SWITCH TO STRENGTH
PCOS
GUIDE
Alyssa Favreau
4 Types Of PCOS:
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INSULIN RESISTANT PCOS
The body is unable to utilize carbohydrates for energy sufficiently, which can result
in weight gain, hormonal imbalances, blood sugar dysregulation, and inflammation.
This type of PCOS can be caused mostly by poor diet or lifestyle choices. High intake
of refined grains, added sugars, excessive alcohol consumption or a sedentary
lifestyle can cause insulin resistance. However, insulin resistance can also be
developed through a genetic predisposition to abnormal glucose metabolism,
inflammation, nutrient deficiencies, and can be induced by medications such as
corticosteroids or antidepressants. To diagnose insulin resistance PCOS, you can
test your fasting blood glucose.
Suggestions for increasing insulin sensitivity:
1. Stay Active: Incorporate weight training at least three times a week and aim for
8k-10k steps per day. This will enhance insulin sensitivity in your body,
specifically by increasing the amount of GLUT4 receptors (what helps glucose
enter your cells) in your cells and number of mitochondria. What does this mean
for you? Help with insulin sensitivity, fuel utilization, and a happy metabolism!
2. Fix your diet: Avoiding refined carbohydrates, added sugars, processed
vegetable oils, and trans fats. Pay attention to what foods you are eating and
focus on more protein in your diet. Aim to include 30g of protein with each meal.
3. Balance your blood sugar: This is essential to help regulate your blood sugar and
insulin levels. To do this make sure to always pair a carbohydrate with a good
source of protein (about 15g) and/or fat (about 10 g) A great smart snack idea
would be half a banana with 1.5 T almond butter, or 3 oz berries with 1/2 cup
greek yogurt. Aim to eat every 4 hours.
4. Supplement smartly: My favorite supplements for blood sugar include
Myoinositol (6 g/ day), Berberine (500-1000 mg/day, Magnesium (300-400 mg/
day), Chromium (200-400 mg/day), Zinc (20 mg/ day), Alpha lipoic acid (100-200
mg/day), Vitamin D 2000-5000 IU/day) and Gymnema Sylvestre (500-1000 mg/
day). Many companies make "glucose disposal agents" that incorporate insulin
sensitizing herbs and dietary ingredient that may help the body to use glucose.
These can be helpful and some are clinically effective. However, I suggest
focusing on diet, inflammation, and lifestyle changes before attempting any
supplementation. Supplements, especially those that enhance insulin sensitivity,
can have undesired side effects, including gastrointestinal upset, headaches,
fatigue, and may cause low blood sugar. Check with a healthcare provider before
starting any new supplement!
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POST-PILL PCOS
Many women can have abnormal cycles or no cycle for months after getting off of
hormonal birth control (or even after the use of IUDs like the copper IUD). This does
not always happen, and some women can get their cycle back right away. However, I
find that the longer someone is on BC, the longer it can take to normalize their cycle
when coming off. Additional factors that play a major role into returning to a normal
menstrual cycle include: the reason for getting on birth control to begin with (as any
hormonal issue pre-BC can resurface or exacerbate post-BC), genetics, alterations in
thyroid or gut health, nutrient deficiencies, diet, and stress.
Treatment for post-pill PCOS (which can also be referred to as post-pill amenorrhea
involves 3 key steps: Replenishment, Removal, and Reinoculation. I also suggest
assessment of thyroid and liver function which can be affected by BC.
1. REPLENISHMENT: This includes replenishing the micronutrients that are
commonly depleted by hormonal birth control. This includes: Zinc, Magnesium,
B6, Vitamin C, and folate. An anti-inflammatory diet with sufficient energy intake
is imperative, as under eating (ie.e. dieting) can hinder your cycle from returning.
A great way to replenish is to take a prenatal supplement (find a good
bioavailable supplement). Optimize your diet with lots of fruits and veggies. You
should also increase your omega-3 fatty foods such as salmon, sardines, walnuts,
olive oil, flaxseed, chia seeds, and grass fed beef.
2. REMOVAL: This is where you want to focus on removing synthetic estrogens and
or progestins within your BC. You can do this through natrual liver support. Liver
support may include toxins such as endocrine distruptors and improving drug
metabolism as well as the elimination of heavy metals. Liver support may include
N-acetylcysteine, milk thistle, DIM, indole-3 carbinol, and sulforaphane. Foods
that can help liver detoxification include: cruciferous vegetables, garlic,
oninions, raw carrots, berries, citrus fruit, leafy greens, flaxseed, walnuts, green
tea, and apples.
3. REINOCULATION: I am strictly talking about reinoculating your gut in this step.
Birth control can cause alterations in your gut microbiome as well as potentially
impact your gut motility. Common reinoculation involves high dose probiotics
(greater than 30 billion CFUs), specific strain probiotics, and fermented food like
kefir, sauerkraut, and pickled vegetables. Work with a professional during the
reinoculation phase!
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ADRENAL PCOS
This type of PCOS can be caused by any alteration or dysfunction in your HPA axis,
and includes conditions such as hypothalamic amenorrhea (though it is not PCOS- it
is commonly misdiagnosed as so), and cortisol dysregulation. Adrenal dysfunction
can result from either high cortisol, low cortisol, or a combination of the two, called
adaptive cortisol.
Symptoms of adrenal dysregulation include: trouble falling or staying asleep, feeling
"tired but wired" at night, chronic and constant fatigue, blood sugar crashes, mood
swings, body fat concentrated around your abdomen, and constant salt or sugar
cravings.
In general, addressing stress, ensuring adequate sleep, prioritizing your diet, and
balancing your blood sugar can be critical in helping bring cortisol levels back to a
healthier place. Using adaptogens can also be extremely helpful, however you can
not "out-adaptogen" or out-supplement adrenal dysfunction. You have to make
sufficient dietary and lifestyle changes!
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INFLAMMATORY PCOS
Inflammation is the root cause of your menstrual cycle irregularities. Inflammation
can come from the diet via: poor micronutrient intake, inflammatory foods (such as
vegetable oils, fried foods, excess added sugars, processed meats, too much
saturated fat), intake of individual food intolerances (or supplement intolerances-
yes they exist!), or excessive food intake.
Inflammation can also come from your gut dysbiosis or infection, as well as your
environment, endocrine disruptors, heavy metals, mold, pollution/ exhaust, and
excess minerals such as fluoride, calcium, or iron. Infections or viruses, especially
stealth infection like Epstein Barr or Lyme disease, can cause underlying low-grade
systemic inflammation. Commonly, inflammation does not have one sole root cause.
Inflammation is like a little cup that will continue to fill up, then produce havoc and
symptoms when the cup overflows. The key is to reduce what you can from adding
into your cup! The treatment for inflammation depends on the source. However, it's
also important to follow an anti-inflammatory diet, focus on stress management,
ensure adequate sleep, balance your blood sugar, and use exercise to help instead of
harm your body (as inflammation can be from over-training or under-recovering).
Helpful supplements for lowering inflammation include: curcumin, omega-3s, N-
acetyl-cysteine, glutathione, bromelain, ginger, alpha-lipoic acid, resveratrol,
Boswellia (frank-incense), cat's claw, vitamin E, and pycnogenol. Having low levels of
vitamin D and magnesium may also contribute to inflammation. By decreasing
inflammation, you can potentially decrease the aromatization to estrogen (which
may be causing estrogen dominance in your body), dropping down insulin levels
(which could be causing insulin resistance), as well as decreasing systemic
inflammation (that could be preventing proper nutrient absorption and thyroid
absorption), which all affect your fertility and health!
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Although I outline for main “types” of PCOS, do not try to “cure” PCOS yourself.
Always work with a healthcare professional to ensure you are getting the right
treatment for you based on your own symptoms, labs, history, and genetics!
If you are looking for a place to start, email [email protected]. I would be
more than happy to assess the root cause of your PCOS symptoms. You are not
alone in this fight, and you CAN live the vibrant and healthy life you are longing for!
With Love and Gratitude,
Alyssa
