Important nutrients for the management of PCOS

Polycystic Ovary Syndrome (PCOS) is associated with a significant amount of nutrient deficiencies. Even if you are eating a varied diet that contains vegetables, fruits, and proteins, it is still possible to become deficient in certain nutrients due to the syndrome itself and the process of the disease.

As a pharmacist, I like to take a comprehensive look at the problem at hand and explain everything in detail.  So today I want to talk about common defficiencies. I will address herbal supplements and other nutrients for use in PCOS in upcoming articles, so stay tuned!

1. Magnesium

Magnesium is a mineral that is found naturally in many foods. It plays a very important role in over 600 enzyme reactions that affect muscle and nerve function, metabolism, blood sugar levels, and blood pressure.

Magnesium deficiency is one of the most common deficiencies in women with PCOS. Additionally, if you have ever taken birth control, which is very common in women with PCOS, they reduce levels of this important nutrient as well. Magnesium supplements have been shown to improve insulin resistance, decrease the risk for developing diabetes, and improve inflammation.  All reasons why this is an important nutrient to take if you have PCOS. Am I suggesting you go out and buy magnesium supplements? Well, I do take them daily myself as I find they decrease my fatigue a lot however you can also supplement your diet with magnesium-rich foods.

Foods High in Magnesium:

  • Seeds (pumpkin seeds, sunflower seeds, sesame seeds)

  • Legumes (peanuts, black beans, soybeans)

  • Whey protein

  • Grains (rice, oats,  barley)

  • Vegetables (spinach, potatoes)

  • Nuts (almonds, hazelnuts)
  • Raw cacao (my favourite source of magnesium!)

Dose: 400 mg of magnesium in the form of magnesium chelate or magnesium glycinate. You should not take magnesium citrate unless you have constipation, as it may cause loose stools. Additionally, magnesium, when taken long-term, should be used in combination with calcium in a 2:1 ratio of calcium to magnesium (so, if you take 400 mg of magnesium, you would take 800 mg of calcium). Pure Encapsulations makes one in this ratio.

2. Vitamin D

Vitamin D is essential in regulating reproductive hormones and impacts anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), and progesterone levels. It also is necessary for blood sugar balance and insulin regulation.

67–85% of women with PCOS are deficient in Vitamin D. Your risk increases if you live in a part of the world where you don’t get much sunlight. I come from Malta which is a Mediterranean island that actually gets a lot of suns and I still have a deficiency for Vitamin D.

Studies have shown that vitamin D supplementation improves fertility, decreases testosterone levels, and lowers inflammation in women with PCOS.

Foods High in Vitamin D:  

  • Fortified dairy products

  • Eggs

  • Liver

  • Fish (swordfish, salmon, tuna)

  • Cod liver oil

Dose: The optimal dose of vitamin D is not known. You should have your vitamin D levels checked by a healthcare practitioner. High doses of vitamin D (up to 10,000 IU/day) may be necessary if you are very deficient, and then optimal levels can usually be maintained with a dose of 1000–2000 IU/day. It is important to take vitamin K along with vitamin D to reduce the risk of calcium deposits in your arteries. I like This particular brand.

3. Zinc

Zinc is a trace nutrient involved in hundreds of enzyme reactions in the body. It is necessary for regulating the menstrual cycle and fertility. Women with PCOS may be deficient in this essential metal for several reasons. Additionally, birth control pills deplete zinc levels.

Studies have shown that zinc supplementation in women with PCOS improves fertility and reduces the effects of high testosterone, including acne, hirsutism, and hair loss.

Foods High in Zinc:

  • Meat (beef, bison, lamb, turkey)

  • Legumes (black beans, azuki beans)

  • Seeds (pumpkin seeds, sunflower seeds)

  • Shellfish (oysters)
  • Whey protein

Dose: The recommended daily intake of zinc for women is 8 mg/day. Long-term use of zinc may affect iron and copper levels in your body, so be sure to work with a healthcare professional to determine if this is a nutrient that is appropriate for you. Zinc picolinate is an easily absorbable form of this nutrient.

4. Vitamin B12

Vitamin B12 is important for red blood cell formation, DNA synthesis, and nerve function. This vitamin is found primarily in animal foods, so the risk for deficiency is higher in vegetarians and vegans. Women with PCOS and insulin resistance have been found to have lower B12 levels than women with PCOS without insulin resistance, and women with PCOS who were obese had lower B12 levels compared with women who were obese but did not have PCOS. Additionally, studies have shown that metformin use significantly lowers serum B12 levels. Vitamin B12 supplementation may improve fertility and fatigue in women with PCOS.

Foods High in Vitamin B12:

  • Shellfish (mussels, oysters, crab)

  • Fish (herring, salmon)

  • Meat (liver, beef, pork)

  • Eggs

  • Dairy products

Dose: The Recommended Daily Intake of vitamin B12 for women is 2.4 mcg/day. Methylated B12 (methylcobalamin) may be easier to absorb than cyanocobalamin. Methylated B12 may increase anxiety levels, so work with your doctor to determine which form of B12 is ideal for you.  Beware that other imbalances in B vitamins can occur so regular blood tests would be advised.

5. Folate

First, let’s clear up some confusion about folate/folic acid. Folate is Vitamin B9 that is typically found in foods, such as leafy greens. Folic acid is the synthetic form of the vitamin (made in a lab).

Why does that matter? People with certain variations of genetic mutations cannot make the enzyme needed to convert folic acid to the active form. Up to 50% of the population is believed to have this genetic mutation. I do not want to make this article too complex but if you are interested in knowing more get in touch via email on [email protected] or DM me on Instagram

If you are trying to get pregnant, I always recommend being tested for this particular mutation so that you know your status.

Studies have shown that 5 grams of folate improved blood sugar control and lipid levels and lowered inflammatory markers in women with PCOS.

Foods High in Folate:

  • Legumes (black beans, soybeans)

  • Vegetables (asparagus, beets, spinach, broccoli, peas, cabbage)

  • Fruits (mangoes, oranges)

Other Nutrient Deficiencies Caused by Common PCOS Medications

Many medications commonly prescribed for PCOS can lead to nutrient deficiencies. So, if you’re taking any of the below medications, be sure to be tested for these deficiencies and work with your healthcare practitioner to determine a plan to get you back to optimal levels.

  • Birth control pills: folate, magnesium, zinc, vitamin B12, vitamin A

  • Metformin: vitamin B12, vitamin B1 (thiamine), folate

  • Spironolactone: folate, sodium

  • Additionally, many SSRI antidepressants also deplete folate