Many women visit to their dietitians when they are looking for help to lose their weight or reverse type 2 diabetes. But mostly dont know that almost all the symptoms of a common female condition called Polycystic Ovarian Syndrome (PCOS) respond very well to a low-carb or ketogenic diet, too?
“Cutting carbohydrates to less than 20 total grams and boosting fat to 75 per cent of the diet rapidly restores periods, increases fertility, and greatly improves distressing symptoms like acne and weight gain,” says Dr. Michael Fox, a fertility specialist at the Jacksonville Center for Reproductive Medicine in Florida. Dr. Fox answers our members’ questions about using low-carb and keto diet to improve reproductive and metabolic issues.
The Lifestyle Factors That Cause PCOS
It is possible to prevent PCOS (or keep it from getting worse) by avoiding these things:
- High-carbohydrate foods
- Excess calorie consumption
- Chronic stress
- Inappropriate level of physical activity, whether too high or too low
- Exposure to endocrine-disrupting chemicals (e.g., Bisphenol A, 4-methylbenzylidene, Methylparaben, Nicotine, Sodium Fluoride, PBDEs/PCBs, and Perchlorate )
- Having a high percentage of body fat (being overweight or obese)
- Having a low percentage of body fat due to unhealthy calorie restriction
Each one of these factors contributes to PCOS in some way. High carbohydrate foods, excess calorie consumption, and inactivity increase insulin levels and insulin resistance. Chronic stress, over-exercising, and having a low body fat percentage increases cortisol levels, creating more insulin resistance.
The least obvious contributors to PCOS are endocrine-disrupting chemicals. These chemicals can cause hormonal imbalances that lead to PCOS, so it is important to avoid consuming them or putting them on your skin.
However, it is important to realize that avoiding these seven contributors to PCOS may not completely reverse the disorder. To get the best results, we need to follow a diet that addresses the underlying causes of PCOS.
Is There a PCOS Diet?
- The scientific literature on diets for PCOS is sparse. However, the researchers of a treatment review suggest that PCOS women will do best by eating complex carbohydrates and avoiding sugar. This suggestion was confirmed in one study on the effects of low-glycemic index diet on women with PCOS, but the results are unimpressive when compared to a similar study that was done on the ketogenic diet.
- In this study, five overweight women ate a ketogenic diet (20 grams of carbohydrates or less per day) for 24 weeks. The results were astounding — average weight loss was 12%, free testosterone decreased by 22%, and fasting insulin levels dropped by 54%. What’s even more impressive is that two of the women became pregnant despite previous infertility problems.
- This provides us with preliminary evidence that the ketogenic diet may be effective in treating PCOS. However, this finding is not surprising.
- Ketogenic diets have been shown in many different groups of people, from healthy subjects to type 2 diabetic patients, to improve insulin levels and reduce insulin resistance — two things that would also help women with PCOS. Ketogenic diets also produce rapid weight loss, which is essential for improving fertility in obese women with PCOS.
- However, there is one important caveat with women and the ketogenic diet. The restriction of carbohydrates on the ketogenic diet may increase stress levels and contribute to insulin resistance. This is why it is important to follow the ketogenic diet, with minor variations if needed.
The New And Improved PCOS Diet
A simple ketogenic diet can help many women reverse their PCOS. For some women, however, carbohydrate restriction may cause excess stress and keep them from getting results. This is why it is important to follow these guidelines to create the right PCOS diet for you:
Restrict Carbohydrates: We recommend starting with below 35g total carbs per day. If this makes symptoms worse after a couple of weeks, then increase your carbohydrate consumption by 5-10 grams per day until you find a sweet spot where you have energy and feel better. From your new carbohydrate intake level, try reducing your intake by 5-10 grams per day to increase your ketone levels and fat burning capacity.
Eat High-Fiber Vegetables With Every Meal: High-fiber vegetables, like broccoli, kale, and spinach, can help combat insulin resistance and reduce inflammation. Have them with every meal for best results.
Eat The Right Amount of Protein: Use different mobile apps to find out what your daily protein intake should be.
Eat Enough Calories to Achieve Your Ideal Weight: Use different mobile apps to estimate your ideal daily calorie intake. If you have an unhealthily low body fat percentage, then make sure you are eating more calories than you need to maintain your weight. If you are overweight or obese, then you need to maintain a calorie deficit to lose weight.
The Lifestyle That Helps Reverse PCOS
Combining a vegetable-rich ketogenic diet with exercise, sleep, and meditation is one of the most efficient ways to reverse PCOS.
Exercise: What kind of exercise should you do? It’s up to you. Many different types of exercise have been found to help women with PCOS, including:
Resistance Training: In a 4-week study, performing resistance training three times a week led to lower androgen and sex-hormone binding globulin levels, weight loss, and increased muscle mass in women with PCOS.
Aerobic Exercise: Aerobic exercise has been shown to help lower inflammation, reduce insulin resistance, promote weight loss, and improve reproductive function in women with PCOS. In one study, 56% of women with amenorrhea who performed aerobic exercise for 12 weeks began menstruating again. These results are pretty amazing, and only aerobic exercise is to blame.
Yoga: Based on research in adolescents with PCOS, practicing yoga seems to improve reproductive hormone levels, insulin resistance, and cardiovascular disease risk factors. It also helps reduce stress levels and enhance the quality of life.
No matter what type of activity you choose to do, PCOS researchers recommend getting at least 30 minutes of low to moderate intensity exercises, like yoga, cycling, or a brisk walk, every day. (Add in resistance training, three days a week, for even better results.)
Another important thing you need to prioritize is stress reduction. The more stressed you are, the more insulin resistant your cells will be. This will cause an increase in insulin levels and PCOS symptoms.
Sleep: The most efficient way to reduce stress levels is with sleep. However, quality sleep is harder to come by for most women with PCOS. In a review published in Human Reproduction, researchers found that “sleep disturbances were twice as common in women with PCOS compared with those without,” and women with PCOS especially had difficulty falling asleep.
The good news for women with PCOS is that the sleep disturbances will most likely be cleared up by the diet and lifestyle adjustments suggested in this article. However, if getting 7-9 hours of restful sleep is still an issue, then meditation will help tremendously.
Meditation: Studies have shown that meditation lowers cortisol levels and improves blood sugar biomarkers, which leads to a reduction in insulin resistance and insulin secretion. Meditating 30 minutes before you plan on going to sleep is a great way to improve sleep quality and reduce stress at the same time.
Reasons to Follow Keto/Low Carb Diet
- Keto diet may improve insulin resistance and glucose intolerance
- Numerous studies are now showing adopting the low-carb ketogenic diet improves insulin sensitivity and glucose intolerance among those with PCOS.
- One of the upsetting features of PCOS is a higher tendency to acne that arises not only in adolescence but persists into adulthood. In recent years, numerous studies have shown reducing the glycemic load (i.e cutting out carbohydrates that rapidly convert to sugar) greatly improves acne, whether people have PCOS or not.
- Low-carb ketogenic experts report that anxiety and depression lift among their patients adopting a low-carb ketogenic diet.
The combination of the ketogenic diet, exercise, quality sleep, and meditation addresses one of the main causes of PCOS (insulin resistance) in many ways. The ketogenic diet limits the most potent stimulator of insulin secretion — carbohydrates. Exercise makes the cells more sensitive to insulin and improves body composition and hormonal levels. Quality sleep and meditation lower cortisol levels, improving insulin sensitivity and quality of life.
Simple breakdown of the ideal PCOS diet and lifestyle:
- Restrict carbohydrates
- Eat high-fiber, low-carbohydrate vegetables with each meal
- Eat the right amount of protein every day
- Eat enough calories to achieve your ideal weight
- Exercise for at least 30 minutes every day
- Meditate every night before sleep
- Make sure you are getting 7-9 hours of sleep every night
- If you need further help with reversing PCOS, consider using some natural supplements.
Natural Supplements That Help With PCOS
There are plenty of supplements that can help reverse PCOS is many different ways, from reducing testosterone levels to improving insulin resistance.
- Flax seeds are known to increase sex-hormone binding globulin levels and reduce androgen and insulin levels, making it an ideal supplement for women with PCOS.
- A recent meta-analysis of 45 randomized placebo-controlled trials on flax seed supplementation also found that flax seeds help people lose weight and inches off the waist. They achieved this result with a daily dose of ~2.5 tablespoons of whole flax seeds.
- Many high-quality studies suggest that cinnamon helps reduce insulin resistance and restore ovarian function in women with PCOS.
- To get these benefits, ½ to 1 teaspoon per day is all you need. Blend the cinnamon into your flax seed butter, and add some nuts for even more of a health boost.
- Nuts are a healthy addition to any diet (as long as you are not allergic to them). Walnuts and almonds, in particular, have the most beneficial effect on women with PCOS. For example, walnuts increase sex hormone-binding globulin, while almonds decrease free androgen levels.
- This means that these nuts address the cause of many PCOS symptoms. The next dietary supplement on this list, however, gets to the underlying cause of PCOS — insulin resistance.
- This compound is found in herbs like goldenseal, barberry, and Oregon grape root, and it has been used in Chinese medicine for centuries to treat a variety of health conditions.
- In one impressive study, berberine was found to reduce insulin resistance as effectively as metformin, a medication frequently prescribed for PCOS. Berberine also led to slightly more weight and belly fat loss, a greater increase in sex-hormone binding globulin levels, and lower levels of free testosterone than an equivalent dosage of metformin. In other words, this natural compound is more effective than one of the most popularly prescribed PCOS medications.
- The recommended dose for berberine is 500 mg taken 2-3 times per day.
- Something else to consider is taking it with milk thistle or coconut oil. Milk thistle and capric acid (a fatty acid in coconut oil) may increase the absorption of berberine.
Apple Cider Vinegar:
- Apple cider vinegar has been shown to increase insulin sensitivity in several studies, including a trial in women with PCOS. In this trial, seven women with PCOS took one tablespoon of apple cider vinegar per day. After 40 days, 4 of the women resumed ovulating, 6 experienced a measurable reduction in insulin resistance, and 5 had a decrease in their LH/FSH ratio (this indicates less androgen production).
- For best results, consume 1-2 tablespoons per day. However, this doesn’t mean you have to take shots of pure vinegar. Use apple cider vinegar as the vinegar for your salad dressings and sauces instead.
- Magnesium deficiencies are the second most common deficiency in developed countries. Magnesium is important for women with PCOS because magnesium deficiency reduces insulin sensitivity and increases nerve excitability, leading to more stress, more tension, and more PCOS symptoms.
- When it comes to magnesium supplements, magnesium citrate is most popular. It’s well absorbed but may have a mild laxative effect in some sensitive people. For the people who are sensitive to magnesium citrate, magnesium bisglycinate is the best option.
- Regardless of which supplement you choose, make sure you are getting around 310 mg of magnesium per day if you are a woman.
- Zinc is essential for the functioning of enzymes, hormones, and the immune system. A deficiency in zinc can cause a hormonal imbalance and make PCOS worse, while zinc supplementation can reduce some of the symptoms of PCOS.
- This was confirmed in one study that found that zinc was able to reverse facial and chest hair growth in women with PCOS. The dosage they used was 220 mg per day of zinc sulfate, which is equivalent to 50 mg of elemental zinc per day.
- One of the most well-studied PCOS supplements is inositol, a sugar alcohol chemical compound found in keto-friendly foods like citrus fruits and nuts.
- Multiple studies have shown that inositol supplementation may improve insulin resistance and decrease male hormones in the bloodstream. Most notably, inositol seems to promote ovulation and fertility.
- In one study, only 6 percent of control group participants experienced menstrual cycles versus 86 percent in the inositol group (a finding confirmed by follow-up research).
- Most studies conclude that, at doses between 1,200-2,400 milligrams per day, inositol can significantly improve PCOS symptoms.
- Chasteberry helps restore the balance between many hormones involved in the menstrual cycle. It does this by lowering prolactin levels.
- This can help women with oligo/amenorrhea and infertility, which has been confirmed in three randomized control trials.
- However, some women with PCOS may not benefit from taking chasteberry if their prolactin levels are within normal ranges.
Reishi mushroom can help reduce stress levels and inhibit 5-alpha reductase, an enzyme that converts testosterone to dihydrotestosterone. There are no studies on the effects that reishi mushroom has on women with PCOS, but its ability to inhibit the production of dihydrotestosterone and reduce stress make it a promising supplement for PCOS.
- For women with PCOS that want to get pregnant, vitamin b9 is essential.
- To improve fertility, researchers suggest that women who are at a healthy weight should take 400 micrograms of folic acid (one of the many forms of vitamin b9), and obese or overweight women should take 5 mg of folic acid.
- If supplementing with folic acid makes you feel worse, then try supplementing with L-methylfolate or 5-methyltetrahydrofolate (5-MTHF). You also can get plenty of folate by eating broccoli, cauliflower, asparagus, kale, spinach, and cabbage.
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- Berberine — Examine
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- Magnesium — Examine
- Zinc — Examine
Not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Before making any major lifestyle changes, be sure to consult with your doctor to see if these changes are right for you.