Biomarkers for hormone health & PCOS
Before we get into the depth of knowledge we can learn from these biomarkers, let’s make sure we are on the same page about a few things:
PCOS is a diagnosis, sure, but it’s not a root cause, some major root causes are adrenal hormones, inflammation, micronutrients, insulin resistance
There will never just be a magic pill for healing PCOS, we need to take a holistic mind-body-spirit approach to target the complexity of this syndrome
Micronutrients are a powerful therapy - these are not the same as what I consider “supplemental items” like protein powders and we need adequate testing options to be accessible to prevent causing more harm than good with micronutrients supplementation
Alright babe, if you’re reading this you’ve probably researched PCOS healing diets multiple times and found keto, vegan, Paleo type diets promoted by influencers on Tiktok, hundreds of books on Amazon you could weed through, and very little information from your doctor. While there is some great information out there on the internet (and plenty of helpful doctors too), there’s no one size fits all approach. By taking a personalized look at your physiology with these markers, you can be empowered to restore whatever areas YOU are actually lacking in.
Vitamin A
Starting with this gem because it is so f*cking important for menstrual health and hormones. Vitamin A actually acts as a hormone and impacts the cell cycle. It also supports the immune system, skin health, gut repair mechanisms and is necessary for ovulation, reproduction and thyroid function. If we are not ovulating (which many ladies with PCOS are not, we are at higher risk of anxiety, insomnia and issues associated with low progesterone). Many people with vitamin A deficiencies actually present with very similar symptoms to PCOS, but that’s beside the point. A few red flags telling me you could be low in vitamin A would be:
Acne, eczema, dry skin
Getting sick frequently
Little bumps on back of arms or acne on face/body (vitamin A super important for skin health)
Eyes are extremely sensitive to light or you feel almost blind driving at night
Irregular cycles
Anemia
Since most vitamin A is stored in the LIVER not the blood, this blood test does not always really reflect the body levels. But since it only costs about $3 to add to the panel, it’s still useful to look at. I’ll also assess how much you’re getting in from your diet and how much we can safely add with foods and supplements.
Deficiency of vitamin A can result from alcohol intake, gut health issues, or low intake of protein, calories or zinc. Abnormal vitamin A levels are also common in hyper- and hypothyroidism.
Food sources of vitamin A
Retinol form: liver, dairy, fish
Provitamin A or carotenoids: sweet potatoes, carrots, leafy green vegetables, small amounts in some fruits
blood sugar Panel
This part is so essential to understand if you struggle with PCOS.
You. WILL. Have. High. INSULIN. Before. High BLOOD SUGAR. Women with PCOS are at a higher risk of Gestational Diabetes, Type 2 Diabetes and Cardiovascular Disease due to their issues with controlling blood sugar. Weight managament is also related. You could gain weight much more easily because of high insulin levels. You could also have worsened menstrual irregularities, fertility issues, acne and hair growth. These markers in this panel can reveal if insulin resistance is a root cause of your symptoms.
If you want to know the mechanisms: Insulin acts “synergistically” (meaning they’re a dynamic duo like you and your bestie, when one levels up, the other does too) with Luteinizing Hormone. Luteinizing hormone increases the production of androgens and decreases the liver’s production of the hormone that binds with testosterone (called Serum Hormone Binding Globulin), this increases the active (unbound) form of testosterone. Higher testosterone can result in acne & hair growth. When high androgens are paired with excess adipose tissue (aka body weight) systemic inflammation can increase and drive up symptoms too.
Targeting androgens and insulin can and SHOULD be a first line approach to PCOS. Then in the long term, weight loss will be easier to achieve (if necessary and desired). Essentially all women can benefit from an anti-inflammatory, low-glycemic diet. Testing insulin allows us to see via lab work that nutrition changes are truly necessary, PLUS be able to track your body’s “progress” in ways other than just the scale. Blood sugar and other markers on this panel can also give us some more info, but high insulin is not just a red flag, it’s a siren that some nutrition therapy may be needed.
Fatty Acids and Omega-3s
If you’ve ever started researching nutrition and dieting, you’re probably confused about fats in foods. They’re bad right? They must make us fat with that name?! And weren’t there studies on fats being bad for heart health and cholesterol?????
Fatty acids extremely important for hormone health and PCOS. The standard American diet is much higher in omega-6 fats (dairy, meats, vegetable oils) than omega-3s, which is why it’s important to test and assess our dietary patterns.
I’ve definitely felt the difference in how my body feels when I eat plenty of the right types of fats. More regular periods, less cravings and clearer skin!
Low levels of fatty acids, or an imbalance of the wrong kinds (more omega-6 type) has been associated with increased risks of chronic diseases (and women with PCOS are already at a higher risk of Type 2 Diabetes, Heart Disease and Depression). The nervous system is also highly concentrated with fatty acids; deficiencies can leave you susceptible to a change in responses to our environmental stressors and impaired memory/cognition. Hello brain fog and burnout. The nervous system is crazy complex, but let’s make sure we are supporting its foundational building blocks.
Celiac and nutrition
Okay you might be thinking why the f*ck is she checking this. I love bread and I’m not giving it up. I KNOW, me too babe. But there’s a couple phenomenon (is that plural idk) that can be related to inflammatory driven PCOS. The first thing this panel checks for is what’s called Non-Celiac Gluten Sensitivity (NCGS). This is when gluten is causing inflammatory symptoms including depressing the nervous system (fatigue, depression, low mood), skin issues like acne, gut issues (constipation and diarrhea) and overall making PCOS symptoms worse. Intolerance to gluten is very common among women with hypothyroidism, which is common to see alongside PCOS. I’m definitely not for fearing gluten and automatically eliminating it, but if we are able to look at these markers and see if you’re more likely to be experiencing NCGS then we can intervene. This panel also includes some key nutrients that are seen to be low both in people with gluten intolerances and PCOS including iron and vitamin D. This panel also includes markers related to iron including:
Iron
TIBC
Transferrin / Saturation
Ferritin
TIBC
Zinc
Women with PCOS have been found to have significantly lower serum zinc levels. This mineral can impact how well blood sugar responds to carbohydrates. It also is important in the transcription of a variety of steroid hormones. One root cause to low zinc levels is a diet high in phystates (found in fiber rich foods) and low in dietary protein, this is a common trend in vegans/vegetarians and one reason I caution women to be fully vegan/vegetarian. Iron and calcium intake also impact zinc.
Red Blood Cell Magnesium
Magnesium is another mineral important for reversing and treating blood sugar dysregulation. Changes in RBC magnesium have also been shown to worsen high blood pressure, premenstrual syndrome and chronic fatigue syndrome.
Thyroid Panel
Unfortunately women with PCOS commonly also have thyroid issues. Hypothyroidism is the most common concern. Nutrition can play a role in managing thyroid health through a variety of factors including iodine and gluten sensitivity. Decreased thyroid hormones can impair the conversion of beta-carotene to vitamin A and may exacerbate your symptoms.
Stress also can play a role in thyroid health. Common overlapping symptoms between thyroid concerns and PCOS include hair loss, fatigue, weight gain or irregular periods, the thyroid may be playing a part.
Alright babe, that was a lot of science heavy information. Hopefully you can see there’s an abundance of actionable steps we can take to improve your symptoms through nutrition therapy and lifestyle.
-Kelli, RD
