PCOS and Gluten: How to Tell if you Need to go Gluten-Free

The consensus is you must avoid gluten if you have PCOS. But medical experts argue that this approach is oversimplifying the issue. 

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Eating PCOS-friendly foods isn’t just about going gluten-free. A large part of a healthy diet involves restricting anti-inflammatory foods, many of which contain gluten.

Check the context of gluten-free for PCOS successes 

Understand the complete picture when you hear about gluten-free PCOS successes. Without the full context, you’ll base your decisions on incomplete information.

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There’s tons of information online about ditching gluten with great results. Blogs, forums, and social media are filled with these accounts.

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Advocates report regular periods, clearer skin, less bloating, and higher energy levels. Then, once they start having gluten again, it’s all over. Their worst PCOS symptoms reappear. But when you dig deeper, you’ll find people are talking about bigger changes. Many eliminated processed foods and sugar too.

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Take the same approach when it comes to reading posts online. While researching the link between PCOS and gluten, I found an article that said gluten may increase prolactin. Pregnant women produce higher levels of prolactin, but if you’re not pregnant prolactin can interfere with ovulation. When I found the research paper they were referring to, the study focused on young children who were diagnosed with celiac disease.

Listen to your body

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If you have PCOS, you’re more likely to experience digestive issues. Being attuned to your body and tracking what you eat will help you determine if gluten is the root of the problem.

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A large body of research suggests a link between PCOS and unbalanced gut microbiota. One team of researchers for Frontiers in Endocrinology sums it up like this:

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“Since microbiota communities are in dynamic equilibrium in healthy women, the unbalanced microbiota composition is regarded as be associated with the PCOS women. It has been widely demonstrated by many researchers that microbiota composition changes and dysbiosis (25) occurs in PCOS animal models and women with PCOS.”

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At the same time, another study suggests gluten may increase leaky gut. Leaky gut is a condition where the gut lining is damaged, allowing toxins and digested food into the bloodstream.

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So, what’s going on here? Is gluten bad for PCOS? Well, here’s where it gets interesting. In the book 8 Steps to Reverse PCOS, Fiona McCulloch, a naturopath who has PCOS, recommends eliminating gluten to heal a leaky gut:

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“When intestinal cells are exposed to gliadin (a major component of gluten) they release a substance known as zonulin. Zonulin is the compound responsible for opening the barriers between the intestinal cells.”

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She explains that for people who have celiac disease, the release of Zonulin is intense and it takes longer to repair the barrier. Your intestinal barrier repairs more quickly if you don’t have celiac disease.

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McCulloch’s evidence-based advice is this:

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“Recent research has found there are many individuals who have gluten sensitivity and increased Zonulin levels but who don’t have celiac disease so always listen to your body and consider how you feel after eating gluten.”

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After battling with bloat and indigestion, I was diagnosed with gut dysbiosis. I’d completed a course of antibiotics a few weeks before. But the truth is I'd also been deviating from my diet. My integrative doctor suggested the following regime:

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• Medication: I took a gut health supplement for a month. It included Oregano extract, turmeric, and ginger.
• Diet: I followed an elimination diet. For 21 days, I eliminated sugar, dairy, alcohol, and all processed foods. 
• Drinks: Each morning, I drank a glass of diluted aloe vera juice to aid digestion

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After a while, I realized I’d feel particularly bloated after eating a salad containing red onion and balsamic vinegar. Another flare-up happened after I ate a green bean stew. I also have IBS and realized, for the most part, I do better when avoiding high FODMAP foods. 

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Recently, I experienced indigestion after eating gluten-free oats. So, I can’t pinpoint gluten alone as the source of my digestive issues. Instead, I know to specifically limit high FODMAP foods, refined carbs, and added sugars.

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Gluten-free isn’t always healthier 

Going gluten-free doesn't automatically mean you’ll eat healthier. Gluten-free foods are often packed with preservatives, while some gluten-containing foods provide important nutrients.

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Gluten-free foods are often low in protein and high in fat and salt, according to the Nutrients journal. A team of researchers from Canada’s University of Guelph cautions about the risks of going gluten-free:

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“As there is limited evidence supporting the use of the gluten-free diet beyond its role in managing gluten-related disorders, consumers are urged to be mindful of the sensorial limitations and nutritional inadequacies of the diet despite ongoing strategies to improve them.”

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As a result, some gluten-free foods aren’t recommended, writes Selvi Rajagopal, M.D., a specialist in internal medicine and obesity, on the John Hopkins Medicine blog.

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“Consuming these foods can lead to weight gain, blood sugar swings, high blood pressure and other problems. So, a gluten-free label doesn’t necessarily make a food healthy.”

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In addition, cutting out gluten might mean you’re getting less fiber and whole grains. Especially if you’re not getting these vitamins and minerals from other foods.

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“Whole grains can lower cholesterol levels and even help regulate your blood sugar. In addition, some gluten-containing foods are sources of important vitamins and minerals, such as B vitamins, iron and magnesium.”

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A better option is to follow an anti-inflammatory, low-carb diet.

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Adopt an anti-inflammatory, low-carb diet

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Adopting an anti-inflammatory diet, instead of a narrow focus on gluten-free, will make sure you get a well balanced diet.

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There’s been anecdotal evidence that reducing gluten can improve period pain. But Sally King, from Menstrual Matters, told Medical News Today:

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“There’s little scientific evidence to suggest that period pain is affected by wheat or gluten in the diet..but we do know that an anti-inflammatory diet can reduce period pain and blood loss.”

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Conversely, anti-inflammatory foods worsen period cramps:

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“And high-inflammatory diets, with lots of processed foods, caffeine, alcohol, and meat can certainly worsen pain and other cyclical symptoms,” said King.

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McCulloch also recommends an anti-inflammatory diet for women with PCOS. 

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“The anti-inflammatory approach removes dairy and sugar and focuses on whole, real, natural food wherever possible.”

Get expert medical advice

Consult with a medical professional to get an individualized treatment plan before going gluten-free for PCOS. 

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Let me be real: I learned so much about PCOS here on the internet. More than a decade ago, a gynecologist gave me a PCOS diagnosis and sent me on my way with only one piece of advice: “Don’t wait too long to get pregnant.” That was it. I had no idea my acne and irregular cycle was connected to PCOS. 

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Years went by before another healthcare professional helped me piece everything together. Then, I went on a quest to learn everything I can about this condition. I write about those lessons here, and I hope it proves helpful to you.

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All to say, I’m not a medical expert. I share my treatment successes, but PCOS varies and what works for me might not work for you. Take what you can from this post, and anything else you read online. But always seek professional advice before you make any changes that affect your health. 

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Make an informed decision before switching to a gluten-free diet for PCOS

If you’re living with PCOS, following a gluten-free diet seems like the natural choice. But as you can see, it’s a bit more complex than that. 

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With all the information coming at you, it can feel intimidating. You want to make the right choices for you, but you don’t know where to start. 

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Gain a good handle on what the research says. Learn from others. Consider how you tolerate different foods. Perhaps you'll take what you need from gluten free recipes - a focus on whole foods - and incorporate that into your diet. Whatever you decide, take your findings to a doctor you trust and chart a path forward.

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Featured image credit: Photo by Adrienn via Pexels

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