Zinc and PCOS ‍

Did you know that recent research indicates zinc can be helpful in managing PCOS symptoms? This is welcome news for those who want to take a more natural approach to handling their PCOS, or those who want to incorporate holistic methods (encompassing nutrition, medication, and exercise) to minimize undesired symptoms cropping up in their day to day. So what can zinc do for your PCOS? It turns out, a lot: it shows promise in mitigating hirsutism and alopecia, while its essential role in fertility and pregnancy are well-documented. So today we’re going to talk about the specific benefits zinc can offer those suffering from PCOS, how to get more zinc naturally through your diet, as well as the most effective ways to supplement with zinc (if you choose to do so, and most importantly with the guidance of your healthcare provider). 

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• What You Need To Know About Zinc
• How Zinc Can Help With PCOS
• How To Get More Zinc In Your Diet
• Supplementing With Zinc 

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What you need to know about zinc

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Zinc is an essential nutrient found throughout your body, as well as in the food we eat and our environment. It helps with your immune system and metabolism function, while it also plays an important role in wound healing and your sense of taste and smell. When it comes to fertility and outcomes after pregnancy, like we said earlier, zinc is pretty important, regulating essential processes like cell growth, hormone release, and general reproduction. The recommended daily amount of zinc intake is 8 mg for adult women who aren’t pregnant and 11 mg for adult men. 

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Unfortunately, zinc does have some drawbacks that are relevant for those who are taking certain medications, since there can be undesirable interactions. For instance, oral zinc can interfere with quinolone and tetracycline antibiotics and their ability to fight bacteria, as well as specific drugs (such as penicillamine) for rheumatoid arthritis. And, of course, there is always too much of a good thing: excess zinc intake can trigger side effects like nausea, vomiting, loss of appetite, stomach cramps, diarrhea, and headaches. Over longer periods of time, too much zinc can also lead to low copper levels, lower immunity, and lower levels of HDL cholesterol (otherwise known as the ‘good’ type of cholesterol). Upper limits of zinc for adults hover around 40mg per day, which means it’s almost impossible to ‘overdo it’ on zinc through food consumption, but it’s a lot easier to accidentally intake too much when supplementing. As such, it is important to always consult with your healthcare provider or registered dietitian before supplementing with zinc. 

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How zinc can help with PCOS 

A study published in 2016 found some promising insights for the effects of zinc supplementation on endocrine health in women with PCOS. This study is considered ‘gold standard,’ given it was not only randomized, but also double-blind and placebo controlled, thereby limiting room for bias in the results. The sample was small (it studied only 48 participants, aged 18 to 40 years old), and all participants were diagnosed with PCOS according to the Rotterdam criteria (to learn more about the ins and outs of this criteria, check out our article on how PCOS is diagnosed, as well as this other informational piece of how PCOS is tested for!). 

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In the study, subjects’ hormonal profiles, biomarkers of inflammation, and oxidative stress were measured at baseline, and then 8 weeks later. Subjects were given either 220 mg of zinc (containing 50 mg of zinc sulfate) or a placebo. After 8 weeks, the results were as follows for the patients who received zinc: 

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• Decreased alopecia  
• Decreased hirsutism 
• Decreased plasma malondialdehyde (MDA) levels 

• An indication of lower oxidative stress

• Reduced high sensitivity C-reactive protein (CRP) levels 

• High CRP can indicate inflammation

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Translated? This basically means zinc may be able to mitigate the severity of some undesirable PCOS symptoms (specifically excess hair growth on the body, and androgenic alopecia on the scalp), as well as reduce the levels of oxidative stress and inflammation in the body. Those are some pretty cool outcomes. And what about what zinc can’t do? Well, researchers noted that zinc did not seem to affect “hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress.” 

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Zinc’s potential health benefits don’t end there for those suffering from PCOS. There is also evidence that zinc helps control insulin sensitivity. This is particularly exciting since approximately 65% to 70% of women with PCOS experience insulin resistance and “compensatory hyperinsulinemia.” Compensatory hyperinsulinemia (CH) sounds complicated and scary, but essentially it refers to the heightened response the pancreas and liver display to early insulin resistance. Insulin resistance appears to be a problem regardless of whether you fall into the obese, overweight, or ‘normal’ BMI ranges, with researchers believing that “part of the insulin resistance appears to be independent of obesity and related specifically to PCOS, with abnormalities of cellular mechnisms of insulin action and insulin receptor function having been documented.” Unfortunately, this means that if you have PCOS, you are statistically more at risk of developing insulin resistance. This, in turn, can lead to a bunch of undesirable long-term health outcomes, such as type 2 diabetes, as well as potential associated “negative effects on both metabolic and reproductive health.”

So the bottom line is, insulin resistance is something we want to mitigate, if possible. Enter zinc. A huge study, carried out via questionnaire from 1980 to 2002 across 82,297 women, found “higher zinc intake may be associated with a slightly lower risk of type 2 diabetes in women.” Of course, these results aren’t fool-proof: the data used for this study was self-reported, and researchers only followed up with subjects after a 22 years gap, during which a number of unaccounted for macro-economic and individual factors could have influenced health outcomes. But scientists point out that since the 1930s, animal studies have shown that “zinc intake may have protective effects against type 2 diabetes.” And though much more research needs to be conducted on humans to examine this relationship, there are peer-reviewed studies demonstrating zinc supplementation's potential antagonistic effect on type 2 diabetes and insulin sensitivity in women. 

If you’re wondering about the ‘how’ behind zinc’s relationship with insulin, you’re not the only one. Researchers aren’t quite sure: one hypothesis posits that zinc may protect insulin cells from being attacked by free radicals (inflammatory particles in the body), while another suggests an enhancement of insulin signal transduction and improved binding of insulin to its receptor may be responsible. In either case, though much more research needs to be conducted (including studying the effects of different zinc dosages and length of time of supplementation), the initial research on how zinc can help with PCOS is promising. 

How to get more zinc in your diet 

Here’s the thing: even though zinc is an essential trace mineral, your body can’t store it, so you need to eat enough everyday in order to ensure you're getting near the recommended daily intake. Additionally, by eating a diet rich in zinc-containing foods, you decrease your need for supplementation and the potential side-effects of long-term use.

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In the typical ‘Western’ diet (high in red meat, dairy, and processed foods) this isn’t a problem, but for those who are growing (teenagers and young children), pregnant, elderly, or vegetarian or vegan, zinc can be a little harder to come by. This doesn’t automatically mean you need to jump to supplements: with a little intention, you can get enough zinc exclusively through your diet. Here we have some of the best sources of zinc, including vegan and vegetarian options for those who follow a majority plant-based diet: 

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(Keep in mind that the recommended daily zinc intake is 8 mg for adult women, and 11 mg for adult men!). 

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• Red meat 

• 100 grams (approximately a 3-4 oz. or 1/4 pound serving) of minced beef covers 44% of the daily recommended intake of zinc 

• Poultry 

• 3-4 oz of chicken will get you to almost 3 mg of zinc 

• Shellfish 

• Alaskan crab 

• Find 7.6 mg of zinc per 100 grams of Alaskan crab (approximately a 3-4 oz. or 1/4 pound serving)

• Oysters 

• Oysters is one of the most zinc-rich foods out there: just six of them give you almost 300% of your recommended daily intake 

• Hemp seeds

• 3 tablespoons will deliver 43% of women’s daily intake 
• If you don’t like hemp seeds, then pumpkin, sunflower, chia, and squash seeds are all good alternatives 

• Mushrooms and kale 

• 1 cooked cup of kale combined with 1 cup of chopped mushrooms will deliver almost 10% of your daily recommended zinc intake if you are a woman 

• Beans and legumes 

• 1 cup of lentils yields over 2 mg of zinc, while 1 cup of cooked edamame, black beans, and canned chickpeas give you between 1.5 mg and 2.2 mg of zinc per serving. 

• Whole grains 

• Get more than just fiber and vitamins from your favorite grains: 1 cup of raw oats packs almost 3 mg of zinc, while cooked quinoa and brown rice both contain between 1 mg and 1.5 mg per cup. 

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To maximize your zinc intake from food sources, we recommend mixing a good amount of veggies, whole grains, and protein sources (whether that be through animal products, or nuts, beans, and seeds) in order to strike the right balance. Though zinc deficiency in adults in the US is rare (and not often considered an emergency), if you are pregnant or trying to conceive, then it is critical that you ensure you get enough zinc, as zinc is essential for healthy development in the womb. 

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Supplementing with zinc 

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If getting zinc through your diet is not achievable for you (or you have spoken with your healthcare provider or registered dietitian  and discovered you have a zinc deficiency which needs to be rectified), then supplements may be the best option for you. However, not all supplements are created equal. 

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We have a whole article dedicated to guiding you through the world of supplements if you have been diagnosed with PCOS, but we want to reiterate 2 important points here: 

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• Make sure you know what’s in the bottle 

• This goes beyond just reading the label. Because the FDA does not regulate supplements as drugs, manufacturers can include different ingredients in the pills compared to what appears on the label. Specifically, in the FDA’s own words: “federal law does not require dietary supplements to be proven safe to FDA’s satisfaction before they are marketed . . . the law does not require the manufacturer or seller to prove that the claim is accurate or truthful before it appears on the product.”  
• So how do you know what you’re ingesting is safe? Unfortunately, you don’t: not unless it is USP or NSF certified. These are independent companies that test supplements (in the case of USP-certified products, this is several times per year), to make sure that what is on the label is what is in the bottle, at the correct dosage. 
• Make sure your chosen supplement brand is USP or NSF certified for peace of mind. 

• Know how much you should be taking 

• Taking too much zinc is a real possibility, and it can lead to problems like copper deficiency. Neither of these is good. Always consult with your physician (or your Allara Health virtual care team) to make sure you’re not going overboard. 

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Now if you’ve consulted with a qualified physician and agreed that you need to supplement with zinc, and you’ve done your research on some brands that have USP or NSF certified zinc supplements: what next? 

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Well, you can decide what type of zinc to take. If you’re looking for maximum bioavailability, then you want to reach for a third-party certified zinc picolinate source. And if you are taking beyond 40mg of zinc per day, then it is recommended to take 2 mg of copper for every 15 mg of zinc (to offset the copper deficiency that can arise from large quantities of zinc). Very Well Health’s article on this topic lists several NSF-certified zinc supplements that contain dosage information, and whether they are suitable for vegetarians and vegans. (This list can be a good starting point, but always double check and do your own research before purchasing and ingesting supplements, though).    

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Next steps

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In closing, it appears that zinc could be immensely beneficial for women who suffer from PCOS. If symptoms such as hirsutism and hair loss bother you, and you either want to complement other strategies (such as electrolysis, birth control, minoxidil, etc.) to mitigate these symptoms, or you want to explore zinc on its own as a solution, we believe it comes with great benefits with little downide. 

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We recommend beginning with increasing zinc intake through food (in particular, oysters, red meat, and beans are excellent sources) for a couple of months and see if you notice an improvement in symptoms. If you decide you’d like to explore supplements, then consider reaching out to your primary care physician to discuss testing for a deficiency. 

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Alternatively, schedule a complementary video consultation. From there, you can get set up with Allara’s certified physicians, women's health nurse practitioners, and registered dietitians: if you have PCOS (or you suspect you do), they can work with you to create a customized, holistic plan designed to manage PCOS symptoms according to your lifestyle and personal preferences. Get in touch.

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Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.

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