Unfortunately, sometimes women do not get better with paleo. Sometimes they even get worse.
What is the relationship between paleo and PCOS? Why does it heal some women so well? Why do symptoms get worse sometimes for others?
Paleo and PCOS: the benefits
First and foremost – paleo is an incredibly nourishing diet. It is rich in healthy EPA and DHA fats (which may in fact best be obtained from fermented cod liver oil if you cannot get wild-caught fish), B-vitamin rich organ meats (or dessicated organ capsules if you don’t like the taste), vitamin C and E rich fruits and vegetables, and calcium, magnesium, zinc, iodine (kelp capsules if you do not regularly eat seaweed), and the crucial fat soluble vitamins A, D, and K (also great to get in fermented cod liver oil).
On paleo, women often become better nourished than they have ever been. After having eliminated processed foods, seed oils, and grains, their bodies are all the healthier and more efficient.
This is one reason that women improve. This can (and usually does) happy to everybody to some extent.
It can energize you, improve the quality of your sleep, clear your skin, rev up your libido, heal your gut, boost your immune system, reduce inflammation, and improve neurotransmitter function.
One major way in which one particular subset of the PCOS population improves is by sharpening insulin sensitivity. Through gut healing and managing carbohydrate intake, the paleo diet often helps women who have insulin problems achieve healthier insulin levels.
Excess insulin is one of the primary causes of PCOS (check out this post for more on the various causes of PCOS) – so women who get insulin under control with paleo often get their PCOS under control.
Another major way in which a subset of the PCOS population improves is by helping with hypothyroidism. Through gut healing, autoimmune healing, stress reduction and a higher nutrient content, paleo often helps women overcome hypothyroidism, which itself often plays a role in causing PCOS.
Paleo and PCOS: where it can go wrong
Unfortunately, even while paleo can be great for PCOS, some women still do fall through the cracks. Here are the most common roadblocks I have seen women run into with paleo and PCOS throughout my years in the field:
1) Weight loss.
I know it may sound counter-intuitive, but sometimes weight loss can cause problems. This is because fat mass is highly hormonal, so any shifts in fat mass can cause hormone imbalance. Usually this imbalance is temporary, though sometimes it is not.
When you lose weight, the toxins that were stored in the fat cells get released into the bloostream. One of these “toxins” is estrogen and other hormones. Sometimes this causes hormonal upset, but should be temporary.
When you lose weight, you also lose a supply of estrogen, since estrogen is produced by fat cells. If your fat mass dips below the amount that your body thinks is optimal, then you may end up with less estrogen than your body thinks is optimal. This can cause an imbalance between testosterone and estrogen, which is a common way for women to develop PCOS. This kind of hormone imbalance may be permanent if you really have lost too much weight.
2) Exercise without refueling properly
Lots of women start to exercise while on paleo. This is awesome! Unfortunately if you do not do it right then it can cause hormone imbalance.
When you work out, your body secrets cortisol and testosterone, along with other muscle-building hormones.
After your workout, if you do not eat carbohydrates and protein, then your testosterone levels will stay elevated. High testosterone can cause symptoms of PCOS. Read this post to learn about how to refuel properly after a workout.
3) Exercising too much.
If you get into paleo and start to exercise, but haven’t exercised much before and really are exercising a lot now, this can cause energetic stress to a woman’s body. This kind of stress causes the body to shut down hormone production – I covered this extensively when I talked about exercise-induced hypothalamic amenorrhea and the causes of hypothalamic amenorrhea.
4) Personal variations in paleo dieting
This topic could comprise a book instead of a few paragraphs. It is important to bear in mind that different foods have different effects, and if your diet is high in any particular subset of food then you may be more influenced by them then you know. Here are a few examples:
A) a diet heavy in nuts delivers to a woman’s system both excess phytoestrogens as well as a lot of omega 6 poly-unsaturated fats. These PUFA fats actually increase systemic inflammation rather than decrease it, and phytoestrogens throw off a woman’s estrogen production.
B) Another example: dairy is androgenic (male sex hormone stimulating). Many people give up dairy on a paleo diet, but others end up eating a lot of dairy, particularly butter. Butter, and its purified form, ghee, have been touted as a solution to the problem of food allergies by being free of casein and lactose, the typical proteins that cause digestive problems. Yet all dairy, regardless of the type remains testosterogenic: pregnant cows produce a protein that inhibits normal testosterone blocking procedures in a human body. This fact is why many people experience acne when they eat dairy.
5) Very high protein diets.
Many people on paleo diets eat a lot of protein.
A high protein diet is not terrible for your health. However, it is not necessarily optimal, either. Protein is a building block molecule, and if the body has already used enough bricks, it will redirect the remaining bricks to unnecessary locations. Cysts are one such example of this. Tumors may be another.
High protein diets also increase levels of Insulin-like Growth Factor-1 in the blood. IGF-1 decreases Sex Hormone Binding Globulin levels in the blood, and SHBG is responsible for binding free testosterone. Most women with high androgen levels have low SHBG levels.
Additionally, a significant number of PCOS patients (I’d guess somewhere around 50%, but that is a total guess, as there are no studies on this) have the MTHFR gene mutation. People with MTHFR have a defect in the body’s detox processes that elevate homocysteine levels in the blood. Homocysteine is extremely unhealthy to have in high levels and high levels have been associated with PCOS.
Protein metabolism elevates homocysteine levels. Women with PCOS should therefore eat a moderate amount, but probably not much above that, of protein in their diets. I recommend .5-.75 grams of protein per pound of lean body weight each day.
6) Low carbohydrate diets
Low carbohydrate diets can contribute to PCOS, though this is a complicated issue since all of the women with PCOS have such different etiologies. For example, overweight women with PCOS almost always see great benefits with a low carbohydrate diet. Yet for thin women with PCOS, low carbohydrate diets are problematic. Glucose is required for proper thyroid function. It’s also necessary for assuring the pituitary gland that it has been properly fed, so that it will go ahead and make hormones as abundantly as it should.
7) Increase in saturated fat intake
While saturated fat is a healthy part of any natural diet, undertaking a big shift in the fat content of your diet (all fat, though especially saturated fat) can cause hormone imbalance.
This is because hormones are made out of fat. If you ate a low fat diet for a long time then added fat back into your diet, your body may over-produce hormones. If you have an inkling toward hormone imbalance on top of that, your body may over-produce imbalanced hormones.
The best way to deal with this is not to give up on fat entirely! It is, instead, to gradually increase the fat content of your diet. Scale back a bit from what you are doing now and see if that helps (again, especially saturated fat from animal products). Then add fat back in over the course of months, slowly. That should help your body adjust to new hormone levels. Also be sure to do whatever healing you can for other health problems, so that your hormones can be as balanced as possible.
Finally, women on paleo diets are often perfectionists. They are sometimes orthorexic, and they stress out about their food, exercise, and bodies more than they ever have a right or reason to. Stress inhibits pituitary function, and in a very big way. It is incredibly important to keep stress as low as possible, and to treat yourself lovingly and gently 100% of the time.
Paleo and PCOS: in summary
This is not an exhaustive list. Every woman is an individual, and therefore needs to treat her PCOS and her symptoms like an individual. Nevertheless I hope these theories that I have crafted and things I have witnessed in my time with paleo can be helpful sign posts for you.
These are some of the ways in which a paleo diet and life style can contribute to PCOS. Much of it is related, in what I consider a “perfect storm” of endocrine problems. Much of it has to do with stress. Much of it has to do with dieting to extremity in one way or another.
Troubleshoot as best you can. The trick to naturally overcoming health problems is to be as educated as possible, and to have the patience and fortitude necessary for experimenting with your body and your diet over time.
PCOS can be tricky to overcome, I most certainly know that.
Paleo is an excellent tool for PCOS for every woman. Yet the real trick to PCOS is to figure out the specific cause of your own PCOS (since many things cause PCOS), and then working on overcoming that specific cause.
You can read more about the causes of PCOS, why you have it, and how to overcome it, in PCOS Unlocked: The Manual, the multi-media resource I created in order to solve the unique case of your PCOS.