The ketogenic diet is nothing new. It has been around for a while and comes in many forms: the Atkins Diet or LCHF (Low carb high fat). And recently, a member of my PCOS Master Plan Program emailed me to tell me about the success she was having on a keto diet. My interest was piqued and I hit the books and medical journals looking at if a keto diet is good for PCOS.
The ketogenic diet aims to lower insulin levels and can induce weight loss which is helpful for women with PCOS. It also improves insulin sensitivity, aids weight loss, manages hunger and improves the PCOS hormone profile. However, the keto diet can be very difficult to sustain over the longer term.
The Ketogenic Diet explained:
Basically, a ketogenic diet significantly restricts carbohydrates, while focusing heavily on high fats (healthy fats) and moderate protein. There are a number of things that happen when you do this:
Your need for insulin drops significantly. From a PCOS point of view, this would be helpful as we tend to have high levels of insulin to begin with. High insulin levels cause our ovaries to produce too much testosterone which makes our symptoms worse.
Also, when we restrict carbohydrates, we cause our body to use fat for fuel, instead of glucose. The burning of fat instead of glucose creates a by-product called ketones, hence the name of the keto diet (1).
Dr Fung, author of The Complete Guide to Fasting, explains it really well. He explains that our bodies have glucose stores that are easy to access and that our bodies turn to when we’re running low on dietary carbohydrate. This is like a refrigerator in our kitchen. It’s where foods is easily at hand and easily topped up.
We also have a freezer in the basement where our longer term energy is stored. It is harder to access. This freezer is our fat cells. The problem is, with our high carb lifestyle, the fridge is permanently well stocked and there is no need to access the freezer (or our fat stores).
The ketogenic diet (and intermittent fasting) allows us to empty the fridge and access the freezer much more easily.
Now, there are many proposed benefits of a ketogenic diet.
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Benefits of a Ketogenic Diet
There are a number of benefits of a keto diet. Here are some of them:
Losing weight on a keto diet becomes easier and is one of the many reasons that women start a keto diet. You see, if your body is well adapted to burning fat for energy, it can then more readily use your own fat stores for energy instead of all the glucose it would normally use.
Cravings are often caused by disordered insulin. As you have carbs, your insulin levels shoot up, only to drop rapidly, causing your body to crave more sweet things and carbs. As soon as you satisfy that craving, your insulin levels shoot up again, starting the cycle all over again.
A ketogenic diet helps to stabilise those insulin levels and can really help to manage those cravings.
Feeling Fuller for Longer
A ketogenic diet that is higher in good quality fats tends to make you feel fuller for longer. Although researchers aren’t clear why a keto diet impacts on satiety, it is well-documented that a ketogenic diet helps with appetite control (2).
Improved hormone profile
One study conducted with women with PCOS who followed a LCHF diet for 6 months found significantly reduced testosterone, fasting insulin and improved LH/ FSH ratio. The women also lost about 12% of their body weight over the 6 months (3).
Improved cardiovascular heath
Research shows that a keto diet is also good for the heart in that it helps to lower cholesterol and boost levels of high density lipoprotein (the good cholesterol). This promotes heart health. Bear in mind that women with PCOS are at risk of cardiovascular disease.
A ketogenic diet also seems to help with acne. High levels of insulin tend to lower the levels of IGF-1 binding protein in the body. Women with PCOS tend to have lower levels of IGF-1 BP already and this leaves higher levels of IGF-1 in the body, causing our acne to get worse.
If we can lower insulin levels, we’ll boost IGF-1 binding protein which will lower IGF-1 levels and improve acne (4).
Okay, so we have spoken a lot about the benefits of a keto diet for PCOS. Are there any negatives?
Cons of a Ketogenic Diet
The diet can be hard to follow
Following a ketogenic diet can be very restrictive and difficult to follow. You are eliminating a high percentage of carbohydrates and that can be difficult for a lot of people. So, it not necessarily sustainable.
“Keto flu” is something that many people experience in the fist week or two of eliminating the majority of their carbohydrates. Headaches, nausea, general achiness are common but the feelings soon pass as your body becomes more proficient in burning fats for fuel, instead of glucose.
Constipation is common when following a ketogenic diet. Your dietary fibre in take tends to drop as you avoid certain carbs. This can be avoided by eating lots of leafy greens and non-starchy vegetables.
If you have hypothyroidism or Hashimotos (which is fairly common in women with PCOS) you may want to rethink a ketogenic diet. You see, insulin is need for proper thyroid function. So, drastically lowering your insulin levels when your thyroid is already struggling may not be the best idea. You are probably better off on a moderate carb diet as opposed to a low carb diet (5).
My Experience of a Ketogenic Diet
As you know, as I have PCOS myself, I am always looking at ways of managing my own PCOS and telling you about those things that have good scientific evidence behind them.
So, for the past 2 weeks, I have been following a ketogenic diet myself. I know 2 weeks is not a particularly long time but I thought that I would share my experience with you anyway.
Before going keto, my diet was pretty good. I generally follow all of the PCOS diet principles you will find on this site: low GL whole foods, no dairy and no gluten. In September I also did a Whole 30. So, my starting point was not a Standard American Diet.
Having said that, I did go on holiday the week before I started keto and indulged in things I normally wouldn’t have – ice creams, eating out and having more gluten than normal. Nothing crazy but not as “clean” as I normally eat.
So, with that in mind, I did have quite a bad headache for the first three days. I was probably a bit grumpy and even a bit tired. After that though, my energy levels have picked up and I feel more alert and able to focus.
I have also noticed that I hardly had any PMS this cycle (my husband knows exactly where I am in my cycle based on my mood 🙂 ). I am also pleased to say that I have lost about 1.5kg in the last two weeks.
Overall, I am happy with how I feel and my PCOS symptoms. I will probably continue my keto experiment until Christmas and will then re-evaluate how I feel then.
Do you have to follow a keto diet for PCOS?
I know this is something that I will get asked and I want to be clear on this. It is NOT necessary to follow a ketogenic diet to manage your PCOS effectively. I have always followed the guidelines that I speak about so often on this site and my PCOS is well-controlled.
Also, many thousands of women come across this site on a daily basis and a huge percentage of them have had great success with following the same guidelines:
Combine this with supplements and exercise and you are setting a good foundation for your PCOS.
But, if you have plateaued in your weight loss efforts or you feel like your PCOS is particularly out of control at the moment, you may want to consider a period of going keto before adding in a few more carbs. I always recommend limiting carbs to about 100g per day whereas a ketogenic diet varies between 20-50g per day.
Getting Started on a Keto Diet for PCOS
If you are eager to give a keto diet a try, I would highly recommend reading the book “The Keto Reset Diet” by Mark Sisson. The book gives a lot of background into why ketosis can be helpful but what I like most about it is that Mark Sisson’s focus is not just on macronutrients (carbohydrates, fat, protein) but rather on good nutrient-dense foods.
He also recommends a graded transition into ketosis, following a 21 day keto reset. This 21 day plan focuses on good nutrition with lower carbs but not necessarily full ketosis. Once you have adjusted to the lower carbs, he then suggests you further restrict carbs to go into ketosis.
This seems like a sensible approach to me.
He also has meal plans and recipes included in the book. I have been trying a lot of these and have really enjoyed them. Just a word of caution: Mark Sisson does include dairy in some of his recipes. I just leave out the dairy or if it a very dairy-heavy meal, I swap it out for something else.
So, to sum it up:
A keto diet for PCOS shows promise and seems to be helpful. It can be difficult to follow and if you are considering trying a keto diet, I would go slowly, be gentle with yourself and see it as a journey. Do as much reading as you can on it and lower your carb intake gradually.
Remember, although it may be helpful, it is not the only way to manage your PCOS. PCOS is for life and whatever way of eating we choose to follow, it needs to be sustainable and become a way of life.
Have you tried a keto diet for PCOS? If you have, I’d love to hear from you! Leave me a comment and let me know if you have found it helpful for your PCOS.
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It isn’t impossible to lose weight when you have PCOS and you can do this on a normal healthy diet, and by heathy I mean avoiding sugar and eating complex carbs like brown rice and pasta. Combined with a fair bit of exercise , I lost 2st. After this time my weight loss slowed down considerably and I thought I’d try keto. My acne has improved considerably in just a week and a half of sticking to 20g of carbs and – obviously – not eating any sugar. I have no cravings for sugar and barely ever feel hungry. Whilst I am yet to lose anything, these benefits are so good for me I’m carrying it on. I don’t think keto is restrictive as long as you take the mindset of “refined carbs aren’t good for me.”
I’m wondering – some cheese is high in fat, but jeto restricts dairy, so what is the stance on this? Dr. Bernstein’s diet is very similar to keto but restricts to 30g carbs a day and allows cheese but restricts carbs in veggies too. I’m a T1 diabetic with PCOS and have always struggled with weight and periods so I’m wondering if I also have to cut cheese out…? Thanks in advance!
May I cancel my order? It’s done the opposite on me. I don’t want them anymore. Please cancel my order. I need my money, I’m going to the bank this weekend to talk to them, then going to go to the police,and talk to them about this. Maybe they can help me. Thank You, sheilabarrow@ntlworld please let me know if you guys cancel my order or not, so I know if I have to go to the police.
I have one questions You posed that lower insulin levels (from keto diet) can have a negative affect if someone has a compromised thyroid. With so many people having thyroid issues on high carb diet that most Americans are on how does lowering carbs affect the thyroid? I would think that the high carb. eating is causing the thyroid to fail due to to much insulin all the time and when the body become resistant it affects the thyroid function as well. I would love to know your thoughts are the research that could help with this.
I just started keto diet. Does loosing through keto also go as a slow pace? I have only loss 3 pounds in a week. I know PCOS people usually loose weight slower? I’m doing exactly what it says. Help…..some people losing more.
Well done congratulations
I am so completely amazed to read these articles and all of these comments. I am 62 years old and was diagnosed with PCOS when I was 22 when I was trying to start a family. I did not know why I did not have periods like my friends did in high school. While I was not, and am not, seriously overweight, I have not known why I could never effectively lose weight. The most devastating symptom BY FAR is this nasty facial hair. It is so embarrassing and I spend tons of money to remove it. When I was diagnosed, I was told by my infertility specialist that there was no cure and very little was known as to the long-term effects. I did manage to successfully conceive and give birth to two amazing children with the help of Clomid. The bottom line here is that I am so happy to finally have some answers. I began the keto diet today and am very excited and motivated by all of your experiences. I am a firm believer in “IT’S NEVER TOO LATE!”
I will keep you posted!
Hi y’all. I just wanted to share my experience with a keto diet. Keto flu, while it wasn’t the case for me, can last up to 2 weeks. Like Tarryn, mine only lasted about 3 days and it wasn’t a headache but just lethargy and crankiness. Some form of keto flu is inevitable because it takes some time for your body to switch gears. I had done a paleo which is grain free, gluten free, dairy free, etc, but it uses lots of nuts and nut flours which get costly. It worked well for me without much effort and totally killed my sugar cravings within the first couple of weeks. Alternatively, if you keep it simple and go with lean proteins cooked in healthy fats, lots of veggies also cooked in healthy fats, and just really ramp up the healthy fats, you don’t have to worry so much about the nuts or dairy as a fat source to go keto. At that point, I wasn’t aware of PCOS symptoms (which have been lifelong for me) and I wasn’t trying to lose weight but I managed to lose somewhere between 20-30 lbs in 3 months. Then I got bored and needed a break from it but didn’t want to undo my progress so I went on Atkins which offered the RTD shakes and snacks. My intention was only to do that for about a week or two. Needless to say, within days, it caused me to fall off the wagon, the sugar cravings came back with a vengeance and my PCOS symptoms would progressively get worse from there. A few years later and at my heaviest weight, and still not knowing what PCOS was, I started having gall bladder issues but I didn’t know that’s what it was. It was just discomfort in my abdomen at that point that would come and go. A year later, after deciding to go on a keto diet instead of paleo, the pain returned and a short time in, I started having attacks. Of course doc wanted to remove and I said “uh no”. I was led to believe there was no way to remove gall stones naturally and I took that as a challenge and found a solution and it wasn’t too shabby if you like apple juice. The sugar content is high so that didn’t help the PCOS but minor setback to get the stones out. I highly suggest if you consider keto and have had gall bladder issues in the past, you do the apple juice and olive oil cleanse first. When you go on low fat diets (like many of us have because we struggle with weight and believed the lie that fat was bad for you), it causes the stones to form. When you don’t eat fat, your pancreas can’t do it’s job and produce bile. So when you start eating the healthy fats, your pancreas wakes up and starts pumping that bile through your gall bladder again and often times, those stones will get stuck and it is excruciatingly painful and lasts for hours on end (mine clocked literally at about 8 hours). I don’t remember the exact details but I do know you drink a certain amount of apple juice daily for 6 days. A chemical found in apples (the name slips my mind) softens the stones. On the 6th day, before bed, you chug 1/2 cup olive oil mixed with 1/2 cup of squeezed lemon juice. I imagine you can do this with coconut oil or avocado oil too but the protocol I used named olive so I did it. Lemon has that same chemical that apples have in it so it helps soften and break up those stones even more and as you can guess, by drinking liquid fat, your pancreas starts working and starts flushing those now softened stones out of your gall bladder and into the toilet the next morning. I have done this cleanse twice and both times I used the 100% apple juice from the grocery store because I was on a tight budget and I needed a lot of juice. Needless to say, organic, fresh juiced apple juice is obviously the better option, but in a pinch the store bought does the job too.
As far as the keto goes, it does work and I have heard many stories about women and how their cycles regulate even after they have gone through menopause. The problem is my husband and I are both carb junkies so we have opted to go with the protocol Tarryn offers on her site, at least for now. He is intrigued by the keto diet so we may consider it later on. We still do a lot of “paleo” recipes and are trying more and more as we go, but we still eat quinoa and wild rice (not white or brown) and I am going to start making bread with spelt (not gluten free but MUCH lower in gluten as an ancient grain), and tiger nut flour. He eats the bread more than I do because he takes sandwiches to work but he also doesn’t have PCOS symptoms LOL. The nice thing is he is completely supportive and is willing to eat however I need to eat to get and stay healthy.
I hope some of the info I have shared is beneficial to you. I wish you all the best!
Thanks so much for sharing your experience, Jenna!
I have been following a ketogenic diet for just over two months. I am down 19 pounds and two pant sizes. I’ve quit all meal time insulin (also have type 2 diabetes) The craziest thing is I have been spotting for the past two months during my monthly cycle! I haven’t done this for YEARS! I always know due to other cues that it’s that time (sore breasts, mood swings) but this is proof to me that the Keto diet is healing. I really wish I had been told changing my diet could help me conceive 18 years ago instead of just putting me on fertility medication. Here I am 42 and two kids later learning about something I was diagnosed with in my early 20’s.
It’s my second week and I have only list around 2 kgs. Is that normal?
I have been diagnosed with PCOS for 9 years and have been ttc for 5 years. I started whole 30 and then just ate clean for 6 months prior to keto. I lost 10 pounds in those 6 months. I’ve been on keto for 2 months and have lost another 18 pounds. I have more energy, and so many of my symptoms are clearing up. Excited to see what my future keto life holds for me!
Interesting that anytime I ever comment it never gets published. I replied to a person who commented I replied sugesting they look into a whole plant based diet and it was not approved. Seems strange to me that it would not as it is not harmful to be informed of all options. Is this how the whole website is that you choose to only approve the comments that make your bussiness look good if so that would be very disappointing.
That is absolutely not the case 🙂 I tend to get a lot of spam on the comments and so I have to approve them to filter out the rubbish 🙂
Hi I’m a PCOS as well. I was found to be PCOS when I was 22. And I started to eat Yasmin. I stopped taking it then I lost my period again and about 0ne year ago I started to have more hair than before. So I started to take Yasmine again. I am never overweight but I know to keep a healthy diet and exercise and losing some weight is necessary because I am more prone to being really fat and getting diabetes and never getting pregnant, especially after 25years old. So I started a low calory and low-fat diet, eating low GI carbs, and workout every day. I lost 10kg in half a year, from 58kg to 48kg. However, I’m still getting ance and more hair on my body. What’s worse, because of the diet, I started to feel really weak and I’m always hungry and once I started to eat, I couldn’t feel that I was full. Then I felt guilty for eating too much. So I want to chANGE my diet. Since fat is able to make me satisfied, I decided to try keto diet. My goal is to control my PCOS and live a more energetic life. And gain muscle. I just started my diet. Stil in transition. Wish me luck! And if you have suggestions on this keto diet please reply to me. I’ll be so grateful!
Hi I am a PCOS sufferer too. I have been doing the keto for 3 months now. I have lost 10kg. Yesterday I went and brought myself a few tee shirts and I was amazed I took a size smaller then normal and it fits. I dropped a pants size too, how do I know by just wearing the same clothes over and over I now need a belt to keep them up. My denims I have not worn for 3 years now I got on and done up too. So I have 40kg still to lose. But I am braking down my goals as 50 kg is a lot to lose. So my 1st goal is to be under 100kg. I am 4.1 kg short from it. But I gave myself a good reason to get there. See I don’t live in the same country as my family I haven’t seen them in almost 7 years. So December I am going out there to see them. And I want to be skinnier then when they last saw me. So I have 10kg more to lose. The last they saw me I weighed 102kg. So to be under 100 kg and health is my goal. But I think I will smash it and maybe lose more. So it any one with PCOS is in doubt about Keto. I say give it a try. Maybe it works for you. I get comments from friends and customer at work everyday. My acne has gone. I have more energy I am walking feather then I ever could dream of. Now I must just get in to more ways to get in to shape.
This is awesome! I loved reading your story! Way to go girl!!!!
I used the keto diet and intermittent fasting to detox my body. I have all the symptoms of PCOS and wasn’t able to have a natural period (the GP told me that crazy lie) I had been on the pill for 13 years and only ever had pill-induced periods. Once I came off the pill I didn’t get my period my two years. I tried the Keto diet in hopes of reversing my PCOS symptoms. After a year of going in and out of ketosis I lost 10 kilos but have very very slowly put some weight back on because it’s hard to stay away from carbs! My big sore acne spots went away, my hair growth calmed down but still no period……..
After needing a procedure done in hospital which required a gradual 4 day fast and eventually just drinking water on the last day……………I finally got my period (after the procedure, of course!) I don’t know whether there’s any connection between fasting and a Keto diet helping me get my period or maybe it was just time, but I definitely felt a lot better and there were no 3pm slumps! I don’t follow a strict keto diet anymore but I still keep away from refined carbs and consume only vegetable carbs. I do miss the Keto high though!
I would try a low fat whole plant based diet. It is what really helps with insulin resistance and is better for you and easier to stay on. A keto diet is temporary and only will causes underline problems in the future.
My only concern with plant based diets is that they tend to be much higher in carb, causing an insulin spike. The higher our insulin levels, the more testosterone we’re going to produce, making our PCOS symptoms worse
Just to say, I have just started 16:8 intermittent fasting along with a Keto diet. I can honestly say I’ve never felt fuller which is an awesome bonus to what I thought would be a very hard lifestyle! I always find a low carb diet tricky as it’s what I crave ALL the time but stick with this for just a few days and the cravings start to fall to the wayside. Phew! I have PCOS and very stubborn insulin resistance and live on a dairy free, gluten free and sugar free diet. Even still, I still haven’t quite licked those symptoms or cravings so hope to see some great results here! I have lost 1kg in under a week (I haven’t got that much to lose but want to feel at my optimum) but mostly want to kick these cravings and free up my mind from thinking about food all day!
Thank you Tarryn for your info and dedication and fingers crossed for everyone.
Dr Fung is crazy. He twists the science to suit his arguments.
I’m not a fan of anything super restrictive and Keto is one of those things. It’s been shown over and over again that it’s not any better for fat loss, and in fact may be worse because it’s harder to adhere to long term. In fact, most long term studies on people who follow the Keto diet show that it is the inability to adhere to it that makes it inferior to other more moderate approaches. And what’s the point of embarking on a way of eating if it’s not sustainable long term?
Recent studies on diet for managing PCOS seem to all lean towards a diet that includes moderate carbohydrate intake (40% of calories). And exercise seems to be just as, if not more important in improving and controlling insulin resistance.
Is the keto diet safe to do when breastfeeding?
I’m almost 2 months into the keto diet and I’m down 21 lbs, or 10% of my starting weight! And being only 5 ft tall, 21 lbs makes a big difference on my frame! I absolutely love it and even though I’m thrilled about being able to shed so much weight, what I really love is the energy I have! I’m not tired and sluggish all the time, and I feel like I have a whole new lease on life! Normally I barely make it through the work week and I want to sleep all weekend, but I actually went hiking this weekend! I have more energy to cook, clean, and everything else too! I don’t know if it’s a permanent change, but I’ve also noticed the coarse, weed-like chin hair I’ve had to pluck twice daily for YEARS has suddenly almost disappeared as of this week.
There are times when it’s a little bit of a struggle to keep my carbs in check, but I can have so many wonderful, indulgent meals that I don’t miss it too much. I definitely experience the reduced appetite and cravings mentioned in this article, and I don’t feel like a slave to food anymore, which is a nice change. Keto flu can be avoided with supplementation, namely sodium, magnesium and potassium in the right amounts. I feel like this is really a life-changing way of eating for me (not a diet, but a total lifestyle change), and I really encourage anyone who is curious to do more research into it. There are calculators out there that will tell you how many carbs/protein/fat to eat based on your weight and your goals, and there are very supportive keto communities out there as well (Reddit is one, surprisingly). I feel like a total infomercial right now, but I promise I’m just really excited about all the positive changes I’ve seen in myself. I’ve suffered from PCOS for years and I think this is a real game-changer for me. I’m not planning to have more kids so I can’t vouch for it’s effect on conceiving, but I have heard some wonderful stories from ladies who have had their cycles regulated and were finally able to get pregnant while doing keto.
Really glad to see this article and have it spread the news to as many PCOS ladies as possible – I hope a few of you see this, do the research and have great success on it as well!
I’ve been on a keto diet for 3 weeks. I’m down 13 lbs. It’s definitely working.
Do you have an update as to how you feel after following the Keto diet?
I’m doing a keto diet (Bodytrim specifically) until recently making changes that are more PCOS friendly (no gluten, dairy and processed foods). This makes it harder somewhat, as the foods I can eat are more restricted. I’m going to give it a try and see how I go. At the moment, I have lost just under 10kg from Dec 5, 2107. There was a tiny bit of weight gain over x-mas/new years but I nipped it in the bud asap. Now I am lighter than prior to x-mas/new years, but it’s hard. I’ve had success with Bodytrim before, so I know it works for me. Hopefully with more stricter guidelines, I should be able to lose more weight. I haven’t had my period this month, which I think is strange, since I have lost weight (I did have it in December 2017 though). I might make an appointment to see my doctor and get some blood tests done, as I’m interested to see the changes in my levels of LH, etc…
I have PCOS. I’ve battled with my weight for years and, since children, have carried 40 extra pounds. I’ve been doing a keto-ish diet (high protein including dairy, no starches, moderate veg and no more than 1 fruit a day) for 3 months and have lost almost 30 lbs! (I’m really cutting my overall calories too.) I’ve done gluten free and paleo-ish diets before with moderate success, but this is by far the most successful I’ve ever been. In the past I’ve gained it right back as soon as I was done, but I’ve nevrr lost this much or continued for this long. For me, this is just the way I eat now and I’ve found ways to make it work. (Cottage cheese, hard boiled eggs, low carb protein bars, turkey pepperoni, low carb yogurt are some of my favs. The basic idea for me is lots of protein, and it really makes a big difference in terms of weight loss. I also have tons more energy and few much better overall. With that said, I can’t really speak how Keto affects other PCOS symptoms- I have an IUD so it’s hard to tell what my cycle would be like, and acne, hair growth, or hair loss are symptoms I’ve never dealt with.