PCOS NUTRITION CENTER BLOG

Food sensitivities are often unknown and may contribute to worsening of symptoms if you have polycystic ovarian syndrome (PCOS). PCOS is a syndrome characterized by a persistent state of inflammation and insulin resistance. If you have had PCOS for some time the insulin resistance component is likely not a surprise and you could even be on a medication to sensitize your cells to insulin. The fact that you may have chronic inflammation in your body is more likely news to you. Inflammation is a word thrown around quite often these days and the purpose of inflammation is not adequately understood.

Understanding Inflammation with PCOS

An inflammatory response is a mechanism (or tool) used by the immune system to protect from invaders, infection and injury. It is a good thing.  In a healthy individual the response is limited in time and resolves after the infection has cleared or injury has healed. However, chronic inflammation can be negative as the impact is not on an invader or injury any longer, but the impact begins working on your own tissues and organs and may cause a cascade of negative health outcomes.

Understanding that inflammation is linked to PCOS provides patients with avenues to pursue lowering inflammatory markers in their bodies. How can you do this? Increase anti-inflammatory foods such as fatty fish, nuts, olive oil, green tea, fruits and vegetables. How else? Consider removing foods and chemicals that may be causing inflammation in the body; in short – consider food sensitivities.

What are Food Sensitivities?

Food sensitivities are not the same thing as food allergies or food intolerances. Food allergies are reactions to a protein within a food and generally appear right away after eating a food. Think: itchy throat, hives, and anaphylaxis. These can be tested by an allergist utilizing a skin prick test. Food intolerances are a result of our bodies not having the ability to metabolize a certain food, this may be due to lack of a certain enzyme or genetic mutations. Think: lactose intolerance, when an individual lacks the enzyme lactase to break apart the sugar in milk products. Food intolerances are tested with different measures, sometimes hydrogen breath tests, blood tests or urine tests, depending on what the suspected offending food may be.

So what are food sensitivities and how are they different? These are generally marked by a delay in reaction, they are associated with the immune system responding with white blood cells releasing inflammatory agents and will manifest with symptoms like: diarrhea, arthritic pain, headaches and migraines. However, there are some cases where the reaction is dose dependent and may not lead to an obvious symptom in an individual. The inflammation related to food sensitivities takes more time to develop than typical food allergies and can target any tissue in your body. These can be particularly harmful if an individual does not know they are having this reaction to a food that is commonly in their diet. For example an individual might be sensitive to eggs and be accustomed to eating eggs multiple times a week or even every day. This daily intake of a food they are reactive to can be the cause of a constant immune reaction causing low grade inflammation in their body. This inflammation can begin affecting organ systems very distant from the gut, like the brain, joints, thyroid tissue and so on.

Testing for Food Sensitivities

Some foods are common culprits in this inflammatory response. You may have heard of some of them: gluten containing grains, dairy, eggs, and soy (among others). There are many books and providers recommending eliminating these foods without testing. However, not everyone with inflammatory markers has an immune response to these foods. That is why testing for specific food sensitivities can be helpful for an individual to target the exact foods that are driving inflammation in their body. In other words, instead of unnecessarily removing entire food groups or foods out of your diet in hopes of lowering inflammation, use a guided approach that considers how you react.

Once determining the reactive foods, it is necessary to remove them from the diet to avoid further inflammation. Using a blood test can guide this elimination protocol and help to make it more manageable (by only removing your specific reactive foods) and more effective due to this lab based method.

If after testing, it is found that you are reactive to a list of foods it is recommended to remove these foods from your diet. Depending on degree of reactivity, it can range from 4 to 6 weeks before reintroduction or 6 months to a year. Many food sensitivities manifest because of inflammation in the gut and compromised gut barrier function (food is getting into the blood stream undigested and it shouldn’t be). Working with a trained practitioner on how long to remove foods and what foods to focus on in the mean time to lower inflammation and restore healthy gut function is imperative. Removal alone isn’t always enough, focusing on healing the gut is also important. As foods are removed that are contributing to inflammation, patients often see increase in energy, decrease in headaches, aches, pains, arthritis, GI disturbances, and sometimes even return of absent menstrual cycles.

A question I receive in my practice often comes in the form of “Will I need to remove these foods forever?” I understand this, especially if an offending food is one of your favorites. The answer to the question is: sometimes. Many patients after restoring gut function and calming their immune reactions are able to reintroduce some of the foods they show reactive to. Oftentimes there is a limited list of foods that still produce symptoms when eaten. So it is on an individual patient basis and even with each different patient, it may depend on the food itself.

A note on tests: Not all food sensitivity tests are created equal. If you are interested in testing for food sensitivities, I recommend asking your medical practitioner if they offer a test that will monitor for type 3 AND type 4 food sensitivities. Many tests will only consider one immune reaction, yet both will drive inflammation in your body, so it is worth selecting a test that will cover both types of reactions. In addition to this, I would also request a list of the foods and chemicals that are tested. Many times we take medications quite frequently or even daily, like a baby aspirin or ibuprofen. Sometimes these chemicals in drugs, chemical preservatives in food or food colorings are what an individual is reacting to, so using a test that accounts for these common chemicals can provide additional guidance and help for an individual.

Tremellen, Kelton, and Karma Pearce. “Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome.” Medical hypotheses 79.1 (2012): 104-112.

González, Frank. “Inflammation in polycystic ovary syndrome: underpinning of insulin resistance and ovarian dysfunction.” Steroids 77.4 (2012): 300-305.

Salama, Amany Alsayed, et al. “Anti-inflammatory dietary combo in overweight and obese women with polycystic ovary syndrome.” North American journal of medical sciences 7.7 (2015): 310.

Caitlin Johnson, RD, CLT is an integrative and functional medicine dietitian. She believes in a holistic, personalized approach to health and healing. She believes in the power of food as medicine. Caitlin specializes in weight loss, food sensitivities, fertility nutrition, peri-menopausal nutrition, eating with thyroid conditions, & working to improve chronic diseases. Caitlin graduated with her BS in Applied Nutrition from California Polytechnic University, San Luis Obispo and interned at Miami Valley Hospital in Dayton, Ohio. She has done extensive training in food sensitivities and functional medicine approaches to healing. For more information, visit her website: www.caitlinjohnsonrd.com