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PCOS: Nutritional Supplements


Magnesium Glycinate


Magnesium is an important mineral that women with PCOS tend to be deficient in. Here are some benefits of optimal magnesium levels:

Reduces PMS Symptoms

Magnesium is a safe and effective treatment for relieving the symptoms of premenstrual syndrome (PMS). Magnesium supplementation of 250 mg daily has been shown to be helpful for lessening bloating, cravings, cramping and reducing anxiety and sleep disturbances associated with PMS.


Lowers Inflammation

A big benefit of magnesium for PCOS is its ability to lower inflammation. Women with PCOS were randomly assigned to take either 250 mg of magnesium oxide plus 220 mg of zinc sulfate (containing 50 mg zinc) supplements or placebo twice a day for 12 weeks. The Magnesium-Zinc group saw significantly beneficial effects on inflammation by lower serum HS-CRP and greater total antioxidant status.

Reduces Insulin Resistance

Individuals with insulin resistance and those with metabolic syndrome or type 2 diabetes tend to be lacking magnesium. One theory is that chronic high insulin reduces magnesium levels. Magnesium is important to help glucose enter cells where it is used for energy. Part of its job in doing this is regulating the function and transport of insulin, which acts as a key to open the cell doors to glucose.

Lowers Blood Pressure

High blood pressure, also called hypertension, is a risk factor for heart disease. A diet rich in fruits and vegetables has been shown to be an effective treatment to reduce high blood pressure as well as other metabolic aspects in women with PCOS and are high in magnesium.


Signs you may be deficient in Magnesium

  • Muscle cramping, pain

  • Frequent headaches or migraine headaches

  • Mood changes like: anxiety, depression or irritability

  • Elevated blood Pressure

  • Insulin resistance or metabolic syndrome

  • Low energy level or chronic fatigue

  • Memory issues, difficulty focusing, problems maintaining attention.

  • Painful menstrual periods or severe PMS symptoms

  • Difficulty sleeping

  • Brittle bones and development of stones

  • Numbness or tingling in hands and feet

  • Intense cravings for sweets, especially chocolate

Dosing for Magnesium

Magnesium supplements are available in a variety of forms, including magnesium oxide, citrate, or glycinate. Magnesium oxide in not well absorbed and may cause diarrhea or GI upset. Magnesium citrate is much better tolerated and has very gentle laxative effect which may help if you suffer from constipation. Magnesium glycinate is the most universal form that is well absorbed and tolerated with minimal GI effects. Appropriate dosing of magnesium ranges from 200-350mg per day. Do not take magnesium if you have a heart problem called “heart block” or any kidney problems or kidney failure.


Zinc

Some researchers suggest that zinc deficiency may be partly to blame for the insulin resistance and abnormal cholesterol levels often seen in PCOS. Fortunately, taking a zinc supplement may help to treat these underlying conditions. Here are some of the benefits of supplementing with Zinc.

Reduces PMS Symptoms

If you suffer from PMS symptoms like bloating, cramps, headaches, and increased anxiety, zinc may help. One important role of zinc is regulating the menstrual cycle. Serum levels of zinc during the luteal phase (approximately 2 weeks before your period) are significantly lower than during the follicular phase. Zinc levels have been shown to be lower in women with PMS. Low zinc status is also linked with mood disorders.

Increases Fertility

Zinc is important for ovulation and to help follicles mature. Women with PCOS who were infertile had lower levels of zinc than PCOS women who were fertile.

Minimizes Hair Loss

In a study, women with PCOS were randomly selected to receive zinc (50mg daily) or a placebo. After 8 weeks, 41.7% of women who supplemented with zinc saw a significant reduction in hair loss (alopecia) compared to only 12.5% of those taking the placebo. Zinc works to inhibit the enzyme that converts testosterone into its non-aromatizable form, dihydrotestosterone (DHT), which is how it can reduce hair loss as well as other symptoms associated with high testosterone levels in women with PCOS like acne and unwanted hair growth.

Reduces Hirsutism


Unwanted and excessive hair growth (hirsutism), caused by excess androgens such as testosterone, is another frustrating symptom of PCOS. Zinc has also been shown to significantly reduce hirsutism when supplemented with magnesium, calcium and vitamin D.


Reduction in Acne

Another added benefit of zinc for women with PCOS is that it may be able to reduce the appearance of acne.

Reduces Inflammation

As an antioxidant, zinc plays a role in helping to prevent cell damage and inflammation caused by oxidative stress. Studies show that women with PCOS have high levels of oxidative stress.

Lowers Insulin

Zinc is also good for PCOS because it can lower insulin levels. Zinc is involved in the synthesis, storage, and release of insulin. Low levels of zinc have also been shown in those with type 2 diabetes. It is believed that insulin binds to zinc to help it attach to cell insulin receptors to allow glucose to enter cells.


Zinc deficiency symptoms vary but may include:

  • Growth and development problems

  • Infertility

  • Hair loss

  • Diarrhea

  • Skin conditions (acne, boils, dermatitis)

  • Loss of appetite

  • Weight loss

  • Delayed wound healing

  • Poor immune function

  • Frequent colds

  • Taste changes

  • Mental slowness

Dosing of Zinc

Therapeutic amounts based on studies are 30 mg to 50 mg daily. Types of zinc to look for include zinc glycinate, citrate, and picolinate. Zinc is contraindicated in people with hemochromatosis.

Food Sources of Zinc

While oysters are by far the food with the highest amount of zinc, other good food sources include red meat, shellfish, chickpeas, and cashews.


B Complex

Taking a general B-complex or a good multivitamin with good amounts of B vitamins is a great supplement with a range of benefits. Some medications like birth control and metformin can actually deplete your body of some B vitamins. B6, Folate, and B12 are important in optimizing hormonal balance. They help to lower inflammation by breaking down homocysteine which may also reduce risk factor for heart disease and other reproductive symptoms.

Dosing of B-complex

Choose a vitamin that contains the methylated forms of folate and B12 (Cobalamin) which are the active forms. Folic acid and cyanocobalamin are the inactive versions. This is extremely necessary for those with MTHFR genetic mutations.


Vitamin D

It is very common to be deficient in Vitamin D and up to 85% of women with PCOS have a vitamin D deficiency. Lower vitamin D levels are significantly associated with worsening insulin resistance in PCOS. Since vitamin D is not commonly found in the foods we eat, we must rely on adequate sunshine or supplementation and due to increase usage of sunscreen and working indoors alongside those with darker complexion (more protective melanocytes), supplementations usually is required. Having adequate amounts of vitamin D may improve insulin resistance, lower inflammation, and help to normalize your menstrual cycle. Dosing of Vitamin D

Vitamin D dosing should be personalized based on your own lab results. For example, if your vitamin D levels are adequate (60-80 ng/mL), a maintenance dose of about 2,000IU per day may be most appropriate. However, you may require higher doses (5,000 units or more) if your blood levels indicate a vitamin D inadequacy or deficiency. If you are severely deficient (less than 25), you may require a short term prescription for a megadose of vitamin D. I always recommend that every person ask to have their vitamin D checked.

Ideally, you want to take D3 (active form) with vitamin K2, which helps direct calcium and vitamin D to your bones where it can be used and stored. Vitamin K2 also helps reduce the progression of atherosclerosis (plaque build up in the arteries).


If you need help evaluation whether or not supplementation is right for you make an appointment today with one of our dietitians. We can help determine if you need to supplement alongside a healthy diet.


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.



References:

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  10. Afshar The Effects of Magnesium and Zinc Co-Supplementation on Biomarkers of Inflammation and Oxidative Stress, and Gene Expression Related to Inflammation in Polycystic Ovary Syndrome: a Randomized Controlled Clinical Trial. Biol Trace Elem Res. 2018 Aug;184(2):300-307.

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  13. Hessam S. Combination of oral zinc gluconate and topical triclosan: An anti-inflammatory treatment modality for initial hidradenitis suppurativa. J Dermatol Sci. 2016 Nov;84(2):197-202.

  14. Mazloomi S, Alizadeh N, Aminzare M. Serum Zinc and Adiponectin Levels in Patients with Polycystic Ovary Syndrome, Adjusted for Anthropometric, Biochemical, Dietary Intake, and Physical Activity Measures. Biol Trace Elem Res. 2017.

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  24. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.


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