PCOS and Carbs: 3 Steps To Identify Your Ideal Carb Intake
There are so many questions about PCOS and carbs, especially how many you should be having. This week alone I’ve read articles claiming that all women with PCOS should be on a very low carb (ketogenic diet) and others suggesting a low GI but relatively high carb diet. The truth is, there is no one rule for PCOS and carbs. It all depends on the root cause of your PCOS.
The reason PCOS and carbs are such a hot topic is because carbohydrates make blood sugar rise. Therefore, anyone with severe insulin resistance needs to stay away from them. While 70% of women with PCOS have insulin resistance, 30% do not – a low carbohydrate diet would probably make your PCOS worse if you’re not one of the majority.
I recently had a client who’d read numerous articles and books saying that all women with PCOS should be on a low carb diet. However, her GP had never tested her insulin, so there was no indication that she had insulin resistance. As it transpired, she had PCOS caused mostly by high stress hormones (she was an endurance athlete and city lawyer) and too few carbohydrates were actually causing a lot of her issues.
If you haven’t read my post on what’s causing your PCOS then do that now. Once you’ve done that then come back to this article to determine your ideal carb intake.
How Many Carbs Should You Be Eating?
It takes a bit of trial and effort to work out how many carbs you should be eating to treat your PCOS cause. I’ve outlined some factors and steps below.
Do You Have Insulin Resistance?
If you’ve been diagnosed with PCOS but not had your blood sugar tested, then you need to get to your doctor ASAP to this checked. Ask them to test your:
– Fasting insulin,
– Fasting glucose,
– HBA1c (this tells you what your blood sugar has been doing over the past month)
If these are out of the normal range then your doctor might tell you that you have insulin resistance. If they are really high then you may even have Type 2 diabetes.
Insulin resistance will be one of the reasons you can’t lose weight and will also be behind your other PCOS symptoms. Even so-called ‘lean PCOS’ can be insulin resistant, so don’t mistake being lean for having normal blood sugar — get it tested.
If you do have insulin resistance then you should be focusing on getting this back into the normal range. Carbohydrates cause blood sugar to rise and studies have shown that low carbohydrate/Ketogenic diets can be effective in normalising blood sugar and weight loss in PCOS insulin resistant women.
If you don’t have insulin resistance then a low carb diet probably won’t be right for you; and if you’re an athlete then it’s probably making your PCOS much worse (or even causing it).
I know this can get really confusing so I’ve created a table to help you work out your ideal carb intake:
Trial Your New Intake
Once you’ve determined how many carbs you think you should be eating, the next step is to try it out. I recommend that you try out your new intake for 30-60 days – see how you feel and what your results are. 30-60 days will give your body time to adjust and for you to know if your new intake is making you better or worse.
Our bodies are such complex systems, so what should work in theory may not in reality. I’ve had many clients who are athletes and have done very well on high carb diets, and I’ve had a few insulin resistant clients who have gained more weight going low carb. The main thing is to give it a try and also to know when to get help from a professional.
I would always recommend that you get help if you don’t fit nicely into one of the categories above. For example, if you have insulin resistant PCOS but you’re also an athlete. I’ve been here and I know it’s not easy to work out, even though I’m a nutritionist!
Regularly Measure Your Blood Sugar
If you’re insulin resistant then get a glucometer and measure your blood sugar every day. If your blood sugar sky rockets and stays elevated for more than 2 hours after you’ve eaten, you know that you’ve eaten too many carbs. Alternatively, if it stays in the normal range then that is a good indication you can tolerate that amount of carbohydrate.
You should also get your fasting insulin, glucose, and HBA1C tested before and after the 60 day period. This way, you’ll have concrete evidence whether your new carb intake has helped your blood glucose. For example, if you tried low (15% carb) for 60 days and felt great but your test results didn’t improve, you might want to drop down to 10%.
I also recommend that you record all your meals and how you feel in an app or notebook. If you do this, it’s much easier to detect patterns, what’s working well and why. I recommend the Meal Logger app. By having a record, a professional will be able to use this to understand what might be going wrong. Without it, you will most likely have to repeat the exercise.
What Signs Should You Look Out For?
Intense sugar cravings. You know what I’m talking about. That 3pm or after dinner MUST EAT SUGAR craving. This is a really good sign that you’re having blood sugar peaks and troughs and that you need to stabilise your blood sugar.
If you’re an athlete and are constantly tired, sore, and not recovering after workouts. This might meant that you aren’t consuming enough carbohydrates.
You’re gaining weight. This might be due to many things, but is definitely a warning sign if you’re an athlete. If you’re restricting your calories and working out but still gaining weight then this is a good sign that you need to seek help.
Summary: PCOS and Carbs
I hope this article has made things a little clearer for you and that you have a plan of what you are going to try for the next 60 days. There is nothing better than trial and error. However, if you’ve already tried a few different approaches and nothing is working for you or you’re still confused, then please don’t hesitate to reach out to me.