Nutritional Support for Polycystic Ovary Syndrome
Practical Tips for Navigating through The Myriad of Information on What to Do When You Have PCOS
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When I get a call from a new client complaining of substantial weight gain, my first question is "Have you recently been diagnosed with PCOS?" Most of the time, regardless of age, the answer is yes. Fortunately, lately, the calls from women with PCOS have increased which does not necessarily indicate that there is an increase in diagnosis, but in my opinion, it indicates that finally gynecologists and GPs, recognise the importance of diet in this syndrome.
Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder of the female young population: it is found in about 5-8% of women of reproductive age and is present in all populations of the world, even if with a different incidence. It is characterized by ovulatory dysfunctions, hyperandrogenism, and the presence of ovaries with a polycystic appearance on ultrasound. It can have repercussions on both the reproductive and metabolic aspects. Although the symptoms of PCOS are well described, the causes are unknown.
In this blog, I would like to share my experience with weight management and PCOS and reassure my clients that each PCOS is unique and special.
Is PCOS the cause of my weight gain?
Can I still lose weight if I have PCOS?
Can I stop sugar cravings during PCOS?
Is PCOS the cause of my weight gain?
Not necessarily, only if you have insulin resistance. Let me explain, insulin is the hormone responsible for opening the gate on the cell's plasma membrane to allow glucose to enter and be metabolized into energy. When I say glucose, I'm not just referring to when you eat sugar but to any food that contains carbohydrates (chickpeas for example).
Insulin resistance is the body's inability to respond correctly to the action of insulin, which occurs when the release of insulin shows a minor effect on the cells, consequently, the pancreas (the organ that produces this hormone) increases insulin production to compensate. The cells are no longer able to respond adequately to the insulin stimulus and the glucose is not absorbed adequately. This condition in turn causes an increase in blood sugar which can lead to being overweight.
Preliminary tests might help to evaluate if you have insulin resistance:
Normally we fast before the blood test, so measuring fasting plasma blood glucose is only partially useful because we rather need some more information about the glucose that remains in the blood after eating and whether the insulin allows it to enter the cell.
Glycosylated or glycated hemoglobin HbA1c evaluates the average trend in blood glucose over the past two or three months. It is therefore a very useful test to evaluate the adequacy of glycemic control during PCOS. The most abundant sugar in the blood, glucose, can irreversibly bind to a specific part of hemoglobin, forming glycated hemoglobin. The higher the concentration of glucose in the blood, the higher the percentage of glycated hemoglobin and there is a good probability you might suffer from insulin resistance.
Triglycerides and Cholesterol panel. When you have insulin resistance, excess glucose in the blood is converted into fat.
The fasting plasma glucose (FPG) test. It's really the last resource, not a pleasant test. The insulin curve is a test that aims to investigate the insulin response to a glucose load. The test measures fasting insulin values (basal insulin) after oral administration of a glucose solution (30, 60, 90, and 120 minutes after administration).
Can I still lose weight if I have PCOS?
Of course, you can. If the mentioned blood test markers (see above) are negative - I would eventually add a full thyroid panel just to make sure your energy metabolism is ok - with a well-balanced diet you can definitely lose weight.
If, on the other hand, you are positive for Insulin Resistance, I would recommend doing a Ketogenic Diet for 3-4 weeks, possibly in combination with hypoglycemic supplements such as Gymnema or White Mulberry, or Banaba.
Can I stop sugar cravings during PCOS?
Yes, you definitely can. A balanced diet rich in low glycemic index foods, combined to achieve a low glycemic load, is highly effective in the long term.
Hypoglycemic supplements such as Gymnema or White Mulberry, or Banaba, in combination with Myo-inositol to improve insulin sensitivity, can really help especially to avoid headaches or sugar drops the first week of a diet.