A Ketogenic Diet for PCOS
There are many diets used to balance hormones, a Ketogenic diet for PCOS being one of them. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, affecting approximately 4% of women . PCOS is often associated with symptoms of excess testosterone: irregular or absent menses, excessive body hair, and infertility. PCOS is also associated with medical abnormalities such as central obesity, insulin resistance, hyperinsulinemia, type 2 diabetes mellitus, and dyslipidemia.
There are no known curative therapies for PCOS, though anti-diabetic medications do improve many of the metabolic abnormalities, like insulin resistance, and elevated serum testosterone and total cholesterol levels. Dietary and exercise interventions also have a big impact on improving insulin sensitivity.
Research has shown that a low-carbohydrate, ketogenic diet for PCOS can lead to weight loss and improvements in insulin resistance which proves useful for treating PCOS symptoms.
So what is a Ketogenic Diet for PCOS?
Some people may know it as the LCHF (Low Carb, High Fat) diet. The goal is to reduce your intake of carbs, and increase your intake of proteins. Click here for our ultimate keto for PCOS cheat sheet.
What you can eat:
- Meat (Any type but do try to use organic or grass fed meats)
- Fish (Any type; salmon is a great fatty fish)
- Eggs (Cook them any way you like; organic is better but not recommended)
- Natural fats (like butter but olive oil and coconut oil are the best)
- Vegetables growing above grounds.
- Dairy products (Since most of my readers have PCOS, it is recommended to cut back on dairy. In moderation, it is perfectly fine.)
- Nuts (Eat in moderation)
- Berries (Eat in moderation)
What you can’t eat:
- Starchy foods (potatoes, bread, and pasta)
- Margarine (Actually has no health benefits and it just tastes yucky)
- Beer (Contains yeast, so it’s a ‘liquid bread.’)
- Fruit (You don’t have to eliminate it completely, but fruit does have natural sugars. Use as a substitute for desserts)
When you avoid sugar and starches, your body can then maintain a regular blood glucose level. If you have PCOS and are diabetic you may find it necessary to have your insulin medication reduced if you cut out out the sugar and starches.
Humans are meant to eat the natural foods this planet provides us with. Years and years ago, early civilizations didn’t eat boxed dinners, pasta, sweeteners, and all of our other modern comfort foods. If you go with using organic meats, you are already taking care of your body. Animals don’t need the help of humans to grow and be healthy but yet the nice sirloin steak you bought at the grocery store has been pumped with hormones. Also, the animals we eat don’t force themselves on diets to be healthy. They eat what they are designed to eat and you can’t get any healthier than that.
In the study The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study, subjects were instructed to follow the low carb ketogenic diet for PCOS, consisting of fewer than 20 grams of carbohydrate per day, for a 6-month study period. The diet included unlimited consumption of animal foods (meat, chicken, turkey, other fowl, fish, shellfish), prepared and fresh cheeses (up to 4 and 2 ounces per day, respectively), unlimited eggs, salad vegetables (2 cupfuls per day), and low carbohydrate vegetables (1 cupful per day). Subjects were strongly encouraged to drink at least six 8-ounce glasses of permitted fluids per day, and discouraged to drink caffeine and alcohol. Subjects were also encouraged to take one multivitamin per day and to exercise at least three times per week on their own, although this was not mandatory.
Body weight and blood pressure were measured at each visit. Blood tests were taken at baseline, 10, and 24 weeks after a 12 hour fast. Serum total and free testosterone were measured by immunoassay and equilibrium ultrafiltration; insulin by chemiluminescent immunometric assay.
This research shows a low carb ketogenic diet for PCOS led to significant reductions in weight, percent free testosterone, LH/FSH ratio, and fasting serum insulin in women with obesity and PCOS over a six-month period.
Effect on Individual Weight and Serum Metabolic Parameters
All subjects who participated through 24 weeks lost weight. The overall mean body weight change from baseline to 24 weeks was -12.1% (range: -4.0% to 16.4%) representing a mean decrease in BMI of 4.0 kg/m2 (range: 3.0 to 7.0 kg/m2) and mean percent change in body weight of -12.0% (p = 0.006).
From baseline to week 24, there were statistically significant reductions in percent free testosterone (from 2.19 to 1.70), LH/FSH ratio (from 2.23 to 1.21), and fasting serum insulin (from 23.5 to 8.2). The mean percent change in percent free testosterone was -30.0% (p = 0.04), in LH/FSH ratio was -36.0% (p = 0.03), and in insulin was -53.7% (p = 0.002). A reduction in serum insulin while maintaining fasting serum glucose (p = 0.10) and HgbA1c (p = 0.24) suggested an overall improvement in insulin resistance. Two women became pregnant during the study despite previous infertility problems.
The mean percent change in triglycerides was -25.8% (p = 0.11), in HDL was -1.9% (p = 0.77), in LDL was +1.6% (p = 0.10), and in total cholesterol was +5.4% (p = 0.53).
Effect on Blood pressure
During the 24 week period, the mean systolic blood pressure decreased 6.3 mm Hg (range: -2.5 to -15 mm Hg) and mean diastolic blood pressure decreased 9.6 mm Hg (range: -2.5 to -22.5 mm Hg) from baseline.
The hyperinsulinemia of PCOS appears to increase androgen secretion from the ovary as well as to decrease circulating sex hormone binding globulin (SHBG). This research study suggests that a low carb ketogenic diet for PCOS may lead to a reversal of these processes. The study also suggests that reduction in LH/FSH ratio may be indicative of endocrine re-normalization resulting from the low carb ketogenic diet intervention, due to an improvement in insulin sensitivity.
Now, if you are going to start the ‘Keto’ Diet, there are some things that you should keep in mind. It is recommend to stop eating all of the bad foods cold turkey. It sounds hard and painful, but we have faith in you! By going cold turkey, some people have experienced some side effects that have only lasted a few days. This includes tiredness, dizziness, heart palpitations, tiredness, and irratibility. Again, this will only last a few days. Eliminating the bad foods will stop your body’s ability to retain water and will be lost through your kidneys. To avoid dehydration, drink plenty of water! There are people who don’t go cold turkey but gradually reduce their intake, and they are still successful with the ketogenic diet for PCOS.
It is completely up to you when you feel like you have reached your ideal weight. If you have gotten to this point, gradually eat more freely.
If any of you decide to try this diet or have already started, please let us know how it goes! We love to hear how all of you are doing with your journey!
1. Volek JS, Feinman RD.Carbohydrate restriction improves features of the Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab(Lond) 2005 ;2:31
2. Accurso A, et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond) 2008; 5: 9
3. Westman EC, et al. Low Carbohydrate Nutrition and Metabolism. Am J Clin Nutr 2007; 86(2):276-284
4. Mavropolous JC, et al. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond) 2005: 2:35