Women With PCOS and Food Intolerances

For women with polycystic ovary syndrome (PCOS) who suffer from food allergies or food intolerances, and sensitivities, enjoying food can sometimes be a challenge. About one-third of all adults believe they have food allergies, although the actual number of true food allergies are estimated to be much lower. More people suffer from food intolerances and sensitivities combined than food allergies.

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Women with PCOS tend to have more inflammation than women without the condition. Inflammation is believed to be a driving force in the development of many metabolic problems associated with PCOS such as insulin resistance, type 2 diabetes, and non-alcoholic fatty liver disease.

While a link between PCOS and food allergies and food intolerances has not been identified, eating foods that cause adverse reactions can increase inflammation in the body and possibly make PCOS symptoms worse. Most people tend to know if they have an allergy to a food because a reaction typically occurs immediately. Food intolerances or sensitivities, on the other hand, can be tricky to determine because symptoms are less severe and tend to show up much later, perhaps even after several days.

Here’s what women with PCOS should know about food sensitivities, how to get tested for them, and how they differ from food allergies and intolerances.

What Are Food Allergies?

Food allergies affect 6 to 8% of all children and 4% of adults. The most common food allergens in adults are shellfish (shrimp, crayfish, lobster, and crab), milk, wheat, soy, peanuts, tree nuts (walnuts), and eggs.

A food allergy is an abnormal response to a food triggered by the body’s own immune system. Food allergens are proteins that enter your bloodstream after the food is digested. From there, they go to target organs and tissues and cause allergic reactions.

Adverse reactions to food usually begin within minutes to a few hours after ingestion. For some, simply touching or inhaling food in the air may produce an allergic reaction. Anaphylaxis is a rare but potentially fatal condition in which many systems of the body are affected at once.

Signs and symptoms of food allergies can vary with the most common ones being welling or itching of the lips, mouth and throat, nausea, vomiting, cramping or diarrhea, and eczema.

Diagnosing Food Allergies

Food allergies can be diagnosed by a board-certified allergist who will typically conduct a detailed history, physical exam, and lab tests. Keeping a food diary with a record of symptoms may be needed. A skin prick test is one useful way to test for food allergies.

Elimination diets can also help to determine what foods you are allergic to. Suspected foods are completely eliminated from the diet for several weeks to see if symptoms resolve. If improvement is seen, the suspected foods may be slowly reintroduced, one at a time, to see if symptoms occur.

Treatment for Food Allergies

Once a food allergy is determined, the only treatment is to avoid that food. This requires careful reading of food labels. Working with a registered dietitian nutritionist can help with meal planning and ensure nutrient needs are met. Epinephrine pens should always be carried by individuals with a history of severe allergic reactions.

What Are Food Intolerances?

While a food allergy affects the immune system, a food intolerance or sensitivity does not. Instead, food sensitivities and intolerances are sometimes referred to as."non-IgE food allergy." Some people’s digestive systems cannot properly digest foods. For those with lactose intolerance, for example, they are deficient in an enzyme needed to digest milk. When these individuals eat dairy products, they tend to have GI side effects like nausea, gas, and diarrhea.

Those who suffer from irritable bowel syndrome (IBS) may find the FODMAP approach helpful to manage symptoms. FODMAPs are a group of certain sugars and fibers in the diet that can cause GI distress in IBS sufferers. FODMAP is an acronym that stands for Fermentable- Oligo- Di- and Monosaccharides and Polyols.

Food sensitivities are common yet many people don’t realize they have one. That’s because those with food sensitivities typically have delayed reactions in which symptoms may take up to 72 hours to show up after eating. Symptoms associated with food sensitivities may include diarrhea, hives, eczema, excess mucus production, “brain fog,” migraines, joint pain, and fatigue. Food sensitivities do affect the immune system and can cause inflammation. For women with PCOS, this means adding to the inflammation already associated with the condition.

If you do have some of the symptoms listed and believe you do have a sensitivity to a food or foods, it’s important to figure out the exact foods that are causing the symptoms. Gluten-containing foods are commonly blamed in the PCOS community for causing many of the symptoms of food sensitives such as brain fog and joint pain when, in fact, other foods could be the culprit. It’s wise to get tested to find out for sure what foods you have a sensitivity to instead of overhauling your diet or excluding a broad list of foods.

Also consider seeking help from an allergist who can offer testing to monitor for various types of food sensitivities.

Diagnosing Food Intolerances

Diagnosing food intolerances can be a complicated process. Elimination diets tend to be less reliable given it may take days to see a reaction and there may be multiple foods involved. Many healthcare professionals call for Mediator Release Testing (MRT) which is a blood test that can test for a large number of food intolerances.

Avoiding the strongest offending foods can reduce inflammation and symptoms. If after testing, you were found to be sensitive to a particular food or foods, it’s important to remove them from your diet for a significant period of time to heal your digestive and immune system. How long you need to eliminate those foods or if you should never have them, depends on the individual. It’s recommended to work with an RDN trained in food sensitivities to help guide you and to recommend replacement foods to meet nutritional needs.

Women with PCOS who eliminate foods they are sensitive to will typically have more energy and fewer symptoms overall. Some experience decreases in their weight.

A Word From Verywell

If you do suspect you have an allergy or intolerance, or sensitivity to a food, seek treatment. Making the necessary changes to your diet will make you feel better and improve your PCOS symptoms.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gupta RS, Warren CM, Smith BM, et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630

  2. González F. Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012;77(4):300-5. doi:10.1016/j.steroids.2011.12.003

  3. Liu AH, Jaramillo R, Sicherer SH, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126(4):798-806.e13. doi:10.1016/j.jaci.2010.07.026

  4. Iweala OI, Choudhary SK, Commins SP. Food Allergy. Curr Gastroenterol Rep. 2018;20(5):17. doi:10.1007/s11894-018-0624-y

  5. Tuck CJ, Biesiekierski JR, Schmid-grendelmeier P, Pohl D. Food Intolerances. Nutrients. 2019;11(7) doi:10.3390/nu11071684

Additional Reading
  • Ebejer K, Calleja-Agius J. The role of cytokines in polycystic ovarian syndromeGynecol Endocrinol. 2013;29(6):536-540. doi:10.3109/09513590.2012.760195

  • Tremellen K, Karma P. “Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome.” Medical hypotheses 79.1 (2012): 104-112.

By Angela Grassi, MS, RDN, LDN
 Angela Grassi, MS, RDN, LDN, is the founder of the PCOS Nutrition Center.