7 of the Best PCOS Supplements Every PCOS Patient Should Consider

Why is PCOS so hard to treat? 

One of the main reasons is because we tend to treat only the symptoms of PCOS and not the CAUSE.

This philosophy extends to supplements as well:

In order to treat your PCOS using supplements, you will need to target those supplements to your body and YOUR hormone imbalances for the best results.

Learn how to properly use PCOS supplements to help balance your hormones, lose weight, increase your energy, reduce hair loss and get rid of the unwanted symptoms associated with PCOS:

More...

Do Supplements Really Help PCOS?

YES. 

Targeted supplements can actually help treat many of the problems associated with PCOS.

The tricky part is targeting your supplements to YOUR body (more on that later).

In order to determine which supplements actually have benefit, we need to go back to the basics.

What is PCOS?

It has lots of definitions, but in the most simple sense, PCOS is the combination of a number of hormone imbalances in the body that lead to certain and specific signs and symptoms.

Which hormone imbalances am I talking about?

Most patients with PCOS have some degree of the following hormone imbalances:

  • Insulin resistance or high blood sugar
  • High testosterone or high androgens
  • Low progesterone or relatively high estrogen levels (this may come as high estrogen metabolites)
  • Usually some degree of leptin resistance and hypothyroidism (this is usually secondary, but still present)

Obviously, we can't put all women with PCOS into this box, but the vast majority of women with PCOS will experience 1 or more of the hormone imbalances listed above. 

So really, it's helpful to think of PCOS as a condition on a spectrum.

The worse your symptoms, the more hormone imbalances you have.

The more hormone imbalances you have, the more supplements/hormones, etc. you will need to treat the problem.

​It is THESE hormone imbalances that lead to the majority of the symptoms that PCOS patients experience. 

Symptoms like:

​You can see that virtually all of the primary symptoms of PCOS can be explained by the hormone imbalances present in the body. 

This is both a good and a bad thing:

Bad in the sense that these symptoms can be difficult to deal with, but good in the sense that we can target your supplements and treatment! ​

  • Bottom line: Target your supplements to the hormone imbalances that CAUSE the symptoms of PCOS. This is the best way to get symptomatic relief and treat the underlying cause. 

Targeting your Supplements

​The next step to getting on the right supplements is making sure that the supplements you choose target the hormone imbalances that we discussed above. 

Believe it or not, there are studies that show how certain supplements can improve these hormone imbalances.

In the next section, I will walk you through how to pick those supplements, how they help and what doses are necessary for optimal results.

When picking your supplements it's important to realize that not all supplements are created equal.

Because the supplement industry isn't regulated like the pharmaceutical industry some brands can slap low-quality ingredients in their products and call it a day.

These type of products will NOT result in the improvement in your symptoms that you are looking for.

All of the recommendations below are from high quality and reputable brands that I've personally used on my own patients. 

The Best PCOS Supplements​

In order to get the best results, it's best to target these supplements to YOUR body. 

Whenever possible I will mention which hormone abnormalities the supplements will tend to treat.

For instance:

The first several supplements target the more common abnormalities in PCOS women like estrogen dominance and high androgen levels.

Please take this into account when you determine which supplements would be best for you.

Let's get started:​

#1. DIM + Indole-3-Carbinol

First up are DIM and Indole-3-carbinol.

Don't let the names scare you, they are actually quite helpful for patients with PCOS.

How do they work and what do they target?

Well, we already know that women with PCOS tend to have high levels of circulating estrogens in their body.

What you might not realize is that there are two important factors when looking at estrogen levels:

#1. Production of estrogen in the body, and the ratio of progesterone to estrogen.

#2. The elimination of estrogen by your liver and the production of estrogen metabolites.

​Most of the focus is put on the production of estrogen in your body. 

But by focusing on the production you leave out a very important part: increasing the speed at which your body gets RID of estrogen.

It turns out that in order to get eliminated from the body, estrogen needs to be "cut" into smaller pieces by your liver.

This elimination process results in estrogen by-products that are still somewhat active on your cells!

So if your body has a hard time metabolizing out these particles then you may have excess estrogen metabolites floating around triggering your estrogen receptors.

Estrogen metabolism and estrogen dominance

​So when we talk about eliminating estrogen we need to do it more quickly AND we want to produce estrogen metabolites that are less metabolically active. 

​This is where DIM and indole 3 carbinol step in. 

These supplements help promote estrogen metabolism (6) in your body and they help to produce less active estrogen metabolites.

Taking DIM helps increase the production of 2-hydroxy estrone which is actually felt to have some protective capacity when it comes to breast cancer (7).

How to Supplement with DIM & Indole 3 carbinol
Why I like it

Helps promote proper estrogen metabolism

May promote healthy estrogen metabolites

Helps treat estrogen dominance

Generally works within 1-2 months

How to Use

  • Take 100 to 300mg per day
  • You may benefit from taking more DIM right before ovulation and towards the end of your cycle when estrogen levels are highest
  • Monitor your symptoms while taking DIM to ensure that you tolerate the supplement
  • Take this supplement in addition to consuming more cruciferous vegetables like broccoli, cabbage, and bok choy
My Recommended Brand and Product:

To get the best results with DIM it's often helpful to combine this therapy with other supplements like Calcium D Glucarate. 

Patients who have symptoms like PCOS, PMS/PMDD, fibrocystic breast disease and endometriosis will most likely find benefit by using DIM provided they use it for long enough and at a high enough dose. ​

#2. Calcium D Glucarate​

​Next up is a very important substance known as Calcium D glucarate. 

This is a substance found in fruits and vegetables (found naturally as glucaric acid). ​

​I should point out here that it's a great idea to make sure you clean up your diet if you have PCOS! As you might have noticed many of these supplements are found naturally in fruits and vegetables. 

Back to Calcium D glucarate:

Why is it so helpful for women with PCOS?

It turns out that this substance has a special impact on phase II metabolism in your liver.

glucoronidation elimination pathway

The phase II elimination pathway in your liver helps your body get rid of 2 very important things that are important for PCOS patients:

First: Estrogen metabolites (as we discussed above). And...

Second: ​Endocrine disrupting chemicals and Xenoestrogens. 

You already know why getting rid of excess estrogen is important (we discussed it above in regards to DIM) so we will focus on xenoestrogens and endocrine disrupting chemicals. 

People nowadays are exposed to certain chemicals on a DAILY basis that can actually mimic estrogen hormones in your body.

These compounds are known as xenoestrogen (meaning foreign estrogen-like molecules) and they can sit on top of estrogen receptors in your body and make your body think that it has more estrogen than it really does.

You may think this is rare, but it's actually not.

Recently the Endocrine society put out a paper (8) discussing how endocrine disrupting chemicals are ubiquitous (meaning ALL over the place) and that they can seriously impact your hormonal function. 

What's more interesting is that we don't have a great way to test for these compounds AND they interfere with our ability to interpret and understand hormone lab tests.

For instance:

Certain endocrine disruptors can reduce circulating T3 thyroid levels WITHOUT altering your TSH levels. 

This combination results in hypothyroid like symptoms but normal thyroid labs.

The same kind of problem can also occur in patients with PCOS and may explain why some women have very obvious lab abnormalities while other patients do not. ​

​So how does Calcium D glucarate fit into this?

Well, it turns out that Calcium D glucarate helps your body ELIMINATE these xenoestrogens, endocrine disrupting chemicals, and estrogen metabolites by increasing liver metabolism and excretion (9).

​The only downside to using Calcium d glucarate is that it provides a temporary boost to elimination which means you will need to keep taking the supplement for best results. 

But this can help quickly eliminate any excess endocrine disrupting chemicals you may come into contact with. ​

How to Supplement with Calcium d-glucarate
Why I like it

Helps promote proper sex hormone metabolism (estrogen + testosterone)

May help detox other substances and chemicals

Helps treat estrogen dominance

Also acts as an antioxidant in the body

How to Use

  • Higher doses of calcium d-glucarate may be necessary for the best results. Start off by taking 500mg per day and slowly increase your dose up to 3,000mg per day. 
  • While increasing your dose monitor for negative side effects or "detox" like reactions: flu-like symptoms, muscle aches, acne, etc. 
  • Calcium d-glucarate helps the body eliminate more than just estrogen metabolites - this will also help your body eliminate medications, cortisol, testosterone/androgens and bile acids (anything that is eliminated via glucuronidation
  • Calcium d-glucarate can also be used in short bursts to help eliminate medications, chemicals, etc. that you may have come into contact with and this method of use may be superior to taking it daily
My Recommended Brand and Product:

#3. Zinc + Saw Palmetto

​Next up is a combination of supplements that will help your body get rid of excess androgens. 

We've discussed how to eliminate estrogen and estrogen metabolites, but we haven't discussed how to reduce testosterone levels.

As you probably know one of the more concerning side effects (from a cosmetic point of view) is the excess hair growth, and sometimes hair loss, that can occur in PCOS.

These symptoms stem from having TOO much testosterone (or other androgens) in the body.

While women do have a need for testosterone, you do NOT want to have excess.

So how do you know if you have too much testosterone?

Well, you can certainly check both your free and total testosterone levels through lab testing, but sometimes these labs can come back as high normal which may prompt physicians to ignore them.

high free testosterone example

(Most women with PCOS tend to have normal total testosterone levels but high FREE testosterone levels or high normal - the lab tests above indicate a fairly normal pattern for PCOS patients)

Instead of focusing on just labs it's helpful to focus on a combination of labs plus symptoms.

List of symptoms associated with high testosterone and high androgen levels:

  • Excess hair growth on the chin, face and upper lip
  • Male patterned hair loss or hair loss in general
  • Acne, especially on the chin/face/back area
  • Mood disturbances like depression, anxiety or general moodiness
  • Weight gain

The combination of symptoms plus high serum levels of testosterone can help identify if you are having issues with androgen. 

And that's where Zinc and saw palmetto step in:

​Both of these supplements help your body ELIMINATE (get rid of) testosterone in a way that doesn't activate testosterone receptors. 

Much like estrogen, testosterone needs to be eliminated in your body and part of that process is a conversion process.

Your body has the ability to turn testosterone into a more potent androgen known as Dihydroxy testosterone or less potent androgen metabolites.

Testosterone metabolism

Zinc and saw palmetto help reduce the enzyme that promotes conversion to the more potent androgen (this is a good thing).

Another ​added benefit is that taking zinc may also promote T4 to T3 conversion if you have thyroid problems. 

This combination of supplements should be taken together for the best benefit and should be seriously considered if you have ANY of the symptoms of excess testosterone listed above. 

How to Supplement with Zinc & Saw palmetto
Why I like it

Helps promote proper Testosterone and androgen metabolism

May also increase thyroid conversion

May help with hair loss if it is related to excess androgens

Many people are deficient in zinc

How to Use

  • Take up to 60mg per day of zinc (max) - Zinc can also help promote proper thyroid function and immunity 
  • Take up to 600mg per day of Saw palmetto
  • Combine both therapies for maximum benefit
My Recommended Brand and Product:

Use 30-60mg of Zinc bound to picolinic acid per day and use it in conjunction with saw palmetto to help lower testosterone levels: 

Use 600mg of Saw palmetto along with 30mg of zinc per day:

#4. Berberine + Alpha Lipoic Acid + Chromium

​This set of supplements should probably be #1 in terms of importance. 

Why?

Because I believe that the majority of the problems associated with PCOS stem from 1 hormone imbalance:

Insulin resistance (10).

Insulin resistance leads to increased testosterone levels, leads to weight gain, and changes sex hormones like progesterone and estrogen levels.

Because of these changes insulin resistance has been implicated as one of the primary causes of PCOS.

This is also why many of the treatments for PCOS target insulin resistance.

​Because insulin resistance is so important in treating PCOS it's usually best if you use a combination of hormones plus supplements plus lifestyle changes to treat the condition. 

This is where most providers and patients get it wrong:

They treat insulin resistance with something like metformin or a single supplement like chromium.

While these therapies may be somewhat helpful you really need to layer multiple therapies in order to have the BEST effect.

That's why this section contains 3 supplements that all help to reduce insulin resistance.

Why?

Because the combined effect of these supplements is far superior to using just one.

​Because we are talking about supplements I won't go into detail on using medications, but you should know that in order to have the most benefit you should be using these supplements in addition to any medications to target insulin resistance. 

So how do these supplements work?

They work by targeting your cells and increasing insulin sensitivity (11).

Basically, they make the existing insulin work better in your body which helps to reduce insulin levels overall.

Berberine, for example, has also been shown to be as effective as metformin (12) at reducing blood sugar levels, and each of these supplements has been shown to help with weight loss to some degree.

These supplements should also be combined with a very healthy whole food diet for best results. 

Another very important aspect of using these supplements is the dose. 

Most of the supplements require very high doses to be effective (I will go over those below), so if you've used them in the past but at lower doses and without combination therapy then that may explain why you didn't get your desired results. 

How to Supplement with Berberine, Alpha Lipoic acid & Chromium
Why I like it

May improve GI function and treat SIBO/SIFO

Up to 50% of patients have insulin resistance + Blood sugar problems

May help with weight loss and improve muscle recovery

Generally works within 4-8 weeks with high enough dosages

My Recommended Brand and Product:

Take up to 2,000mg per day of Berberine: 

Alpha lipoic acid should be used in dosages of 1,800mg to 2,400mg per day for best results with weight loss and reducing insulin (make sure to also get the sustained release version of ALA): 

You should be using up to 1,000mcg of chromium each day: 

*Note: You will need to use at least two of the supplements listed above for best results, but I generally recommend using all 3. 

#5. Fish Oil

​Next up on the list is fish oil. 

You probably already know that fish oil is healthy, but you may not realize why.

Fish oil is another one of those supplements that most people take at some point in their life, but they may not be taking a high-quality fish oil supplement at a high enough dose.

So why is fish oil helpful for PCOS patients?

Primarily because it does 3 very important things: 

  • Reduces insulin resistance (and has been shown to help with weight loss)
  • Reduces leptin levels (which again helps with weight loss)
  • Reduces systemic inflammation which improves all hormonal systems

​I've written extensively on how fish oil can help with weight loss and reduce blood sugar levels which you can read about by clicking here

Since we've already discussed the importance of insulin resistance, I want to focus on leptin levels (which are more difficult to treat). 

Leptin is a hormone secreted by your fat cells that is supposed to send a signal to your brain to burn more calories to help with weight loss.

If you are overweight and have PCOS, chances are high that you have a condition known as leptin resistance.

If you have leptin resistance your body thinks you're in a state of starvation which increases your appetite and lowers your metabolism - basically it makes weight loss impossible. 

Leptin resistance is one of the primary reasons that women with PCOS have difficulty with weight loss (among other reasons), and it's something that doesn't get a lot of attention.

This is where fish oil steps in:

Fish oil has actually been shown to help reduce leptin levels (13) and reverse leptin resistance - this, in conjunction with its effects on insulin resistance, is why fish oil can directly help with weight loss. 

You can learn all of the ins and outs of fish oil supplementation in the article above, but for now, just realize that you can really boost the effects of fish oil on leptin resistance by adding in the right type of exercise. 

If you do decide to use fish oil make sure that you combine it with a healthy lifestyle (exercise + whole food diet) for best results, also make sure you use a high enough dose (it's higher than you probably realize). 

How to Supplement with Fish Oil
Why I like it

May help to reduce leptin resistance and lower leptin levels

Up to 50% of patients have insulin resistance + Blood sugar problems

Helps reduce systemic inflammation

Can be combined with exercise for even more weight loss

How to Use

  • Recommended dose ranges from 2,000mg to 6,000mg per day (depending on condition)
  • Start titration at 1,000mg per day and increase up to therapeutic dosage as recommended
  • Higher daily doses will be necessary for weight loss and treating insulin resistance
  • Duration of therapy should be consistent for at least 3 months (6+ months for insulin resistance + weight loss)
My Recommended Brand and Product:

Take up to 4 capsules daily as tolerated: 

#6. Adrenal Support

Next up is a more controversial topic and that is adrenal function.

We can argue and discuss the connection between cortisol and adrenal fatigue, but at the end of the day what's more important is helping you INCREASE your energy levels.

One of the main symptoms of PCOS is fatigue.

While it's true that the fatigue experienced in PCOS patients is likely multi-factorial (meaning several things are probably causing it) one thing is for sure:

Taking an adrenal supplement has the potential to dramatically improve your energy levels.

​Why is that?

Well, nowadays it's not uncommon for women (and men) to be exposed to extreme levels of stress.

This low-grade chronic stress can really impact your hormones and energy levels.

In addition, stress has a DIRECT effect on hormone imbalances like insulin and thyroid function (14).

This gives us an opportunity to treat this problem with certain adrenal adaptogens.

​The adaptogen Ashwagandha has been shown to do several very important things in patients (all relevant studies are in the links to the claims made): 

That's a pretty exhaustive list of benefits that can all come from Ashwagandha and it isn't even complete. 

As you go through the list and read the studies that I've provided I think you will find that ALL of these hormones are somehow connected in your body.

How else can you explain that Ashwagandha helps with ALL of the conditions, ranging from sleep issues to weight loss and metabolism?

The bottom line:

If you are suffering from fatigue in some way, or any of the symptoms listed above, you should seriously consider using Ashwagandha in appropriate doses: ​

How to Supplement with Ashwagandha
Why I like it

May Improve Thyroid + Adrenal Function

Naturally occurring and generally safe

May also improve Mood + Depressive symptoms

Generally works within 4-8 weeks

How to Use

  • Dosage varies from 500-2,000 mg per day depending on tolerance and degree of symptoms
  • Length of treatment varies by condition, for adrenal fatigue supplementation as long as 6+ months may be required.
My Recommended Brand and Product:

#7. Bio-identical Progesterone​

Lastly, it's worth mentioning the supplement (or hormone rather) progesterone. 

Unlike other hormones in the US, progesterone can be purchased over the counter.

But just because it can be purchased over the counter doesn't necessarily mean that it should be.

​Just in terms of raw numbers, the female body has more progesterone than it does estrogen. 

So if that is any measure of importance, then progesterone might be more defining to female sexual characteristics than estrogen (but we will save that for another time).

What's more important than that is the question:

Should you consider using progesterone? ​

That's an interesting question and worth exploring. 

Before we discuss whether or not you should use it, we need to talk about progesterone facts. 

First:

Over time all women will eventually have low progesterone. 

This decrease in progesterone starts around age 35 when progesterone levels tend to fall more rapidly than estrogen levels.

age related decline of estrogen and progesterone

So starting from age 35 progesterone levels fall until women reach menopause at which point progesterone levels tend to fall to zero.

While estrogen levels fall to almost zero, estrogen levels may actually stay high.

And this primarily happens due to estrogen conversion in peripheral fat cells. ​

Second:

​Women with PCOS tend to have low progesterone levels at baseline and higher estrogen levels at baseline. 

This starting combination can exacerbate progesterone deficiency as women age and may lead to worsening symptoms long term.

​But just because this happens does it mean you should use progesterone? 

​It's true that progesterone can literally be life changing for some women, but it can also be detrimental for others (leading hormone problems and weight gain). 

My recommendation ​is to check your progesterone level AND check to see if you have any of the following progesterone deficiency symptoms prior to supplementing. 

Symptoms of progesterone deficiency: ​

  • Sleep disturbance
  • Water retention
  • Irregular periods (if menstruating)
  • Anxiety or difficulty relaxing
  • Emotional and other mood problems
  • Decreased libido
  • Hot flashes
  • Breast tenderness and pain
  • Breast lumps or cysts
  • PMS, fibroids, & endometriosis

​If you find that you have a combination of these symptoms plus low progesterone levels on serum testing then it would be worth a trial of progesterone therapy. 

Just make sure to monitor your symptoms as you ​use it and discontinue use of progesterone if you experience negative side effects. 

How to Supplement with Bioidentical progesterone
How to Use

  • If menstruating: Use 20-40mg per day on days 14-28 of your cycle (the latter half of the month)
  • If in menopause: you can use 20-40mg per day either 6 days per week (with rest on the 7th) or 26-28 days per month (with 1-3 days off per month)
  • Make sure to monitor your symptoms while using and discontinue use if you experience any negative side effects
  • Discuss the use of bioidentical hormones with your physician
My Recommended Brand and Product:

Back to you

I hope you found my recommended list of PCOS supplements helpful.

Just remember that these supplements only represent ONE part of a complete treatment regimen for patients with PCOS.

You can't forget lifestyle changes like diet and exercise.

Also, if you decide to use any of these supplements, make sure that you use the recommended brands and the recommended dosages for best results.

For most of these supplements, you will need to use them for at least 3 months to experience optimal results.

​Now it's your turn:

Are you using supplements to treat your PCOS?

Which ones have worked?

Which haven't?

Leave your questions or comments below! 

References (Click to Expand)

The best PCOS supplements pinterest
Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

65 thoughts on “7 of the Best PCOS Supplements Every PCOS Patient Should Consider”

  1. I have read many of your posts the past two days and they’ve been very helpful to give me a better understanding of thyroid function, hormones and some direction to try to improve my health. There are many moving parts and with varying medical opinions, it is very confusing!

    I am a 45 year old female. My TSH has been 3.2 -5.5 over the past 5 years. I have had many hypo symptoms: Fib cysts, heavy periods, insomnia, unexplained weight gain, dry hair, brittle nails, fatigue, a little brain fog, low libido, moodiness and slight depression. I have a history of being low on iron (have taken iron supplements at times) and low vitamin D. When I mentioned the gray areas of TSH, the nurse at myPCP told me they only treat TSH of 10+. My Hemoglobin A1C was 5.4%.

    My OBGYN has been helping with hormone therapy. I had saliva testing 12 months ago that showed:
    E2 2.96
    Pg 196.88
    Ratio of Pg/E2 66.56 (low)
    Testosterone 21.14
    DHEA 20.88
    Cortisol Morning 3.34
    Cortisol Noon 2.44
    Cortisol Evening 2.02
    Cortisol Night 1.00

    I was told I had Stage 3 Adrenal Failure (likely caused by a period prolonged stress)and that we would try to nourish my adrenals back to health and that in turn, should help my thyroid.
    With that, I took 10mg DHEA, BI Prog Cream, Quell Fish Oil and Doug Lab Adrenomend.
    I couldn’t take the DHEA so stopped. I have since gotten BI Testosterone Pellets (estrogen blocking) twice, each 3 months apart. I was told to stop the Progesterone cream and am now taking:
    -Douglass Labs Ultta Preventive 2x daily
    -Douglass Labs Ferronyl Iron 1x daily
    -Quell Fish Oil EPA/DHA Plus D 1x daily (I haven’t been as much lately because of all
    the oiliness from it and the testosterone!)
    -Douglass Labs Tri-Iodine 12.5 3x week (to help my body absorb the testosterone)
    -Douglass Labs Adrenomend 2x daily
    -Compounded BI Progesterone 100MG 1x (at night to help sleep)
    -Compounded Anastrozole 1MG 1x daily to keep the testosterone from converting to
    estrogen
    -5000 IU of Vitamin D3 daily

    The first round of testosterone pellets went alright. My libido improved some, energy improved and sleep. But…some of that improvement could have been from the supplements (iron gave me energy, prog cream helped me sleep, etc.). I have had seb cysts/acne and very oily complexion and oily hair and my weight has been =/- 5lbs. I read that you normally see the positive effects of the pellets 4-6 months after getting them. I think my body doesn’t like the high amounts. I’m not sure what my first pellet doses were but I know they were increased the second time to:
    Testosterone 12.5MG
    Testosterone 80MG
    Testosterone/Anastrozole 60MG/4MG
    Although my pellets were not supposed to be able to convert to estrogen, my estrogen increased from the first pellets to the second and my testosterone went down even though my dosage had been increased. I feel like that is my body telling me it is too much??
    After the first round of pellets my Estradiol was 115, and testosterone was 259.7. They added the Anastrozole to keep my estrogen down. Last month (after 2nd round of pellets with increased dose of testosterone) my Estradiol is 28 pg/mL and my testosterone is 249.7.

    I asked them to check my thyroid again. It showed:
    TSH 3.00 (which was a bit lower than before)
    FT4 .73
    FT3 3.70

    They put me on 25MCG of Synthroid. I have been taking it for 4 days. I was told to take it in the morning but am taking it at night because of convenience and also read your shared post that may be better for some people.

    I’m a little confused if I am just hypothyroid or if I have Hashimoto’s. I think my lab results above show Hashimoto’s. I read that left untreated that could lead to rheumatoid arthritis, lupus, etc. I haven’t had the antibodies tests and am also not sure if I should one or both of them. Do I need to know my RT3? Any advice on this? I am not clear if anything else should be done for Hashimoto’s vs. just hypothyroid other than some dietary changes???

    Also, I wondered if I should ask for insulin and leptin testing since my weight has been a struggle the past few years and my HG A1C was 5.4%. I read your post about recommended supplements and even the temporary Rx normally for diabetic patients to stabilize your levels. By the way, your buttons on the supplements link for Alpha Lipoic Acid and Chromium both go to your recommended Berberine. I’d like to know which brands you recommend for the ALA and Chromium.

    With all this…I am wondering if I should stop the testosterone pellets, go back to the progesterone cream, work with the synthroid and other supplements and ask for one or both of the thyroid antibodies tests, leptin and insulin tests??? Should I do a BI testosterone cream? I will ask the nurse practitioner at my OBGYN about all of this. I think they converse with some doctor in the D.C. area for hormone replacement advice. I just wonder with the super high testosterone pellet doses if I’m in the right place for me.

    I was disappointed to see that you are not taking new patients. Do you have a waiting list or can you refer me to any other physicians? I am in Little Rock, AR but I’ll fly anywhere in the U.S to see a good doctor to figure out my labs/results and get a plan in place.

    Thanks for all your posts and any suggestions.

    Reply
  2. “Serum 8 am cortisol: For best results this level should be somewhere between 4-16. Levels higher than 20 may require different treatment.” What is your unit of measure? My lab’s unit is ng/mg and doesn’t appear to correlate to yours.

    Reply
  3. I was diagnosed with PCOS nearly 10 years ago. I have been taking Metformin for years and have not noticed much of an improvement in my health. The last year I have been taking Aldactone for the high testosterone. But it does not seem to be working either. I would like to try these natural methods because what I am doing doesn’t seem to be working. Can a woman try all of these? Are there any contraindications for using all of these on the list?

    I currently take 100mg of Prometrium. Is the bioidentical progesterone in either the cream or oil really superior? I have been hesitant to try it because I have small children and worry about transfer issues.

    I changed my diet drastically and managed to lose 60 pounds and have maintained the weight loss for nearly 2 years. I have never taken my PCOS very seriously, instead focusing on my thyroid. But I feel the PCOS is the missing piece to achieving optimal health. I am losing hair drastically and have hirsutism , which is so frustrating! I have about 25 pounds left to lose and have hit a plateau, which is driving me crazy.

    Thank you for any insight.

    Reply
  4. Thank you for this information. I’m going to start using these supplements to treat my POCS and estrogen dominance. I am 41 years old, for many years I have been synonymous hormones, the whole hormonal system I am disturbed. I already use progesterone cream, but unfortunately my androgens have PCOS symptoms. I hope this therapy will be helpful. Greetings from Poland.

    Reply
  5. I still have a question about saw palmetto. Will this herb not worsen the symptoms associated with estrogenic domination?

    Reply
      • I want to say thanks a million to Dr. Westin Childs for the supplements recommendations, I was diagnosticied with POCS several years ago and for the same number of year I have been through different problems such as infertility, high blood pressure, hair loss and uterine fibroids, plus the worse one which was the pain in my right knee for which I took several MRIs and different exams and the doctors told me it was arthritis, the pain was terrible, I felt like I had two stones in my knees, it was hard and painful for me to walk. I started taken Berberine 500, Alpha Lipoic Acid, Zinc and Chromium and the two main problems were away like one month after High blood pressure and the pain in my right knee.
        I tried taking Saw Palmetto to stop the hair loss but it did alter my menstrual cycle, so I had to stop it, but I tried a no sugar and low carbs diet + the berberine, ALA, zinc, and chromium and the hair loss was reduced 60 %. I just want to share my experience as it could be beneficial for other women as well.

        Reply
  6. Dear Dr Westin

    I have PCOS and just started Saw Palmetto and Zinc. My dosage is 1x580mg of SP in am on empty stomach and 1x30mg Zinc after food. I know both works in reducing sebum level in your body by lowering your excess androgen but after taking both together for few days I find my skin turns quite dry and I start feeling anxious and seems unable to focus.

    I read that SP can cause anxiety and dizziness..is it due to this? Can I choose to just take Zinc (with b6) by itself to help with hairloss and controlling sebum level? Can you reply to my email id directly : [email protected].

    Reply
    • Hi Chelaine,

      I’ve never had anyone experience anxiety or dizziness using saw palmetto, but each person is slightly different. You shouldn’t have a problem just using zinc, though it won’t be as strong as the combination.

      Reply
  7. Can the excess of androgens at PCOS after 40 years of life also cause estrogen dominance? Can Testosterone in PCOS convert to estrogen? Progesterone cream helps me a lot, diet paleo and chrome for insulin, but I still have symptoms of excess androgens (greasy hair and skin, hair loss). But I still have a problem with stopping water and constipation (estrogen?). Will mastering androgen help in the problem of estrogen dominance too? I do not know why, but I’m afraid to take a saw palmetto, so far I take a zinc. Unfortunately, many antiandrogenic herbs also raise estrogen by converting testosterone to estrogen, and unless palmetto saws do not have this estrogen-boosting effect.

    Reply
  8. And what do you think about using myo-inositol on PCOS? How does it affect estrogen levels, supposedly helps with insulin and high androgens?

    Reply
  9. Hi, I’m 24 years old and was diagnosed with pcos after an ultra sound showing I had more than 14 cysts on my ovaries. I have horrible acne and am starting to develop some facial hair. I stopped taking the birth control pill 9 months ago and since then haven’t had my period. I’ve been dealing with an awful array of symptoms as well like anxiety and depression. I know I should see an endocrinologist, but don’t have insurance any longer. I’m wondering if you suggest I take any of these supplements or if there’s no way to know without proper lab tests?

    Thanks, Greta

    Reply
    • Hi Greta,

      If you can’t afford to see a physician then a trial of some of these supplements would be worthwhile.

      Reply
    • Hi Greta, chasteberry root/Vitex has helped me regulate periods without birth control pills for 16 years; I’m 37 yrs old now and was diagnosed with PCOS at 20 yrs old… I stopped taking BCP after a year because I think they’re too risky. As for labs, unfortunately not too many understand what to do with that info, patients and specialists alike. PCOS is a disorder on a spectrum, and you have to tailor your supplements to your symptoms in order to find relief. As for the the emotional aspect of it, it gets easier to handle in the fullness of time and by not dwelling on it so much; that’s not to say bury your head in the sand, but be easy on yourself and know that you’re not a freak… it’s so common and now that, lo and behold, people are finally actually talking about it more and giving us laymen info that we can use from complex studies, it’s easier to experiment with less risk. My layman advice is to try Vitex and, if you don’t already lead a low-carb life and think of moderate exercise as a therapy to balance your body and brain, try those as well.

      Reply
  10. GREAT ARTICLE and thank you! Very informative, probably one of the most understandable of all the articles I’ve read! Ok, so my question is:

    I’ve been sick a little over a year now. I’m a little different than the typical PCOS patient. I’ve lost about 40 pounds, I have course hairs a few places(like 10) but nothing out of the ordinary. I had three babies very easy, no issues. I have a period every month but VERY heavy. My blood sugars were elevated although I was eating very clean. They have come down since detoxing my body. Now to the question(lol)..
    Do you think PCOS is toxicity? In my journey to find what in the world is wrong with me I found due to my past business I am very toxic to plastics. I also was exposed to 6 different molds, 3 being the dangerous ones in a boutique I owned. Your suggestions are a lot of the suggestions I was given to get rid of plastics and detox. I have high DHEAS, high Testosterone, IGF high, elevated blood sugars, very toxic to plastic, haven’t tested my body for mold but the building was full of it. I have all the blood work of PCOS but symptoms don’t fit me. What is your take on toxicity and the PCOS connection?

    Reply
    • Hi Brooke,

      I think it would be unwise to assume that environmental factors such as exposure and toxicities don’t play a role in the development or potentiation of PCOS. I think more important than that, though, is how much do they play a role? I think that answer depends on the individual and their specific circumstances.

      Reply
  11. Would you recommend taking all of these supplements at the same time? Or would you recommend trying a few and seeing the results you get and then switching it up to find the best cocktail?

    Reply
    • Hi Erica,

      As a rule of thumb stick to 3-5 supplements at any given time. If you take less than that you probably won’t see great results and if you take more than that you will start to interfere with absorption and have to worry about interactions.

      Reply
  12. Hello. I was wondering what kind of diet you would recommend having pcos. Should I eat low carb and if so how many carbs should you have a day? Are there foods I should avoid having pcos? I have high testosterone but am not insulin resistant but I’ve gained almost 50 pounds and I can’t seem to lose any no matter what I try. Thank you

    Reply
    • Hi Amber,

      Ashwagandha tends to have a normalizing effect on hormones such that it brings down high levels or brings up low levels. So it can actually work for both high and low DHEA/testosterone levels.

      Reply
  13. What is the best thing to do in order to lower DHEAS? I have PCOS and high testosterone and DHEAS causing acne and oily skin!

    Reply
  14. Dear Dr. Westin Childs,

    I am so happy to read your article. I have been diagnosed with PCOS for around 10 years. I heard that increasing estrogen might lead to cancer. Is anti-androgen equal to increasing estrogen? Thank you!

    Reply
    • Hi Grace,

      Women with PCOS tend to have both increased androgens and estrogen activity, so it’s important to treat both of these conditions if present. Treating one will not necessarily improve the other.

      Reply
  15. Is it ever safe to use these supplements and have an alcoholic drink at some point in the day? I am going to start out with the berberine, chromium picolinate, and alpha lipoic acid. If I have a drink would it hurt me?

    Reply
  16. This was a great read! I’ve been researching about Saw Palmetto online to help with my PCOS related acne. I’m on antibiotics, prescription face medicine, and also spironolactone (for many years… I have refused accutane)

    My understanding was that the Saw Palmetto will help to aid in relieving the testosterone, my question is will the changes in testosterone have a chain affect on the other hormones?

    I don’t use birth control, the synthetic hormones are unmanageable, IUD had me bleed for 8 months straight, and as well all know, condoms suck. Last year I stopped using any form of birth control and I figured with PCOS the pregnancy odds weren’t in my favor. And when I was ready for a baby I would treat the PCOS and maybe be able to conceive. But as it is my face is oily, and acne is painful and itchy. So I want to sort out the testosterone. Will this have a domino effect? I’ve never been concerned with getting pregnant before.

    Reply
  17. I am 22 years old and I was diagnosed with PCOS at 14, after starting menstruation and not having another cycle for 8 months. Since then I have only had about 12 cycles. As a teenager, I saw this as a blessing, but now that I am older, I am concerned about my ability to conceive. I remember my doctor having me take progesterone pills to induce menstruation, and it worked, but I have not treated my PCOS since. I have pretty much all of the symptoms listed. I have decided to take better care of myself and have changed my diet and exercise habits. Hopefully, I haven’t allowed things to get too far out of hand. I’ll get started on these supplements as soon as possible. Thanks?

    I do have one question on the progesterone, if I haven’t menstruated in a year, can I just start it anytime and go for 14 days?

    Reply
  18. Hi, I have PCOS with a family history of high androgen levels/horomone imbalances caused by endometriosis or PCOS. When I went to the OBGYN and received a blood test, the results came back
    normal except for a very high DHEA-S level (i can’t remember the exact number but it was far out of normal range.) I got my right ovary taken out last month due to a cyst growing to the size of nearly my uterus and I’ve noticed a slight improvement in symptoms. What supplements could I take to lower the DHEA-S levels even further to normal levels?

    Reply
  19. Hi there!

    I just started Berberine, Zinc, and Saw Palmetto on top of some Inositol and Chasteberry, and I was wondering how long it should take me to notice any difference in weight loss/hirsutism? I was previously on hormonal birth control and Metformin and within a couple weeks of stopping the birth control and Metformin, I immediately noticed hair regrowth where it had been lessened/slowed down. I stopped taking the birth control and Metformin because the former made me crazy, and I actually gained some weight back that I had lost because they couldn’t find the right “fit”, and the latter made my bowels … explosively irritable.

    Thank you!

    Reply
  20. Hello and thank you for this information. I started taking Progesterone which I think is a generic for Premetrium at 200 mgs. in the evening before I go to bed along with a pump of estrogel that my Dr. prescribed. The progesterone really helps to relax meso I can go to sleep and My Dr. said my labs look good but the problem is that I seem to be alot more hungry now and have gained another 6 lbs since starting the the progesterone and Estrogel last Oct. of 2017. After reading your article I am beginning to think its the progesterone causing the weight gain. I have gradually put on 15 lbs in the last year and a half. I am 56 years old and I am active and watch my diet and work out so this is very frustrating to me. Do you think it is the progesterone that is contributing to the weight gain?

    Reply
  21. Hi! Thanks so much for your article. I am 41 now and for five years I’ve been suffering from progressive systemic malfunctions which manifested in almost total food sensitivities with no true allergies present, hormonal imbalance with massive night sweats (I do have elevated testosterone levels), cyclic gut and severe joint inflammation followed by rashes and breakouts all over my face, chest & back. Two months ago, after months of experimenting and failing, I decided to tackle this from the angle of adrenal insufficiency. I previously took DIM and while it helped with night sweats, it didn’t really do much else. Then I found Berberine HCL & my gut and I finally made peace. Took it for a month only, as I am thin, have been my whole life, 96lbs, so I tend to be conservative with dosing. After that, for my adrenals I started taking licorice root with peony and for the first time in five years I can finally sleep. My night sweats are gone, breasts no longer sore, my breakouts have diminished by 90% in just over two weeks but am noticing that without Berberine, my gut inflammation has returned. I have to restart it and am wondering how safe or effective it would be to combine Berberine with licorice root and peony AND I am also thinking about restarting DIM as licorice root cannot be taken for long, I have to stop it in the next two weeks and am worried about my hormones going wild again. Any ideas on this combination of supplements? Thanks so much!

    Reply
  22. I recently was diagnosed with PCOS. Fortunately, my symptoms aren’t horrible. I have be doing HIIT exercises for a couple of years now which I have found manages most of my symptoms except my acne. Blood work indicated that my testosterone levels are in the normal range, but that I have high DHEA-S levels. I haven’t found much on the internet about supplements that can help regulate DHEA-S. Any recommendations?

    Reply
  23. I have used an organic chromium yeast, chromoprecise for PCOS and fertility. It has been very helpful in managing my blood sugar balance. I am sure you know the physiological reasoning and functions better than me. I read an article about PCOS, chromium, and fertility. This article was very helpful to me in my journey: http://healthandscience.eu/index.php?option=com_content&view=article&id=1215:pcos-and-infertility-can-be-helped-with-dietary-changes-and-a-single-nutritional-supplement-us&catid=20&lang=us&Itemid=374
    Maybe you can address your view on chromium, PCOS, and fertility? I would be very interested in your perspective.

    Reply
  24. Dear Dr. Child,
    I experienced more hair loss, whenever I decreased my estrogens (like after birth, when hair falls into telogen-phase).

    Will this also occur when “bad” estrogens are eliminated from the body due to calcium d glucarate and DIM?

    Thanks a lot for your help!
    Best
    Gretchen

    Reply
  25. Thank you for this article! Here in France doctors seem to treat PCOS by using the pill and that’s it! My question: Can I take the supplements you recommend while breastfeeding?

    Reply
  26. Hi, I am wanting to take both zinc and DIM at the same time for acne. Can I take both without one affecting the other??

    Thanks!

    Jos

    Reply
  27. Thanks so much for putting together this article. However, I notice that you don’t mention Don Quai or Vitex which tends to be highly recommended elsewhere. Is that because these other supplements compensate for them?

    Reply
  28. Hi, Thanks for your information on the above, I recently diagnosed with PCOS. For the above supplements you explained, do I need to take all 7 or if only one of the combination. Let’s say I take the first combination of DIM-plus calcium and Indole 3-Carbinol, do I need to take zinc plus saw palmetto. Currently, I am taking vitex, NAC and fish oil. Can you recommend for me which combination suitable for me?

    Reply
    • Hi Caliexta,

      It really depends on you. You only want to use supplements which target the hormone imbalances that you are personally facing. You can figure those out with some blood tests.

      Reply
  29. Hello,

    I was wondering if it was safe to take most of these supplements at the same time due to multiple PCOS related symptoms. I plan on gradually adding supplements has I go along but I’m not sure if it’s safe to take 10+ supplements at the same time

    Reply
    • Hi Rebecca,

      Most people do just fine when taking many of them at the same time. You want to be careful though, as taking too many supplements can start to cause absorption issues. I usually try to put people on no more than 5 supplements at any given time.

      Reply
  30. Hi Dr Child,

    As I was doing my research on Indole 3 Carbinol and DIM is similar. I need to take both types together to be more effective?

    Reply
  31. Hello Dr.

    I’ve been reading many of your posts regarding pcos, adrenal health and supplementation

    I haven’t found anything about inositol as a supplement to help pcos. I would like to know your knowledge or stance about inositol and if it’s worth it.

    Sincerely,
    Damita

    Reply

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