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:
🌿 Inositol supports insulin sensitivity and ovarian function
☀️ Vitamin D supports hormone regulation; deficiency is common in PCOS
Fatty fish Egg yolks Fortified dairy & plant milks Mushrooms exposed to sunlight (like maitake, portobello)
💪 Magnesium May support insulin sensitivity
Leafy greens Nuts & seeds Whole grains (brown rice, oats, quinoa) Legumes Dark chocolate (70% or higher cocoa)
⚡ Chromium may improve glucose metabolism
Broccoli Green beans Whole grains (barley, oats, whole wheat bread) Nuts (Brazil nuts, almonds, walnuts) Grapes & apples Lean meats
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.
Focus on balanced meals with lean protein, fiber, and healthy fats to support steady energy and prevent sluggishness. Include selenium- and zinc-rich foods like eggs, beans, and nuts.
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.
Any general advice posted on our blog, website, or application is intended for reference and educational purposes only and is not intended to replace or substitute for any professional medical advice, diagnosis, treatment, or other professional advice. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately qualified and licensed medical services provider.
Join our email list to gain access to a treasure trove of nutrition tips, the latest on nutrition research, and delicious recipes, all curated by our expert registered dietitians.
Book a Virtual Session With a Registered Dietitian
