In this episode of PCOS Unfiltered: Nourish, Heal, Thrive, I sit down once again with Dr. Anya Szigeti, functional medicine practitioner and author, to uncover the overlooked connection between PCOS and Hashimoto’s thyroiditis. We dive deep into why these two conditions often coexist, the root causes that fuel them, and the subtle symptoms many women miss. Dr. Anya breaks down the most important labs and functional tests to request, the impact of gut health, inflammation, and stress on hormones, and how lifestyle and nutrition interventions can begin to restore balance. She also shares her personal healing journey from severe thyroid dysfunction to reclaiming her health through functional medicine. This conversation will empower you with the knowledge and tools to advocate for yourself, ask the right questions, and take actionable steps toward healing.
In this episode, we cover:
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*Website: www.backtohealthfunctionalmedicine.com
*Appointment Booking: https://backtohealthfunctionalmedicine.janeapp.com/
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*Holistic Hashimoto’s Healing Community on Skool
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*FB https://www.facebook.com/theszigetimethod
Key Takeaway:
Your body is always talking to you. Symptoms are not random—they are messages that something needs attention. With the right testing, support, and lifestyle shifts, healing from PCOS, Hashimoto’s, or both is possible.
(0:02 - 2:01) Welcome back to PCOS unfiltered, nourish, heal, thrive. The show where we cut through the noise and get real about reclaiming your health from the inside out. I'm your host, Lindsie, and today's episode is one you don't want to miss. We're diving deep into a powerful and often overlooked connection, the link between PCOS and Hashimoto's thyroiditis. My guest, Dr. Anya Szigeti, is back to break down the science, the symptoms, and the root causes that tie these two conditions together. We'll cover why they often coexist, the subtle signs you might be missing, what tests you should really be asking your doctor for, and how a functional medicine approach can help you feel like yourself again. If you've ever been told your labs are normal, but you know something is still off, this conversation will empower you to dig deeper and advocate for your health. As always, the content shared on PCOS unfiltered is for informational and educational purposes only. The views and opinions expressed by the host and guests are not intended to serve as medical advice. Always consult with a qualified healthcare professional before making any changes to your diet, exercise, or treatment plan. The information shared is based on personal experience and expert interviews and is not a substitute for professional medical guidance. Now let's get started. So what are the most important labs or functional tests that you run when someone presents with PCOS symptoms? So as I mentioned, I have my foundational labs, my functional labs. And when for every woman patient that comes to me, I run a full thyroid panel because it is just so common, unfortunately, for women and the undiagnosed piece of autoimmune thyroid is so disappointing. So I make sure I run that.
(2:01 - 2:18) I actually run comprehensive metabolic testing on all my patients as well. So that's fasting insulin, hemoglobin A1c, and the CMP, which includes fasting glucose. So that way I can get a good picture of insulin resistance, blood sugar management, all those pieces.
(2:19 - 4:44) I often run many different inflammatory markers like CRP, as I mentioned, and then may run ESR and homocysteine, just depending on the individual. With PCOS, I definitely want to look at gut health. And so I have a comprehensive diagnostic stool analysis that I love. It's probably one of my favorite tests that really gives us a lot of information as to what's going on in the gut because the gut is the foundation of our health. And if that's off, then literally everything else is going to be off. And I use food as medicine as one of my major weapons in my practice, one of my major tools. And so if you're not able to digest and absorb your nutrients, we have to start there. That's for everybody. That's PCOS, that's Hashimoto's, that's everybody across the board. And so then I definitely want to have a look at the hormone levels and make sure that they're tested properly. So the sex hormone levels. So this is another gripe with some testing that's done, not in my practice. And patients will bring me their results and they'll say, oh, I got my sex hormones done through blood work. And I'm like, okay, great. What day of your cycle did you have it done? And they have no idea. So if you're a cycling female, those tests are worthless because we cycle and our hormones fluctuate all throughout the month. So if you don't know what day you had that blood work drawn of your cycle, we don't know what the reference range is. We don't know what it should be. So that's a huge piece right there. And then I also look at sex hormones through the urine, which is a completely different way for most of the sex hormones. There's a few that I'll look at in the blood, but that will give us the entire biochemical pathway. So we can see the levels of each. We can see, do you have enough of the precursors to even make the hormones that we're looking at? We're looking at estrogen, testosterone, DHEA, all those fun ones. How are you metabolizing those? How are you detoxifying those? Because all of those pieces are so important to your health, how you feel, your symptomology, and then later disease progression as well. Yeah, that's where I love. I love the functional medicine aspect because you're focusing on the cause there. Yeah, you're really getting down to the root of what's going on.
(4:45 - 5:02) Are there any red flags in hormone or thyroid labs that tell you there's a deeper immune component at play? Yeah. So for sure, if I see any antibodies, that's a huge red flag for me. So that's the TPO or the thyroid globulin antibodies.
(5:02 - 7:39) I run reverse T3. So T3 is the active form. But if we have too high of a reverse T3, that's letting me know that there's poor hormone conversion, which is likely due to chronic stress, inflammation, infections type of thing. And then if you have a low free T3, that's a mouthful, and T4 level. So the thyroid hormone levels, if those are low, even if you have a normal TSH, then again, we might have some conversion issues. So it's not a cookie cutter, you know, get a text message, your labs are normal, like you'll never get that from me. There's definitely patterns and imbalances that really give us a lot of information. And then we can pinpoint a plan of action customized to you and your specific imbalances to move forward, which is the awesome with functional medicine. Yeah, well, and that's where like, I'm again, I mentioned it in my first few episodes about insulin resistance, but there's kind of the normal level. And then there's the optimal level, which I know is a lot of what you focus on as well. Yeah, yeah, yeah, for sure. So if your lab gets flagged by the lab, your level gets flagged by the like, you know, we're going to work on it. But then I run it through my own metrics, which is a much narrower range, because I'm looking at optimal function, not just like the critical lab, you know, levels on either end of the spectrum. Yeah, for sure. So how does your approach change when a client has both PCOS and Hashimoto's? Well, the interesting thing with this is that my approach with each client is unique, regardless of what their diagnosis is. So I look at the whole person, I look at their entire health history, I look at, you know, where are they today. And, you know, I can speak for myself and say that I'm in a much different place right now in life than I was two years ago, five years ago, 10 years ago, 15 years ago. And so there are different factors that I was working on with my own health five years ago, that have shifted. And so now I'm working on different things, because we're all a beautiful work in progress. And so each person is going to have an area that is more of a higher priority, I will say that more imbalanced, more out of, out of the range, higher symptomology, more disruption in their life, an area that could potentially cause more issues if it goes unattended for a longer period of time. And so we kind of do like a triage.
(7:40 - 14:18) And we look at, you know, what are the most important, the most relevant that are going to have the biggest impact on your health. And let's start there first. And let's look at your nutrition. Let's look at your lifestyle. Let's look at your stress. How are you sleeping? Let's look at all these different pieces of the puzzle, and pull together what we can optimize from those and start to create a nice balancing day for you to help balance your hormones from the moment you wake up all the way through your sleep. Look at all the different pieces, because there's so many things that we're doing on a day, you know, in a moment to moment basis that are either balancing our hormones or completely throwing them out of whack that we could be modifying, and can have a cumulative effect as we do it every single day and build those habits. Yeah, yeah. I mean, and I know that personally, we've had to kind of attack one thing, one ish thing at a time. And then once we kind of get that, you know, under control, we kind of, you know, check back a little bit. But yeah, and then we move on to the next thing, kind of like set a little triage there. So what are some dietary or lifestyle interventions that benefit both conditions? Yes. So one of the biggest is blood sugar balance, blood sugar stabilization, becoming resilient with our blood sugar levels. So really focusing on whole foods. I don't even like the word diet, but whole food nutrition. And just keeping it simple, making sure you're getting your proteins, your healthy fats, your colorful foods and your fiber, those will help with both conditions. And included in that is anti inflammatory. So cutting out the stuff that doesn't serve your body right now, the things that are very, very challenging for the body to digest and process and trigger inflammation. So if we can cut out, you know, ultra processed foods, I don't want to call them foods, ultra processed products, gluten is a challenging one, I'm actually doing a four part series in my holistic Hashimoto's healing community on gluten, because it is there's so many different levels of gluten issues, that we're taking four, you know, four separate sessions to break it all down. Dairy is another one that is challenging, and can be very inflammatory for both conditions. And so those are things to at least consider removing for a period of time to see how your body does, because a lot of them just, they're not serving you. And then looking at that healing pieces of the puzzle. So you know, after we do the gut testing, we can see exactly which types of probiotic strains would be ideal for you, because you don't want to just throw a bunch of probiotics in because that can cause a whole bunch of other issues. And then we need to support some leaky gut strategies with bone broth, and there's a whole host of gut soothing nutrients that can help repair the leaky gut. And then stress reduction, if that's, you know, needed, which I think most of us need some of that anyway, looking at mindfulness, sleep hygiene, movement, removing our bodies in a way that's supporting our bodies versus doing more harm. I know for myself, back when I was working on fostering my autoimmune condition, I was doing ultra marathons and Ironman triathlons, which are definitely not recommended for that type of condition, because I was just burning my thyroid out even more. And then, you know, if needed, some targeted supplementation. And so supplementation is an area that I always want to say supplement with caution, because as we were talking before we started recording is that there's a lot of companies out there, there's a lot of marketing dollars spent, and you have to be very careful with what you're putting in your body. This is food, this is supplements, this is personal care products, because we're putting that in and on our bodies as well. This is what we're watching on social media, watching on the news, what we're listening to the people that we're surrounding ourselves with, all of that affects your health. So looking at all those pieces of the puzzle. Yeah, for sure. My backup for just a second too, because you mentioned the diet thing. And that's Yeah, that's a huge like, unfortunately, we should be able to refer to our diet as what we eat. But it's become the norm that when you say diet, people just think you're on something doing something crazy. Or temporary. Yeah, it's temporary. Exactly. So yeah, again, just going back to making a lifestyle, you know, and you even mentioned about removing some of those things. I know I even tell my clients, sometimes add in before you even remove because mentally, again, that kind of helps you. We we a lot of times find that we have connections to some of these foods. Maybe maybe you guys used to do pasta night with the family. And that's just like that tie to that connection to your family members or whatever. And so it's hard to give that up when you think about it that way. So even just sometimes adding in just to flood your body with those vitamins and minerals that it needs kind of makes it easier than to eventually detach from some of those other things that aren't serving you. And so yeah, is there a particular order in which you recommend addressing these conditions? Or do you treat them simultaneously? I, again, it depends. But I definitely need to make sure that we're getting like the the triage ones attended to first. So typically, that's blood sugar inflammation. And then looking at the gut. Because again, we want to make sure that we're able to absorb our nutrients and we're balancing out any infections and healing any permeability issues. Then I would say the immune system balancing. So the stress piece, I think is a big one there. And then actually, ironically, balancing out the hormones is kind of the I would say the last phase. But if we don't have the blood sugar balanced, and we don't have inflammation calm, and we don't have the gut lined up in the immune system responding properly, then it doesn't matter what we do with the hormones because they're still going to be so out of balance because those are much more of the root causes of the hormonal imbalances. Yeah, yeah. I was gonna say by tackling all that other stuff, you're already starting to fix. Oh, yes. The stuff that you kind of tackle last. Yeah, for sure. Exactly.
(14:19 - 16:56) So how do stress and emotional health play a role in autoimmune conditions and hormone imbalance? So chronic stress is going to affect our HPA axis and cause it to be dysfunctional. So this results in cortisol imbalances, and that's going to negatively affect the T4 inactive thyroid hormone to T3 active thyroid hormone conversion. It raises insulin, and it fuels inflammation. And so all of that creates the perfect storm for PCOS and Hashimoto's. And when I say chronic stress, it doesn't just mean the stress we think about like, I'm not stressed. No. Most of us are emotionally stressed. And we don't even realize it. It's the unconscious stress that's actually much worse. Because that's happening. All of us. But that's happening all the time, a lot of the time behind the scenes, and things you can do to calm yourself is hold your dog. So if you see a little nose peeking up, this is my emotional support animal. I figured I'd introduce him since he was introducing himself. But on top of that, when we are stressed, it's going to exacerbate all these symptoms we've been talking about. So fatigue, like when you're stressed, oh my gosh, you're I feel like so much more tired. My mood is not good. And then then it disrupts my sleep too. And so it's been all overlap and have this domino effect. So understanding, you know, number one, having the awareness that this is happening, and it's having an effect on your health is super important, because then you can have ownership over it. Because you're like, oh, I can actually do something about this. And it's causing an issue for my, the way I'm feeling and what's happening with my life. So it's, it's, it's empowering in a way. Yeah. And I feel like women too, we, we keep it in, in general, probably more than more than men. Yeah, which just doesn't help. I know, it's been that's been a journey for me, for sure. I mean, from, again, thinking back way back when, but my nursing days and, and just stuff that was going on in my life, especially at the time. And then to running the gym. And yes, I was stressed, but then internally, how much I just kept in as well. And so I've definitely still learning. Yeah, definitely. Yeah, a long way. (16:57 - 20:33) Yeah, from that, you know, internalizing versus just finding those outlets. And a lot of times for me, it's movement, you know, exercise, just any type of movement, but just learning how to deal with that better, for sure. Yes. And what role does trauma or long term stress have in the So actually at my functional medicine conference earlier this year, we dove into early childhood trauma, adverse childhood experiences. And there is a test that you can take. It's 10 questions and you get one point for each. Yes. On there. And the presenter was sharing that he has all his new patients fill it out before he meets with them. And he knows right off the bat, if they're four, they're going to be a challenge. And if they're above a seven, it's going to be almost impossible to help them. Like it is mind blowing the amount of trauma and how much that plays into our health. And the correlation is so strong with different types of imbalances and autoimmune diseases. It's triggering the HPA axis overdrive, immune system dysregulation, increased gut permeability, and all those will set the stage for PCOS later, for Hashimoto's later, for all these other conditions, unfortunately. So knowing that, but knowing that there are amazing science-based techniques that really help like systematic therapy, EMDR, these can completely help to rewire the nervous system and the brain pathology or patterning. I myself have used hypnotherapy and it has had amazing, amazing impacts on my healing journey. And so, you know, I love the fact that a lot more information is coming out about it now, but it's a thing. So if you've had traumatic experiences in your childhood or your past, even if you don't consciously correlate them to your health now, they need to be processed because those unprocessed unresolved traumas are almost like a cancer festering inside and your body is going to react to that. And it's going to present in whichever area is kind of like your weak link. So for me, it was my thyroid. It wasn't, but my thyroid is dysfunctional as my body was attacking my thyroid. That was my weak link. And so someone with PCOS, their weak link might be therapy. It's like, everyone's going to have a weak link in their body, unfortunately. And if we don't take the steps to process and heal from traumas, then that can be negatively affected. Yeah. Yeah. That's one thing I've learned. And even before I really kind of like dove deep into the PCOS side, but even just in general, working with a lot of women with, you know, having them to get them to lose weight. And yeah, there's always something deeper there that I've learned. I mean, we could go down a rabbit hole with that. I am going to have a guest on that's going to talk about that somewhere actually. But yeah, I mean, these traumas definitely play a role in some, some, I feel like you may not even really know about, like you may not, there might be some type of memory, but I know for me, there was some stuff that came out.
(20:33 - 21:18) Yeah. During one of my, my hypnotherapy sessions and yeah, but it really did. It really helped me process at all. Yeah. Yeah. Incredible. Powerful. What would you say to a woman who has been told that her labs are normal, but she knows something still feels off? And we've kind of talked about this along the way, but what would you say? I would say that your body is right. Your body is telling the truth. You just haven't had the proper testing level or the testing done. Cause like, for example, with thyroid, which is a lot of the work that I do, they're coming in with a TSH and they're like, oh, my thyroid labs are fine. I'm like, okay, but what did they run? Cause you need to look at the full picture.
(21:19 - 21:43) We need to see how your thyroid's functioning. We need to look at your inflammation, your insulin, your stress, your gut function to really understand what's going on. And your body knows, your body is very smart. And the symptoms that it's sharing with you are secret messages saying it needs attention. And if you ignore them, they're going to just turn the volume up. I know this from experience.
(21:47 - 22:12) Listen, yes. Yes. That's, that's, I mean, that's a great way to put it. It's true. It really is. Because again, like I said, looking back, yep. Ignoring this stuff until I finally couldn't ignore it. Uh, so what are some questions women should be asking their doctors if they suspect they may have both PCOS and Hashimoto's? Yes. So asking them to run the detailed testing.
(22:12 - 23:53) So that's looking at, um, free T3, free T4, reverse T3, um, the thyroid antibody tests, TPO and thyroid globulin in addition to TSH, which is an important test, but not by itself. Um, looking at the fasting insulin, glucose, hemoglobin A1C, which unfortunately insulin, hemoglobin A1C, most doctors only run if you have a history of diabetes, which again, blows my mind because if we can learn about it earlier with most of these conditions, we can do a lot of things to, um, prevent the progression of the condition. So very important to know where you are and then, um, and if they can do one inflammatory marker, like CRP, um, vitamin D level is very, very important. And then I have yet to see a conventionally trained doctor run the diagnostic stool test, but I would love if they could, um, or even the Dutch test, which looks at cortisol function and the sex hormones through the urine. Um, so those, even the basic blood work ones that I mentioned first with the thyroid and the metabolic function, those will at least give you some insight, at least answer some questions and help to provide you with some information as to what's going on with your health. Um, and then if they won't run it, then maybe it's time to find a new practitioner. Yeah, for sure. Uh, do you believe it's possible to heal or reverse the symptoms of these conditions through functional approaches? I am a living proof that it's possible. Um, and so just a quick snapshot about my experience.
(23:53 - 32:01) So we, if we talk about just one test, the TPO antibody test, so that's thyroid peroxidase antibody. So that's one of the diagnostic tests for Hashimoto's thyroiditis, the reference range, the optimal reference range for that is less than nine. My levels were over a thousand, like the lab just said greater than a thousand. Wow. And unfortunately my doctor was like, well, your TSH is still fine. So we'll just wait until it gets worse and your thyroid just stops functioning and then we'll just give you hormone. So I fired her basically and got a, was able to find a functional doctor, a holistic functional doctor who helped me without medication through lifestyle and dietary modification. And we, we dove into many of the areas that we've talked about today. Um, and I was able to eliminate the majority of my life altering and annoying symptoms. Like exhaustion was one of the worst ones for me. And I've witnessed many of my patients do the same. So yes, there's hope holistic healing is possible. Um, but it's critical that first step, like you need to figure out what's going on and then format a customized plan to address it. So women have been able to restore ovulation, balance their cycles, reduce their antibodies, lose the weight, clear the brain fog, regardless of what, you know, major symptom is affecting your life. There's so much that you can do to help to balance that out, but you have to figure out where you are and then format a plan to bring your body back into balance. Yeah. I mean, yeah, I think, and that's what's brought both of us back here, you know, I mean, cause I'm the same way, right. I was on the brink of an autoimmune condition. I had symptoms that were definitely affecting my life. Uh, I wasn't full blown, but I was definitely probably not too much longer and I would have been right there. And, um, yeah, and I've reversed all of those things, you know, and, and yes, there's, I still think about my health is my priority now. Um, and that's also what's led me here doing what I do. And I know same thing for you as well. So you can spread the word and share and help these help, help women realize that you can heal again. You're not restricted by this diagnosis at all, no matter what it is, whether it's PCOS or Hashimoto's or anything else. Like I do truly believe that you can heal and maybe, maybe it's not a hundred percent, but you can feel so, so much better. You can do a lot more for yourself. Yes, absolutely. So wrapping up, uh, what's one myth you wish more people understood about either PCOS or Hashimoto's. Well, kind of with the, the theme of what we're talking about today is that these conditions can coexist one, so must, uh, busting that myth. Um, but then pushing on the, like the weight loss is just a matter of willpower and that you need to just exercise more and eat less where you're just lazy. Like, that's not true. Like there are things that are off in your body. Your body knows best. There are imbalances and your body is asking for help and asking for someone to dive in and investigate what's going on. So I just, I really would love for people to know that piece. And then of course, just echoing what we were just talking about, that there's so much that we can do to heal the body and bring the body back into balance holistically through lifestyle, through dietary modifications. Um, and you can feel better and you can, you know, achieve whatever fill in the blank, uh, health goal is that you would like, regardless of what, um, ICD-10 code you're given, which is a diagnostic code, which very often people just get labeled with and sent on their way. Yeah. Yeah. I love that you brought up the weight loss piece there because yeah, I feel like back in the day, sure. You could tell people probably, you know, eat less, move more, but it's just not like that anymore. Our bodies, the gut microbiome gets passed down, right? Especially like during, we haven't even really talked about this, but, and you know more, but, but through a vaginal birth, right? You get a lot of that, um, the gut microbiome from your mother. I know before I got into nursing, I was seeing such a trend in C-section, the rise in C-sections. And a lot of times it was for convenience, convenience for the woman, for the doctor, but they're missing out on that key piece there. So, so just biologically we've changed as a, as generation, you know, generation after generation, I think. And so that simple eat less, move more, you know, calories in versus calories out just doesn't work like that anymore because there've been so many other contributing factors now. And that's where even some of the traumas, I feel like play a role, a role in that as well. Um, and so it's just not that easy. And that's where you have to look at definitely the big, big picture. Yes, for sure. Where can listeners go to learn more about this connection or get the right kind of support? Well, I do my best at educating on social media. I think you talked about this last time. I'm, I'm, it's a work in progress with me. I'm, I'm trying. Um, and I do have a bestselling book that has, you know, is a great guide to get started and it has over a hundred blood sugar balancing delicious recipes in it to help support, um, hormones across the board. And I host a holistic Hashimoto's healing community with live sessions, focused on healing and supporting each other along our journey. So if someone does have Hashimoto's, um, definitely reach out and I can provide information on that. And if you are struggling and you want real answers and you want to discuss the testing that we've talked about or the symptoms that you're having, I do offer free consults. Um, so we can just have a conversation and see if we're a good fit to work together and I can share how I practice medicine. You can share what's going on with you and just, um, just have a conversation and get some clarity as to what's going on. So I do have that available as well. Awesome. Such a great conversation. Lots of good stuff covered. Um, I always love our conversations. But yeah, and this, uh, if you have not heard, um, Dr. Anya's full story, then be sure to check out the other episodes where she was a guest as well. And, um, yeah, if, uh, you know, if you're struggling at all, please feel free to reach out to her. I'll also put the info here, all of your info in the show notes as well. So people will have the direct links there, but again, thank you. Thank you so much. And I'll see you next time. That's a wrap on today's deep dive into the PCOS Hashimoto's connection. Huge thanks to Dr. Anya Szigeti for sharing her expertise, personal journey and actionable steps we can all take to get to the root cause of these conditions. I hope you're walking away with a better understanding of how intertwined our hormones, immune system, gut health and stress truly are and how much power you have to support your own healing. If you'd like to connect with Dr. Anya, check the show notes for her social media links, her bestselling book details on her holistic Hashimoto's healing community and how to book a free consultation with her. And if this episode resonated with you, please share it with another woman who needs to hear that she can feel better no matter her diagnosis. Until next time, remember your body is talking to you, your symptoms are sending you messages and all you need to do is listen and know that you have the power to take the next step toward balance and healing.