Naturopathic Treatment Plan

Sarah Jenkins's Goals

• Improve daily energy levels, resolve postprandial bloating, and achieve sustainable management of PCOS symptoms and insulin resistance.

Overview & Next Steps

Sarah's initial plan focuses on stabilizing blood glucose levels and addressing underlying nutrient deficiencies contributing to fatigue. We will implement targeted nutritional strategies, foundational supplementation, and coordinate comprehensive lab work with her primary care provider. Follow-up is scheduled in 4 weeks to review lab results and assess symptom progression.

Discuss the following testing with your MD

• Fasting insulin, fasting blood glucose, and HbA1c
• Comprehensive thyroid panel (TSH, free T3, free T4, anti-TPO)
• Serum ferritin, vitamin B12, and 25-hydroxyvitamin D

Discuss the following with your MD

• Recent onset of irregular menstrual cycles (oligomenorrhea) over the past 6 months
• Potential transition from immediate-release to extended-release metformin (Glucophage XR®) to reduce GI side effects

Labs & Imaging- Send copies of previous labs and/or imaging

• Pelvic ultrasound report from 14/11/2024
• Complete blood count (CBC) and lipid panel from 05/09/2024

Labs & Imaging- Send copies of upcoming labs / imaging reports when available

• Updated metabolic and thyroid blood work once completed via MD
• Repeat pelvic ultrasound if ordered by MD

Referrals

• Pelvic floor physiotherapist for evaluation of mild dyspareunia and pelvic tension
• Registered acupuncturist for cycle regulation and stress management

Resources

• Handout: Low-Glycemic Index Meal Planning Guide
• Book: "8 Steps to Reverse Your PCOS" by Fiona McCulloch, ND
• App: Clue or Flo for basal body temperature (BBT) and cycle tracking

Supplement Suggestions

• Myo-inositol / D-chiro-inositol (40:1 ratio) 2,050 mg PO BID with meals
• Cholecalciferol (vitamin D3) 2,000 IU PO daily with food
• Magnesium bisglycinate 200 mg PO QHS

Nourish- Dietary changes

• Aim for 30 g of protein at breakfast to stabilize morning cortisol and blood glucose curves
• Pair all complex carbohydrates with a source of healthy fat or protein (e.g., apple with 2 tbsp almond butter)
• Increase soluble fibre intake to 25–30 g daily via chia seeds, flaxseeds, and cruciferous vegetables

Movement- exercise goals

• Perform 15 minutes of brisk walking immediately following lunch and dinner to improve postprandial glucose clearance
• Incorporate strength training 3x/week for 30 minutes focusing on compound movements
• Limit high-intensity interval training (HIIT) to 1x/week to avoid excess cortisol elevation

Other

• Practice 5 minutes of box breathing (4-4-4-4) prior to meals to stimulate vagus nerve and optimize digestion
• Maintain consistent sleep hygiene: aim for lights out by 22:30 and wake at 06:30 daily

Future Plan

Next Visit

• Follow-up in 4 weeks (approx. 15/05/2025) to review blood work, evaluate GI tolerance to supplements, and refine macronutrient targets.

3 Month Plan

• Re-evaluate menstrual cycle regularity and ovulatory signs via BBT tracking
• Repeat fasting insulin, HbA1c, and ferritin levels to assess intervention efficacy
• Taper inositol dosing if ovulatory cycles are consistently established

6 Month Plan

• Comprehensive metabolic and hormone reassessment
• Transition to a seasonal maintenance dietary protocol

1 Year Plan

• Annual preventative screening and full blood panel review
• Long-term cardiometabolic risk assessment and maintenance lifestyle review