PCOS & Acne: The Underlying Causes of PCOS and How to Treat It

What is a phytoestrogen?

Adverse Reactions to Ketogenic Diets: Caution Advised
Endometriosis may in fact be an autoimmune condition. Hello, Did you happen to pose the alopecia areata question to your Facebook group? I even had been getting acid reflux recently before I made this switch. Low carb was a really bad idea for me even though I was very overweight and I kept carbs at 60g a day. Research has also indicated that o mega-3 may be also effective in improving hirsutism excessive body hair growth and insulin resistance in patients with PCOS. It does not help everyone. And hey, YAY for at home waterbirths!!!


The Paleo Autoimmune Protocol – An Elimination Diet for Autoimmune Disease

Supplements to support your adrenals and HPA axis include adaptogens like rhodiola and nutrients like magnesium. A chronically activated immune system creates inflammation in the body. If you have PCOS but without the insulin resistance, then you may be an inflammatory type.

Mental and physical stress can increase inflammation, as can poor gut health. You may also be affected by environmental toxins or food intolerances. Clues you have chronic inflammation include getting sick all the time or experiencing chronic infections. Also look for things like chronic digestive problems like bloat, diarrhea or constipation, autoimmune disorders, eczema, sore joints, or asthma.

You may also show inflammatory markers on a blood test such as Vitamin D deficiency, abnormal blood count, elevated C-RP, thyroid or autoimmune or gluten antibodies. Treatment — work on fixing your gut. Use probiotics and treat any possible infections like parasites, bacteria, or fungus. Reduce exposure to chemicals and plastics.

Avoid inflammatory foods like A1 dairy, gluten, and sugar. Work on reducing mental stress as well. Normally when you stop the pill, this returns to normal. This is probably you if you had normal periods before the pill and now after going off of it, you no longer do. You also have high LH on a blood test, or normal LH and high prolactin.

However, if your prolactin is high but LH is normal, then use Vitex instead. After three to four months of use, it should kick start your period and should stay regular. It addresses all of these factors simultaneously. Once these are in place, some fine tuning may be in order, but most of the time covering these basics will do all the heavy lifting.

Have you been diagnosed with PCOS or suspect it? Do you see yourself in one of these categories? Thank you so much Tracy for this article. I had been so distraught lately about what to do about PCOS. I have every single symptom but the one about being overweight. I am actually quite underweight and petite. Maybe one of these days you could make a article about this as well. You are a awesome example for keeping up your weight and still eating a healthy diet.

But anyways getting off topic haha I am definitely going to visit a natural practitioner. I check this blog almost everyday! Have a great day! I find his highly insulting as a 47kg healthy woman who has pcos. I take a million natural supplements n eat all the recommended pcos foods and exercise daily. Progesterone deficiency is usually due to oestrogen dominance rather than excess androgens.

Although as with everything else, stress, diet and environmental factors can all contribute to progesterone deficiency.

All the other symptoms you describe are pretty typical of PMS. Most of the time, it means having very few periods in a year… but apparently it could also include periods that are extremely heavy with severe cramps, or even a continuous period.

For me, that would me sense! Also, do you know anyone that have a website and who could help me lose weight… someone who thinks a little bit like you about nutrition and health in general.

But anyway… I agree with you Stella — yes you can lose weight if you need to! So if you need to lose a few pounds, you will! Hi Tracy, I am wondering, how long did you take vitex berry for? How does one know when to stop taking it. Hi J, check out this post by Lara Briden for the ins and outs of using vitex: Great post Tracy — I always wondered how PCOS actually occurred in the body, and you laid it out very nicely and sensibly here.

I have a bit of excess hair on my lower back but my mother assures me I was born with it! Hi Tracy, thanks for the article, you break it down really well. PCOS has been the bane of my life, especially the acne that came with it. Thanks for the info! Do you know if progesterone deficiency contributes to acne and if so, can it be controlled with a healthy diet and lifestyle? The reason why I wonder is because I eat pretty primal and am fairly active, but still have acne after 6 years.

I will check out those supplements! Probably food sensitivities would be the best idea — cutting out known known food sensitivities makes candida cleansing more effective for sure. I just took a look at the GAPS intro diet. To me, it seems like I would be starving all of the time, having to live off of broth then soup then eventually other soft foods.

What are your thoughts on the GAPS diet? It seems intense but may be a good option at this point. Lindy, I suggest talking to your ND, and doing detox. Yes acne will get worse as mine did, but now after using Pekana liquid 3 kit detox, helped get things under control. Your skin is showing the signs of natural detox of the body, but with pcos we need a little help because are bodies are so stressed out with everything going on.

Both are worth the little bit of coin, and the detox is a 30 day easy to fit in your schedule kit. Hi Tracy, just signed up for the next Candida cleanse an hope this is just what I need at the moment! Thanks for this article…. I too have PCOS, and had cysts removed from both ovaries. I started developing acne primarily around my chin area when I was in my early 20s. Hormones have returned to good levels. I have been taking herbals and supplements for pcos.

Any research you can find with duration of use till they are off it???? Blood sugar excellent now, acne only flares up during menses, and I lost that cranky testosterone drive that was really dampening my relationship with husband. Thanks for this article. This is something that really bugs me at the moment because I have excessive hair growth but I show no other symptoms of PCOS. Sore and red skin and acne to name but a few!

Whatever the blood tests say I do want to get a saliva test because my acne is ALWAYS a lot worse around my hormonal time of the month!

Is it possible to have PCOS with no other symptoms like me? What else could it be? Does anyone have any experience with Vaniqua? I always hear about women with acne and other symptoms of hormonal imbalances not necessarily PCOS whose blood tests at the doctor turn out totally normal, when if they have acne and other hormonal symptoms, their hormones are obviously NOT normal.

Thanks so much Tracy for writing about it! It also became worse since I have gone into a very stressful routine for the last year. Also, congrats for your wonderful website, you really make the difference and helps a lot of people! I would like to ask for your advice on some issues relating to my pcos. I must begin by illustrating an idea of where I am coming from.

Reading this article actually changed my life! I came across it one night and realized pcos was one consideration for the root cause of my severe acne I had missed.

Before I came across this article, I have not had a period in about a year. During that time, I failed to see any doctor or professional about it. I did a self diagnosis. I told myself it was because I was under constant stress in college taking more than the recommended number of credit hours.

I have strayed away from carbs as much as I could and absolutely never, never refined sugar. I do however, have a weak point. I allow myself to over eat vegetables and fruit justifying that it is low in cards. I could easlily put away two heads of lettuce with a dozen plus kinds of different vegetable and still have room to eat an entire watermelon for dessert.

I have come to realize this a major flaw in a healthy lifestyle. I am now committed to eating smaller portions. But I have completely cut away all dairy and red meat. The only other meat I would eat is shrimp or salmon. Here is where my issue comes up. Since my diet for years has always been strictly veggies, I had never stopped to think that I could develope insulin resistance by eating too much.

I read the three stores you posted on the bottom of the pcos article about women who had beat their pcos. Since I am struggling to balance my hormones without over eating I am thinking that this may be my answer.

I have still not yet had a period. Do you believe that I will have to eat only meat? I am so used to eating vegetables and believing that plants do wonders for your skin and health.

Hi Lauren — the people who only eat meat are a bit extreme. I just bought the 7 day candida cleanse. I must say I dont know where to start from im 17 and I do need some guidence. If you would please help me I would really appreciate it. Cant wait to start it: I got diagnosed with Pcos a few months ago.

I didnt have high levels of testerone or facial hair just really bad acne and hair loss. It gets me really upset every day i was wondering as time goes on will i get all the symptoms?

I use to drink thought 4 litres of coke every day from 15 to I recently just found out that I have pcos. The only symtoms I have are no periods and the ultra sound indicated that I have cysts on my ovaries. I am very much into supplements, so I wanted to get onto a protocol especially with Standard Process Supplemets. Hi Tracey, i had a blood test and found out that i have high levels of testerones. Please advice on what i should do to reduce my testerone levels.

Is Symplex f going to help me??? I literally laughed out loud when I read this. Was this comment serious? It seems like she must have been kidding to prove the point? I also have regular periods. The thing that has always always worried me is my body hair.

I have hair on my breasts, chest, stomach, butt, I have a mustache not at black as the body hair though. Recently the hair on my neck has been increasing. The worst is my skin is very white and the body hair is black. My skin is also very sensitive and and epilation and plucking leaves it irritated.

Not to mention acne. I remember staring at the mirror as a teenager crying and wishing all the pimples and hairs could go away.

I have been to the obgyn a couple of times and they never said anything about PCOS. Diet has influenced my acne but not my body hair. There was a Turkish study where it helped women with hirsutism and many people on the net swear by it.

I started it one week ago and today I had my ovulation and it was painful. I usually know my ovulation and it is not that painful. I also take flaxseed. You should go back to the doctor and insist they test you for it. Anyway… I mean you might not have it, but hirsutism and acne are indicators there is certainly a chance, and it would be really nice for you to just know.

I hope you are awere of that everybody has hair all over The body and face exept palms and under feets. Some have more than others, some have dark hair on The head, as well as the body. So it is a bit sad that you say that these people has hirsutism, because they have hair and maybe acne. Humans are animal, born with hair all over The place?

I have a very high sex drive, maybe even too high. Is it still possible? And my periods are very regular if I have sex or masturbate on a regular basis. However, my sex drive seems unaffected by it… I also sometimes have an uncomfortable feeling in my thyroid gland. And a constant cough — flaxseed has improved it drastically.

Thank you for the patience. I know how hard it is as a girl to talk about excess hair and how terrible it makes you feel. Like you I am a normal weight, normal periods etc, and my main symptoms are acne and excess hair.

Have you had any blood tests to test your hormone levels? Mine all came back normal anyway but that was the first stage for me. Thank you so much. So I have to wait till I go home or have enough money to have them tested here. When I started spearmint tea my face became absolutely clear.

But the painful ovulation scared me. The pain started to disappear, I had another cup of tea and it came back again, this time stronger. Also I could feel my ovary really hard, I had never ever felt that before. I read that spearmint reduces you androgen levels but since they are still there, they just transform into estrogen. And excessive estrogen is a big problem. So when you take spearmint you should also do something for excessive estrogen not sure what.

And maybe you should drink the tea only five days a month like they did in the Turkish study. I think homeopathy can help with these kind of problems. It certainly helped me with my kidneys and it always helps me when I catch a cold or a flu so maybe that is the answer.

Try consulting a homeopath. At first I thought it was just cystic acne, so I removed milk from my diet, and started taking saw palmetto pills.

This helped a lot, and my period started after I was taking the pill for a month or so, but I still have cystic acne and whiteheads on my cheeks,although not as bad as what I had on my forehead. Tracy After perusing your blog religiously for months in search of answers for my own acne issues, my close work with my naturopath has finally diagnosed me with PCOS.

You help many of us keep asking the questions necessary to finally hone in on the root of our acne, and, ultimately, ourselves. I have two question about the diet for PCOS, though: I am a vegetarian because I live in the states and I find our meat industry appalling and immoral.

I would not be able to live with myself for going back on this decision, so I am posed with a dilemma as far as the PCOS diet. The idea of limiting myself too much also makes me sad, as life is just more fun with leeway and not stressing too much about food.

It worries me, as I have been obsessive about foods in the past, that this will not be healthy either. I know you mention that each person is different, but a general ballpark might help me with this question. Again, thanks for your amazing resource, and your tenacity for helping. It really does make a huge impact. Hi Cheryl, Im sorry to hear you have been diagnosed, but I am very happy to hear that you now know what is wrong! From reading that I have been doing since writing this article , it kind of sounds like it just manages the symptoms… so if you do the low carb paleo thingy, then it should work to keep your symptoms away, until the minute you stop doing it.

I encourage you to read gokaleo. Will it come out in a Kindle version? This blog was perfect for me. I have been eating for Candida elimination for the last 6 months and decided to start to add back some fruit since it is season now. I was shocked to become so sick from a few cherries. I had no idea that fruit was a problem for me. You are a life saver! I wish you perfect health and prosperity.

Thanks for the info. I am here because I ate a good amt of garlic they other night and thought I was dying! Bad pain, nasusea bloat gas and constipation. I started doing Whole30 in March, it helped my gut dramatically, and now follow Paleo since then. Anyway the pain the other night has me researching and I wonder if I have a sensitivity to fructans. Or just cut out the fructans? If I have a problem digesting them should I take a probiotic as well? I currently do not. I need a nondairy probiotic….

Thanks for all the info! By far, far, far the highest fructan foods are from the allium family onions, leeks, garlic. Oh, and the green part of alliums are okay, so you could buy green garlic looks like a leek and just use the green part, or use chives, or the greens of green onions, etc. My favorite probiotic is Prescript-Assist: I can eat polyols on a rotational basis. I have a lot of trouble with fructans and am wondering if there is a particular enzyme that is best to help digest them?

Or did you go straight to the enzyme supplement? Thank you for answering about the palm shortening! I wanted to try out the Paleo low fodmap diet. I printed out the food list. But I keep wondering if I should add in the SIBO recommendations as well and just do a great big elimination diet all at once.

Is there a chart for that? Does it take out all carbs? I feel that I need some carbs. I eat white rice, popcorn, and fruits and vegetables and tiny amounts of maple syrup or honey for my carbs. I was going to cut out the honey, and popcorn. I have bloating that I cannot totally figure out. I have done lots of things with my doctor antibiotics, h pylori protocol, many probiotics, l glutamine, aloe, etc. I already eat a good amount of vegetables, healthy fats, and proteins, and am gluten and dairy free.

I never really eat out or eat unhealthy oils or sugar. I have been diagnosed with pcos and other health issues but really think the root may have been mercury issues, and I have already worked on that, and am doing much better. Just wondering because I bloat up more readily eating roast starchy veggies such as sweet potato than the same veggies in say a blended soup.

Hi Sarah, I am thinking of starting the Paleo diet for an auto-immune condition. It all seems very overwhelming, but promising. Do you know of any person or organizations that I could contact that would be able to assist me in setting up an acceptable food list and just give me direction?

Thanks so much for all your hard work! Your website is incredible! In the meantime, I would suggest contacting Mickey Trescott of autoimmune-Paleo.

My book will also have complete food lists and will be out just two weeks from tomorrow. You could also try the facebook group The Paleo Approach Community. Cabbage is an absolute no go…as is any vinegar and any squash even spaghetti squash. What is the problem exactly with nuts?? I usually have 20 or 30 grames of nuts every day, is this too much?

Sarah has more information about nuts here: Is soy lecithin isolated free of phithostrogen and allergens tha would be safe for people with leaky gut. I feel that if that the case would be helpful to have the soylent food replacement to help the diet. Have you heard of it? My understanding is that soy lecithin does not have phytoestrogens or the more common allergens although sensitivity to lecithin is still possible , however lecithin by itself can contribute to a leaky gut, so taking it in supplement form is not something I recommend I have not heard of soylent.

Very interesting, and something I realize I have to try. Finally, why are tomatoes ok, but not tomato sauce? We use sauces without sweeteners.

But, is there a problem with cooked tomatoes? The green part of leeks would be really good in chicken soup. I believe parsley and cilantro are fine. Unfortunately, you have to experiment. Thank you, ThePaleoMom and J. I actually had already made it last night before seeing these comments. I used carrots, celeriac thinking that perhaps the root would be better than the green?

I will try the green onions and leek greens at some point as well, and may use them for a crockpot recipe instead of onions for later this week.

I was so confused why a good doze of onion, garlic, and fermented drinks make me sick in my stomach. I even looked up onion intolerance and the like to see if this was a known condition. Just one comment about saurkrat, not sure if it is just me or not, but I tried half a cup of it almost a week ago hoping it will help, but it really did hurt me.

Fermented foods also trouble some people, or it may simply have been too large a serving. However, if I repeat for two or more days, its blimp city for me. I do worry about not getting enough veggies, I mostly eat lettuce, and carrots in my soups. Interestingly, my parents have told stories about when I was a breast-feeding infant — if my mom consumed onions, I would get gassy and fussy.

I think that may be a suggestion that the FODMAP intolerance is pretty fundamental to my make-up and may be unlikely to resolve completely.

Now that I have a pretty good understanding of what my body wants, I can at least keep it from self-destructing. I just made the pumpkin well, acorn squash gingerbread muffins as a treat for my kids. I had one—they are very good! If you have any information on molasses, I would appreciate it. Does anyone have any suggestions for what the heck I can snack on?? Half of this battle is mental, I think, but I am feeling really frustrated.

Dried fruit and coconut flesh are high in sugar and inulin fiber respectively, both of which Sarah recommends avoiding or consuming only in moderation on the AIP. Good snacks include small servings of protein perhaps jerky or leftovers from the day before or raw vegetables. Amazing, theoretic as well as practical book you have written!! If you have SIBO, you will need to address that with your physician. You may find this book helpful: I have no digestion issues whatsoever.

I would not remove them unless you have been diagnosed with or strongly suspect an intolerance to them. You might consider looking into infections, histamine, or thyroid issues re: I was on docusate sodium, then I added senekot. Then the pharmacist told me to go on polyethylene glycol What about diet — should I be increasing insoluble fibre or soluble fibre, should I be reducing starches and sugars???

I have probiotics, but maybe I should take more than one pill a day. I also plan on making coconut kefir yogurt though that might have sugar in it too. I also take 50 mg Amitriptyline, mg pregabalin, mg azathioprine, and mg valproic acid. I was doing ok with BMs with all those meds, but only started having issues after I started the new diet. I talked to my doctor about stopping the pantaprazole.

She says to go ahead, but my pharmacist said to stay on because of the prednisone. It was prescribed by the original specialist that diagnosed my illness and who prescribed the prednisone as well.

The digestive track issues I think I could get immediate feedback once I get the diet right. I might even be able to alleviate illness symptom mostly fatigue and pain peripheral neuropathy from the illness — fancy way of saying nerve damage in my lower limbs.

Ok so long post, I apologize. I hope you have some guidance for me. Sarah does recommend a low-FODMAP diet if you have been diagnosed with any kind of SIBO or fructose malabsorption or strongly suspect those foods are a problem for you based on how you feel after you eat them. Milk of magnesia and probiotics can help relieve constipation, as can any kind of fiber the general rule of thumb is to shoot for 9 cups of a variety of veggies and fruit per day as well as getting enough quality sleep and exercise.

Can coconut flour inulin actually cause bacteria overgrowth? Debating on whether just to cut back or cut them out completely for fear of creating an overgrowth.

Do you know if a fermenting process would change the polyol content? I am thinking of water kefir. I add various friuts to the 2nd ferment and was thinking cherry juice might be nice and tasty. I know that the fermentation process converts fructose, but am not sure if it has any effect on the polyols.

On various lists I have seen almonds and cashews on the absolute no list and on the be careful list. Has there been an update? Thank you for all of the information! I always read conflicting information on coffee. I love the taste of coffee and drink 2 cups of decaf in the morning organic, swiss mountain process decaf. What is your opinion on the type of decaf I drink…should I stay away from all forms of coffee for a while?

Sarah discusses coffee in more depth here: What tests would you need to get done? Sarah discusses that here: Thank you for getting back to me! I started the AIP diet a few months ago. Anyone else gone through that?

Sarah explains why food reactions seem to get worse after eliminating those foods here: I never had such bad issues eating SAD food. Thanks for the reply Claire. Do you cook in cast iron pans and eat liver?

Any kind of poor gut health can make it difficult for your body to absorb the nutrients you eat or supplement. Can you please explain what cooking with cast iron does? I almost exclusively cook with it. Please try this one. I reacted to the vitamins and large doses of honey. I almost always get nauseated from B vitamins. My doc has switched me to the higher fat mixture, which I somehow lost track of — brain fog! So the idea now is to take less of the multivitamin, supplement with a good mineral combination, extra electrolytes — a homemade version without sweeteners, and switch out half the honey with coconut oil for energy.

Just in case anyone else needs to get rid of SIBO and does not want to go the antibiotic route. Regardless of the initial treatment, it has to be followed with a very strict diet that is very similar to the FODMAP plan. Everyone reacts differently and sometimes a little wise tweaking is necessary. For comparison, here is the link for the post treatment SIBO food list.

Can you clarify for me what was the initial treatment for you. How did you know you were ready to change to a maintenance diet? What is your maintenance diet? I am in the midst of the Elemental diet. For two weeks I can only ingest not eat! Bleh a mixture of vitamins, fat, honey and pure and complete protein powder. It is meant to starve the little beasties to death. Because the bacteria feed on a specific type of carbohydrate regular food is limited to items on the safe list, gradually adding food from the cautionary list.

Link above several months on the very limited list. Ok thanks for clarifying. My doc told me about SIBO. I read a little about it here but she has had several people test and treat for it.

She gave me a kit that measures gases. You breathe into the tube and there are little glass vials attached one at a time. Then when all the samples are collected — every 20 minutes for 3 hours — and labeled, you send the box off to the lab.

In about a week the doc gets the results and you decide which course to take. My doc suggested I try the Elemental diet because I am somewhat used to fasting and the antibiotics are harsh. There is another option that takes a month of strict food list, high dosage garlic and oregano oil or goldenseal. The garlic and goldenseal kill the bacteria and the strict diet keep it dead.

I did not do this because I just wanted to get it over with. I ordered it from Jo-Labs. It is kinda yucky but there are ways to make it better. The non-homemade version is Vivonex and it is very expensive. I go to a naturopath but the research and treatment was done by an Allopath M. Everything about my sleep patterns is the same and I allot myself 9 hours to get sleep.

Sarah discusses insomnia here: And then began insomnia at the exact same time. I have a post that talks about insomnia and histamine intolerance here: I eat a lot of vegetables but still feel so hungry.

Is it possible I just need to try the digestive aids first? Are you getting enough fat? I pop a couple from time to time as a supplement and a little snack treat. I like the flavor of the lemon but you could use something else. When I was on the elemental fast I used natural peppermint and orange flavoring to make it more palatable. Your gut needs to heal and the coconut oil helps, as does gelatin.

We make a gelatin using Tulsi tea, honey and pure beef gelatin but you could use almost any liquid to make it. We even tried coconut milk once. I eat a lot of coconut oil and gelatin. I drink lots of water and a fair amount of rooibos tea. I also have concerns about orthorexia. Coconut oil is not restricted. Coconut flakes are limited to a quantity as is coconut milk. You can eat as much as you like during those meals and if you cannot make five hours, you do four.

Last night I had a company dinner and used Gather Paleo Entertaining cookbook and a recipe from the celiac site. There was plenty of food and I could eat most of it. I only changed a couple of items. I started reintroductions about two months ago, on a very slow schedule, beginning with FODMAPs as Sarah suggested, which seemed to go fine. Same problem here Kelli! Yes, having to cook for other people not doing AIP is extra challenging. There are six in my family everyone with separate intolerances and allergies , so we often have four dinners to make.

I have been diagnosed with Celiac for 2 years now. My doctor has been trying to put me on statins since then too, but I refuse. Says my cholesterol is way too high. I want to control everything natural by diet. I have cut out dairy now too and am trying to limit meats to possibly once a day if that. He said I should incorporate beans into my diet for the protein, but I know that legumes are usually not tolerated well for celiacs.

I know you are not a Dr but what is your opinion on this? Sarah recommends the autoimmune protocol for all autoimmune patients, which includes meat and seafood for protein. Teresa, all of my counts are better since going Paleo.

My doc even had to lower my prescription thyroid dosage. I urge you to get tested for SIBO too. It is a drag to treat and follow up on but healing is the goal.

I feel much the same as Kelli. During this period I have been addressing SIBO, gut healing, digestive enzymes, stomach acid, and colon bacterial undergrowth. Of course I am now supersensitive to small amount of these foods, and rechallenging foods, even after all of the above, has not proven benefitial. I have a particularly strong intolerance to fructans but not so much polyols.

Are there any digestive enzymes in particular you would recommend? Or just a general wide spectrum blend? Thank you so much! I think trying plant enzymes Thorne Research has one and Enriching Gifts is another good brand would be the best first thing to try. It seems more manageable than the one in the book. What do you mean by cream in the table? Do you mean the whipping cream? Thank you in advance! It seems like I can tolerate some of the foods when cooked, but not raw.

Some of this is outdated. I want the probiotics. Can you adapt this not only for fructose but also for a diabetic as I am both with a Wheat intolerance also! I developed symptoms of food intolerance after cancer treatment colorectal. Before that I ate a varied diet without pain, bloating and misery.

Of course one of the methods of encouraging a return to intestinal normalcy is fiber. I finally figured out that it was part of the problem. Do you have cancer survivors experience this?

How She lost 125 lbs. with PCOS