Reversing PCOS, Insulin Resistance & Infertility

1. PCOS,
INFERTILITY
& KETO
TEMPLE STEWART, RDN
REGISTERED DIETITIAN NUTRITIONIST
1

2. Objectives
Background
What is PCOS
Insulin Resistance
Inflammation
Practical Application
I
II
III
IV
V A Case for Keto
VI
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3. Background
MY STORY
- 190 lbs
- Student Dietitian
- Acne, no period, oily skin,
puffy, anxious
- Over-exercising
- Eating Low-Calorie
3

4. Background
MY STORY
- 150 lbs
- Ketogenic Diet
- Resistance Training/Walking
- Pregnant Naturally
- Breastfeeding
- Regular Periods
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5. PCOS
- the #1 CAUSE of female infertility
- the MOST COMMON endocrine disorder of
young women involving multiple organ
systems
- symptoms include: irregular periods, high
levels of androgens in the blood, hyper cystic
ovaries, male pattern baldness, acne,
hirsutism
Polycystic Ovary Syndrome
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1

6. PCOS
Diagnostic Criteria for PCOS
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3

7. PCOS
- anovulatory cycles, infertility, pregnancy
disorders, fetal concerns
- cardiovascular disease
- NAFLD
- Sleep apnea
- Mental Health issues
- DM II, Metabolic Syndrome
Health Risk Associated with PCOS
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8. Weight & Metabolic Health often determine the severity of the disease
PCOS
Polycystic Ovary Syndrome
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Severity
Weight
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9. PCOS
So what are the
LINKS?
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10. Insulin Resistance
Insulin Resistance
A key feature in obese PCOS (70-95%), as well as
lean PCOS (30-75%).
• Too much insulin inhibits aromatase (which stops androgens from converting to
estrogen).
• There is no estrogen spike to signal ovulation, the ovaries then retain and accumulate
eggs.
• High insulin causes the ovaries to make excess testosterone.
• More than 50% of women with PCOS will be diagnosed with Type II DM by age 40.
• All women with PCOS should be tested with a blood test such as fasting insulin, HOMA-IR
index, or 2-hour glucose challenge test
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5,6,7,8,9

11. Inflammation
Inflammation
Circulating CRP (an inflammatory marker) was 96% higher in women
with PCOS compared to controls). Women with PCOS exhibit an
elevation in circulating CRP that is independent of obesity
• Inflammation impairs oocyte quality and causes anovulation.
• Inflammation impacts hormone production and is associated with endometriosis.
• In studies properly matched for BMI, CRP with PCOS was increased by 102%
• Inflammation directly stimulates excess ovarian androgen production.
• Weight gain and increased BMI increase the inflammatory load.
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10,11,12,13,14

12. Insulin Resistance
Diet Interventions in PCOS
• Indicate a higher pregnancy rate
• Lowers the miscarriage rate
• Improves ovulatory cycles
• Lowers free androgen index
• Improvement in sex hormone-binding globulin
• Lowers total testosterone levels
12
17
A 2021 systematic review of RCTs showed that dietary interventions
improve PCOS, specifically low-carb is superior for fertility and normal
menstruation.

13. THE CASE FOR KETO
The Diet Solution is a
Well-Formulated Ketogenic Diet.
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14. Insulin Resistance
Keto for PCOS & Insulin Resistance
A 2005 study showed the ketogenic diet improved insulin sensitivity
approximately 75%.
• A decrease in BMI, insulin resistance, prevention of high LDL-C, increased levels of FSH &
SHBG, and decreased testosterone was seen in a low-carb diet meta-analysis.
• In comparison with low-fat diets (if calories are the same), the ketogenic diet improves
triglycerides, HDL, blood glucose, and insulin sensitivity.
• In a study of keto vs. conventional pharma therapy for PCOS, keto showed better
decreases in blood sugar and weight and improvement.
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15, 16, 17, 18, 19

15. • Reducing carbs helps lower insulin, as well as REDUCES hunger, therefore making it easier
to consume less.
• Keto/low-carb diets consistently outperform low-fat diets in the areas of weight loss
and blood sugar control
• In PCOS, this study showed better biochemical markers (LH, FSH, SHBG, insulin sensitivity &
HOMA-IR), also reduced androgenic production.
Insulin Resistance
Keto for PCOS & Insulin Resistance
A 2005 study showed the ketogenic diet improved insulin sensitivity
approximately 75%.
15
20, 21

16. Inflammation
Keto for Inflammtion
The Ketogenic Diet is Anti-Inflammatory as you naturally remove
foods that promote inflammation.
• The ketogenic diet helps lower inflammation via various anti-oxidant mechanisms,
reduces reactive oxygen species, and limits oxidative damage to DNA.
• A well-formulated ketogenic diet contains fatty fish, eggs, olive oil, avocados, berries,
grass-fed proteins, omega-3s, leafy greens, mushrooms, peppers, etc all of which prove
to be anti-inflammatory.
• Weight loss is anti-inflammatory.
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22, 23, 24, 25, 26, 27

17. Practical Application
Practical Applications
• Discuss with your MD, OB, etc before changing your diet.
• Follow a well-formulated ketogenic diet for individualized
needs.
• Focus on anti-inflammatory foods.
• Consider myo-inositol/d-chiro-inositol, fish-oil, thiamine, Q10,
berberine, zinc, selenium and chromium supplementation.
• Medicinal Herbs: aloe vera, cinnamon, green tea, chamomile,
white mulberry, spearmint tea, licorice root
• Homeopathic: Serenoa repens, Camellia sinensis, Rosmarinus
officinalis , Glycyrrhiza glabra, and Vitex agnus-castus
• Strategically use HIIT workouts.
• Prioritize sleep and stress reductions
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18. Practical Application
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19. @The.Ketogenic.Nutritionist
@The.Ketogenic.Nutritionis
t
The Ketogenic Nutritionist
hello@templetheketonutritionist.com
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20. References
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