The PCOS-Thyroid Link Explained with Dr. Erica Armstrong

I sat down and read it , even though I you know my attention span is like this these days . This book gripped me . I told her before we started recording . I was genuinely so impressed with this book , with the amount of detail , even just as a resource for PCOS Take the thyroid piece out of it . It's a great resource for PCOS .

So I will have a link in the description or the show notes . So if you guys want to take a look at this book I know it's on Amazon and stuff like that , so highly highly recommend . But we're going to talk a little bit about it soon . Erica , would you introduce yourself to us ? Tell us a little bit about you .

So we put the whole picture together , connect the body systems and figure out what actually is driving disease so that we can reverse it and optimize health . So we specialize in PCOS , thyroid , gut health , hormone balance and autoimmune conditions and other things , but those are the top things that we treat .

So I'm anxious to kind of get your expertise on how that works , what the connection is and maybe some things that our audience can implement now . So can you explain a little bit about PCOS and thyroid issues and kind of how they connect or what the overlaps are there ?

That's an autoimmune condition where your thyroid is being attacked and then unable to produce enough thyroid hormone over time , and so one study actually showed that Hashimoto's was present in 23% of women with PCOS almost a quarter of women with PCOS . So it's really important , if you have PCOS , to have thyroid on your radar for screening .

So there's a lot of ways that these conditions overlap , but the largest one , especially that we see in our functional medicine practice , is that they share root causes , and so in our practice we have the doctor and the dietician working together , putting the whole story together , figuring out root causes and utilizing advanced lab testing as well as the conventional

testing , which includes full thyroid panels for everyone with PCOS , and so that is how we were able to figure out over time that , hey , these conditions are popping up all the time and they're sharing root causes , and we've actually diagnosed a lot of thyroid disease when there has been previous PCOS or diagnosed both of them together .

Because of this , we feel that it's important for everyone with PCOS to have a full thyroid panel as part of their yearly health maintenance and then , if symptoms warrant it . So , um , there's several root causes , um , why these conditions occur together . Um , I wrote about this in my book and broke it down by chapter of you know the most common root causes .

Thank , thank you . So the biggest root cause is inflammation , which is usually coming from the gut , because that's where the majority of the immune system lies and it's .

Some other root causes are adrenal health , nutrient deficiencies or insulin resistance , but that's why it's important to also work with a functional medicine team , so that you can work with someone with advanced training in these root causes , like gut health and microbiome balance or adrenal testing , and so we can put the whole picture together .

The other root cause I didn't mention was mitochondrial health and mitochondria you may remember as a powerhouse of the cell . It's the energy producing part of the cell .

Each egg in the ovary has almost 600,000 mitochondria in it to produce enough energy for ovulation to occur , and so that is why taking care of the mitochondria are very important , so that you ovulate . Then , after ovulation , comes the natural period . So that is the synopsis of the root cause .

And speaking of mitochondrial health , shout out to we did a podcast . It was published . Well , let's see when this one comes out . Look back to January . But we did a podcast on PCOS and mitochondrial health , which might be interesting to you if that really resonated with you . So , yes , I am fascinated . Okay , so we know that this occurs a lot .

We know that there's a lot of connections here . What I'm curious about are let's say , you have PCOS , because this is a functional PCOS podcast , right ? So everyone listening probably has PCOS . So if you suspect that you might also have thyroid issues , what are some signs of that ?

I know that a lot of the symptoms , like irregular periods and things like that , can overlap , but what are some of the thyroid specific signs that we should look for to ask for more testing ?

Insulin resistance is actually found in both conditions . It's well documented with PCOS but not as commonly known with hypothyroidism . But thyroid hormone affects how your cells break down sugar and how well your cells can take up sugar and insulin into the into the cell . So that can affect your energy .

Both cause weight gain or the inability to lose weight and both can cause hair loss . So it is so fun , yeah , yeah , to differentiate what might , what might be going on . But I would say , if , if you're not improving with basic PCOS guidance , or you know your labs are looking great but you're still having symptoms , it's time to dig deeper .

Or , like I mentioned earlier , like I think , at least once a year have a full thyroid panel . I know we'll probably talk more about you know how to get that done .

And what we're looking for in functional medicine , functional nutrition , is a much smaller range , which I believe in your book you go up to 2.5 , right For TSH . So conventional med is usually like up to four and they don't worry .

So I see a lot of people who are like three right , and you know they're kind of hanging out in that like subclinical hypothyroidism range where they're not getting appropriate treatment . But perhaps if they had a full panel you could really kind of see what's going on with . Let's tell our audience what is a full panel .

You could really kind of see what's going on . Let's tell our audience what is a full panel , what things would be tested for .

And then thyroid antibodies , in particular the Hashimoto's antibodies , which are TPO . So those four are . You're going to get your your best bang for your buck on those four tests .

almost seems like it just doesn't do that much or it doesn't really help that much , because Hashimoto's is , you know , autoimmune in nature and there's that inflammation connection and so if we're not treating that root cause , you know , you're just kind of throwing thyroid hormone and it might help a little , but it doesn't usually kind of treat the root .

Really key in on the gut health and try to stop the production of thyroid antibodies .

If there's any kind of autoimmunity , I usually see that there's some sort of food allergy or severe food sensitivity at play , because that's part of where that inflammation from the gut is coming from and it's kind of a little bit of a chicken or an egg situation . The food sensitivity there first and then that kind of made the gut you know all that stuff .

Or was it the other way around ? Probably that , but nevertheless , you've got that going on . You're going to have to do something about it in order for you to really actually make progress . So I agree , I'm a fan of the approach . This leads into our next kind of topic .

So there are some diet recommendations for PCOS that personally , I stay away from in my practice , but they are common and so some people may have tried them . Things like super low carb diets , keto carnivore diet I've seen um well , I've seen a lot of people also talk about like dangers of eating too many cruciferous vegetables and stuff because of the goitrogens .

So are there any commonly recommended nutrition practices or diets or whatever for PCOS that you don't like , for you know these two things together

don't like , for you know these two things together ?

Whether or not you have insulin resistant type PCOS or not , even at the adrenal PCOS , balancing the blood sugar is going to be step one , and it's also important for thyroid , since it can affect both things .

So , and then we want to replace the important nutrients , so especially magnesium , zinc , b vitamins these are all been found to be much lower in women with PCOS and then omega-3s for inflammation and coenzyme Q10

, as we were talking about that mitochondria . That is the first nutrient that starts the energy production , and so it's very important for ovulation . And then , like we were just talking about , screening for celiac or gluten sensitivity , especially if you have thyroid disease or Hashimoto's antibodies Celiac is actually five times more likely in people with Hashimoto's .

So then we would personalize that advice whether or not gluten should be avoided . And then eating for gut health , so increasing fiber as tolerated and that diversity of phytonutrients . So , that is the way we approach nutrition at Root . A couple of things about the cruciferous veggies you mentioned .

Um , you would have to eat a ton of cruciferous veggies to be worried about a goitrogen , which means it can lead to a goiter or like a thyroid nodule . Um , but I think the benefits of cruciferous veggies far outweigh any potential theoretical harm , because they're anti-inflammatory , they're detoxifying , especially for estrogens . They're fiber-filled , blood sugar balancing .

So if you want to further reduce your risk , you can just cook them , which will break down those compounds .

And that's also that's one reason why it's key that our gut , you know , is balanced and that we have the right balance of bacteria in there , and then we eat to support those with fiber , like you mentioned , because all those excessive estrogens can cause a lot of issues . So cruciferous veggies are pretty amazing . Do not avoid them .

Now , I could see like a potential if somebody was like chugging , I don't know , broccoli sprout powder or something like maybe , but it's just , it's kind of like this thing that I see . I see a lot of people really villainizing different parts of food .

You know like lectins or you know things like that , and it's just , I think we get , we lose the plot a bit with all of this stuff with nutrition .

I think sometimes when you know too much about nutrition , you start to kind of like dig down a little bit too much and kind of I don't know , you villainize , you start villainizing stuff when the reality is that look at what the majority of people are eating on a day-to-day basis , right , and how could we make this a more whole foods diet ?

How can we make this more appropriate ? It's like we really don't need to worry about all of this other stuff . One thing I do want to talk to you about is a common complaint that I get from clients , which is that they know about full thyroid panels .

They know about the connection between PCOS and thyroid issues , they've done their research right and they struggle to get the testing . I sometimes have people go in with a list of labs and , by the way , in the book you have a great list of labs to ask for , which are all things that I would ask myself .

So the issue is not the knowledge base or having the resources to know what to ask for . It's getting their requests met . So they go to the doctor and the doctor's like you don't need that , or that's not medically necessary , whatever . So any advice for those situations ?

But let me give you a couple of key points from the doctor's perspective why they're hesitant . So the number one reason is that they'll order this test and then insurance won't cover them and the patient will get a large bill and they'll end up mad at the doctor .

After that happens to you a few times and people are real mad at you , you kind of put up your guard like I'm not sure if I should order this because you're going to get a bill , sometimes like over a thousand dollars . So that happens .

And then the second big reason they won't order it is they don't have any time outside of the visit to review it , and so if you have a lot of labs that's piling up in their inbox , they're only paid for the time they spend in the visit .

Okay , so , knowing that from my previous history , the way to ask is to tell them that or to actually try to figure out the cost of labs through your insurance before you ask for them , tell them you're aware it might not be covered and you're okay with an out-of-pocket bill if you are so that's a really good tip .

You know she's talked a lot about the perspective being on the conventional side , because we tend to sometimes more alternative people get , they tend to really villainize you know , conventional medical and the system has issues , don't get me wrong , but it's . It's usually not the practitioner's fault , well , not always the practitioner's fault .

A lot of people go into conventional medicine with , you know , big hearts . They want to help , they want to do what they can , and then they're kind of like chained to the system that they can't really fix from the inside .

There are direct ordering websites out there that you could use it . You know , if you're saying , hey , I can get this , can I follow up with you with the results ?

But if you don't know how to interpret them , then but that's where , if you're able to , a functional medicine practitioner is so nice to have on your team . I know it's not feasible for everyone the way that things currently are , but If you can manage it it is really really helpful .

Let me ask you this actually so what inspired you to start work really focusing on PCOS and thyroid Was ? it just that you saw it so often .

I was literally that doctor who told you your labs are normal , I don't know what's going on or you can be referred to this specialist . They ended up with colonoscopies . They were normal and they would end up back in my lap and I would be like I want to help you . I feel like we're missing something here . I feel like there is something driving this .

Woman after woman can't keep saying this to me . I hear you , I believe you , and I had to go to functional medicine and figure out how to approach this differently , with a completely different mindset and a completely different model of care .

And the more I learned , the more it made sense and I started putting a little bit of that into my family practice within the limitations that I could , and the results that I was getting were so much better than I had in years and I was like , okay , there's something to this , it really works .

I need more time with people , I need restrictions lifted , I need to be able to order the tests I want . I got to do this on my own , so I jumped ship and started root about six years ago with a dietician , because nutrition is core to functional medicine .

And there , as we were able to do this advanced testing , we were diagnosing so much PCOS , which is completely on under diagnosed , as well as thyroid and , and diagnosing them together . And it was like it was just clicking and um , we were . We were getting women to have regular periods .

Within two or three months , they were getting pregnant after even failing IVF , and the results were so uplifting that it just became my passion , like , okay , we do have answers , you know they're , they're feeling better and they're achieving their goals and and I need to share this with the world so I'm let's put it in a book I love that .

I didn't want anybody else to have to experience that . But it's so frustrating to be within certain confines . You know , even in like the dietetic world , right , there are some confines with like what we would traditionally recommend for PCOS , for example , and it just didn't ring true for me .

It was so frustrating to kind of run up against these walls and then when you finally discover like , okay , this is how the system works , this is the body systems , right , this is how it's all connected , and then you start , you know , being able to kind of like figure out where things are going wrong and make changes .

It's such a wonderful feeling and it's so empowering . I love getting like pictures of , you know , ultrasounds and all that stuff . It's such a nice , it's just so such a one .

80 from from the previous experience , right , so , um , I love that and I think that that passion is is , um , what's really nice and it's really important , and I and we need more people doing this kind of work .

I love that you're really honing in and specializing on this like particular topic too , because I think , um , at least from my experience , you know , I started out more broadly looking at like functional nutrition Right , and as I kind of went along , I just kind of got more and more specialized because I think there's just so much to be said just about this

particular issue , right , like you wrote a whole book about it , like there's so much , um , we need people who like really really are thinking thoughtfully about these conditions and everything . So , anyway , I think it's really cool . So , um , speaking of the book , tell us about this lovely book that I have read , that I really like .

It helps you figure out what yours might be and then it gives you steps that you can actually do to start to reverse those root causes . Um and so it does include even some uh blood sugar balancing recipes and a supplement schedule , a list of labs that you should have . Um and um . Yeah , I mean it's . It's a great place to get started , um for anyone .

And then , if you do decide you need more personalization or more testing , that's when you know people reach out directly to people like you and us at Root .

The book is nice too because you know you and I both know functional work can be a little bit the sticker price can be a little bit tough for people at the beginning and I think , long-term most of us kind of come around to realize that your health is worth investing in and it plays out later with cost savings down the road .

But at the beginning it might be nice to have a resource like this where you can really read and learn and implement some strategies and actually see in your own body like , oh yeah , this is working or there is something to this .

And then if you get stuck or you know you can't , um , can't , dive deeper on your own , then you can , you know , reach out and work with somebody . But , um , yeah , I really like it's very step-by-step . The first actually the majority of the book I would say is like just it's really deep conscious information about the connection between these things .

So I , like I said I will have that linked in the show notes . Um , but if we want to find you , where can we find you ? Where are you online ?