PCOS: Essential Nutritional Supplements and Food Sources

Polycystic Ovary Syndrome (PCOS) management requires a multi-faceted approach. Nutritional supplements can play a critical role in addressing common underlying issues like insulin resistance, inflammation, and hormone imbalance, but they should always complement a nutrient-dense diet.

Here are five essential supplements, their benefits, and rich food sources for women with PCOS:

1. Myo- and D-Chiro-Inositol (MCI)

Inositol, often considered B-vitamin-like nutrients, are the most impactful supplements for addressing the root causes of PCOS.

Benefit	Mechanism
Improves Insulin Sensitivity	Helps cells respond better to insulin, regulating blood sugar and reducing hyperinsulinemia.
Restores Ovulation/Cycles	Supports follicle maturation and is proven to help normalize menstrual cycles and increase ovulation frequency.
Reduces Androgens	Lowers elevated male hormones (like testosterone), which can decrease symptoms like hirsutism and acne.
Improves Egg Quality	Essential for reproductive health, often boosting success rates for women seeking conception.

• Dosing: The most effective clinical dose is typically 4 grams of Myo-Inositol (MI) paired with 100 mg of D-Chiro-Inositol (DCI) per day, reflecting the body's natural 40:1 ratio.

• Food Sources: While high therapeutic doses require supplementation, dietary sources include whole grains (especially germ), nuts, cantaloupe, and citrus fruits.

2. Magnesium Glycinate

Magnesium is a critical mineral, and women with PCOS are frequently deficient. The Glycinate form is highly absorbable and minimizes digestive upset, while Citrate offers a gentle laxative effect.

Key Benefits

• Reduces Insulin Resistance: Magnesium is essential for regulating insulin function, helping glucose enter cells for energy. Deficiency is strongly linked to insulin resistance and type 2 diabetes.

• Lowers Inflammation: Supplementation has been shown to reduce inflammatory markers (like HS-CRP).

• Alleviates PMS Symptoms: Effective for reducing anxiety, sleep disturbances, bloating, and cramping associated with PMS.

• Supports Blood Pressure: Optimizing magnesium intake can help lower elevated blood pressure, a common cardiovascular risk factor in PCOS.

  
  

Deficiency Signs

Look out for signs like muscle cramping or pain, frequent headaches/migraines, mood changes (anxiety, depression), elevated blood pressure, insulin resistance, intense cravings (especially for chocolate), and difficulty sleeping.

• Dosing: Appropriate therapeutic dosing ranges from 200 to 350 mg per day. Magnesium oxide is not well absorbed and may cause GI upset.

• Caution: Avoid if you have certain heart conditions (like heart block) or kidney failure.

🍽️ Food Sources of Magnesium

Prioritize including these magnesium-rich foods in your daily meals:

• Dark Leafy Greens: Spinach, kale, chard

• Nuts and Seeds: Pumpkin seeds, chia seeds, almonds

• Legumes: Black beans, lentils

• Dark Chocolate (70% cocoa or higher)

3. Zinc (Glycinate/Picolinate)

Some research suggests zinc deficiency may be partly to blame for the insulin resistance and abnormal cholesterol levels often seen in PCOS.

Key Benefits

• Minimizes Hyperandrogenism: Zinc helps inhibit the enzyme that converts testosterone into its more potent form, dihydrotestosterone (DHT). This action is key to reducing symptoms like hair loss (alopecia), acne, and unwanted hair growth (hirsutism). Zinc has been shown to significantly reduce hirsutism when supplemented with magnesium, calcium, and Vitamin D.

• Lowers Insulin Levels: Zinc is involved in the synthesis, storage, and release of insulin and helps it bind to cell receptors, improving glucose uptake.

• Regulates Menstrual Cycle: Low zinc status is associated with PMS and fertility issues, as it is vital for ovulation and follicle maturity.

• Anti-inflammatory: As an antioxidant, zinc helps counteract the high levels of oxidative stress often present in PCOS.

  
  

Deficiency Signs

Symptoms may include hair loss, skin conditions (acne, dermatitis), poor immune function (frequent colds), taste changes, and delayed wound healing.

⚠️ Crucial Dosing Warning (Copper Balance)

• Dosing: Therapeutic amounts range from 30 mg to 50 mg daily. Choose highly bioavailable forms like Glycinate, Citrate, or Picolinate.

• Caution: High-dose or long-term zinc supplementation (over 30-40 mg/day) can deplete the body's copper stores. Copper is essential for iron absorption, energy production, and nerve health. If you plan to supplement with zinc long-term, ensure adequate copper intake through diet or consider monitoring levels.

  
  

🍽️ Food Sources of Zinc and Copper

Zinc Sources	Copper Sources
Oysters (highest source by far)	Organ Meats (liver)
Red Meat (beef, lamb)	Shellfish (oysters, crab, lobster)
Shellfish (crab, lobster)	Seeds and Nuts (sesame seeds, cashews, almonds)
Legumes (chickpeas, beans)	Legumes (lentils, chickpeas)
Nuts and Seeds (cashews, pumpkin seeds)	Dark Chocolate (70% cocoa or higher)

4. Omega-3 Fatty Acids (EPA and DHA) 🐟

Omega-3s, specifically Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA), are essential polyunsaturated fatty acids that the body cannot efficiently produce. They are best known for their powerful anti-inflammatory effects.

Key Benefits

• Reduces Inflammation: Omega-3s shift the body's production of inflammatory eicosanoids toward anti-inflammatory ones, directly combatting the chronic, low-grade inflammation (Interleukin-6, TNF -alpha) seen in PCOS.

• Improves Insulin Sensitivity: Studies show omega-3 supplementation can significantly reduce insulin resistance and improve glucose metabolism in women with PCOS.

• Lowers Androgens and Hirsutism: Regular intake has been shown to decrease elevated testosterone levels, which can help lessen symptoms like acne and excessive hair growth.

• Supports Cardiovascular Health: They help lower triglycerides, improve blood pressure, and reduce the risk of heart disease, a major long-term concern for women with PCOS.

Dosing: A combined EPA and DHA dosage of 1,000 to 2,000 mg daily is typically recommended for therapeutic benefits. Look for high-quality supplements that are third-party tested for purity and heavy metals (like mercury).

🍽️ Food Sources of Omega-3s

• Fatty/Oily Fish: Salmon, mackerel, sardines, anchovies, herring (SMASH fish).

• Flaxseeds/Chia Seeds: Contain $\alpha$-Linolenic Acid ($\text{ALA}$), which the body must convert to $\text{EPA}$ and $\text{DHA}$ (conversion is inefficient, so direct sources are preferred).

• Walnuts

5. B Complex Vitamins

Taking a general B-complex or a good multivitamin is essential, especially as medications like birth control and metformin can deplete your body of some B vitamins.¹⁶ B6, Folate, and B12 are critical for hormonal balance.¹⁷

Key Benefits

• Hormonal Balance & Heart Health: These B vitamins help to lower inflammation by breaking down homocysteine, which may reduce the risk factor for heart disease and other reproductive symptoms.

• Metabolism Support: B vitamins are integral cofactors in energy production and metabolism.¹⁸

• Dosing: Choose a vitamin that contains the methylated forms of Folate (5-MTHF) and B12 (Methylcobalamin). Folic acid and Cyanocobalamin are the inactive versions. Using the methylated forms is extremely necessary for those with MTHFR genetic mutations.

🍽️ Food Sources of B Vitamins (Especially Folate and B12)

• Folate (B9): Dark leafy greens (broccoli, spinach), asparagus, legumes, liver.

• B12 (Cobalamin): Animal products only (meat, fish, eggs, dairy). Vegans/Vegetarians must supplement or consume B12-fortified foods.

6. Vitamin D3 with K2

It is very common to be deficient in Vitamin D, with up to 85% of women with PCOS affected. Lower Vitamin D levels are significantly associated with worsening insulin resistance in PCOS.

Key Benefits

• Improves Insulin Sensitivity: Adequate levels help cells utilize insulin more effectively.

• Hormone & Cycle Regulation: Deficiency is often linked to irregular or absent menstrual cycles.

• Lowers Inflammation: Vitamin D acts as an immune modulator, helping to lower chronic inflammation.

  
  

The D3 & K2 Synergy

• Dosing: Dosing should always be personalized based on a blood test (25 (OH) D level). A maintenance dose is often around 2,000 IU daily, but higher doses (5,000 IU or more) may be required temporarily to correct a deficiency.

• Important: Take D3 (the active form) with Vitamin K2. K2 helps direct the calcium that D3 aids in absorbing away from soft tissues and into the bones, which is vital for heart health and preventing vascular calcification (atherosclerosis).

  
  

🍽️ Food Sources of Vitamin D

Vitamin D is not commonly found in the foods we eat, making supplementation often required.

• Fatty Fish: Salmon, mackerel, sardines

• Fortified Foods: Milk, cereals, and orange juice

• Sunlight: Exposure to sunlight allows the body to synthesize its own Vitamin D.

  
  

As a dietitian, I can help you evaluate your current diet and lab work to create a personalized nutrition and supplementation plan that addresses your specific PCOS needs. Make an appointment today to discuss if supplementation is right for you alongside a healthy diet.

Schedule Today

To see our recommended nutritional supplements, please click the link below which will take you to my Fullscript account where you can see my nutritional protocol for PCOS.

Nutritional protocol for PCOS

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