Transcript
Welcome to Wellness Unpacked. I’m your host, Tisha, your gut and hormone nutritionist and TMI bestie. I help people like you to improve their hormones, gut health, and their relationship to food and their bodies using an inclusive and anti-D diet lens. Join me as we deep dive in a conversation about diet, culture, hormonal health.
Sexual health, and let’s be honest, the topics that maybe we’re too shy to bring up anywhere else, follow me on Instagram at Nourish with Tish and make sure to subscribe to the podcast so you’d never miss an episode. Let’s dive in. Welcome back to the podcast for another episode. In today’s episode, we are doing part two of the PCOS deep Dive.
So if you haven’t listened to part one yet, stop this right now, go back and listen to that podcast in part one. We talked about what PCO was. PCOS is how it’s diagnosed some of the common symptoms, and we also looked at some of the key strategies for managing PCOS, including balancing blood sugar and reducing inflammation.
In today’s podcast episode, we’re gonna be taking a look at the third pillar of managing PCOS, which is reducing androgens. So we’ll take a look at some of the key nutritional strategies to do that. We’re also gonna talk a little bit about the role of exercise and stress reduction in managing PCOS, and then we’re gonna take a look at nutrient de.
Nutrient deficiencies and some of the key herbal supplements that might help with managing overall symptoms. As always, this podcast is for informational purposes only. If you’re looking for additional support, I highly recommend working with a healthcare provider or dietician to really get to the root cause of your PCOS and find a nutrition strategy that works best for you.
With all of that said, let’s go ahead and dive right in. So as I said before in the first podcast episode, we really talked about the role of bouncing blood sugar and reducing inflammation. And to be honest, you could really just stop right there. Those are going to be the key foundational steps when it comes to looking at the role of nutrition in managing PCOS, and in fact, when we’re thinking about hormonal health and reducing overall antigens.
By addressing those first two pillars. So by balancing your blood sugar and by reducing overall inflammation, that alone is going to make such a big difference in this third pillar. So if you’re looking for a place to start, I highly recommend go back to that first episode. Start there. When it comes to reducing overall androgens and hormonal support, there are some key things that we can do.
We’re gonna talk a little bit about just some nutritional strategies, some lifestyle interventions, and then we’re also gonna talk about supplements. ’cause this is kind of when supplements might be most impactful. So first and foremost, in thinking about. Supporting overall hormone health, it might be worthwhile to get your thyroid checked.
And that’s because hypothyroidism and PCOS often go hand in hand. In fact, it’s very common to see hypothyroidism show up in individuals with PCOS. And one thing about hypothyroidism is that it can also lower sex hormone binding globulin, which can lead to higher androgen levels. ’cause as I mentioned before, sex hormone binding GLO globulin.
Holy moly. Binds up testosterone. So if you don’t have enough of SHBG, what ends up happening is that you have more testosterone that is roaming free. So hypothyroid dem can contribute to this overall androgen load. So if you suspect that might be you, it could be worthwhile just to get it checked out.
Okay. And in general, in general, when we’re thinking about overall hormonal support, I really think it always kind of goes back to making sure that your body feels safe. I’ve talked a lot about this in previous podcast episodes, but it’s because it is so paramount. So paramount, and one of the key ways to do that.
Is to eat consistently. So eating every three to four hours can really help with overall hormonal support. And part of this is because of the role that that has on insulin and cortisol levels. So eating in the morning, first thing in the morning when you wake up helps to wake up your metabolism. And it also helps to support insulin sensitivity.
So skipping breakfast can lead to higher insulin levels throughout the day, and over time, this might increase your risk for insulin resistance. Skippy and breakfast can also keep your cortisol levels higher. Skipping breakfast can also keep cortisol levels elevated for longer. So I’ve talked about this in my cortisol podcast, but essentially in the morning when you wake up, your cortisol levels should be at the highest it.
They should be peaking first thing in the morning that’s going to give you that get up and go energy level, and as the day progresses, you are. Cortisol levels will slowly decline, and that’s really important because you have this inverse relationship between cortisol and melatonin, which helps you sleep at night.
So if your cortisol levels are staying elevated. It’s not gonna give that signaling for your melatonin to increase. So what can end up happening is you have wonky cortisol levels throughout the day and then you end up with wonky melatonin hormones at night or hormonal levels at night, and so you’re not sleeping as well.
And this can kind of create a vicious cycle. So eating within an hour of waking up can actually be really beneficial for insulin sensitivity and also for cortisol levels. And because balancing blood sugar is so crucial to PCOS, you really don’t wanna go be going too long without eating because this is going to cause this like consistent spike and crash of insulin.
It’s going to negatively impact your blood sugar. It’s going to cause cravings, it’s gonna dysregulate your hunger. Eating consistent meals throughout the day is just really a great way to support overall hormone health. And then another key aspect, another reason why I think it’s important to eat relatively frequently and to avoid going for extended periods of time without eating is because of the role that.
Starvation or lack of calories or lack of consistent mealtime can have on progesterone levels. So when we’re thinking about PCOS, one of the key symptoms is this anovulation or the lack of ovulation, or even just inconsistent ovulation. And the only way to have adequate progesterone levels is to ovulate.
And so when we’re thinking of how can we help with ovulation, one of the key strategies is really to help our body feel safe. And I have an entire podcast all about progesterone. So if you wanna learn more about that, definitely go and check that podcast out. But in a nutshell. If you, if your body does not feel safe, if your body does not feel like it’s a good time to get pregnant, it will put fertility on the background.
So whether or not fertility is your goal, whether or not conception is your goal, you want to make sure that you are ovulating regularly, partially because that’s the only way that you’re getting progesterone. And because we know that PCOS is also linked to anxiety and depression and that progesterone is a feel good hormone, so it can help our body feel calm.
We really wanna make sure that we are getting adequate progesterone and that we are ovulating regularly. It’s also worth noting that low progesterone can stimulate the production of androgens. So having this low progesterone can increase these androgens, and again, it kind of becomes this vicious cycle.
So in thinking of general guidelines to support progesterone production, we wanna make sure that we’re eating enough. Period. Eating enough calories in a day, we’re supporting our overall we’re supporting our bodies by fueling properly. You wanna make sure that you’re eating enough healthy fats because you need fat for steroid hormone production.
So these are sex hormones, so things like cortisol, estrogen, progesterone, and androgens, all are derived from cord, from cholesterol. So we need to make sure we’re getting enough dietary fat. You also wanna focus on reducing stress and addressing any nutrient deficiencies like magnesium, zinc, B six, vitamins A, c, and E.
Okay, so that kind of sums up those three pillars. So just to reiterate, if we’re focusing on nutritional strategies for PCOS, the first thing we wanna do is really balance our blood sugar. The second piece is reducing inflammation, and that’s going to be primarily through eating anti-inflammatory foods.
And then the third pillar is reducing androgens. And as mentioned, if you’re bouncing blood sugar, if you’re focusing on this. Inflammation piece. You’ll likely see the reduction in androgens from that alone, but we will talk a little bit about the role of supplements and how that can be an additional component and additional tool in your tool belt to help with reducing overall androgens.
So now we’re just gonna touch briefly on stress and physical activity. And the reason we want to talk about that is because. Okay. These two pieces are really monumental for reducing overall inflammation and balancing blood sugar. So it’s going back to those two initial pillars. So let’s start first by talking about physical activity.
So we know that exercise can improve insulin sensitivity, it can reduce inflammation, and it can also support mental health, which again, can feel really important. It can be really beneficial for individuals with PCOS who struggle with anxiety and depression. So what kind of exercise is. Best for PCOS.
The research shows that aerobic activity at least three days a week for 30 minutes is recommended because of the role that it has on insulin sensitivity and strength training three days a week on non-consecutive days may provide additional benefits with respect to androgen levels. So, in other words, it seems that aerobic activity might be best for overall blood sugar and that strength training might be best for reducing overall androgen levels.
That being said, it’s worth not. It’s worth noting that all movement is good movement. So pick something you like and that you can do regularly and avoid high. Intensity training. If you’re already dealing with high stress and fatigue, again, going back to ovulation and making our bodies feel safe. Really high intensity workouts, especially in combination with undereating and not getting enough calories.
Is going to negatively impact your menstrual cycle. It’s going to get in the way of you getting your period regularly of you ovulating, of you getting those adequate progesterone levels. So even though yes, exercise is great, we wanna be moving our bodies daily, I highly recommend focusing on lower impact activities.
And making sure that you’re giving yourself adequate recovery time. So if you are going to the gym, if you’re having a really heavy strength training day, make sure the following day is a rest day or something easy, like a long walk. And if you’re like, well, how do I know if my workout is too intense or not intense enough?
I think a good rule of thumb is that if you have a workout and immediately after you feel drained, you feel like you need to take a nap, you no longer have any energy for the rest of your day, that exercise was too intense for you. So ideally a workout, you should feel tired in the moment, but. Shortly after your energy level should come back.
In fact, you should probably feel a little energized after moving your body if that’s not the case. If you feel really exhausted or if the next day you feel trained and not just the classic, you know, like, I like sore muscles, like day two workout, but really, really fatigued. I would consider that a sign that, okay, let’s step back.
Let’s dial it back and let’s go for something less intense. Okay. Next we’re gonna talk about sleep and stress because of course, if we’re thinking about body safety, if we’re thinking about overall hormonal health, we’ve gotta talk about these. So I don’t think I’m gonna say anything that you don’t already know here.
You wanna make sure that you’re getting seven to nine hours of quality sleep. And if you wanna learn more about how to have qua quality sleep and make sure you’re practicing good sleep hygiene, definitely check out the podcast episode all about cortisol and burnout. I also have my masterclass beat the burnout, and in it we talk all about good sleep hygiene and some of the key ways to make sure that you’re actually getting good high quality sleep, and why it’s so important when it comes to overall stress levels, to cortisol protection and to blood sugar.
Okay. So definitely check that out. And then when it comes to stress, of course, if you can reduce overall stress, that’s great. If there are things in your life that you know you can change and you can make that happen, amazing. I know sometimes that’s not always feasible. That’s not realistic. So in those cases, can you.
Can you have coping mechanisms? Can you have strategies in place to help manage your overall stress load? Right? So that might be incorporating mindfulness or breath work. You know, practicing yoga having some time to yourself, reading at night, going for a walk in nature. Just strategies to allow your nervous system to relax.
And again, if you wanna learn more about that, definitely check out my podcast all about stress and burnout, where we talk specifically about stress reduction strategies. And then just as a final thought on stress, I do wanna mention the role of diet as a stressor. So as we talked about earlier about inflammation.
High inflammation in the body can cause stress. It does drive cortisol levels, and one way that our bodies can become inflamed is by the foods we consume. And I What about this, like with an asterisk here to say that like you eating a sweet treat here and there is not going to unravel your health. Okay, but.
As I mentioned before, incorporating lots of anti-inflammatory foods is going to be a beneficial strategy to help reducing overall stress on your body. Right? And during this time when we’re thinking about how can we support our body health, I’d be very mindful of how much alcohol you’re consuming, how much processed foods you’re consuming, especially if those processed foods are displacing more nutrient dense foods like.
Protein rich foods, fiber rich foods, anti-inflammatory, antioxidant rich foods, right? So this isn’t to say that you need to eliminate processed foods, that you need to eliminate foods that are, you know, maybe a little bit more inflammatory, especially, especially knowing the link between PCOS and disordered eating.
I really, really want you to act with caution before restricting. Anything in your diet this might be a good time to work with a healthcare provider or dietician or a therapist if you’re looking to make drastic changes to your diet, especially if you have a history of disordered eating. So big asterisk there, but I, I do see this because there is some truth to this, right?
We do know that certain foods can have an inflammatory response in the body, and so it’s really just about. Is there room to add in nutritious foods? Is there room in your diet to add in anti-inflammatory foods and to add in fiber rich foods? Okay. Okay, cool. So next, let’s talk a little bit about some of the nutrient deficiencies that you might wanna be aware of when thinking about PCOS.
So first and foremost B12 is a really big one, especially if you are taking metformin because metformin can actually cause a B12 deficiency. So if you’re taking Metformin to manage your PCOS to manage your blood sugar, it is worthwhile to just get your B12 check to make sure, because it can cause a B12 deficiency.
And why does this matter? So for starters. B12 can affect your energy levels, but also B12 is important for clearing the body of homocysteine. So B12 and other B vitamins help to break down homocysteine so that it can be recycled. And what happens if it’s not being recycled, if it’s not being broken down, is that it can drive inflammation.
So high homocysteine levels can. Lead to inflammation. So that is one consideration if you’re taking Metformin just to get your B12 levels checked. B12 levels can also be impacted by overall gut health. So if you’ve had food poisoning in the recent past or if you have any kind of chronic digestive issues, that can also cause a decrease in B12.
So definitely worth looking into. Next is vitamin D. Now, I would say most people should probably get their Vitamin Ds check their vitamin D levels checked anyways. But with PCOS, up to 85% of people with PCOS are vitamin D deficient, and we know that menstrual imbalances and fertility dysfunction are linked to vitamin D deficiency.
Vitamin D also helps with insulin sensitivity and blood glucose levels, and it can also help to decrease testosterone levels. So if you suspect you might be low in vitamin D, it could definitely be worthwhile to get your blood checked. If you live in a colder climate, if you don’t get a lot of sunshine, if you’re not eating vitamin D rich foods, then those are a good chance that you.
Are deficient in vitamin D. A lot of people are so definitely worth getting checked out. Calcium is another one that might be deficient in people with PCLS. And this is especially true if you are deficient in vitamin D because of how calcium and vitamin D work together synergistically so. If you have vitamin D deficiency, you could have calcium deficiency.
And of course we need calcium for bone, overall bone health, but it can also help improve insulin resistance. So adding lots of calcium rich foods can also be really beneficial if you have PCOS. Okay. And lastly, we’re going to talk about supplements. And I know I often know that when we talk about supplements, that can feel like the most exciting part.
It can be the. It feels like it’s the easiest solution to take a supplement and watch your symptoms disappear. But I promise you that dealing with those first two pillars, like we talked about, bouncing blood sugar, reducing inflammation is going to make such a big difference. And supplements are really just a tool in your tool tooled out.
They don’t get to the root cause. They just help with symptom management, right? So I think that’s really important because I think sometimes when it comes to supplements, we treat it. Like we treat a lot of healthcare interventions in our modern society where it’s kind of treated as like a medication and you’re like, take this for X amount of time, symptoms go away, but you didn’t really get to the root cause of why you had the symptoms in the first place, right?
So I love supplements, I love herbs. We’re gonna talk about some really great ones, but as a reminder, supplements are not benign. They very much have an impact on your body, and they often do have contraindications. And I say this because if you’re looking to take a new supplement, I highly, highly recommend working with a healthcare provider who knows about supplements.
Okay. I know I’m a broken record, but I just, I feel like so many people, myself included, I feel like in the past I would just load up on supplements and I wasn’t like really sure what any of them were doing, and I was not paying attention to how they interacted with each other. And. Yeah, like a lot. It’s important to remember like a lot of medications are derived from herbs.
A lot of supplements are, they’re treated like they are just benign food-like substances. But they do have a very real impact on your body. So we wanna be cautious, right? Okay. That’s my, that’s my TED talk on that. So I also wanna say this is not an exhaustive list of supplements for PCOS, but here are some options that do have some research backed behind it.
So first is myo, acetol and de chiro an acetol. Chances are if you struggle with PCOS, maybe you’ve already heard of an acetol, so it’s a polyol. And both Myo-Inositol, and D chiro acetol have been identified as insulin mediators, and so they can actually help with insulin sensitivity in PCOS. They can also help to improve ovulation, which is great, and improve menstrual regulation.
It appears that Myo Isol is better for metabolic impact and de chiro. Isol might be better at decreasing hyperandrogenism and menstrual cycle regulation. So it seems like one maybe is better for the overall blood sugar piece and one is better for the hormonal piece. That being said, it seems like when paired together, that is when they do the.
Best and ideally if you’re taking both, you wanna have a combination where it’s at a ratio of 40 to one of Myo-inositol to de chiro acetol. Because in research that seems to have the best outcome. The next supplement we’re gonna talk about is NAC or N-Acetyl Cystine, and it is a widely recognized antioxidant and it is a precursor to glutathione, which is considered to be the body’s master antioxidant.
It seems that NAC is really effective for improving insulin sensitivity and may also improve pregnancy and live birth outcomes in people with PCOS. It also in one study was shown to outperform metformin in enhancing lipid profile, fasting blood sugar, and fasting blood insulin levels. However, other research has shown that when compared to metformin, women taking NAC were less likely to experience pregnancy or ovulation.
So research is a little mixed there. But it does appear that NAC is capable of decreasing BMI and total testosterone levels, so it does seem like there could be some benefit to taking it. Something I also think is interesting is that NAC is often used in. Gut health issues because it acts as a biofilm disruptor.
So essentially, with dysbiosis in the gut, you can have these biofilms, which literally protects these bad bacteria, and it can make it really hard to clear and get rid of ’em. And so NAC is one strategy to help break down this biofilm and. I’m not saying necessarily there’s a connection to PCOS, but I do think it’s really fascinating when we know that there is this link of dysbiosis and PCOS and NAC also has this benefit that maybe for that reason as well, it might be a helpful tool in your tool belt.
Berberine is another supplement that is often used in treating gut health, and it may be beneficial for people with PCOS again because of this role in reducing insulin resistance. Berberine can also help with reducing overall androgen levels. So one study found that both Berberine and Metformin had a similar impact on antigen androgen levels leading to a reduction in testosterone and a corresponding decrease in the free androgen index.
And its ability to reduce overall androgen levels might make it a beneficial supplement specifically for acne. So there was research that showed that taking berberine. Could help improve the acne status of individuals with PCOS, which I think is super fascinating. So another herb that may be beneficial for overall reduction of androgens is white p and e.
So white p and e helps you decrease total and free testosterone levels and also. Increase aromatase activity, and that is essentially when testosterone is getting converted into estrogen. And in the case of PCOS, where maybe you are struggling with high levels of testosterone and decreased levels of estrogen, then this aromatase activity can be very beneficial.
YP and E can also help with ovulation and improving fertility with women. With PCOS, you will often see p and e and licorice together in supplement formulas, and that is because they seem to work better in combination with one another. So if you’re looking for white p and e for your PCOS, just know that you’re probably going to find something like p and e and licorice.
It is worth noting that. Licorice can increase your blood pressure. So if you have hypertension, if you have a history of blood pressure it’s definitely, I would, I would talk to your doctor before taking this. Omega-3 is another one that I feel like it’s just kind of an easy one to throw into your.
Supplement regime because of its impact on inflammation. So it can help to reduce inflammation because it is this because it is these anti-inflammatory fats, it can also help to balance out that ratio of Omega-3 to omega sixes. So if you don’t know, omega sixes are more inflammatory and omega threes are more anti-inflammatory.
So it can help balance that ratio out a little bit. It can also help to reduce testosterone levels and omega threes can also improve insulin resistance, cholesterol levels, and menstrual regularity. And then some final ones to consider are really more for balancing overall mood and stress levels. So magnesium can be a great one.
It can help support the stress response and also support metabolic health. And a lot of people are actually deficient in magnesium. Either due to, you know, maybe not consuming enough magnesium rich foods. So things like leafy greens or cacao powder, things like that. Also our food supply tends to be low in magnesium these days because our soil is depleted.
And if we were going through high periods of stress, we are likely depleting our magnesium stores. So in that case, it could also be beneficial to take magnesium. Magnesium can also help with insulin resistance and anxiety and depressive symptoms, which again may be common in individuals with PCOS. I feel like the best way to take magnesium is in a supplement right before bed, so you can have it in glass of water.
I really love magnesium glycinate for the average person just because it’s easily absorbed into the body. But if you’re someone who also struggles with constipation, magnesium citrate might be a great option because it has a slight laxative effect. And then the final herb I’m going to mention is ashwagandha.
Ashwagandha is an adaptogen, so it can be really beneficial if you’re someone who’s struggling with a lot of stress. What I love about Ashwagandha is it helps to regulate your nervous system, and so it can both be energizing and calming at the same time, and I think this can be a really useful herb if you are going through a high stress period.
That you can’t step away from right now. So as I mentioned earlier, if there are ways for you to mitigate stress in your life, you definitely want to do that. But I also understand that sometimes you’re just in phases or seasons of life where that’s not possible. So maybe you’re a new parent, maybe you start a new job.
Maybe you’re commuting and there’s just not much you can do about it. Then in those instances, using adaptogenic herbs like ashwagandha. Can be beneficial because they help make your nervous system a little bit more resilient. And what I like about Ashwagandha specifically is it doesn’t cause you to feel drowsy, so it has a calming effect without making you feel sleepy.
And in fact, I actually used to use it a lot when I worked in a corporate office on days where I felt like I had new clients and maybe it was a little bit more jittery and it was helpful for allowing me to feel calm. While still being alert. So just throwing that one out there in case you are in need of a little additional adrenal support.
So on that note, that pretty much summarizes PCOS part two. I hope you got something out of it. PCOS is a very complex condition and there’s no one way to navigate it. And I say that because if you are somebody who. Want to use other tools like Oral Contraceptives or Metformin to manage your PCS symptoms.
I don’t want you to feel like you can’t because those things are deemed quote unquote less natural. Find whatever support works for you. This is just additional context because we know that nutrition and lifestyle can in fact play a role, especially when it comes to that insulin resistance component, which as I mentioned earlier, shows up the.
Shows up in the vast majority of people with PCOS, and yeah, it’s really about finding what works best for you. For some people, oral contraceptives aren’t going to be an option, especially if you’re somebody who’s looking to conceive. Some people don’t do well on Metformin, that’s totally fine. Or maybe you try some of these.
Herbal recommendations and find they don’t work for you and you wanna branch out and try some more conventional options, that’s totally okay. This is really about giving you the most tools, the most options, so you can find what works best for you personally. So on that note, we’re going to end it here.
Thank you so much for tuning in today, and if you have a chance to leave a review, I would really appreciate it. That is by far the best way to support podcast. If you get a chance to just write a few kind words, it would mean so, so much to me. And otherwise, if you have any questions, if there’s anything you wanna see on the podcast, any issues, any nutrition concerns, anything that’s really speaking to you, please feel free to reach out to me on Instagram at Nourish with Tisch.
You can also check out my blog nourish with tch.com ’cause I’ve got a lot of really great resources there. So yes, thank you so much for tuning in and enjoy the rest of your day.
References
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