Top 3 Supplements for PCOS

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 women with polycystic ovary syndrome (PCOS) in my private practice and 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.

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.

Natural Calm Magnesium Iced Tea
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.

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 recommend an algae-based omega-3 supplement instead of a fish oil supplement as fish oil can be contaminated with environmental pollutants, such as mercury and polychlorinated biphenyls (PCBs). I take these plant-based sugar-free omega3 gummies (15% off code: DylanCutler15).

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.

Photo by Brian Garcia

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 (15% off code: DylanCutler15) as B12 is a must to supplement for vegans (and even some vegetarians and carnivores).

This article is sponsored by Natural Calm Canada.

In health, Dr. Dylan Cutler

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Top 3 Supplements for PCOS

Disclaimer: Nutritional and supplemental choices should be made in consultation with your current health care provider.

7 Evidence-Based Ways to Get a Better Sleep Tonight

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.

7 Evidence-Backed Ways to a Better Sleep Tonight
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.

7 Evidence-Backed Ways to a Better Sleep Tonight

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.

7 Evidence-Based Ways to Get a Better Sleep Tonight

Personally, I know caffeine can provoke anxiety, so I keep it to a minimum. Try a calming tea instead like ashwagandha or turmeric.

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.

7 Evidence-Backed Ways to a Better Sleep Tonight

4. Supplement with magnesium and/or CBD oil.

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 Natural Calm magnesium powder in cold water or hot tea before I crawl into bed to wind down for sleep.

7 Evidence-Based Ways to Get a Better Sleep Tonight
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.

CBD Oil Benefits
Code Phruitful10 for a discount on 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.

5. Meditate.

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 improve sleep quality even more effectively than sleep hygiene education. There are several apps available, like Headspace or Calm, as well as this free meditation by Jason Stephenson.

7 Evidence-Based Ways to Get a Better Sleep Tonight

6. Gentle yoga.

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. Youtuber Yoga With Adriene is a great resource. 

7 Evidence-Based Ways to Get a Better Sleep Tonight

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. 

In health,

Dr. Dylan Cutler

This article is sponsored by Natural Calm Canada.

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.

Can CBD Oil Decrease Inflammation?

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.

CBD Oil Benefits
Use code Phruitful10 for 10$ 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). 

Can CBD Oil Decrease Inflammation?
Use code Phruitful10 for 10$ 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.

The Science Behind CBD Oil Benefits
Use code Phruitful10 for 10$ 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 or breastfeeding. 

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 Phruitful10 for 10$ off your first order.

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CBD Oil and Inflammation

References

1. Pacher P, Bátkai S, Kunos G. The Endocannabinoid System as an Emerging Target of Pharmacotherapy. Pharmacol Rev. 2006 September; 58(3): 389–462.

2. Aizpurua-Olaizola O, Elezgarai I, Rico-Barrio I, Zarandona I, Etxebarria N, Usobiaga A (January 2017). “Targeting the endocannabinoid system: future therapeutic strategies”. Drug Discovery Today.22 (1): 105–110.

3. Lu HC, Mackie K. An Introduction to the Endogenous Cannabinoid System. Biol Psychiatry. 2016;79(7):516–525. doi:10.1016/j.biopsych.2015.07.02.

4. Mackie K (May 2008). “Cannabinoid receptors: where they are and what they do”.J. Neuroendocrinol. 20 Suppl 1: 10–4.

5. Booz GW. Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress. Free Radical Biology and Medicine. 2011 Sep 1;51(5):1054-61.

6. National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press; 2017 Mar 31.

7. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015 Oct 1;12(4):825-36.

8. P Soares V, C Campos A. Evidences for the anti-panic actions of Cannabidiol. Current neuropharmacology. 2017 Feb 1;15(2):291-9.

9. Leweke FM, Piomelli D, Pahlisch F, Muhl D, Gerth CW, Hoyer C, Klosterkötter J, Hellmich M, Koethe D. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Transl Psychiatry. 2012 Mar 20;2:e94.

10. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, Li Y, Wang X, Zhao L. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018 Jan 23;9(6):7204.

11. Goyal H, Awad HH, Ghali JK. Role of cannabis in cardiovascular disorders. Journal of thoracic disease. 2017 Jul;9(7):2079.

12. Baron EP. Medicinal properties of cannabinoids, terpenes, and flavonoids in cannabis, and benefits in migraine, headache, and pain: an update on current evidence and cannabis science. Headache: The Journal of Head and Face Pain. 2018 Jul;58(7):1139-86.

13. De Gregorio D, McLaughlin RJ, Posa L, Ochoa-Sanchez R, Enns J, Lopez-Canul M, Aboud M, Maione S, Comai S, Gobbi G. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019 Jan;160(1):136.

14. Russo EB, Burnett A, Hall B, Parker KK. Agonistic properties of cannabidiol at 5-HT1a receptors. Neurochemical research. 2005 Aug 1;30(8):1037-43.

15. Reggio PH, Muller C, Morales P. Cannabinoid ligands targeting TRP channels. Frontiers in molecular neuroscience. 2018;11:487.

16. Russo EB. Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management. 2008 Feb;4(1):245.

17. Karsak M, Gaffal E, Date R, Wang-Eckhardt L, Rehnelt J, Petrosino S, Starowicz K, Steuder R, Schlicker E, Cravatt B, Mechoulam R. Attenuation of allergic contact dermatitis through the endocannabinoid system. science. 2007 Jun 8;316(5830):1494-7.

18. Liou GI. Diabetic retinopathy: role of inflammation and potential therapies for anti-inflammation. World journal of diabetes. 2010 Mar 15;1(1):12.

19. De Filippis D, Esposito G, Cirillo C, Cipriano M, De Winter BY, Scuderi C, Sarnelli G, Cuomo R, Steardo L, Joris G, Iuvone T. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. PLoS One. 2011 Dec 6;6(12):e28159.

20. Gigli S, Seguella L, Pesce M, Bruzzese E, D’Alessandro A, Cuomo R, Steardo L, Sarnelli G, Esposito G. Cannabidiol restores intestinal barrier dysfunction and inhibits the apoptotic process induced by Clostridium difficile toxin A in Caco-2 cells. United European gastroenterology journal. 2017 Dec;5(8):1108-15.

21. Naftali T, Schlieder L, Lev B, Benjaminov FS, Lish I, Hirsch J, Konikoff FM. Cannabis induces clinical and endoscopic improvement in moderately active ulcerative colitis (UC). J Crohns & Colitis 2018 Feb 1 (Vol. 12, pp. S306-S306).

22. Galloway EA, Cottier KE, Kim J, Vallecillo T, Davis TP, Vanderah TW, Largent-Milnes TM. Role of Sex Hormones in Regulation of Sodium-Proton Exchanger NHE1: Implications for Migraine. The FASEB Journal. 2018 Apr;32 (1_supplement):533-60.

23. Fogan L. Treatment of cluster headache. A double-blind comparison of oxygen v air inhalation. Arch Neurol. 1985;42:362–363.

24. Greco R, Demartini C, Zanaboni AM, Piomelli D, Tassorelli C. Endocannabinoid system and migraine pain: an update. Frontiers in neuroscience. 2018 Mar 19;12:172.

25. Tassorelli C, Greco R, Silberstein SD. The endocannabinoid system in migraine: from bench to pharmacy and back. Current opinion in neurology. 2019 Jun 1;32(3):405-12.

26. Sarchielli P, Pini LA, Coppola F, Rossi C, Baldi A, Mancini ML, Calabresi P. Endocannabinoids in chronic migraine: CSF findings suggest a system failure. Neuropsychopharmacology. 2007 Jun;32(6):1384.

27. Lochte BC, Beletsky A, Samuel NK, Grant I. The use of cannabis for headache disorders. Cannabis and cannabinoid research. 2017 Apr 1;2(1):61-71.

28. Rhyne DN, Anderson SL, Gedde M, Borgelt LM. Effects of medical marijuana on migraine headache frequency in an adult population. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2016 May;36(5):505-10.

29. Dunn LK, O’Neill JL, Feldman SR. Acne in adolescents: Quality of life, self-esteem, mood and psychological disorders. Dermatology online journal. 2011;17(1).

30. Oláh A, Tóth BI, Borbíró I, Sugawara K, Szöllõsi AG, Czifra G, Pál B, Ambrus L, Kloepper J, Camera E, Ludovici M. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The Journal of clinical investigation. 2014 Sep 2;124(9):3713-24.

31. Iffland K, Grotenhermen F. An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies. Cannabis and cannabinoid research. 2017 Jun 1;2(1):139-54.

32. Zendulka O, Dovrtelová G, Nosková K, Turjap M, Sulcová A, Hanus L, Jurica J. Cannabinoids and cytochrome P450 interactions. Current drug metabolism. 2016 Mar 1;17(3):206-26.

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.