Endocrine Abstracts

Introduction: There is a significant overlap of symptoms between polycystic ovary syndrome (PCOS) and thyroid disease, despite the fact that they are two different diseases. Both diseases individually affect a woman’s metabolic parameters and fertility, and their association makes them much more difficult to manage.

Objective: To investigate the effect of elevated thyroid stimulating hormone (TSH) concentrations on metabolic and endocrine parameters in women with PCOS. Analysis of the correction of TSH values and insulin resistance (IR) on pregnancy using levothyroxine with myo-inositol and d- hiro- inositol.

Methods: Examines between 25 and 35 years of age, diagnosed with PCOS were divided into 2 groups: women (n=50) with Hashimoto’s thyroiditis, with TSH ≤6 mIU/l and regular thyroid hormone levels who did not conceive and women (n=50) without elevated serum TSH. Each exminee underwent hormonal analyses during the early follicular phase, glucose and insulin on an empty stomach for 30,60 and 120 minutes during an oral load test with 75 g glucose, body mass index, transvaginal ovarian ultrasound. The lipid profile was checked and homeostatic model assessment (HOMA). Women with PCOS and elevated TSH were divided into two groups (n = 25). One group took levothyroxine 0.25 g and myoinositol plus d chiro inositol for 6 months, and the other group (n=25) levothyroxine 0.25 mg. Both groups adhered to the same diet with exercise 3 times a week for 30 minutes. After 6 months, the same hormonal, biochemical analyses were checked.

Results: In women with elevated TSH and PCOS, the lipid profile and HOMA were significantly impaired compared to the control group (P<0,01)There was no statistical difference in androgen and prolactin concentrations between examines. In women with PCOS and elevated TSH after taking levothyroxine and myo-inositol, d-chiro -inositol combination therapy, there was a statistically significant correction of TSH, anti TPO, HOMA and pregnancy in relation (44:24%) in correlation with women who used only levothyroxine. In both groups of patients, there was a statistically significant correction of the lipid profile.

Conclusion: Hashimoto’s disease in the range of subclinical hypothyroidism in combination with PCOS has a negative impact on the metabolic profile. Combination therapy of myo-inositol, D-chiro-inositol and levothyroxine has shown a significant effect on fertility rate and pregnancy by promoting insulin sensitivity and improving thyroid function. In women diagnosed with PCOS, especially those who want to become pregnant, it is necessary to examine the function of the thyroid gland at the first visit to the endocrinologist. Keywords:polycystic ovary syndrome, Hashimoto’s thyroiditis