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Are women with Polycystic Ovary Syndrome more likely to have autoimmune thyroiditis if they are obese?

moderate confidence  ·  Last reviewed May 11, 2026

Autoimmune thyroiditis (AIT) is a condition where the immune system attacks the thyroid gland, often leading to hypothyroidism. In women with Polycystic Ovary Syndrome (PCOS), the risk of AIT appears to be higher if they are also obese. A large retrospective study of 1,249 women with PCOS found that obesity was linked to a significantly increased prevalence of AIT, suggesting that weight status may play a role in autoimmune risk in PCOS.

What the research says

A 2023 retrospective cohort study of 1,249 women with PCOS (aged 18–44) found that the overall prevalence of autoimmune thyroiditis was 20.3%, similar to rates in other European countries 4. However, when the researchers compared obese versus non-obese women with PCOS, the prevalence of AIT was significantly higher in the obese group: 23.6% versus 18.6% (p = 0.045) 4. This difference was not explained by the specific PCOS phenotype (the pattern of symptoms), meaning obesity itself appeared to be an independent factor associated with higher AIT risk 4. The study also noted that 13.45% of all PCOS women had subclinical or overt hypothyroidism, and 1% had hyperthyroidism 4. These findings suggest that obesity may amplify autoimmune susceptibility in PCOS, though the exact mechanisms are not fully understood. Other research has linked PCOS with chronic low-grade inflammation and insulin resistance 210, which could contribute to autoimmune processes, but direct evidence connecting these pathways to AIT in obese PCOS women is still limited.

What to ask your doctor

  • Should I be screened for autoimmune thyroiditis given my PCOS diagnosis and weight status?
  • What are the signs and symptoms of thyroid problems I should watch for?
  • If I have autoimmune thyroiditis, what treatment options are available that are safe with PCOS?
  • Could weight management or lifestyle changes help reduce my risk of thyroid autoimmunity?
  • How often should my thyroid function be checked if I have PCOS and am overweight?

This question is drawn from common patient questions about OB/GYN & Women's Health and answered using cited medical research. We do not provide individualized advice.