If you are a woman with PCOS, you may have been told that a vegan diet is the best way to manage your condition. There is a LOT of misinformation about PCOS, but nutrition can be a powerful ally to symptom management if done right. However, a vegan diet is not always the best fit for women with PCOS.
In this blog post, I’ll walk you through what a vegan diet is and why I don’t recommend it to my PCOS clients.
What is a vegan diet?
A vegan diet is a type of vegetarian diet that excludes all animal products, including meat, eggs, dairy, and honey. A vegan may also avoid any products made from animals, such as not wearing leather.
Vegans eat fruits, vegetables, grains, nuts, and seeds.
These days, it is easier than ever to follow a vegan diet. From oat milk to veggie burgers, there are many products available at the grocery store that exclude all animal products. About 0.5% of people in the US follow a vegan diet (1, 2). More people consider themselves vegetarian – an estimated 2% of the US population.
Although there are many potential benefits of a well-planned vegan diet, there are also significant risks. These risks are not often discussed and are of greater significance for those who have PCOS, Hypothyroidism, or Hashimoto’s disease.
An important note on gut health, PCOS, and a vegan diet
Poor gut health is linked to PCOS. It can also be a symptom of PCOS – this is kind of like the chicken or the egg – which came first?
For women with PCOS, gut issues are common, including IBS (6).
Digestive issues and a vegan diet might be a challenging combo. Here’s why:
To meet your nutrient needs on a vegan diet, you have to eat plenty of beans, lentils, leafy greens, whole grains, nuts, and seeds. All of these are very difficult to digest and can make gut problems worse.
And in case this sounds like I’m saying that “beans are bad” or that you shouldn’t eat kale, I’m not – they’re healthy foods. But it can be more gentle to your digestive tract to have them in combination with other foods, such as eggs, meat, and dairy. This is kind of like Goldilocks and the Three Bears: not too much, not too little. Eating too much of these very high-fiber foods can irritate your gut and make it difficult to heal your gut.
Getting your nutrients from animal-based foods makes it easier to absorb them, without needing such high-fiber, high phytate, and lectin-rich foods for nutrients and thus reduces gut irritability.
So, along with a healthy digestive tract, what nutrients are of great significance to women with PCOS? Let’s cover those now!
A vegan diet lacks many nutrients important for PCOS
The following nutrients are absolutely essential for managing PCOS and are very difficult to get through a vegan diet.
If you’ve ever followed a vegetarian or vegan diet before, you’ve probably had the experience of friends, family members, and random strangers suddenly being interested in your protein status, once they learn that you’re a vegetarian or vegan.
The truth is that it is possible to get enough protein as a vegetarian or vegan, but if you’re someone with PCOS, it might be a whole lot trickier.
Dietary protein has a lot of important roles in your body. There is a lot more to it than just bulking your biceps. For my clients with PCOS, I like to draw their attention to four specific roles of protein.
- Liver function. The liver helps to keep hormone levels balanced, which is a harder task for someone with PCOS. The liver also plays a role in blood sugar balance and in the support of your thyroid (7). And you know what the liver needs to do this important work? Protein!
- Building hormones. Your liver makes certain hormones, such as sex hormone binding globulin (SHBG) which grabs onto extra estrogen and testosterone floating around in your body (8). If your body is low in protein, it doesn’t have the building blocks it needs to build new projects, such as this sex hormone binding globulin.
- Building muscle. While you don’t need to be a bodybuilder, doing some strength-building exercises offers several benefits to folks with PCOS; more muscle helps with insulin sensitivity, improves metabolism, and even helps with weight management. Not to mention that greater strength helps us to get through day-to-day living with less fatigue.
And one more bonus? Less stress! Building muscle does require protein, and while you might not need a fancy expensive shake, it might be harder to meet your needs as a vegan.
- Blood sugar balance. Protein is the VIP for helping your blood sugar to stay balanced, a real challenge for women with PCOS. A big blood sugar spike after a meal is a stress on your system; having a protein-rich meal helps to prevent these kinds of spikes.
So, now that we know about the many roles of protein for a woman with PCOS, you may be wondering about vegan sources of protein. What about beans and tofu?
It is true that there are plenty of plant-based proteins around, from beans and lentils to quinoa and broccoli, however, they come with a price: plant-based proteins have compounds in them called lectins and phytates.
Lectins and phytates have the potential to make it harder for your body to absorb the nutrients in your food.
Beans are a healthy food – they’re rich in fiber and other nutrients. I don’t recommend skipping beans altogether, I simply don’t recommend them as your primary source of protein (9).
And soy? For women with PCOS, I recommend staying away from soy and soy products.
How much protein do you need? I recommend at least 80 grams protein each day for women with PCOS, mainly from animal proteins such as dairy, eggs, fish, beef, or chicken.
Have you heard of this nutrient before? Choline is far less known than calcium, zinc, or copper, nutrients we’ll be discussing in the next section.
Choline – found in eggs and liver – is important to support liver function. We began to learn in the previous section just how important the liver is for the management of PCOS as we explored protein. Two eggs and about three ounces of liver meet your daily requirement.
To continue the discussion, choline is responsible for allowing your thyroid hormones to activate and do their work. Choline also supports your liver’s ability to detoxify chemicals and extra hormones.
Choline is also very important for the prevention of fatty liver, which women with PCOS are at a higher risk for.
And while you can get choline from some vegan foods, you’d really have to eat a lot of them to reach the amounts you need in a day. For example, you’d have to eat five cups of shiitake mushrooms or just over seven cups of lima beans to meet your daily recommendations of choline (10).
While all minerals are essential, there are a few minerals of special significance to women with PCOS. And spoiler alert: they’re harder to get from a vegan diet because of the phytates.
Your zinc level may be a predictor of your development and severity of PCOS. Women with lower zinc levels tend to have worse PCOS symptoms and more severe insulin resistance (11).
Women with PCOS are often prescribed oral contraceptives (aka birth control pills, or, “the pill”). Unfortunately, birth control pills do a better job of addressing symptoms than actually correcting the root causes of PCOS. And on top of that: one of the side effects of birth control pills are that they can throw off your mineral levels.
Zinc is one mineral that can be lowered with birth control pill use (12), in addition to B12.
The foods that are naturally high in zinc are oysters, beef, crab, lobster, and pork: all foods that are not permitted on a vegan diet (13).
Where is calcium most abundant in our food system? In milk, milk products, and fish with bones, such as sardines.
Calcium can improve PCOS symptoms, including regulation of the menstrual cycle and weight (14).
Most vegans get their calcium from calcium-fortified foods. I’ll give you a few thoughts on supplements a bit later in this post.
For reasons not yet entirely understood, women with PCOS tend to have higher than average blood copper levels (15).
On top of that: birth control use – which is very common among women with PCOS – can make things worse. Beyond its effects on zinc and B12 status, as mentioned above, birth control can throw off copper. In this case, copper levels can actually go too high (16).
Where can you find copper in your food most abundantly? In seafood, like oysters, as well as beef and liver (17). However, it is fun to note that chocolate is also a source of copper – yum!
B12 is one nutrient you absolutely cannot get from plant-based foods unless you’re eating fortified foods or a ton of tempeh (fermented soy). Soy can be problematic for women with PCOS.
Vitamin B12 does a lot of work in our body and is of great importance for forming red blood cells (18). Vitamin B12 is of special interest for women with PCOS because it can help with insulin resistance.
B12 is naturally highest in beef, clams, organ meat, and fish (21).
Having now discussed some of the most difficult nutrients to obtain with a vegan diet, you may be asking yourself a question that I get often from clients: what about a vitamin supplement?
Can’t I just take a supplement?
It seems simple, right? Just take a multivitamin and call it a day?
As a registered dietitian nutritionist (RDN), I recommend that my clients take a “food first” approach. That means aiming to get as many of your essential nutrients from where they occur naturally, instead of a capsule or pill.
Not only do the nutrients tend to work together in harmony, but they’re also usually in the form that is most absorbable to the body.
Supplements may be in a less absorbable form because they’re less expensive to produce. I discussed this a bit more in a recent Instagram post.
On top of that: there is no guarantee that a multivitamin will have everything you need. Most don’t. For example, it is rare to see a multivitamin that has any choline in it at all (22).
Having said that, there are times when a supplement is warranted. There is no one-size-fits-all approach to PCOS; every woman’s needs, preferences, and lifestyle are unique. That is why working with a knowledgeable registered dietitian can be so helpful in finding the eating plan that best suits your health conditions and goals.
Key takeaways: PCOS and a vegan diet
A vegan diet is very restrictive and difficult to sustain, long-term.
If you’re trying to support your health and manage your PCOS using nutrition and lifestyle changes, a vegan diet is not the path of least resistance or the easiest to adopt. And why would you choose to forgo foods that don’t need to be excluded to support your health and better manage your PCOS?
I’ll bet that you’re ready for relief from your PCOS symptoms. I can help you to bid farewell to your acne and fatigue and give you tools to better manage your powerful cravings for sweets. Click here to learn more about the PCOS nutrition program that can offer you lasting relief. And if you’re ready to chat, book your free consultation right here.