Gluten and PCOS

If you have polycystic ovary syndrome (PCOS), chances are you may have considered following a gluten-free diet. Gluten and PCOS is a hot topic among the internet and social media. Some websites warn against eating gluten and claim it may cause hormone imbalances, inflammation, and worsening insulin resistance. Others argue that there is no research to support a gluten-free diet for women with PCOS.
In this article, we will discuss the controversial topic of gluten and PCOS and whether or not you need to follow a gluten-free diet if you have this condition.

What is Gluten?

Gluten is the name for a group of proteins found in grains like wheat, barley, and rye. Gluten provides texture, retains moisture, and promotes elasticity to bread and other baked goods.
Everyday foods that commonly contain gluten include:
  • Pasta
  • Bread
  • Crackers
  • Cookies
  • Pastries
  • Cakes or Pies
  • Cereal 
  • Beer
Because of its unique properties, gluten is also used as an additive in processed foods like gravy, condiments, soup, and lunchmeat.

Gluten-Related Disorders

There are two main types of gluten-related disorders: celiac disease and non-celiac gluten sensitivity.

Celiac Disease

Celiac disease is a serious autoimmune condition in which a person’s immune system mistakenly attacks the lining of their small intestine after eating gluten-containing foods. The only treatment for celiac disease is a strict and lifelong gluten-free diet. Only an estimated 1 percent of the population has celiac disease, although experts suspect that many people remain undiagnosed. Your doctor can screen for celiac disease with a blood test to look for antibodies called anti-tissue transglutaminase (tTGA). 

Gluten Sensitivity

Gluten sensitivity is a condition in which a person experiences a variety of symptoms after eating gluten-containing foods, but does not have celiac disease or a wheat allergy. Symptoms of gluten sensitivity vary and may include gastrointestinal upset, brain fog, anxiety,  headaches, or skin disturbances. Gluten sensitivity is thought to affect up to 13 percent of the general population and may be more prevalent in women than men (1). There is no one overall test to diagnose gluten sensitivity. Rather, health providers may recommend omitting gluten as part of a short-term elimination diet and/or food sensitivity tests to screen for this condition.

Benefits of a Gluten-Free Diet for PCOS

Although there are no studies specifically looking at the relationship between gluten and PCOS, many women report a reduction in symptoms after eliminating gluten from their diet. How could this be?

Lower Refined Carbohydrates 

Most gluten-containing foods in the American diet are also higher in refined carbohydrates and/or added sugar. Eating less of these foods can improve blood sugar levels in women with PCOS. This is helpful because an estimated 70 percent of women with PCOS have some degree of insulin resistance, a condition that reduces your body’s ability to breakdown carbohydrates. Insulin resistance is responsible for many common PCOS symptoms like acne, unwanted hair growth or hair loss, irregular periods, and infertility. By eating less refined carbs and added sugar, women with PCOS may experience improved blood sugar levels, less insulin resistance, and overall symptom improvement.

Gut Health

If you are one of the individuals with PCOS who also has a gluten sensitivity, you may experience benefits from eliminating gluten from your diet. Food sensitivities occur when your immune system overreacts to a particular food which can then trigger more inflammation, leaky gut, and an imbalance in gut bacteria. These three factors largely affect PCOS and overall health. In fact, women with PCOS are more likely to have leaky gut and dysbiosis—an imbalance in gut bacteria—than women without this condition (2). Temporarily eliminating food sensitivities as part of a gut healing protocol can reduce inflammation, heal leaky gut, and rebalance your gut microbiome to treat PCOS from the inside out. 
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At Root Functional Medicine, we offer personalized testing to identify food sensitivities and develop a short-term elimination diet based on your individualized results. Learn more about our food sensitivity test and elimination diet.

Thyroid Health

Women with PCOS are three times more likely to also have an autoimmune thyroid disease called Hashimoto’s thyroiditis (3). With Hashimoto’s, the immune system mistakenly attacks the thyroid gland causing progressive damage and inflammation which eventually leads to hypothyroidism. Some studies have shown benefits in using a gluten-free diet with Hashimoto’s and other autoimmune conditions (4, 5, 6). 

Cautions with a Gluten-Free Diet

If you suspect that you may have celiac disease or gluten sensitivity, check with your doctor before eliminating it. Otherwise, the blood test used to screen for celiac disease can result in a false negative if you have already eliminated gluten from your diet.
What’s more, many gluten-free food items have poor nutritional value, are high in added sugar, and can worsen insulin resistance and PCOS symptoms. If you decide to try a gluten-free diet, focus on eating whole and unprocessed foods that are naturally free of gluten like fruits, vegetables, nuts, seeds, lean protein, and gluten-free whole grains (i.e. brown rice or quinoa).

Gluten and PCOS: Key Takeaways

Currently, there are no research studies to support a blanket gluten-free diet recommendation for all women with PCOS. Many women with PCOS report feeling better on a gluten-free diet; however, this may be related to eating less refined carbohydrates, a gluten sensitivity, or an underlying Hashimoto’s diagnosis. If you have celiac disease, following a lifelong gluten-free diet is required. 
While gluten sensitivity does not cause PCOS, it is often a symptom of an underlying imbalance, like poor gut health. In fact, some food sensitivities can be reversed after properly healing the gut! 
When it comes to gluten and PCOS, we practice individualized functional medicine and take each patient’s story and experiences into consideration when making recommendations. That being said, we may suggest a temporary elimination of gluten while working with you to address the underlying causes of your PCOS. 
Our Functional Medicine Membership Program offers individualized support if you are looking to get to the root of your PCOS symptoms. 
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