The functional nutrition approach to healing Polycystic Ovary Syndrome (PCOS) focuses on identifying and addressing the root causes of symptoms through diet and lifestyle changes. This whole body, root cause approach is individualized based on a comprehensive functional nutrition assessment, individual symptoms, health history, and labs aiming to restore balance to the body.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder typically common in females. It is the major reason for oligomenorrhea (irregular cycles – longer than 35 or 36 days) and fertility challenges. PCOS is most commonly diagnosed by the Rotterdam Criteria in which an individual must have 2 out of the 3 characteristics to be considered having PCOS.

1. Oligo or amenorrhea: struggle with ovulating + fertility challenges.
2. Hyperandrogenism: elevated androgen labs and androgenic symptoms
3. Polycystic ovaries that are seen on ultrasound: this characteristic varies as cysts on ovaries are very common and should not be one of the characteristic to having PCOS. PCOS cysts are very distinctive having typically 12 or more follicles measuring about 2-9 mm in diameter.

The 4 sub-categories of Polycystic Ovary Syndrome:

1. PCOS-A: Most common: High androgens, irregular or no periods, and polycystic ovaries
2. PCOS-B: High androgens and irregular or no periods
3. PCOS-C: High androgens and polycystic ovaries
4. PCOS-D: Least common: Irregular or no periods and polycystic ovaries

The whole body, root cause approach to Polycystic Ovary Syndrome from a functional nutrition perspective:

Overall from a whole body, root cause approach, to heal Polycystic Ovary Syndrome (PCOS) we would look at using a therapeutical diet to first manage symptoms, targeted practitioner grade supplements, and then work to fix insulin resistance/improve insulin sensitivity, blood sugar dysfunction, hormone imbalances (specifically androgen imbalance), mitochondrial dysfunction, and gut health. Any potential root causes are identified using the STAIN method specifically looking at stress, toxins (mold, plastics, heavy metals), adverse food reactions, infections, and nutritional imbalances.

During the initial comprehensive functional nutrition assessment, we will look at:

• Past Medical History: initial comprehensive patient questionnaire, symptom questionnaire, root causes: STAIN (stress, toxins, adverse food reactions, infections, nutritional imbalances), history of N/V/D/C (nausea, vomiting, diarrhea, constipation), family history of chronic health conditions, current medications/OTC’s and dietary supplements, lifestyle factors such as sleep, stress, exercise, etc.
• Anthropometrics: changes in body weight, weight loss, weight gain.
• Nutrition Focused Physical Exam: abdominal distention/bloating, hair loss/hair thinning, red, swollen, or coated tongue, skin rashes.
• Dietary and Food Habits: nutrient density in meals, caloric intake, meal pattern and timing, macronutrient balance, fiber types and sources, processed food and refined sugar intake, alcohol intake, adverse food reactions (food allergies or intolerances), FODMAPs, lactose, fructose, or sucrose intolerance, gluten sensitivity, histamine intolerance, prebiotic sources, probiotic sources, fermented foods, gut microbiome diversity.
• Conventional Labs: fasting glucose and insulin, advanced lipid panel, thyroid testing – hypothyroid causes irregular cycles leading to weight gain and hair loss, prolactin – elevated levels can cause irregular cycles.
• Functional Labs: DUTCH test for hormone imbalances, GI-MAP by diagnostic solutions, or OAT test by mosaic diagnostics.
• Wearables Data: apple watch for exercise/HRV (heart rate variability), whoop for exercise/HRV, oura ring for sleep tracking, CGM (continuous glucose monitor) for blood sugar tracking.

A personalized functional nutrition care plan will be created for you based on the data from the initial comprehensive functional nutrition assessment that includes personalized diet therapy that is condition specific, personalized targeted supplements depending on the PCOS subtype, as well as lifestyle changes in stress level, sleep quality, and exercise which are important for hormone health.

By addressing these underlying causes — through personalized approaches like nutrition, simple lifestyle changes, and targeted supplements — functional nutrition aims to bring the body back into balance and resolve PCOS at its root.

What are common symptoms associated with Polycystic Ovary Syndrome?

Symptoms are a sign that something is off internally within one of these systems: Inflammation, Gut Dysbiosis or Gut Imbalance, Impaired Detoxification, Hormonal Imbalance, Mitochondrial Dysfunction, Circadian Rhythm Disturbances, Oxidative Stress, Neuro-disruption, or Immune dysregulation. Symptoms are essentially your body crying out for help in the only way that they know how to communicate. Symptoms associated with PCOS include:

• Fatigue
• Irregular menstrual cycle
• PMS symptoms
• Hirsutism: excessive hair growth

What are Root causes of Polycystic Ovary Syndrome?

• Insulin Resistance
• Hyperinsulinemia
• Hyperandrogenemia: Women often experience PCOS (hirsutism, acne, and alopecia), irregular menstrual cycles, and biochemical alterations associated with elevated testosterone levels, higher dehydroepiandrosterone (DHEA), androstenedione (ASD), reduced SHBG, and the binding protein insulin-related growth factor (IGFBP).¹

How can i help treat Polycystic Ovary Syndrome using functional lab testing?

• DUTCH testing to evaluate androgens, progesterone, estrogens, and cortisol. Using the DUTCH Complete to evaluate Insulin, inflammatory, and adrenal PCOS.
• GI-MAP stool test to assess gut imbalances.

My storefront is linked here to order functional labs for gut health issues, hormonal imbalances, or vitamin/mineral deficiencies. If you need help creating a personalized functional nutrition care plan based on the interpretation of the labs, you can work with us here.

Functional lab testing would be a good idea if you really wanted to hone in on the specifics of gut microbiome imbalances, hormonal imbalances, vitamin/mineral deficiencies.

Are there any therapeutic diets used in healing Polycystic Ovary Syndrome from a root cause approach?

The best therapeutic diet to healing PCOS will look at improving glucose levels and insulin sensitivity as well as making sure androgen levels are balanced. (typically androgens are elevated in PCOS) An overall treatment plan will look at addressing diet, lifestyle, and exercise. It will include addressing the reason(s) why your cortisol is elevated which is important for long term healing.

Looking at it from the STAIN framework — Stress, Toxins, Adverse Food Reactions, Infections, and Nutritional Imbalances — we aim to identify the root causes and design a personalized nutrition care plan based on your unique biochemical individuality. Biochemical individuality is the concept that each of us has a different nutrition blueprint to achieve optimal wellness. We each have our own, unique genetic expression and that is shown in a personalized nutrition care plan made just for you.

Tip: Keep a food journal so that pre and post meals you can become more in tune with your body and see how certain meals make you feel. Continuously check in with yourself to see how you are feeling, this is the type of subjective information that only you can know for yourself and make sure to share this information with the dietitian that you are working with!

Ask yourself: Do I feel bloated after eating this specific meal? It’s helpful to have a dietitian that is able to look at your food journals so that they can decipher what specific ingredient or a combination of ingredients that may be causing these symptoms. Having a food journal is also helpful to look for any potential food reactions that may be related to PCOS.

5α-reductase Activity:

5α-reductase activity is elevated in women with polycystic ovary syndrome (PCOS) resulting in increased androgen activation, which can lead to hirsutism (excess hair growth), acne, and alopecia (hair loss).

Foods to inhibit 5α-reductase:

• Green Tea
• Flax seed (lignans)
• Soy Isoflavones
• Fatty fish (Omega-3 fats)

Herbs that inhibit 5α-reductase:

• Saw Palmetto (Serenoa repens)
• Stringing Nettle Root (Urtica dioica)
• Chaste Tree Berry (Vitex agnus-castus)
• Black Cohosh (Actaea racemosa)
• Pygeum (Pygeum africanum)

Nutrients/Phytonutrients that inhibit 5α-reductase:

• Quercetin
• Omega-3 fish oils
• Krill (astaxanthin)
• Beta-sitosterols
• L-lysine
• Rice bran

Are there any supplements, probiotic strains, botanicals, or Herbs that are helpful in healing Polycystic Ovary Syndrome?

Helpful supplements for healing PCOS: to improve glucose/insulin sensitivity:

• Myo-inositol and D-chiro-inositol is one of the most heavily studied supplements to use for healing PCOS. It is used to improve insulin sensitivity.
• Berberine (not for long-term use since it will disrupt gut health and the gut microbiome)
• Vitamin D3 + K2

Helpful supplements for healing PCOS: to reduce androgens: for hyperandrogenism:

• Adaptogenic herbs: Ashwagandha
• Phosphatidylserine
• Spearmint tea to help reduce symptoms
• Green tea (EGCG)
• Traditional Chinese Medicinal herb blend: White peony/licorice

Remember supplements are there to “supplement” or to help the main treatment which is using a food as medicine approach to healing.

Note: the supplements that work for someone else to heal PCOS may not work for you. This is where nutritional biochemistry and biochemical individuality come into play. This means that your unique genetic makeup requires personalized levels of nutrition that are adapted to your specific needs in order to achieve optimal health and healing specifically when it comes to healing PCOS.

Make sure to order from a high quality and third party tested brand instead of purchasing from Amazon where practically anyone can sell anything without any rigorous testing. To make it easier for you, you may order from my supplement dispensary below through Fullscript’s catalog where each brand and product meets strict top quality standards. You can learn more about third party testing here.

My supplement dispensary is linked here (with a 30% off discount!) and you do not need to be a client to place an order.

What are some diet and lifestyle tips that can help me during the process of healing Polycystic Ovary Syndrome?

Look at sleep, diet, exercise, and stress management.

Here are some helpful tips for you to begin the process of healing PCOS:

• Stress Management: Find ways to decrease overall stress. This can look like reducing screen time for a book especially when winding down at the end of the day.
• Sleep: having a healthy sleep hygiene to help wind you down at night will help with overall stress and better sleep.
• Sprinkle cinnamon (the spice) on your food to help with insulin resistance! This may not move the needle completely towards healing PCOS by itself but it will help gradually as you continue with diet, lifestyle, and exercise changes.
• A simple change could be swapping the sweetener in your latte with cinnamon — if you have a big sweet tooth like me but want the benefits of lowering glucose and improving insulin sensitivity.
• PCOS friendly workouts: yoga, pilates, strength training can improve insulin sensitivity and balance cortisol.
• Drink one cup daily spearmint tea to help reduce symptoms of PCOS.
• Adopt a low-toxin daily routine. This limits the exposure to endocrine disrupting chemicals found in plastics (BPA, BPS), personal care products, perfumes/colognes, and household cleaning supplies which can interfere with optimal hormone balance.
• Using a bidet

Gentle reminder: It’s important to be patient during this process of healing which may take some time but will ultimately be worth it in the long run. You got this.

Note: Don’t stress yourself with an all or nothing mentality where you feel like you have to implement everything on this list all at once. Sometimes in order to reach the end goal, you need to take baby steps at first and build these habits bit by bit.

How can I heal Polycystic Ovary Syndrome with the help of a functional nutrition dietitian?

Each person is unique and this is recognized in a personalized functional nutrition assessment and intervention plan that engages and empowers the patient in this process to restore optimal function, manage symptoms and promote overall health and well-being.

Functional nutrition addresses the whole person, not just an isolated set of symptoms. We look at it from a root-cause perspective and create a focus on prevention through nutrition, therapeutic diets, targeted supplementation, exercise, interpretation of conventional and/or functional lab testing, botanicals, detoxification protocols, and stress management tools.

Overall from a whole body, root cause approach, to heal PCOS we would look at using a therapeutical diet to fix insulin resistance/improve insulin sensitivity, blood sugar dysfunction, hormone imbalances (specifically androgen imbalance), mitochondrial dysfunction, and gut health, personalized targeted supplements depending on the PCOS subtype, as well as lifestyle changes in stress, sleep, and exercise. Finally, we would work to rebalance the gut using the 5R Treatment Protocol linked here.

By addressing these underlying causes — through personalized approaches like evidence-based nutrition, simple lifestyle changes, and targeted supplements — functional nutrition aims to bring the body back into balance and resolve PCOS at its root.

References:

1. Ding H, Zhang J, Zhang F, Zhang S, Chen X, Liang W and Xie Q (2021) Resistance to the Insulin and Elevated Level of Androgen: A Major Cause of Polycystic Ovary Syndrome. Front. Endocrinol. 12:741764. doi: 10.3389/fendo.2021.741764 ↩︎