important test is ‘thyroid antibodies’. If your doctor won’t order, then offer to pay for it privately (it’s usually less than $50 in Australia). You should also have a proper insulin test (insulin or glucose tolerance test with insulin). Finally, a tendency to low blood sugar can be a sign of adrenal (HPA axis) dysfunction (which also affects thyroid). All three problems (thyroid, insulin, and adrenal) could be coming from an underlying problem with gut health. If you react to gluten and dairy, then best to stop eating them. That could translate into real changes in your PCOS and hormone health.

      • Thank you so much for your reply! It’s wonderful to know what language to use with medical professionals – I’m sure that will help me take more control of my health.

        In addition to cutting those foods out of my diet (which I have been working toward doing), could you recommend supplements that I can research for help with treating/achieving/maintaining gut health?

  41. Thank you so much, Lara! Chelation is hard, but after six months of doing it, many of my symptoms have improved (numb extremities, insomnia, brain fog, crawling/itching scalp, extreme depression, etc.) Unfortunately, I’m always fighting yeast and bacterial infections, and now hypo-thyroidism. It’s a long road. We recently transferred ten hours away for work and I can’t find a doctor anywhere near us (remote location) that will do chelation, so I’m consulting with my doctor via the phone and will have to make the ten hour drive twice a year to see her. It’s encouraging to hear you say that mercury detox needs to be done. So many doctors dismiss it, or know nothing about it. Yes, I will probably need to space out the time between rounds to give my thyroid a break. Thank you, once a again.

      • Thanks for the response again, Lara. I’m actually doing the Cutler Protocol, which is low dose oral DMSA and ALA therapy. I started with oral nutritional therapy and it almost killed me. NAC and Cilantro mobilize mercury without having a strong enough bond to properly eliminate it. It works for those with lower levels of mercury, but for those of us who have been damaged with extreme amounts and have poor detox mechanisms, it’s deadly. I wish there was a better, more natural way, but I’m thankful that there is a drug that has actually provided a measure of long term relief. I would love to hear your take on what to do when you are a poor methylater with compromised detox pathways. As always, I learn so much from you. Thank you.

        • Hi Amber, I went to 11 specialists before I finally found a Dr. who could figure out what was going on. I had numb extremities, violent heart palpitations, night sweats, ringing ears, blurred vision, brain fog, horrible insomnia, crawling sensations in my scalp, heavy long periods and severe depression, etc. I was insulin resistant, had seriously low ferritin and dangerously high hemoglobin. My hematologist thought I had cancer and tested me for everything; she finally said,” you have signs of being poisoned” and sent me to the Dr. who asked me if I had had any exposure to mercury. I had recently had 4 old fillings replaced and the dentist didn’t use any precautions (no rubber dam, or suction, or ventilation) that is when my symptoms started. My doc. started me on low dose chelation therapy with DMSA and Alpha Lipoic Acid (the Cutler Protocol). I had immediate relief from many of the above symptoms…It’s a long process, though and my thyroid was affected by the mercury – maybe permanently. I’ve been doing chelation for 2 years now. My Doc. tests me by having me take about 100 mg. of DMSA and then collecting urine for 8 hours. My last test looked good for mercury, but my lead levels are now high. I would recommend finding a doc. who knows about chelation (not easy). If you google “cutler protocol” you’ll learn a lot about it also.

  42. Hi Lara,
    Thank you for your article on thyroid health. I suffer from many of the symptoms of PCOS and have been diagnosed insulin resistant, but, I’m not overweight and my free and total testosterone was below normal. I have been diagnosed with mercury toxicity and am on DMSA chelation therapy. I’ve had my thyroid antibodies tested and they were normal. My first TSH test came back at 3.5; the second test was 1.5. My reverse T3 was at the top of the charts, T4 was normal and T3 was below normal. My doctor started me on just 1/4 grain of Nature Throid, which helped immediately; my hair loss dropped in half, my hands and feet warmed up, I stopped retaining water, and I began to sleep again. I was elated, thinking that I’d found the answer, but the good effects only lasted about two weeks. I’m still taking the 1/4 grain, because I’m still better than before taking it, but it’s not doing what it did at first. My doc. retested me and my levels all look very good, so she doesn’t want me to take any more than 1/4 grain, but I still feel that my thyroid is not running like it should. Can the thyroid fluctuate wildly like my tests seem to show? Could I still require more thyroid hormone even though my levels seem normal? Could it be the mercury chelation that is causing the fluctuations? The only kind of chelator that I can handle without going crazy is DMSA. Could that be affecting my thyroid function? Thank you for your continued research into women’s health.

    • Short answer: yes, the mercury chelation could be causing your thyroid fluctuations. As mercury is mobilised (as part of the detoxification) it will suppress your thyroid and cause other symptoms.

      That said, the mercury detoxification needs to be done. Maybe talk to your doctor about doing it a bit more slowly.

  43. Hi Lara,
    Have you found it possible to have both PCOS and Hypothyroidism, or is it usually one or the other? You mention that Hypothyroidism increases risk for PCOS – if a woman were to develop PCOS from thyroid disease, should she then start treating herself just for PCOS? Some of these treatments are very similar to those for Type 1 PCOS, such as supplementing magnesium and selenium.

    I was diagnosed with PCOS through blood work, but never had my thyroid tested. I have very irregular periods as well as the tell-tale signs of PCOS (hirsutism, acne, body hair, skin tags, difficulty losing weight, and acanthosis nigricans.) I do have high cholesterol, though. This article made me wonder if I should have my thyroid tested in case I have both hypothyroidism and PCOS.
    Thank you for your time and knowledge!


    • Yes, it is absolutely possible to have both thyroid and PCOS. The link between autoimmune thyroid disease and PCOS has been researched, as shown in this research paper:
      High prevalence of chronic thyroiditis in patients with polycystic ovary syndrome.

      The researchers don’t say which comes first (thyroid or PCOS). It could be that both conditions come from an underlying inflammatory pattern (which is why similar anti-inflammatory treatments can help both type 1 PCOS and thyroid disease). Or it could be that thyroid disease contributes directly to the symptom picture of PCOS.

      The thing to understand about PCOS is that it is not a disease, per se. It is a set of symptoms that signal the existence of deeper, underlying metabolic problems. In many cases, one of those underlying metabolic problem is Thyroid disease.

      (BTW. great comment Jessica. Thank you for your help in allowing me to explain it more clearly. I love reader questions and feedback)

      • Thank you so much! What an eye opener.

        What are your thoughts on DCI (d-Chiro-inositol) as a treatment for PCOS / Thyroid symptoms? Here is a recent study on its effect for irregular periods:

        My endocrinologist had not heard of it, so I took the initiative to try Chiral Balance’s DCI for 4 months, and low and behold, I had a period all 4 of those months – my first time ever having consecutive periods. Of course, I have also bettered my lifestyle over the last year. The DCI became expensive to maintain since results only last if it is taken every day, twice a day. So, I am now trying your suggestions of supplementing Magnesium, Selenomethione, zinc, and occasionally B6 without any DCI. No periods yet, but it has only been 2 months.

        If I were to bite the bullet and continue taking DCI, would it be safe to combine it with your suggested supplements?

        Thank you,

        • Hi Jessica,
          thanks for sharing those studies. I have seen some of the research for d-chiro inositol (DCI) and myo-inositol, and it is very impressive. Yes, by all means keep taking it. The only reason that I have not yet listed it as a treatment is that I have not yet had a chance to prescribe it very much (it’s just become available in Australia). I am prescribing it more now, and will include a section about it in my upcoming book.

          Inositol works as an ‘insulin-sensitizer’. In that sense, it will work best when insulin resistance is the underlying cause of PCOS or irregular periods.

          • I have been taking a combo d-chiro inositol/myositol supplement twice a day for just over a month and have noticed an improvement in some symptoms, along with some new ones. I know you say that you have to give it three months, but I can’t find anything to explain why the new symptoms are showing up.

            I bought your book and have been charting my cycle, but now I am noticing some other symptoms that weren’t there before I started taking the d-chiro. When I first starting having problems, I would have a normal period, which would stop as normal, and then spotting would begin a few days later. I would spot all the way until ovulation and then it would stop until my next period started.

            Now, I notice a clear watery discharge for a couple of days around ovulation, and then this month I started having another type of spotting (pinkish brown) after the watery discharge ends, also around ovulation.

            I cannot find anything that explains what is happening, except for maybe I am super-ovulatory now after the supplement!

            I sleep really well and I am doing all of the above (after reading your book!) to supplement for the thyroid problems, as I have a history of problems on a blood test and a family history of major problems. My hair is growing like crazy and I don’t feel that worn out, so I think I am in a good place there — I turned 40 last summer and I can’t tell if this is perimenopause or just something else going on. I want to fix it myself if I can, as I know the doctors will just want to push hormonal contraception instead of looking deeper.

            Do you have any insight into the watery discharge and spotting around ovulation? Thank you for your time!

          • Does your “watery discharge” have the consistency of fertile mucus? (like raw egg white)? If so, then both the discharge and the mid-cycle spotting are good signs that you are ovulating more strongly than before. Your post-period spotting (from before) might have been a sign of an anovulatory (or non-ovulation) cycle.

            It’s probably worth getting a proper thyroid check (“thyroid antibodies” blood test).

          • Dr. Laura, I am not sure if this will show up beneath your comment above. Thank you for your insight. The consistency is watery, no egg white texture. I saw it last month a week after I began taking the supplement, but it was a few days after the watery discharge ended.

            I suspect that stress has something to do with the spotting around ovulation. The first half of my cycle was pretty stressful. I have only been on the supplement for about a month, so I want to give it some more time. The thyroid test is a good idea. Thanks again!

          • Hi again to all — this is just to update you all that all the issues with my cycle have returned to normal this month after taking the combo supplement! (It took two cycles, in case you’re wondering.)

            BTW — I hope it’s OK to post this info — the supplement I am taking is called Ovasitol and is made by Theralogix. I bought it from the PCOS Nutrition Center for about $85 for a three month supply. If you don’t buy it from an affiliate it’s more expensive, at least right now.

            Also — since I started taking the supplements for thyroid in Dr. Briden’s book (I think it’s the iodine and selenium combo) my thyroid seems to be back in balance and my hair is growing like crazy. Thank you Dr. Briden and I hope this info helps!

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