As registered dietitians, we often combat the myth of “hormone imbalance.” Hormone fluctuations are a normal part of a body’s homeostasis. However, when the endocrine system produces too much or too little of a certain hormone, disease can occur. 

For those living with these conditions, the impact on daily life can be significant. However, many hormonal disorders respond well to targeted nutrition and lifestyle support. That’s where we come in!

Registered dietitians work closely with patients and healthcare providers to support the management of conditions like PCOS, hyperthyroidism, hypothyroidism, and adrenal gland disorders, all of which stem from disruptions in hormone production. In this deep dive, we’ll cover evidence-based nutrition interventions for these hormonal diseases.

How Does Nutrition Help With PCOS?

Polycystic Ovary Syndrome (PCOS) affects 1 in 10 women of reproductive age. The cause is mostly unknown, but researchers believe insulin resistance, chronic low-grade inflammation, and possible family history may contribute to its development. The disease can cause weight management challenges, fertility difficulties, and increase risk for related conditions including diabetes, high blood pressure, high cholesterol, and sleep apnea.

PCOS is Characterized By:

Irregular or absent ovulation → leads to irregular menstrual cycles or missed periods

Excess androgens → causes physical signs like acne, hirsutism (excess facial/body hair), or male-pattern hair thinning, and/or elevated androgen levels on lab tests

Polycystic ovaries on ultrasound → ovaries with multiple small follicles

Nutrition plays a central role in managing PCOS by improving insulin sensitivity and supporting hormone regulation. Balanced meals with whole grains, lean proteins, healthy fats, and key nutrients like inositol and vitamin D may reduce symptoms and improve overall health. For some, a lower-carbohydrate approach may also enhance insulin control and hormone balance.

Nutrition Tips For PCOS

Nutrition plays an important role in managing PCOS, but there’s no one-size-fits-all solution. Healthcare providers and dietitians partner with patients to create individualized strategies. Here are some general guidelines:

1. Blood sugar management

• Increase whole grain, fruit, and vegetable intake
• Carbs paired with protein and healthy fats
• Meal timing strategies like eating every 3-4 hours

2. Lower carbohydrate approach

• Early evidence points to potential benefits: significant decreases in fasting insulin, fasting glucose, and HOMA-IR, reduced testosterone levels, and improved cholesterol profiles
• Can lead to increases in insulin sensitivity

3. Key Nutrients to Prioritize:

How Nutrition Helps With PCOS Medication Side Effects

Many common medical treatments for PCOS can cause side effects. A registered dietitian can help manage these issues with nutrition, soothing any discomfort and improving quality-of-life.

Oral contraceptives: These are frequently prescribed to regulate menstrual cycles and reduce symptoms, but they can also deplete nutrients such as folic acid, B vitamins, vitamin C, vitamin E, zinc, and magnesium. Patients may need to adjust eating patterns to compensate.

Metformin: Often used to improve insulin sensitivity, metformin may cause digestive issues like nausea, diarrhea, cramping, or loss of appetite. It can also lower vitamin B12 levels over time. Try eating smaller, balanced meals, adding more soluble fiber to soothe the gut, and incorporating vitamin B12–rich foods such as eggs, fish, dairy, or fortified plant-based proteins.

Nutrition Strategies for Hyper and Hypothyroidism

Hypothyroidism (underactive thyroid) is when the thyroid doesn’t produce enough hormones, leading to fatigue, weight gain, cold intolerance, and constipation. This affects 5% of the population. Hyperthyroidism (overactive thyroid) is when the thyroid produces too much hormone, leading to unexplained weight loss, rapid or irregular heartbeat, heat intolerance, and anxiety. This affects about 1% of the population.

Thyroid disorders cannot be managed through diet alone, but nutrition can play a valuable supporting role in managing symptoms and optimizing treatment outcomes.

Nutrition Interventions for Thyroid Health:

Thyroid Medication Timing Matters! ⏰

Always take thyroid medications on an empty stomach, 1 hour before or 2-4 hours after meals. Avoid calcium, iron, and coffee for optimal absorption.

Recipe: Thyroid Health Buddha Bowl

Nutrition Therapy For Adrenal Gland Disorders

Nutrition is important for people with adrenal gland disorders like Addison’s disease and Cushing’s syndrome, in conjunction with medical treatment. 

Addison’s disease is a rare condition where the adrenal glands don’t produce enough cortisol (and sometimes aldosterone), leading to fatigue, low blood pressure, weight loss, and salt cravings. 

• Nutrition therapy emphasizes adequate sodium intake and preventing hypoglycemia
• Ensure adequate calcium and vitamin D for bone health if treatment plan involves corticosteroids

Cushing’s syndrome is caused by excess cortisol. Symptoms include weight gain (especially around the abdomen and face), thinning skin, and high blood pressure.

• Nutrition therapy focuses on managing blood sugar and blood pressure
• Consider a low or altered carbohydrate diet to optimize blood pressure.

Q&A: Nutrition Support For Hormonal Diseases

Q: “I have PCOS and I’m trying to lose weight. Should I try intermittent fasting?”

A: Intermittent fasting can be beneficial for some, but it’s not right for everyone. Women with PCOS who experience irregular periods or high stress levels may find that extended fasting periods worsen hormone imbalances. Instead, focus on consistent meal timing (every 3-4 hours) and balanced macronutrients at each meal. If weight loss is your goal, work with your dietitian to plan a moderate calorie deficit.

Q: “My thyroid medication isn’t working as well. Could it be my diet?”

A: Dietary factors can interfere with thyroid medication absorption. These include taking medication with coffee, calcium supplements, or iron, eating high-fiber foods within 2 hours of medication, and consuming soy products regularly. Work with your healthcare provider to optimize timing, and consider a registered dietitian consultation for personalized guidance.

Q: “Are there any supplements I should avoid with hormonal conditions?”

A: Always consult your healthcare provider before starting supplements, especially:

• High-dose biotin – can interfere with thyroid lab tests
• Estrogen-containing herbs (like red clover) – may affect hormone-sensitive conditions
• Excessive iodine – can worsen both hyper and hypothyroidism

The Role Of A Registered Dietitian In Hormonal Disease Management

Hormonal diseases ofter require medical treatment, but sometimes that is not enough. A holistic approach that supports your long-term health goals through nutrition and lifestyle may be the most effective and sustainable treatment. Registered dietitians play a key role in this process by helping patients understand how food choices, meal timing, and key nutrients can influence hormone production, metabolism, and symptom management.

Are you navigating hormonal disease? Connect with a Culina Health hormone health specialist and start building a nutrition plan tailored to your body’s unique needs.