Find out which three supplements Dr. Cutler recommends the most frequently for her clients with PCOS, and why.
FAQ: What supplements Should
I take for PCOS?
This is one of my most frequently asked questions from people with polycystic ovary syndrome (PCOS) on social media. My answer will depend on the type of PCOS you have, your symptoms, your lifestyle, possible deficiencies, and other factors. However, there are three supplements that come out on top in terms of high-quality research, benefits, and little likelihood of harm.
It is important to state that managing PCOS is complex and therefore requires a combination of supplements and lifestyle changes. As their name implies, supplements are merely a ‘supplement’ to a healthy lifestyle grounded in sound nutrition, daily movement, adequate sleep and rest, stress management, a support network, and mindset work. Always make supplemental choices and doses with your own current healthcare provider.
MAGNESIUM
Women with PCOS are up to 19 times more likely to be deficient in magnesium than the rest of the population. While we’re not sure why this is, it is concerning because low levels of magnesium can increase our risk of type 2 diabetes. Women with PCOS are already at increased risk of developing diabetes!
During my PhD, I published a clinical study in Food Science & Nutrition which assessed dietary intake in women with and without PCOS. One of the findings was that magnesium intake was decreased in women with insulin-resistant PCOS. Also, the more magnesium that women with PCOS consumed, the lower their testosterone and inflammation were.
Supplementing can benefit in several ways. There is plenty of research
on the benefits of magnesium for the general population which may also apply
for PCOS. Studies have shown magnesium can help address insulin resistance,
reduce inflammation, improve sleep, reduce anxiety, improve PMS symptoms, and
lower blood pressure. These are all commonly seen and experienced by women with
PCOS.
Photo by Dylan Cutler
I supplement with Natural Calm magnesium citrate to ensure I am consuming enough magnesium each day.The raspberry-lemon flavor makes a delicious hot or iced tea (recipe here)! The recommended daily amount of magnesium for a women over 19 is 320 mg a day.
Disclosure: I receive a small commission when the following products mentioned are purchased through my links (thank you!). This allows me to provide you free articles and social media content daily. I only work with brands I adore and use myself.
Omega-3
Along with the brain and mood-boosting benefits that omega-3 fats are known for, like reducing anxiety and depression (previously discussed here), they also have specific implications for women with PCOS.
Supplementing with omega-3 may help regulate periods and decrease testosterone. Omega-3 can also lower reproductive hormones such as LH and the LH to FSH ratio (typically increased in PCOS). Finally, omega-3 has been shown to increase adiponectin which is an anti-inflammatory cytokine.
Photo by Tatyana Nekrasova
I supplement with an algae-based omega-3 supplement instead of a fish oil supplement as fish oil can be contaminated with environmental pollutants, such as mercury andpolychlorinated biphenyls (PCBs).
Vitamin D
Women with PCOS are more likely to have lower levels of vitamin D than women without PCOS. These low levels have even been linked to insulin resistance, obesity, infertility, and hirsutism associated with PCOS.
Studies show that when women with PCOS supplement with vitamin D, insulin and glucose levels seem to improve, inflammation subsides, and testosterone decreases.
While the best source of vitamin D is the sun, this option is limited if we live in the Northern hemisphere, wear sunscreen, or stay indoors. Therefore, supplementing can help.
When choosing a vitamin D supplement, look for D3 and at least 1500-2000 IU a day (recommended by The Endocrine Practice Committee). For vegans, be aware that some D3 supplements are vegan while others aren’t. I take a vitamin D plus B12 together as B12 is a must to supplement for vegans (and even some vegetarians and carnivores).
Quality sleep is greatly underrated in terms of our health and well-being. Dr. Cutler shares her top strategies and tips for a better night’s sleep.
When it comes to our health we often focus on nutrition and exercise, which are great, but if we are not providing our body with adequate rest, our efforts may go unnoticed. Studies show that 1 in 3 adults don’t sleep enough. I am sharing my top strategies and tips for a better night’s sleep.
Made in Canva.
1. Establish sleep stability
Generally, we want to be waking and sleeping at the same time each day. This is important because our bodies follow a circadian rhythm. When our circadian rhythm is disrupted, several outcomes may occur including unintentional weight gain, increases in leptin (the hunger hormone) and insulin, increased impulsivity, and slower cognitive responses.
Our sleep-wake circadian rhythm is highly based on light. Opening the blinds in the morning upon waking can help increase wakefulness in the day, and sleep quality at night.
2. Avoid substances like caffeine and alcohol in the evening
We are each affected by caffeine differently, so this is something we each need to experiment with. Recent research actually found that coffee and tea consumption before bed didn’t affect sleep, much to my surprise! Meanwhile, alcohol and nicotine before bed did disrupt sleep.
Personally, I know caffeine can provoke anxiety, so I keep it to a minimum. Try a calming tea instead like chamomile, ashwagandha*, or turmeric.
*Some people should take caution when using herbs, including ashwagandha, so always confirm with your healthcare provider first.
3. Turn off electronics 1-2 hours before bed
You may be hearing a lot about blue light lately. We are exposed to blue light from light sources like the sun, lightbulbs, and electronics. During the day sunlight is very beneficial. However, the blue light from our electronic devices, which most of us are using in the evening, may impair our production of melatonin. Melatonin is critical for sleep. One study found that evening blue light exposure decreased sleep quality. Opting for a book, music, or a podcast in the evening can limit our blue light exposure.
If being on devices is a must, there are programs available that can block blue light, such as F.lux or night mode on our phones. However, we don’t have studies yet to determine how effective these programs are. Blue light blocking glasses are available, too, which experts think may be more effective than screen programs.
Magnesium supplementation can have several benefits including more restful sleep. One symptom of magnesium deficiency can be insomnia or restless sleep. Magnesium helps maintain GABA production which is essential for relaxation and sleep. A few studies have shown that magnesium can improve insomnia. In addition, magnesium intake has been positively associated with depression (a known factor in insomnia). I stir magnesium powder in cold water or hot tea before I crawl into bed to wind down for sleep.
Foods high in magnesium include leafy greens, avocado, bananas, nuts, and seeds.
CBD, or cannabidiol, contains cannabinoids, which are important players in our body’s endocannabinoid system. CBD oil is non-psychoactive but may help regulate mood. One endocannabinoid, called anandamide, that is produced in our bodies is actually referred to as the “bliss molecule”. Low levels of anandamide have been linked to decreased happiness and increased anxiety. Increased anxiety negatively impacts sleep. Particular foods can increase our production of anandamide, like dark chocolate. CBD can prevent the breakdown of anandamide, and therefore, create more bliss.
Disclosure: I receive a small commission when the following products mentioned are purchased through my links. This allows me to provide you free articles and social media content daily (thank you!). I only work with brands I adore and use myself.
Code Phruitful20 for 20% off first purchase of Icaria CBD oil.
In 2019 a clinical study was published which included 72 people. These adult subjects were given 25 mg of phytocannabinoids per day. After one month, 79% of the anxiety-sufferers experienced improvements in their reported anxiety scores. Also worth noting is that many cases of insomnia are tied to anxiety. The same study found that 67% of those suffering from poor sleep experienced improved sleep after one month. However, over time, this effect didn’t remain.
**Always check with your healthcare provider before using any supplements.
5. Meditation and Yoga
Since creating a meditation routine before bed, I have become excited when it is time for bed (this is quite a feat for a workaholic like myself). Meditation is one way to elicit the relaxation response. It has been shown to be even more effective at improving sleep quality than sleep hygiene education. There are several apps available, like Headspace or Calm, as well as podcasts, such as Sleep Meditation by Lauren Ostrowski Fenton.
Another way to elicit the relaxation response is through yoga. Regular yoga has been shown to improve sleep and quality of life. I opt for free yoga in the comfort of my home. I find it much easier to maintain a practice when I can sneak in 20 minutes here or there instead of making an additional trip to attend an hour-long class at a studio. Youtubers Yoga With Adriene, Ani O Yoga, and Abiola Akanni have resources I enjoy.
6. Have an orgasm
Orgasms involve hormones such as oxytocin, serotonin, dopamine, and cortisol which are key players in our overall health.
Studies show that orgasms may help improve sleep, reduce stress and anxiety, increase circulation and blood flow throughout the body transporting nutrients to our brain, heart, and reproductive organs, increase self-esteem and confidence in women, increase leukocyte levels (white blood cells) and release DHEA (critical for immune function & bone health), relieve pain which may help ease migraines, headaches and menstrual cramps for some, and be pleasurable! Joy is absolutely necessary for optimal health. We need prescriptions for play!
7. Avoid news, work, or other stressful triggers
I know this one is easier said than done, and I am still working on this myself. But every stimulus can have some kind impact on our minds and bodies, particularly our nervous systems. I try to avoid the news and current events in the evenings. It can also help to let the people around you know that this is a boundary that you have set for your well-being.
Cutler WB, Garcia CR, Krieger AM. Sexual behavior frequency and menstrual cycle length in mature premenopausal women. Psychoneuroendocrinology. 1979 Jan 1;4(4):297-309. Galinsky AM, Sonenstein FL. The association between developmental assets and sexual enjoyment among emerging adults. J Adolesc Health. 2011 Jun;48(6):610-5. Catrina SB, Rotarus R, Wivall IL, Coculescu M, Brismar K. The influence of vasopressin deficiency and acute desmopressin administration on melatonin secretion in patients with central diabetes insipidus. J Endocrinol Invest. 2004 Jan;27(1):47-51. Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014 Jul;74(11):1195-207.
Discover the latest research studies on CBD oil for decreasing inflammation and migraines.
CBD, or cannabidiol, is a non-psychoactive member of a plant family of compounds known as cannabinoids. We each have an endocannabinoid system which plays a role in regulating mood, pain, memory, and appetite (1, 2, 3). Our bodies actually produce two endocannabinoids; anandamide (known as the “bliss molecule”), and sn-2-arachidonoylglycerol. These endocannabinoids bind to cannabinoid receptors, which have been found in the brain, lungs, liver, kidneys, and immune system (2, 4). Then, an enzyme breaks down these endocannabinoids. We obtain phytocannabinoids from particular foods, like broccoli, cabbage, carrots, parsley, sunflower seeds, and cacao. When we consume higher amounts of phytocannabinoids, via CBD, for example, our body will break down the CBD thus preserving our endocannabinoids.
Some of the potential health benefits of CBD include decreasing inflammation, pain, stress, and anxiety (5-9). For the sake of time and attention to detail, this article will focus on peer-reviewed studies regarding inflammation. Please review the use of CBD products with your own healthcare provider before using them.
Disclosure: I receive a small commission when the following products mentioned are purchased through my links. This allows me to provide you free articles and social media content daily (thank you!). I only work with brands I adore and use myself.
Use code Phruitful20 for 20% off your first order of Icaria – Vancouver CBD Oil for Busy Female Professionals, based in North Vancouver, British Columbia.
CBD and Inflammation
Inflammation can range from acute (like a rash or the swelling we experience after injuring a knee) to chronic (presenting in conditions such as inflammatory bowel disease, Crohn’s disease, Alzheimer’s disease, heart disease, PCOS, and more)(10, 11). Pain often accompanies inflammation. CBD may decrease pain by binding to serotonin receptors and interacting with TRPV1 channels (12-15). An oral spray containing CBD was approved in Canada over ten years ago to treat pain in both multiple sclerosis and cancer (16).
Animal studies have demonstrated how the endocannabinoid system plays a role in inflammation occurring from allergies. For example, a study using a mouse model for allergic reactions of the skin found that when mice lacked cannabinoid receptors, their skin allergic reactions were heightened. Following in the same vein, when mice had increased levels of anandamide, their skin allergic reactions were decreased (17).
When it comes to conditions of chronic inflammation, CBD may also provide relief (18). A study published in PLoS One in 2011 found that CBD may decrease inflammation in patients with ulcerative colitis (UC). The researchers obtained bowel biopsies of 10 patients with UC and 8 control subjects. The biopsies were then cultured with CBD. The results indicated a protective action of CBD against further intestinal damage (19).
This isn’t the only evidence that CBD may have beneficial effects on gut conditions. A cell study in 2017 demonstrated that CBD may protect against inflammatory damage and restore the intestinal barrier (20). In Crohn’s disease, a randomized placebo-controlled trial on CBD was published in 2018 (21). The study included 50 patients with Crohn’s disease. After 8 weeks of administration of a CBD oil (containing 15% CBD and 4% THC), the Crohn’s Disease Activity Index decreased and quality of life increased compared to the control group that consumed an olive oil placebo (Naftali et al., 2018).
Use code Phruitful20 for 20% off your first order of Icaria – Vancouver CBD Oil for Busy Female Professionals, based in North Vancouver, British Columbia.
CBD and Headaches
Migraines may be related to inflammation. The prevalence of migraines is increased in women for reasons largely unknown (evidence published in 2018 suggests sex hormones may play a role)(22). There is evidence that women who suffer from migraines have greater FAAH enzymatic activity which results in greater breakdown of endocannabinoids (23). Other research indicates a decrease of anandamide in the cerebrospinal fluid of migraine sufferers (24). This further supports the theory that endocannabinoids may play a role in the regulation of migraines (25-27).
A review published in Current Opinion of Neurology in June of 2019 discussed the use of CBD oil for migraine relief (25). It is possible that the endocannabinoid system has several pathways of which it regulates migraine pain (25).
While human clinical trials on CBD, specifically, for migraine relief are sparse, a study was published in Pharmacotherapy in 2016 which included 121 patients who were migraine sufferers. The researchers found that daily medical marijuana use reduced the frequency of migraines from 10 to 4 migraines a month (28). While not specific to CBD, this study further suggests that the endocannabinoid system may play a roll in some types of headaches.
Use code Phruitful20 for 20% off your first order of Icaria – Vancouver CBD Oil for Busy Female Professionals, based in North Vancouver, British Columbia.
Can CBD Alleviate Acne?
One physical sign of inflammation can be acne. While we have all likely dealt with acne at some point in our life, it has the potential to greatly impact our self-esteem and quality of life(29). A pre-clinical study in 2014 determined that CBD may have a therapeutic effect on acne vulgaris partly due to its anti-inflammatory properties (30).
Are there any Side-effects?
CBD has been shown to be relatively safe for consumption with some reported side-effects being fatigue, diarrhea, and loss of appetite (31). It may put extra stress on the liver and interfere with other medications. Enzymes cytochrome p450, CYP3A4, and CYP2C19 metabolize CBD, so if other medications or supplements are also metabolized by these enzymes, there may be interactions (32). It is important to discuss with your healthcare provider before using CBD, especially if pregnant, breastfeeding, or using herbs, supplements, or medications.
The research on CBD and the cannabinoid system is evolving rapidly. I am curious to see what an increase in future clinical studies will confirm for us.
In health, Dr. Dylan Cutler, Ph.D.
The post was sponsored by Icaria – Vancouver CBD Oil for Busy Female Professionals, based in North Vancouver, British Columbia. Use code Phruitful20 for 20% off your first order.
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Disclaimer: As the sole author of Phruitful Dish, I have based my posts on my own experiences and personal knowledge. However, I am not a medical doctor or a licensed nutritionist. The information in this blog is not intended as medical advice, and it is not endorsed by my employers or institutions I am affiliated with. Nutritional and supplemental choices should be made in consultation with your health care provider. This blog is intended to inspire and encourage readers to educate themselves on how nutrition and lifestyle are important and often overlooked aspects of health. Therefore, please use the information at your own risk. Occasional links may be provided leading to third party websites. The existence of these links does not infer a responsibility or an endorsement of the linked site, its operator, or its contents.
