Hello all,
As promised, The PCOS Newsletter will bring you insights and opinions from various healthcare professionals and doctors on PCOS. Our care team spans multiple disciplines, including GPs, endocrinologists, gynaecologists, nutritionists, and more. Throughout 2025, we’ll feature perspectives from each of these specialties, giving you a comprehensive understanding of how different areas of expertise approach the management of PCOS.
We’re excited to kick off this series with Sophia, a functional dietitian with extensive experience in supporting individuals with PCOS. In this article she will be sharing her approach to PCOS, what she looks for in consultations and what are some of the most common recommendations she makes for us.
Over to Sophia.
Hello everyone!
My name is Sophia Deahl, and I’m taking over Fran’s newsletter this week to provide insights from a functional dietitian’s perspective on PCOS. If you don’t know what a "functional approach" is, don’t worry – I’ll break it down and dive deep into how it can transform the way we manage PCOS.
A little bit about me:
I am a registered dietitian specializing in functional medicine. I have a Master’s in Nutrition, Healthspan, & Longevity, completed the training at the Institute for Functional Medicine and have a background in Psychology & Neuroscience Research, which all inform my approach.
I believe in supporting individuals in making sustainable and realistic behavior changes that are tailored to their unique physiology, genetics, health needs, and goals. As someone who has worked with countless women navigating PCOS (and experiencing it myself), I’m deeply invested in taking a root-cause, sustainable approach to managing this condition! My goal is always to empower clients with a holistic, personalized strategy that doesn’t just put a band-aid on symptoms, but addresses them at their core.
I also share insights weekly on my Substack, where I focus on realistic nutrition and lifestyle strategies rooted in a functional approach to optimise health and longevity. Feel free to follow me there! My paid subscribers receive an exclusive newsletter with even more in-depth, personal insights.
This is not medical or nutrition advice, rather it is educational in nature. Check with your healthcare provider before supplementing or altering your diet and lifestyle.
What is Functional Dietetics?
Functional dietetics is the approach of looking beyond symptoms to identify the underlying causes of imbalances in the body. Rather than merely managing symptoms of PCOS (like irregular periods or acne), functional dietetics digs deep into how nutrition and lifestyle factors are interwoven with the body’s biochemical processes. The aim is to restore balance within the body’s systems through:
Individualized, whole-food nutrition
Targeted supplementation
Lifestyle shifts, targeting areas such as gut health, insulin resistance, and inflammation
Hormonal regulation
The Functional Dietitian’s philosophy for hormonal imbalance and PCOS
When it comes to PCOS, the functional approach takes a deeper look at the many complex factors at play.
PCOS is not just a hormonal issue—it’s a metabolic and inflammatory condition.
PCOS is rooted in hormonal imbalances (like elevated testosterone), often tied to insulin resistance, inflammation, and gut dysbiosis (imbalances in your gut microbiome). As a functional dietitian, I look for how these systems are interacting and aim to bring them back into balance by supporting health and healing the gut. We also consider how lifestyle factors like stress, sleep, and exercise contribute to managing symptoms long-term!
What do we look for when we meet clients with PCOS?
When I meet with clients with PCOS, I tend to focus on a variety of relevant areas. These are integral in understanding the connections between their symptoms and what might be happening within the body. I focus on their health history, symptoms, and functional labs to get a clear picture of patterns going on:
Menstrual and Hormonal Cycles: I assess the regularity of periods, ovulation patterns, and any signs of hormonal imbalance, like acne or excess hair growth. This helps me understand how the endocrine system is functioning.
Blood Sugar and Insulin Sensitivity: Given the connection between PCOS and insulin resistance, I explore dietary habits, energy levels, and possible signs of blood sugar dysregulation (like cravings, energy crashes, or weight gain). Ideally, we would test fasting glucose and fasting insulin to determine the extent of insulin resistance.
Gut Health: Many women with PCOS also have gut imbalances, which can contribute to inflammation and nutrient malabsorption. I ask about digestion, bloating, and food sensitivities to understand if gut health could be playing a role in their symptoms.
Lifestyle Factors: Stress levels, sleep patterns, and exercise habits are important in PCOS management. Elevated stress can exacerbate insulin resistance, so understanding their lifestyle helps to build a more complete picture.
Medical History and Lab Work: Understanding their medical history (including any other autoimmune conditions, thyroid issues, etc.) and reviewing lab work gives insight into nutrient deficiencies, inflammation levels, and hormonal imbalances.
By looking at these areas, I aim to uncover how they may be interacting to create the symptoms of PCOS. Often, it’s not just one thing—it’s a web of interconnected factors.
What are some of the most common conclusions we reach?
From my experience, I’ve found that many women with PCOS face the following underlying issues:
Insulin Resistance: Most of the time, insulin resistance plays a major role. Even if someone isn’t prediabetic or type 2 diabetic, this could be affecting their weight, energy levels, and fertility.
Chronic Inflammation: Inflammation is often present, which may stem from an imbalanced diet, gut dysbiosis, or stress. This can trigger the hormonal imbalance and symptoms we see.
Nutrient Deficiencies: Hormonal regulation requires certain nutrients like magnesium, B-vitamins, and omega-3 fatty acids. Many women with PCOS are lacking in these essential nutrients.
Gut Health Imbalance: An unhealthy gut can contribute to systemic inflammation and poor nutrient absorption, making it harder for the body to regulate hormones.
Common recommendations in my PCOS Plans
My approach to treating PCOS always comes down to personalization but common recommendations I make to most of my clients include:
Anti-inflammatory Nutrition: A diet rich in whole foods, anti-inflammatory fats (like omega-3s from fish, flax, and chia), fiber, and colorful fruits and vegetables is foundational. I also suggest reducing processed sugars and refined carbs, which aggravate insulin resistance.
Functional Foods: These are foods that have been shown to help reduce symptoms and biomarkers in individuals with PCOS like organic soy, flax meal, green tea, turmeric, cinnamon, beans, and spearmint tea.
Balanced Macros: A diet with adequate protein and healthy fats, with a focus on fibrous carbs over refined carbs helps support balanced blood sugar levels and reduce insulin spikes. I often encourage my clients to adopt a more Mediterranean-style approach; this has been found to be both effective AND sustainable.
Gut Healing: Incorporating probiotic-rich foods, like fermented vegetables and greek yogurt, and prebiotics (foods that feed beneficial bacteria, like beans, onions and garlic) is key to restoring gut health.
Stress Management: Teaching clients stress-reduction techniques like yoga, meditation, or deep breathing exercises is crucial. Chronic stress exacerbates insulin resistance and inflammation, increasing symptoms. Chronic stress and mental health concerns are super common, unfortunately with PCOS. However, stress management is incredibly helpful.
Targeted Supplementation: I often recommend supplements like magnesium glycinate, zinc, myo-inositol, vitamin D, and omega-3 fatty acids to support hormonal balance in PCOS whenever warranted!
A functional approach can make a transformative impact by addressing the root causes of PCOS rather than simply managing its symptoms. The key to success lies in personalization, consistency, and a commitment to building sustainable lifestyle habits that support long-term health and balance.
Feel free to follow me on Substack for more personal insights and a deeper dive into nutrition and lifestyle strategies that will help you thrive!
Sophia.