PCOS Support

The link between PCOS and insulin resistance

The link between PCOS and insulin resistance Many people with PCOS also have insulin resistance.

What really causes PCOS?

Insulin Resistance - Major Cause of PCOS Symptoms

Although estimates vary, 50 to 80% of women with PCOS have insulin resistance.

Hyperinsulinemia (high blood insulin levels) produces hyperandrogenism (excessive levels of male hormones such as testosterone) by stimulating ovarian androgen production and by reducing serum s*x-hormone binding globulin (SHBG). This can make PCOS symptoms a lot worse.

What Is Insulin Resistance?
The hormone insulin performs many essential functions in the body but is primarily known for its role in glucose regulation. Under normal circumstances, insulin assures the efficient transfer of glucose from the bloodstream to the body. Insulin also serves as a signal to the liver to begin or discontinue glucose production.

If the level of glucose in the cells is sufficient, insulin levels drop, signaling the liver to slow down glucose production. In contrast, if the cells of the body are not receiving enough glucose, the level of insulin will rise, signaling the liver to produce greater amounts of glucose.

Insulin resistance is the inability of insulin to perform its job effectively in the body. In early stages, the body simply compensates by causing the beta cells of the pancreas to produce more insulin. Ultimately in some women, however, the beta cells may wear out and the body ceases to produce insulin in the amounts needed. The resultant condition is Type II diabetes mellitus.

What Are the Causes?
Insulin dysfunction is thought to be caused by several factors:
• Genetic abnormalities of one or more proteins of the insulin action cascade
• Fetal malnutrition
• Increased fat around the middle.

It's thought that perhaps 50% of people have an inherited propensity for this disorder. You may be in this group if you have a family history of diabetes, cardiovascular disease, hypertension or PCOS. The other 50% who develop insulin resistance probably do so because of unhealthy diet, no exercise, and obesity.

Although obesity is a major risk factor, lean women with PCOS can also have this insulin problem.

Although you can't change your genes, there's plenty you can do to change how they behave. What you eat, whether you exercise, how well you sleep, how you manage stress, and the pollutants you are exposed to will directly influence what your genes do. So to a great extent, the insulin hromone can be controlled by you.

Insulin Resistance and PCOS

As early as 1921, a French study described the presence of diabetes in women with facial hirsutism. PCOS women also show higher levels of possible precursors of diabetes, such as glucose intolerance and lack of insulin sensitivity.

Over the past 20 years, it has been established that hyperinsulinemia is a fundamental disturbance in many women with polycystic o***y syndrome (PCOS). A subgroup of women with this syndrome have 'metabolic PCOS' which can be considered to be a pre-diabetic state. Clinically, this subgroup is most easily identified in obese women with a strong family history of diabetes in whom menstrual disturbance is the predominant feature.

The increased incidence of insulin resistance occurs in all PCOS women, not simply obese women. Most women with polycystic o***y syndrome (PCOS) are obese and are known to be insulin resistant. Obesity per se is a cause of insulin resistance.

A significant degree of insulin resistance exists in non-obese women with PCOS and is significantly related to serum LH and free testosterone levels.

Therefore, measures to decrease this condition may have to be considered earlier to decrease the potential risks of developing diabetes mellitus and coronary artery disease at later ages of life in both overweight and normal weight women who have PCOS.

A major complicating factor for PCOS women is that some types of cells - most commonly muscle and fat - in the body can be insulin resistant, while other types of cells and organs are not. As a result, the pituitary, ovaries, and adrenal glands of an insulin resistant woman will be stimulated by far higher levels of insulin that would be desired, thus causing elevated luteinizing hormone and androgens. This phenomenon is referred to as "selective resistance".

How Do I Know if I Have Insulin Resistance?

You may have this problem if you have three or more of these clinical laboratory markers:

• High blood pressure chronically over 140/90 (optimal is 120/80).
• 15 or more pounds over your ideal weight.
• Triglycerides over 160 (optimal is less than 100).
• Total cholesterol over 240 (optimal is 180-200).
• HDL “good” cholesterol less than 1/4 of total cholesterol.
• Fasting glucose over 115 (optimal is less than 100).
• Elevated uric acid levels
• Glucose (blood sugar) above 115
• Elevated glycohemoglobin A1C
• Elevated liver enzymes (sometimes)
• Low plasma magnesium levels.
Insulin problems are a contributing factor to:
• Polycystic o***y syndrome
• Infertility
• Diabetes
• High blood pressure
• Cardiovascular disease
• Inflammatory disorders
• Cancer
• Other degenerative disorders
• Shortened lifespan.
• Acne
• Apple-shaped obesity
• Difficulty with weight loss
• Hirsutism
• Sugar or carbohydrate cravings.

Insulin resistance is a big problem for women with PCOS because it is "selective". Your muscle and fat cells can be insulin resistant while other types of cells and organs are not. For instance, your pituitary, ovaries and adrenal glands may be over-stimulated by high levels of insulin, thus increasing androgens and luteinizing hormone. This hormonal imbalance may render you infertile, in addition to creating other health problems.

Low levels of myo-inositol have been found in women with PCOS.
Current research suggests that women with PCOS may benefit from supplementing with myo-inositol combined with folic acid, taken 1-2 times daily for 3 months. The benefits demonstrated in research so far have involved myo-inositol in supplemental form rather than from food sources; it is also unlikely that food sources can supply high enough levels to achieve an effect.

Nutrition & PCOS
From a clinical perspective, nutrition has much to offer women affected by this debilitating disorder. Whilst every case is unique, and requires an individualized and multi-factorial approach, effective treatment protocols commonly centre around the nutritional support of these key areas:
• Weight management
• Blood sugar balance and insulin function normalization
• Hormone balance
• Ovarian health support

Much of the most recent research in this area has focused on the clinical application of myo-inositol.

What is Myo-Inositol?
Myo-inositol is one of nine different types of inositol. It is a naturally occurring substance produced in the human body from glucose, although it is not a sugar. Better described as a ‘vitamin-like’ substance, myo-inositol is often considered to be a member of the B complex group of vitamins. However, because it is produced by the body in amounts considered sufficient to support health, it is not officially termed an essential nutrient. In addition to the body’s own production from glucose, myo-inositol is also found naturally in many foods such as organ meats, fruit, grains, nuts and beans.

Myo-inositol - Key role in insulin signalling
Myo-inositol is a key factor involved in insulin signalling. It is an immediate precursor to another type of inositol, D-chiro-inositol, which interacts with select sugars in the body to form inositol phosphoglycans – these play an important role in mediating the actions of insulin. Whilst myo-inositol can be made by the body and also found in foods, low levels can occur, and this can have an adverse impact on the body’s insulin-signalling pathways.

Low levels of myo-inositol, D-chiro-inositol and inositol phosphoglycans have been observed in individuals with impaired insulin sensitivity and PCOS

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What is PCOS?

PCOS is not a disease, but rather complex hormonal condition that’s usually marked by cysts in the ovaries, high levels of male hormones, and irregular periods.

PCOS is a poorly named condition as the “cysts” which are often noticed on ultrasounds are in fact not cysts but multiple under-developed follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation.

The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Progesterone levels are lower than usual, while androgen levels and often estrogen are higher than usual.

Common PCOS symptoms:

The hallmark symptoms of PCOS are irregular periods, acne, excessive facial and body hair, and hair loss on your head. But you might be experiencing any of the following:

• Cycles that are consistently longer than 35 days

• Infertility

• Multiple follicles on your ovaries on ultrasound

• Acne

• Unwanted hair growth

• Hair loss or thinning hair on your head

• Insulin resistance and/or blood sugar issues

• Anxiety, depression, mood swings, fatigue, low libido, cravings

• Weight gain and difficulty losing weight

• Blood tests show high luteinising hormone (LH) to follicle stimulating hormone (FSH) ratio

• Blood tests show excess androgens like testosterone or DHEAs

Is PCOS treatable?

Having suffered with PCOS personally, I deeply acknowledge the frustration and pain of many of the symptoms listed above, but I am here to tell you that you do have control and can address your PCOS symptoms using targeted nutrition, supplementation & lifestyle changes.

The best and most effective treatment will depend on your type of PCOS and the root cause so let’s dive on in to the top causes of PCOS, and the best approach to get you on the road to being symptom free!

Five common root causes of PCOS

1. INSULIN RESISTANCE Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can't use insulin properly. When cells can't use insulin properly, the body's demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones.

2. INFLAMMATION

Chronic, low-grade inflammation can prevent ovulation, disrupt hormone receptors leading to imbalances, and can increase cortisol, which can result in high androgens like DHEA and testosterone. Gut imbalances are a HUGE source of inflammation.

3. ADRENAL DYSFUNCTION

This type of PCOS is triggered by an abnormal stress response. Under too much stress, the adrenal glands produce extra cortisol, but also DHEA to compensate. Elevated DHEA can trigger elevated testosterone and estrogen.

4. POST-PILL PCOS

If you have recently stopped taking birth control, it is common to experience many of the signs and symptoms of PCOS such as irregular or missing periods, acne breakouts and hair changes. If before going on the pill you did not suffer from PCOS symptoms, it is likely you are suffering from post-pill PCOS.

The pill strongly suppresses androgen production. When you stop taking the pill, the androgen suppressing mechanism is suddenly lifted and this can cause your body to temporarily greatly increase its production while it finds its new normal. The good news about post pill PCOS is it is usually temporary.

5. HYPOTHYROIDISM

PCOS and thyroid disorders are two different conditions but there is an emerging relationship between PCOS and thyroid disorder. They both share common characteristics, like period irregularities and increased insulin resistance, and it is also very common for both conditions to co exist. It is estimated that about 25% of women with hypothyroidism have PCOS.

Hypothyroidism can worsen the symptoms of PCOS, including increased insulin resistance, irregular periods, abnormal hair growth, and male-pattern baldness. Hypothyroidism can be tricky to diagnose and is sometimes missed in women with PCOS, this is why it's important that women diagnosed with PCOS have their thyroid function thoroughly checked (TSH is not enough, ask for a full thyroid panel).

The four types of PCOS

Polycystic o***y syndrome or PCOS has become a common problem in the past few years. PCOS is considered to be caused by an imbalance in reproductive hormones. It can lead to the formation of small cysts in either or both the ovaries and also causes complications during pregnancy. According to nutritionists, 1 in every 10 women are affected by this disease. But before searching for treatments, you should be certain about what type of PCOS you suffer from.

The four types of PCOS
1. Insulin resistance PCOS
According to the latest research, it occurs in 70 per cent of the cases. As cells become numb to the effect of insulin, a condition called insulinoma arises which causes this type of PCOS. Abdominal weight gain, sugar cravings and fatigue are among its symptoms.
Regular exercise and movement are helpful to treat this. Avoid high sugar food and opt for a balanced diet. Reduce stress and sleep well to manage insulin levels. Supplements like Myo-inositol helps treat this condition effectively. (Haldane Pharma’s Brand of Inositol is REVOSIT)

2. Adrenal PCOS
This occurs during a massive stressful period. Marked indicators are high levels of cortisol and DHEA.
Reduce stress levels through yoga, meditation and good sleep. Avoid high-intensity exercise. Magnesium, vitamin B5 and vitamin C can help support the adrenal glands and nervous system

3. Inflammatory PCOS
This type of PCOS occurs due to chronic inflammation. Poor diet and unhealthy lifestyle lead to increased testosterone levels, which causes PCOS. High C reactive protein (more than 5), headaches, unexplained fatigue, skin issues like eczema are some of the symptoms.
Maintain good gut health by balancing gut bacteria, improving digestive enzymes and repairing leaky gut tissue. Avoid food that triggers inflammation. Help yourself with natural anti-inflammatories such as turmeric, omega 3 fatty acids and antioxidants like NAC.

4. Post-pill PCOS
This occurs after stopping the intake of oral contraceptive pills. According to Pooja, "The artificial Progesterone causes a party in the ovaries after you stop the pills", and this can cause PCOS. Taking the pills can stop the symptoms temporarily but can worsen the condition once stopped.
This type of PCOS is a temporary situation and reversible. Good sleep and low stress can help. Nutrients like magnesium, vitamin E, vitamin B6 and zinc are helpful.

How does my diet affect PCOS?

Women with PCOS are often found to have higher than normal insulin levels. Insulin is a hormone that’s produced in your pancreas. It helps the cells in your body turn sugar (glucose) into energy.

If you don’t produce enough insulin, your blood sugar levels can rise. This can also happen if you’re insulin resistant, meaning you aren’t able to use the insulin you do produce effectively.
If you’re insulin resistant, your body may try to pump out high levels of insulin in an effort to keep your blood sugar levels normal. Too-high levels of insulin can cause your ovaries to produce more androgens, such as testosterone.

Insulin resistance may also be caused by having a body mass index above the normal range. Insulin resistance can make it harder to lose weight, which is why women with PCOS often experience this issue.

A diet high in refined carbohydrates, such as starchy and sugary foods, can make insulin resistance, and therefore weight loss, more difficult to control.

What foods should I add to my diet?
Foods to add
1. high-fiber vegetables, such as broccoli
2. lean protein, such as fish
3. anti-inflammatory foods and spices, such as turmeric and tomatoes

High-fiber foods can help combat insulin resistance by slowing down digestion and reducing the impact of sugar on the blood. This may be beneficial to women with PCOS.

Great options for high-fiber foods include:
• cruciferous vegetables, such as broccoli, cauliflower, and Brussels sprouts
• greens, including red leaf lettuce and arugula
• green and red peppers
• beans and lentils
• almonds
• berries
• sweet potatoes
• winter squash
• pumpkin
Lean protein sources like tofu, chicken, and fish don’t provide fiber but are very filling and a healthy dietary option for women with PCOS.

Foods that help reduce inflammation may also be beneficial. They include:
• tomatoes
• kale
• spinach
• almonds and walnuts
• olive oil
• fruits, such as blueberries and strawberries
• fatty fish high in omega-3 fatty acids, such as salmon and sardines

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What is Estrogen Dominance and How can it Affect you?

Are you struggling with mood swings, weight gain, or low libido? If so, you could be dealing with a hormone imbalance called estrogen dominance. Estrogen is one of the most important female reproductive hormones and is crucial for day-to-day functioning.

It regulates menstruation, improve the thickness and quality of the skin, helps regulate cholesterol production in the liver, contributes to bone health, and more. Without it, you end up with symptoms of menopause, like vaginal changes, hot flashes, moodiness, irregular periods, and more.

But, too much of a good thing causes biological chaos, in the case of high estrogen.

Estrogen dominance can wreak havoc on your whole body!

Having too much estrogen, and not enough progesterone–known as estrogen dominance–is not only linked to a long list of frustrating symptoms; it also puts you at risk for a variety of chronic issues. By far the greatest risk associated with estrogen dominance is hormone-dependent cancers such as estrogen receptor positive breast cancer in women. The statistics are staggering, one in eight women will develop breast cancer in her lifetime.

Thyroid issues can also occur because excess estrogen blocks the thyroid hormones from hitting their receptor sites and doing its job. Excess estrogen can wreak havoc on your body if it’s not in proper balance with your other reproductive hormones, mainly progesterone. Since progesterone is a natural diuretic; estrogen dominance can also lead to high blood pressure. Properly balanced progesterone will also stabilize blood sugar; therefore, estrogen dominance has been linked to insulin resistance and diabetes.

Could I be estrogen dominant?
Are you struggling with mood swings, weight gain, or low libido? If so, you could be dealing with a hormone imbalance. Similar to low progesterone, estrogen dominance can cause a variety of symptoms, some obvious and some subtle.

Symptoms of Estrogen Dominance

PMS
Weight gain (particularly in hips, midsection, thighs)
Fibrocystic breasts
Fibroids
Endometriosis
Abnormal menstruation
Fatigue
Reduced s*x drive
Depression
Anxiety
Bloating
Breast tenderness
Mood swings
Brain fog
Insomnia
What causes estrogen dominance?
Being overweight
Excess body fat is one of the main causes of estrogen dominance. Not only does fat tissue absorb and store estrogen in your bloodstream, it also synthesizes estrogen from your other hormones. As expected, the more fat cells you have, the more estrogen you will make. The more estrogen you make, the more fat you store, and the cycle continues.

Stress
Chronic stress is one of the main reasons women become estrogen dominant. When you are stressed, or overly busy, your cortisol levels go sky high and your body must use up its progesterone to keep up, which will ultimately deplete your “oh so helpful” hormone, progesterone. As more progesterone is used for cortisol production, less is available to balance estrogen – leading to increased estrogen levels. Also, excess estrogen will cause the pancreas to over produce insulin, so you can’t burn fat efficiently, no matter what you are eating!

Environment
Thousands of man-made products contain xenoestrogens, industrial chemicals that mimic the behavior of estrogens and disrupt your hormone balance. You would literally have to live in a bubble to escape the excess estrogens we’re exposed to in our daily, modern environment. They’re everywhere–in our water, our food, personal care products, furniture and clothes. You encounter a shocking number of these hormone imbalancing xenoestrogens each day, without even knowing it.

Birth control pills and hormone replacement therapy (HRT)
Erratic periods and heavy bleeding are often a result of estrogen dominance. Hormone replacement therapy medications and most oral contraceptives only add more estrogen on top of excess estrogen, without the balance of progesterone. Progesterone balances the effects of estrogen, and without enough, you end up with symptoms of estrogen dominance.

What can I do to correct estrogen dominance?
Eat a whole food nutrient dense diet.
Eliminate all toxic, processed foods from your diet that contain hidden estrogens, including conventional meat, dairy products, and produce. Choose grass-fed, pasture-raised, and organic whenever possible to avoid added hormones, pesticides, and fertilizers used in conventional farming methods. It’s also important to consume adequate amounts of fiber. Fiber helps remove excess estrogen from the body and helps stabilize blood sugar levels which is critical for optimal hormone balance.

Filter your water.
Thanks to runoff and pollution, hormone-disruptors are rampant in our water supply. Bottled water is equally problematic. Estrogenic chemicals in plastic bottles leaches out into the water. To protect your water, install water filters on all your facets and shower heads. Look for a triple-stage filter: a sediment filter, a ceramic filter, and an activated charcoal filter.

Quit birth control.
Talk to your functional medicine doctor about non-hormonal birth control options.

Exchange your personal care products.
Switch out chemical-filled personal care products for safer versions that are free and clear of any synthetic compounds such as parabens and sulfates.

Get moving.
Exercise can speed up the liver’s detox processes, sharpen insulin sensitivity, boost weight loss, help mitigate mood swing problems associated with estrogen dominance, and reduce levels of stress hormones in the body. Choose lower impact exercises as opposed to high impact, which can raise cortisol levels.

Reduce stress.
Practice relaxation techniques such as meditation, yoga, and gratitude. Start a de-stressing practice that will free up that pregnenolone for progesterone. It is also important that you make sure you’re getting adequate sleep at night to let your body detox and recover from the stresses of the day.

Take supplements.
Magnesium: Magnesium allow the body to absorb calcium and regulates the pituitary gland, which in turn regulates hormone levels. It has also been known to have a calming effect which will help reduce stress and aid with sleep. Vitamin B6: Vitamin B6 helps to regulate your hormones and can help reduce blood estrogen levels and result in improvements in PMS symptoms.