If you answered yes, then you have got to pay close attention to your vitamin D levels, as it is estimated that between 67-85% of us ladies with PCOS, have a vitamin D deficiency! Often at critically low levels.
The reason for this shocking statistic is not yet known, however it is believed that we may have certain genetic variants that affect vitamin D's function in our body.
Vitamin D and many other nutrient deficiencies are rarely, if ever, discussed by doctors, in relation to hormonal conditions. We are taught that PCOS is genetic and the only ways to 'manage' symptoms are to lose weight, take the oral contraceptive pill or medications such as metformin. This is totally inaccurate.
Optimising your vitamin D level, is one simple way to improve your condition and symptoms of hormone imbalance. Let me tell you why....
Benefits of vitamin D for PCOS
Did you know that vitamin D is actually a hormone?
This 'sunshine vitamin' is created by our body, through a chemical reaction on our skin, when exposed to sunlight.
Not only are we more likely to be deficient in this nutrient when we have PCOS, but having sub-optimal levels actually makes our symptoms worse!
Some of the benefits relating to PCOS include....
Increased insulin sensitivity
Vitamin D has been shown to improve insulin resistance and lower the risk of type 2 diabetes, which is a condition closely related to PCOS. A deficiency can negatively affect glucose metabolism, potentially leading to worsening of PCOS symptoms such as weight loss resistance, hirsutism and acne.
Improved skin health
Contrary to what we have been told, we should be regularly exposing our face and body to sunlight for healthy looking skin. (Obviously, without burning) As I just mentioned in the last point, vitamin D helps with glucose metabolism therefore reducing the process of glycation (AGES) within the skin.
High blood sugar or constant fluctuations can also trigger hormonal acne, due to the increase in sebum and cortisol production.
Vitamin D also helps to down regulate sebaceous gland activity and helps to control sebum production. It also decreases overactive cell turnover, which can help to prevent pores from becoming clogged, decreasing the risk of breakouts.
Vitamin D supports the immune system and helps to reduce inflammation by interfering with certain signalling molecules, responsible for the inflammatory cascade.
Specific immune cells known as macrophages are stimulated by vitamin D and in the skin they directly attack the bacteria that can drive acne, instead of producing an inflammatory response.
Individuals suffering with chronic inflammatory conditions are often deficient in vitamin D and commonly experience benefits after optimising their vitamin D levels.
One study found that women using IVF are half as likely to conceive if they are vitamin D deficient!
In a small-scale intervention study including 13 pre-menopausal women with chronic anovulation and hyperandrogenism, vitamin D repletion combined with calcium daily, resulted in normalisation of menstrual cycles in seven women and two women became pregnant.
Vitamin D has been found to be directly involved in follicle egg maturation and development.
The benefits on fertility may be due to vitamin D's effect on insulin and blood glucose, which influences hormone balance.
Boosts mood and mental health
Anxiety and depression are common symptoms for women with PCOS to experience. When the sun is shining we all tend to feel happier and exposure to vitamin D can be one of the reasons for this benefit.
Acne, weight gain, hair loss, difficulty conceiving and facial hair growth are symptoms that are likely to bring anyone's mood down.
Getting natural sunlight also positively effects our circadian rhythm (body clock) which controls our hormone and neurotransmitter production.
study on women with PCOS found that Vitamin D deficiency seems to be linked to the condition. After vitamin D supplementation, absent and/or irregular menstrual cycles began to normalise and dysfunctional uterine bleeding stopped in the majority of participants.
Vitamin D deficiency has been linked to muscular weakness, musculoskeletal pain, fatigue, low moods, immune dysregulation and inflammation, which are also common symptoms of PMS.
Both blood pressure and androgens were lowered in PCOS women taking vitamin D, during one study. Androgens often drive symptoms such as acne, hair loss, anovulation and hirsutism. In PCOS, the aim is to normalise hormonal balance and the ratio between male and female hormones, which is usually imbalanced. Vitamin D may help this process.
Vitamin D is mostly known for its bone health and immune supporting benefits. I have already mentioned how vitamin D is anti-inflammatory and how this can benefit certain PCOS symptoms such as acne. Women with PCOS are more likely to suffer with thyroid conditions in their lifetime, specifically Hashimotos Thyroiditis, which is an autoimmune disease. A vitamin D deficiency is associated with increased likelihood of autoimmunity as vitamin D acts as an 'immune modulator'.
How to get enough vitamin D
Unlike other nutrients, vitamin D is hard to obtain through diet alone, therefore we need to focus on sun exposure and supplementation to meet our needs.
Foods that do contain small amounts of vitamin D include oily fish, liver, dairy, eggs and fortified products such as non dairy milk.
Vitamin D is a fat soluble nutrient, therefore we need to ensure we are eating adequate amounts of healthy fat in our diet every day, otherwise we are at risk of deficiency.
Despite what we have been told, exposing as much of our skin as possible, to the mid-day sun, for 15-30 minutes each day, is the best way to get vitamin D. Without SPF.
The key here is NOT TO BURN. If you have red hair and pale skin, obviously listen to your body and don't over do it, just start with 15 minutes. The darker your skin, the more exposure you actually need to create vitamin D and this is the reason why certain ethnic groups are at risk of deficiency.
An interesting health hack I learned a few months ago is to avoid cleaning your skin with soap or body wash for a few hours after sun exposure as it can interfere with the production of vitamin D on our skin! If you are super sweaty, have a quick rinse using just water, then shower properly in the evening.
When choosing a supplement, I only recommend the form vitamin D3, not D2, due to its superior bio-availability in the body. Without knowing your vitamin D levels, you should only be taking 1,000-2,000 IU of vitamin D per day, which is a maintenance dose. Because vitamin D is fat soluble, it is stored in the liver, and in excess amounts can be toxic. Before supplementing with anything over 2,000 IU, (even if you have PCOS and dark skin!) you need to test your levels. This can be done by your GP or privately, through a simple blood test. Only when you know your results can you safely and accurately take higher, more therapeutic doses, in order to correct any possible deficiencies.
Please be aware that the ranges used by conventional doctors for nutrient levels aren't optimal. With my clients I like to see levels around 75-150 nmol/L (30-60 ng/ml) to have the full hormonal benefit.
Again, I highly recommend working with a health practitioner who can support you with nutrient dosing and providing access to practitioner grade supplements.
In summary, I believe that vitamin D levels are a big factor in PCOS.
This being said, we also need to address all of the other things we know to improve this condition such as diet, movement, detoxification, stress levels, quality sleep and environmental toxins, in order to fully balance our hormones.
Deficiencies of certain nutrients such as vitamin D, can be drivers of PCOS, but they aren't the root cause.
Are you a woman with PCOS who has also been diagnosed with a Vitamin D deficiency? Did your symptoms improve when you corrected this through adequate sun exposure or supplementation? Let me know in the comments section below! :-)