Vitamin D deficiency is relatively common in this country, and some studies suggest that over 60% of people with PCOS could be Vitamin D deficient. Vitamin D is best known for helping your body absorb calcium from food, which is important for keeping bones strong. Vitamin D could also benefit your immune system, keep muscles working well, and may possibly help prevent certain types of cancer, heart disease, and diabetes.
We make vitamin D when our skin is exposed to sunlight during certain times of the year and hours of the day. The problem is that we don’t have much exposure if we live in a northern climate in the winter, if we spend a lot of time indoors, if we have darker skin, and if we use sunscreen. And of course too much exposure to UV light can cause skin cancer. So some of the reasons are vitamin D levels are low could be because we don’t have as much sun exposure as previous generations did.
Vitamin D in Food
Food sources of vitamin D include egg yolks, fatty fish, and fortified milk/dairy, and fortified cereal. The RDA for most people is between 400-800 IU per day, which is hard for most people to get from foods.
Symptoms of Vitamin D Deficiency
Symptoms of deficiency include fatigue, hair loss, bone or muscle pain, depression, and/or frequently getting sick.
What role does vitamin D have in PCOS?
- Supplementing with vitamin D may improve insulin resistance. This is important since insulin resistance and high levels of insulin make PCOS symptoms worse.
- Supplementing with vitamin D may decrease inflammation. Inflammation can increase insulin resistance and increase your risk for heart disease.
- Several studies suggest that supplementing with vitamin D can help improve fertility for women with PCOS.
- Supplementing with vitamin D may help mood, which is important since people with PCOS have a greater risk of depression than the general population.
*** Since people with PCOS are at greater risk for vitamin D deficiency, symptoms for deficiency can be vague, we don’t have a lot of good sources of vitamin D, and there are a lot of potential benefits to getting your vitamin D levels up if you PCOS, you may want to consider supplementing.
If you suspect you have vitamin D deficiency, ask you doctor to test your levels since you may need a prescription strength supplement.
Most people can safely supplement with 1000-2000 IUs per day, though you can talk with your doctor about supplementing in even higher doses if they suspect deficiency. Some multivitamins have 1000 IUs of vitamin D you may want to consider taking (though the pill is big!). Here is the multivitamin I take.
Let me know if you have any other questions about vitamin D and click PCOS nutrition to contact me to talk about nutrition counseling for PCOS.
Because everyone’s situation with PCOS is different, there is not one perfect way of eating that is right for everyone. However, your PCOS symptoms can and will improve with changes to your lifestyle, including how you eat.
As I’ve mentioned before, the majority of people with PCOS have insulin resistance. It is this insulin resistance that causes ovaries to make more androgens and can lead to weight gain. Doing what you can to reduce insulin resistance can help improve your PCOS symptoms, which is why I’m saying that eating a diet to lower insulin resistance is the best diet for PCOS. Here are some strategies:
- Eat carbohydrates with protein. It’s even better to add fiber and healthy fat! Simple carbs on their own raise blood sugar really quickly. Protein, fiber, and healthy fat don’t raise blood sugar as much and will slow down how quickly the sugar from the carbs hits your bloodstream. When blood sugar spikes, your body makes more insulin which can lead to weight gain and cause your ovaries to make more androgens. Check out this blog post for a review of carbs, protein, and fat: Nutrition Basics: Macronutrients.
- Add more non-starchy veggies to each meal. Non-starchy veggies are low in calories and carbohydrates so your blood sugar will not be affected much by them. They are also high in fiber, vitamins, and minerals. Some tips – buy convenience vegetables. Frozen veggies are just as good as fresh and just need to be microwaved, which is the best way to preserve vitamins since it’s a fast cooking method. Also consider buying pre-washed and chopped veggies or salads that you can throw on your plate, in a salad, on a sandwich, or in a wrap.
- This may sound redundant, but add foods that are high in fiber to your meals and snacks. This includes veggies, but also fruit, beans, and whole grains. High fiber foods digest slower and are more filling, which is helpful if you find that you are hungry a lot.
- Choose unsaturated fats instead of saturated fats most of the time. Eating foods high in saturated fat can cause an increase in insulin resistance, even shortly after eating a fatty meal. Unsaturated fats can actually help improve insulin resistance.
- Limit sugary drinks. This includes juice, drinks with honey, and sugary coffee drinks. Liquid sugar makes our blood sugar spike the fastest since our body does not have to break down the food to be absorbed. The sugar hits your blood quickly. My suggestion is to save your sugar for desserts instead of drinks.
- And the final tip of the day – work in those treat foods. That’s right. Don’t aim to eat a perfect diet all of the time because you are very likely going to feel deprived if you never eat sweets or chips again. You are much better off allowing yourself to eat these foods when you really want them so that you won’t feel the need to eat a lot of them all at once when you “fall off” your diet plan.
Changing what you eat is not the only way to improve insulin resistance. Stay tuned for more ways to improve insulin resistance with other lifestyle changes.
Click on PCOS nutrition counseling to learn more about working with me for individual nutrition counseling!
While I’ve already mentioned carbs, protein, and fats in previous blog posts, I feel like it might be helpful to take a step back and explain what each of these nutrients is and why they are important.
Macronutrients are the major nutrients that our bodies need to properly function. Most foods contain a combination of carbohydrates, protein, and fat but tend to have one dominant macronutrient.
- Provide us with energy. Breaks down to blood sugar which is the fuel that all of our cells run on for energy.
- Sources of carbs include grains, foods made from flour, starchy vegetables (corn, peas, beans, sweet potatoes, and potatoes), cereal, oatmeal, fruits, juice, milk, and anything made from sugar (honey, brown sugar, corn syrup, or maple syrup).
- Non-starchy vegetables (greens, tomatoes, carrots, cucumbers, peppers, broccoli, green beans, cauliflower, cabbage, etc.) are made up of carbohydrates, but have a lot of water and fiber, and therefore are not a large source of carbohydrates or calories. (They are a great source of fiber, vitamins, and minerals!)
- Carbs are not “bad”. When people avoid them to lose weight, they are very likely to “binge” on them later since our body craves the energy that carbohydrates provide.
- Carbohydrates digest quickly, especially if they don’t have much fiber, protein, or fat. Having a lot of carbs at one time can make blood sugar and insulin spike.
- 45-65% of calories should come from carbohydrates.
- All of our body is made up of protein. Our body uses protein to build and repair itself, keep fluids and pH balanced, and can act as chemical messengers (hormones). Enzymes are a type of protein which helps with digestion, moving muscles, and clotting blood.
- Concentrated sources of protein include meat, fish, chicken, beans, tofu, tempeh, soy, milk, cheese, yogurt, and “veggie meat”.
- Protein digests slower than carbs and doesn’t make blood sugar rise as quickly.
- 10-35% of calories should come from protein.
- We use fat to help store energy, regulate body temperature, protect our organs, and send hormones throughout our body.
- Unsaturated fats are considered “heart healthy” and are more commonly found in plant sources and fish. These fats are liquid at room temperature and can be found in olive and canola oil, avocado, nuts, nut butter, and seeds. Omega 3 fatty acids are most commonly found in fish, flax, chia, and some algae.
- Saturated fats are solid at room temperature and are associated with increasing risk of heart disease. This type of fat should be limited and examples include high fat dairy (butter, whole milk, high fat cheese), processed meat, fat you see on meat, and coconut or palm oil.
- Trans fats are created when unsaturated fats are chemically processed (hydrogenated) and turned into a solid fat. These fats cause the most damage to our hearts and have been taken out of a lot of foods in recent years. Sources can still be found in shortening, non-dairy coffee creamers, shelf stable cookies, pies, and pastries, fried foods, and some margarines and oils. Look for the words “partially hydrogenated” on ingredient lists and avoid these foods as much as possible.
- 20-35% of calories should come from fat, with the majority coming from unsaturated fat.
Are you interested in learning more about nutrition and how it affects PCOS? Click PCOS Nutrition to contact me about nutrition counseling!
Yes! Assigning blame can be satisfying, right? Now before you hit the couch for the foreseeable future, let’s dive into how PCOS affects energy and more importantly, what can you do about it.
Not enough quality sleep
When people say they are tired all the time, the first thing I ask about is their sleep habits. Quality sleep not only makes you feel better, but also helps your metabolism function better, improves your blood sugar, prevents weight gain and food cravings, and makes your immune system stronger. So basically it helps with a lot of common PCOS problems. You may not be getting enough sleep or your sleep may be interrupted by obstructive sleep apnea or anxiety. If you suspect that you have sleep apnea (which is more common in people with PCOS), talk to your doctor about getting a sleep study. You can also talk to a doctor or therapist about managing anxiety which is also more common in those with PCOS.
A lot of people need to work on making sleep a priority. We need 7-9 hours per night. And sleep quality will improve if you turn your phone on silent and turn off the TV.
When insulin is not sticking to cells like it should and blood sugar has trouble getting into your cells, a few things happen that can make you tired. You body makes more insulin and your cells aren’t getting the energy they need to function well. If your body makes extra insulin, that can lead to a low blood sugar or “sugar crash” which can cause you to feel exhausted.
Eating meals and snacks with a balance of protein, carbohydrates, and fiber can help keep blood sugar even throughout the day. This can help prevent ups and downs and also will slow down your body’s insulin production. Even blood sugar and less insulin can make you feel less tired.
Not enough movement
Moving your body each day can help insulin work better (improve insulin resistance), and blood sugar can get into the cells during exercise even without insulin. Adding more movement can help keep blood sugar even throughout the day. Exercise gets the heart pumping and this can “wake you up” and also help channel some anxiety to help your relax better later. A lot of people report sleeping better on days when they exercise. (Sleep better=more energy)
Any movement is good movement. If you are able to sneak in a few 10 minutes walks per day, that is awesome. Lunch time is a great time to walk since it can help prevent the afternoon slump. Do exercise that you like so that you will actually keep doing it!
Low levels of Vitamin D, Iron, or Vitamin B12
If you are deficient in any of these nutrients, your energy level is likely to suffer. You can always ask your doctor to check lab values if you suspect you have a deficiency.
Vitamin D deficiency is very common with people with PCOS. You can safely add a supplement of 1000 iu or look for a multivitamin with 1000 iu.
Iron deficiency is most common in pre-menopausal women especially those that are pregnant or have heavy menstrual cycles. It is also common in people who drink a lot of milk, eat a vegetarian diet, have celiac disease, or a history of bariatric surgery. If you are deficient and having trouble tolerating the supplement, talk to your doctor or dietitian to help you find a supplement that works for you.
Vitamin B12 deficiency is more common in people who take the drug Metformin or acid reducing medications or in people who follow a vegan diet or who have had bariatric surgery. You can safely add a 1000 mcg supplement of Vitamin B12.
People with PCOS are more likely to suffer from depression than most people, and depression causes a serious lack of energy. Talk to your doctor or mental health professional for help managing depression.
People with PCOS may suffer from an underactive thyroid, which can cause low energy levels. Talk to your doctor about having a full thyroid panel done if you suspect you have an underactive thyroid.
Bottom line – Yes PCOS can zap your energy! But, there are things that you can do to help improve your energy and feel better. I strongly recommend talking to your doctor about energy levels since you may need to have some blood work done.
Interested in getting some individual nutrition counseling to manage your PCOS symptoms? Click here to contact me for a discovery call.
Many people that I talk to miss or skip meals for various reasons. Common reasons that I hear about usually have to do with being too busy, not leaving yourself enough time, or not being hungry at a particular time of day. Other people miss meals as an attempt to lose weight.
So what’s the problem with this?
When we miss meals or go a really long time in between eating, it can lead to binge eating or eating large quantities of food later in the day. People who don’t eat much breakfast or lunch will often say they eat from the moment they get in from work or school until they go to bed. Also when we train our body to ignore natural hunger feelings, we can slow down our metabolism. This is also true for people who undereat all day long and don’t end up eating a lot later in the day. If you don’t take in enough total energy throughout the day, your metabolism can slow down to protect your body from starving.
If you have PCOS, you also have to take into account insulin resistance, which most people with PCOS have to some degree. This means that the insulin our body produces to help shuttle sugar into all of our cells isn’t working properly. Our body makes plenty of insulin when we eat, but if the insulin isn’t sticking to our cells and letting that blood sugar into the cells, then our blood sugar levels can rise. If we eat a large meal, especially one that is high in carbohydrates, our body will make a lot of insulin. High insulin levels make PCOS symptoms worse. High insulin can cause the ovaries to produce more male hormones which will make skin and hair issues worse. High insulin can also make you feel hungry and crave carbs. It can make you gain weight since insulin tells your body to “store” energy instead of “burn” it.
We humans (and all other living beings) have natural body cycles called circadian rhythms, which help determine when we eat and sleep. These circadian rhythms impact how our body grows and repairs itself, regulates metabolism, and produces hormones.
Our body functions best when we eat (and sleep) around the same time each day. Ideally we are sleeping when it’s dark out and eat during the daylight, but this is not possible for everyone’s schedule. By functioning “best”, I mean that we feel most rested, have energy, feel hungry before meals, feel satisfied after meals, and our immune system is doing a pretty good job of keeping us well.
If you are someone who eats one or two times a day or who doesn’t eat much during the day but eats a lot at night or who never feels hungry, my suggestion is to start by committing to eating three times a day around the same time each day. Most parents are pretty good at putting their kids on a sleeping and eating schedule. We can see that our kids function best with consistent bedtimes and regular meals and snacks. As adults we are better at hiding when we feel lousy, but we might have that cranky kid inside us craving the structure we provide for others or used to have for ourselves.
Where to start?
- Eat something within an hour of waking up in the morning.
- Try to eat lunch and dinner around the same time each day.
- It’s ok to eat just a small amount if you are not hungry. But don’t skip a meal time!
- Don’t worry so much about what you are eating at this point, but instead focus on eating consistently.
- Notice how you feel after eating.
- If you are hungry soon after a meal, the meal was not large enough or might have lacked a macronutrient (carbs, protein, or fat).
- If you are not hungry for the next meal, the earlier meal may have been too large.
- If you are hungry 3 hours after you ate, then add a snack and this is okay!
- Give your body several weeks to adjust to this new eating pattern. Things to notice:
- When are you feeling hungry? Is it different than before?
- How is your energy level?
- Any changes in what you are craving?
- How is your mood?
Working on how you eat can be just as important as what you eat. And changing how we do things is hard! I know that eating consistently often takes more planning and can be more time consuming, but the payoff can mean having more energy and feeling better. And isn’t that what this is all about?