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TOPIC: Ladies with PCOS! I just read a helpful article

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February 16, 2013 11:05 AM
I want to share this with you all, I find it very eye opening and I plan on using this information as a guide. It's:20 simple steps you can take to control polycystic ovarian syndrome (PCOS) http://www.examiner.com/article/20-simple-steps-you-can-take-to-control-polycystic-ovarian-syndrome-pcos-1. It's 20 pages of information, but well worth the reading. I copied and pasted it all into a document for myself to print out. I'm pasting it here for anyone to read, or you can use the website link I posted. Here goes, I hope it helps someone else like me.

20 simple steps you can take to control polycystic ovarian syndrome (PCOS)

Step 1. Move your body!

Get as much aerobic exercise as you can. Moving your body makes your muscles increase their uptake of glucose, improving insulin sensitivity during and after periods of exercise. As insulin resistance is at the root of many PCOS symptoms, improving your insulin sensitivity and glucose disposable is a key element in controlling PCOS.
A study published in the Annals of Internal Medicine in 2005 found that exercise and dietary modification was much more effective than the drug metformin in preventing people with metabolic syndrome from progressing to full blown diabetes. Metabolic syndrome and PCOS are very similar in that they both stem from reduced glucose tolerance and insulin resistance. In fact, many women with PCOS have or will develop metabolic syndrome if untreated.
A minimum of 30 minutes exercise each day will improve your health in a number of ways:
Better cardiovascular fitness
More energy during the day
Better sleep at night
Better insulin sensitivity
Lower body weight
Healthy blood pressure
Improved mood
Reduced risk of heart disease, stroke, cancer, depression & diabetes
Healthier cholesterol levels (exercise boosts good cholesterol or HDL and reduces the amount of fat or triglycerides in the blood)

Step 2. Balance your exercise routine and exercise smart using HIIT

A balanced exercise routine should include many different types of exercise. Gentle aerobic exercise such as a half hour walk each day is great for stress reduction and strength training is excellent for healthy bones and strong muscles.
High intensity interval training or HIIT has become popular in recent years as an alternative to long hard slogs at the gym or on the field. HIIT provides the same or better aerobic and fat burning benefits as traditional forms of exercise but with a much reduced time commitment involved.
HIIT is exercising smart. It has been found to improve insulin sensitivity, reduce fasting blood glucose levels and provide the fastest and greatest increases in strength and fitness. Put simply, it gives you more 'bang for your buck' in terms of benefits for the time spent.
Researchers at Heriot-Watt University in Edinburgh, Scotland have discovered that as little as 2-3 minutes, 3 times per week of High Intensity Interval Training significantly improved insulin sensitivity by 23% in just 2 weeks! Participants exercised strenuously for 30 second bursts over 2 weeks, completing just 4-6 of these short bursts on 6 out of 14 days.
The study found that:
The area under the curve (AUC) for plasma glucose reduced by 12 %
The area under the curve (AUC) for insulin reduced by 37 %
NEFA (non-esterified fatty acid) concentration time reduced by 26 %
Aerobic performance improved by around 6%
Simple examples of HIIT that could easily fit into your everyday life might include
running up a few flights of stairs for 30 seconds
sprinting up the street or around the block for 30 seconds
strenuously punching a punching bag for 30 seconds
doing star jumps for 30 seconds
skipping rope for 30 seconds
“The efficacy of a high intensity exercise protocol, involving only ~250 kcal of work each week, to substantially improve insulin action in young sedentary subjects is remarkable. This novel time-efficient training paradigm can be used as a strategy to reduce metabolic risk factors in young and middle aged sedentary populations who otherwise would not adhere to time consuming traditional aerobic exercise regimes.”
You get the idea – almost anything strenuous for only 30 seconds at a time will help you increase your insulin sensitivity tremendously.
Everyone can do this … sometimes it is hard for us to fit a half hour exercise session into our day, but everyone can fit at least one 30 second session into their day, every single day. It takes hardly any time, no preparation and probably won’t even make you sweat!

Step 3. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Eat more fresh produce and less processed food

Scientists are consistently concluding that interventions involving diet and and exercise are more effective at improving outcomes for women with PCOS than any other measures such as surgery or medication.
What constitutes a healthy diet though? There is a great deal of conflicting advice out there and it's all too easy to find two experts with contradicting views on the same subject. No one solution will work exactly the same way in two people. We are all unique and what works for one woman may not work for another.
Although there are no hard and fast guarantees, there are many simple steps you can try which are likely to make a difference. Try them out and see how you respond.
As a general guideline, try and eat more fresh produce and foods that someone who lived 100 years ago would still recognize and less processed and packaged foods as these are likely to be higher in fat, salt, sugar and calories and lower in nutrients and fiber.

Step 4. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Eliminate or significantly reduce all refined carbohydrates

Refined carbohydrates have less nutrition than their whole food counterparts, are absorbed into the blood stream much more quickly producing a spike in blood sugar and then insulin levels and frequently a rebound low blood sugar and food cravings shortly thereafter.
Foods to avoid include:
white rice
white bread
pasta
white flour
pasta
pastry
cakes
biscuits
lollies
white and milk chocolate
canned fruit
fruit juice
cordial
sugar
syrups
soft drinks
breakfast cereals (rolled oats, muesli, porridge, high fiber cereals may be the exception here)
Whilst some people find that they need to completely eliminate grains or gluten in order to achieve the results they are looking for, simply by switching from a processed food to a wholefood when you have the choice can improve your health. For instance, swap white rice for brown rice, soft drinks for water, a piece of cake for a piece of fruit or white chocolate for a piece of high quality 85% cocoa dark chocolate.

Step 5. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Limit your total carbohydrate intake to 150g per day or less

People with insulin resistance, including most women with PCOS, have a reduced capacity to tolerate carbohydrates. In PCOS, consuming more carbohydrates than you are able to tolerate can result in a cascade of negative effects. Firstly, blood sugar becomes elevated which in turn increases insulin levels. Cellular resistance to insulin results in all that insulin floating around in the blood stream, unable to do it's primary job of transporting glucose from the blood into the cell.
Instead it may be used by the theca cells in the ovaries to produce excessive amounts of the hormone testosterone, which can result in excess facial hair, excess body hair and high cholesterol and triglycerides and fat storage around the abdomen. The high testosterone levels can also disrupt the delicate balance between the orchestra of hormones which control the female reproductive cycle causing infrequent periods, infrequent ovulation, periods which last far too long or are too heavy, periods which are too light or even completely stop ovulation and menstruation.
Regulating the amount of carbohydrate consumed each day is therefore very important in controlling PCOS. Most women with PCOS will find that they need to limit their total carbohydrate intake to 150 grams or less per day. Many will find that between 60-80 grams of carbohydrate is suitable, some will find that they need to reduce it as low as 20 grams per day.
To find out how much carbohydrate is being consumed currently, there are a number of diet tracking apps, programs and websites that can be used. My Fitness Pal and Nutrition Data are both good options. If total daily consumption is above 150 grams of carbohydrate per day, it is easier to gently work down to 150 grams per day, in increments of 10% of current total daily carbohydrate intake per week rather than going 'cold turkey' on the carbs. For instance, if a person was consuming 400 grams of carbohydrates per day, they would reduce this to 360 grams of carbohydrates per day and maintain it for one week, before reducing to 324 grams of carbohydrates per day and so on.
Step 6. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Favour foods which have a lower glycaemic index (GI)
People with insulin resistance, including most women with PCOS, have a reduced capacity to tolerate carbohydrates. When blood sugar levels become elevated the body responds by increasing insulin levels. Cellular resistance to insulin results in all that insulin floating around in the blood stream, unable to do it's primary job of transporting glucose from the blood into the cell. That excess insulin may be used by the theca cells in the ovaries to produce excessive amounts of the hormone testosterone, which can result in excess facial hair, excess body hair and high cholesterol and triglycerides and fat storage around the abdomen. The high testosterone levels can also disrupt the delicate balance between the orchestra of hormones which control the female reproductive cycle causing infrequent periods, infrequent ovulation, periods which last far too long or are too heavy, periods which are too light or even completely stop ovulation and menstruation.
The glycaemic index is a way of measuring the effect that carbohydrate containing foods have on blood sugar; the speed with which carbohydrate containing foods are digested and broken down into their component sugars and that those sugars subsequently enter the blood stream.
Foods which are higher on the glycaemic index are absorbed very quickly into the bloodstream, resulting in a sharp spike in blood sugar and insulin levels and frequently a corresponding dip in blood sugar levels to a level below normal, which can cause symptoms such as dizziness, headache and hunger, particularly cravings for carbohydrates. These foods are usually more highly processed than lower GI foods, however, unprocessed foods can also be high on the glycaemic index.
By choosing foods which are lower on the glycaemic index, you can ensure that blood sugar levels remain lower, resulting in less insulin production and consequently fewer side effects from PCOS, including lower long term risk of cardiovascular problems.
Foods with a glycaemic index of less than 55 are considered low GI and the healthiest choices, foods with a GI value of between 55 and 69 are considered medium GI foods and those with a GI value above 70 are considered high GI foods and are best avoided most of the time, although taking the glycaemic load into account can be a more wholistic approach to choosing blood sugar friendly foods.
An apple for instance has a glycaemic index value of 40, but a glycaemic load of only 6, making it a health choice for a snack. Chickpeas, dried then soaked overnight and cooked for 35 minutes have a glycaemic index value of only 10, making them an exceptionally healthy choice for maintaining stable blood sugar levels.

Step 7. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Limit fruit to 2 servings per day.

People with insulin resistance, including most women with PCOS, have a reduced capacity to tolerate carbohydrates. When blood sugar levels become elevated the body responds by increasing insulin levels. Cellular resistance to insulin results in all that insulin floating around in the blood stream, unable to do its primary job of transporting glucose from the blood into the cell. That excess insulin may be used by the theca cells in the ovaries to produce excessive amounts of the hormone testosterone, which can result in excess facial hair, excess body hair, high cholesterol and triglycerides and fat storage around the abdomen. The high testosterone levels can also disrupt the delicate balance between the orchestra of hormones which control the female reproductive cycle causing infrequent periods, infrequent ovulation, periods which last far too long or are too heavy, periods which are too light or even completely stop ovulation and menstruation.
Fruit is an excellent source of vitamins, minerals, enzymes, phytochemicals and fibre, however, it does contain a significant quantity of sugar mainly in the form of fructose. Fruit is an important part of a balanced, healthy diet, however, for people with insulin resistance intake should be limited to no more than 2 servings per day and if you choose to have 2 servings in one day, they should be separated by several hours.
Tropical fruits such as mango, papaya, pineapple, watermelon, cantaloupe etc have higher levels of sugar and are higher up the glycaemic index and are therefore a less healthy choice for people with insulin resistance. Fruits such as apples, pears, citrus and stone fruit which are grown in more temperate climates tend to be lower in sugar and lower on the glycaemic index, making them a healthier choice.

Step 8. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Limit unhealthy fats and increase healthy fats

Unhealthy fats include trans-fats (contained in almost all processed foods), too much saturated fat especially from non-organically raised meat, polyunsaturated oils such as canola, corn, sunflower, vegetable, soybean oils, hydrogenated and partially hydrogenated oils.
Healthy oils include cold pressed coconut, olive, macadamia, avocado or rice bran oil, egg yolks, fatty fish, butter and the fat from organic, pasture-raised, grass fed meat and poultry in moderate amounts only. All oil is 100% fat so needs to be limited to a reasonable percentage of a healthy diet and factored into total caloric requirements.
It is also important when using oils for cooking to ensure you choose an appropriate oil for the temperature it will be heated to. An oil should never be heated above its smoke point. Healthy oils with high smoke points include avocado, rice bran, ghee, macadamia, almond, extra light olive oil and refined coconut oil.

Step 9. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Reduce alcohol consumption

Alcohol is a highly refined form of sugar and a hallmark feature of PCOS is an inability to metabolise sugar well. Drinking alcohol stimulates the appetite and also keeps the liver busy detoxifying the alcohol metabolites when it could be getting rid of excess hormones which cause some of the most distressing symptoms of PCOS. Excessive consumption of alcohol can also damage the lining of the intestines and reduce the ability to absorb nutrients from food and disturb the balance of microflora required for healthy digestion and a healthy immune system.
Alcohol also contains a lot of calories without providing a feeling of satiety. A 150ml (5 fluid ounces) of red wine contains 125 calories, 40ml (1.5 fluid ounces or 1 jigger) of distilled 100 proof liquor such as gin, whisky, rum or vodka contains 124 calories and a 375ml (12 fluid ounce) can of regular beer contains 153 calories. When you start to look at cocktails the picture becomes horrific. A long island iced tea contains nearly 800 calories and 44 grams of carbohydrate. A margarita contains around 750 calories and 56 grams of carbohydrate, a pina colada around 650 calories but a whopping 90 grams of carbohydrate. A white russian is a slightly better proposition at 425 calories and 26 grams of carbohydrates. Better choices amongst the cocktail list are a cosmopolitan with only 150 calories and 10 grams of carbohydrate or a mojito at 160 calories and 12 grams of carbohydrate.
Women with PCOS are at an increased risk of non-alcoholic fatty liver disease. One study found that 30% of women diagnosed with PCOS also had raised liver enzymes indicative of liver disease. There's a certain amount of logic in not adding another risk factor for liver disease to those odds, when it's one you have control over.
Some women with PCOS take the drug metformin to help improve their insulin sensitivity. It tends to cause gastrointestinal distress by itself, but adding alcohol can make it worse.
If drinking alcohol is a part of your life that you choose not to give up, drinking a maximum of one glass of red wine with dinner on a regular basis, rather than drinking infrequently but having multiple units of alcohol in the same time period appears to have less of a negative effect.

Step 10. Eat a healthy diet by increasing foods which are beneficial and avoiding substances which harm: Reduce caffeine consumption

Caffeine is a drug. A legal drug and a commonly consumed one, but a drug nonetheless. It is a stimulant and can help make us more alert and energetic when used sparingly and appropriately, such as when driving long distances or working extra hours. When overused however, it can exhaust the adrenal glands causing chronic lethargy, hormonal disruption, anxiousness and irritability.
The bulk of the scientific literature seems to suggest that a moderate caffeine intake, up to 3 caffeinated drinks per day, may be beneficial. A cup or two of tea a day can reduce your risk of heart disease. A cup or two of coffee may reduce the risk of diabetes and improve brain function and memory. More than this, however, can have negative effects.
What you eat along with your caffeinated drink also impacts the effect that the caffeine will have. Drinking coffee along with carbohydrates increases insulin resistance and blood sugar levels, so if you are going to have a cup of coffee, enjoy it by itself without any muffins, toast or fruit.
A study published in the journal Diabetes Care in 2002 found that caffeine reduced insulin sensitivity by 15%. As insulin resistance is already a key issue for women with PCOS, caffeine restriction or avoidance may be helpful in managing this condition.
Step 11. Supplement with herbs and nutrients which support healthy carbohydrate metabolism: D-chiro inositol
D-Chiro Inositol (DCI) is a member of a family of substances referred to as inositols and generally considered to fall within the B vitamin complex.
It can be found in small amounts in a range of foods such as buckwheat, chickpeas, soya lecithin, pumpkin and pumpkin seeds as well as in the Ayurvedic herb bitter melon (momordica charantia). It is also produced by healthy human bodies from d-pinitol and myo-inositol, both of which are relatively abundant in the average diet.
DCI plays an important role in insulin signal transduction in human metabolism as a secondary messenger. Insulin transports the sugar from the blood into the cell where a d-chiro inositol-containing Inositol Phosphoglycan or DCI-IPG converts the sugar into either adenosine triphospate (ATP) to be used as energy or glucagon to be stored for later use.
It is currently thought that many cases of insulin resistance, polycystic ovarian syndrome and even type II diabetes mellitus are caused by a functional deficiency of this substance through both dysfunction of the enzyme which produces DCI as well as an overly efficient method of excreting what DCI is present in the body.
Studies have found that women with PCOS excrete DCI in their urine at 6 times the rate of healthy control subjects, whilst tissue biopsies taken from people with Type II diabetes have shown a significantly decreased level of DCI-IPG in their cells.
Supplementing with d-chiro inositol can help to address the functional deficiency and may increase the amount of DCI-IPG available in the cells to properly metabolise glucose into energy.
There is early evidence that DCI may also help those with Type II Diabetes Mellitus, however, further clinical trials will be required before this will be known definitively and the effect quantified. For the time being, taking DCI is an excellent way help minimise the risk of PCOS developing into Diabetes.
Human clinical studies have so far shown that DCI supplementation in women with PCOS and those who are insulin resistant can improve a whole raft of symptoms and clinical markers such as:
Increasing cellular insulin sensitivity
Increasing fertility
Improved ovulation frequency by 300%
Increased low progesterone levels
Reduced serum insulin levels
Reducing raised serum androgens (testosterone) both free and total
Reducing glycosylated haemoglobin (HbA1c) an indicator of long term sugar levels
Reducing plasma triglyceride levels (the amount of fat in your blood)
Reducing (bad) LDL cholesterol
Increasing (good) HDL cholesterol
Reducing raised blood pressure, both systolic and diastolic

Step 12. Supplement with herbs and nutrients which support healthy carbohydrate metabolism: Vitamin D

Vitamin D deficiency occurs in a very high percentage of women with PCOS, over 70%, and appears to be a contributing factor to some of the biochemical abnormalities seen in the condition such as irregular menstruation and infertility. Increasing Vitamin D levels has been shown to improve insulin sensitivity and help in the treatment of obesity. Researchers at the Medical University of Graz in Austria have found that low Vitamin D levels correlate with the occurrence and severity of belly fat, weight gain, high blood pressure, elevated blood sugar levels, insulin resistance, elevated insulin levels, elevated triglycerides and high cholesterol levels.
In a study of 13 women with PCOS, 8 were found to have a degree of vitamin D deficiency – some quite severe. All 13 women were treated with vitamin D2 (not the recommended form of Vitamin D by the way D3 is much much better) at a dose of 50,000 IU once or twice a week, and also received 1,500 mg of supplemental calcium per day.
Nine women in the study had either irregular or completely absent menstruation prior to the study. After Vitamin D supplementation 7 had their cycles return and/or normalise within 2 months and … here’s the good bit … the 2 who didn’t have their cycles return or normalise … were pregnant! Any incidences of dysfunctional uterine bleeding also resolved within 2 months of Vitamin D supplementation.
Other studies have also shown that a percentage of women with polycystic ovary syndrome had sub-optimal levels of vitamin D. Low vitamin D has been clearly linked to insulin resistance and obesity.

Step 13. Work with a qualified professional to choose a selection of herbs and nutrients which support healthy carbohydrate metabolism.

Minerals
Chromium - is an essential component of glucose tolerance factor (GTF) which works along with insulin to transport the blood sugar into the cells of our body so that it can be used as fuel to generate energy. If you have enough chromium in your body, then you need less insulin to maintain a healthy blood sugar range. It also plays a part in protein and fat metabolism and in maintaining healthy cholesterol ratios and levels.
Magnesium - deficiency in the general population results in increased insulin resistance, as well as increased smooth muscle and platelet reactivity,and is associated with both cardiovascular disease and diabetes. Women with PCOS have been found to have significantly lower serum and total magnesium compared with the controls, and this may contribute to the progression from insulin resistance to type 2 diabetes and heart disease. Population studies have confirmed that a high daily magnesium intake is associated with a lower incidence of type 2 diabetes, while individuals with low serum magnesium have a higher incidence. Magnesium deficiency occurs more frequently in diabetics despite adequate dietary intake, because urinary excretion is increased in the presence of elevated insulin and glucose in the urine.
Manganese is an essential trace element which is involved in energy production and metabolism, being an integral part in the creation of glycogen, fatty acids and cholesterol – all of which we need to stay healthy and energetic. It has been found in clinical studies to increase the efficacy of d-chiro inositol at reducing elevated blood sugar by a factor of 2. It is a potent antioxidant and improves the strength of cell walls and boosts the immune system which helps the body fight off viruses and bacteria.
Vanadium - mimics many of the actions of insulin in the body and has been studied for a potential role in the treatment of obesity, hypertension, diabetes and insulin resistance. Whilst very high doses are required to achieve a therapeutic effect, it does appear to be long-lasting. One human study found that 100 mg of vanadium daily for three weeks reduced fasting blood sugar and HbA1c levels by 10-15% and this effect was sustained two weeks after the therapy ceased.
Zinc - plays an important role in the synthesis, secretion and storage of insulin. High blood sugar causes zinc to be lost in the urine more quickly than normal.

Step 14. Work with a qualified professional to choose a selection of herbs and nutrients which support healthy carbohydrate metabolism: St Mary's Thistle, Gymnema sylvestre, Cinnamon, Fenugreek, Green Tea, American Ginseng, Aloe vera, cruciferous vegetables

Herbs
Gymnema sylvestre - is considered the gold standard treatment for blood sugar and carbohydrate metabolism problems by herbalists. Gymnema takes away the desire to eat sweet foods, reduces the amount of sugar and carbohydrate that is digested from the food you eat, stimulates the production of insulin and increases cellular sensitivity to insulin. It has been shown in animal studies to reverse the damage that high blood sugar can do to the liver. It has been the subject of many clinical trials providing evidence of its ability to lower fasting blood glucose, increase glucose uptake by cells reducing insulin resistance, increase C-peptide (a measure of how much insulin the pancreas is producing), reduce HbA1c and glycosylated plasma protein levels and reduce the amount of insulin that diabetics require.
Cinnamon - is a potent antioxidant containing nearly 7000 ORAC units per teaspoon. It also has a high manganese content and potent antimicrobial activity in addition to being very effective at lowering blood sugar, by up to 29% according to one study. Interestingly, although the study compared the efficacy of 1, 3 or 6 gram dosages and the higher dosage had a quicker and more profound response, the effect of the lowest dosage persisted for longer - 20 days after people stopped taking it.
American ginseng (panax quinquefolius) - has been found in several studies to decrease fasting blood glucose levels and HbA1c levels without affecting insulin levels. It also reduces blood sugar levels after a meal.
Fenugreek - has been found to reduce fasting blood sugar levels and both blood sugar and insulin levels after a meal.
Green Tea - contains a substance called epigallocatechin gallate (EGCG) which is a potent insulin sensitizer, improving glucose tolerance and reducing the risk of Type II diabetes developing. EGCG also re reduces the amount of glucose produced by the liver.
Aloe vera juice - has been found in a study from Thailand to reduce fasting blood glucose levels with just a tablespoon of 80% juice twice a day.
St Mary's thistle - contains a compound called silymarin which has been found to decrease fasting blood glucose, mean blood glucose, HbA1c, insulin levels, C-peptide levels, insulin requirement and urinary glucose.
Cruciferous vegetables - like broccoli, cabbage, kale, bok choy, Brussels sprouts and contain a compound called 3,3'-diindolemethane or DIM which has a raft of potent biological actions including anti-cancer, anti-inflammatory, anti-androgen and anti-microbial activity.

Step 15. Work with a qualified professional to choose a selection of herbs and nutrients which support healthy carbohydrate metabolism.

Vitamins
Alpha-lipoic acid - has been found to greatly increase insulin sensitivity in addition to being an incredible antioxidant and having the ability to help the body 'recycle' other antioxidants. Unusually, it is both fat and water soluble, meaning it is capable of passing into any body tissues including crossing the blood-brain barrier.
Carnitine - has been shown to increase glucose uptake by cells, improve glucose storage, decrease serum insulin levels and improve insulin sensitivity in several studies. It is also commonly used as an aid to weight loss.
Vitamin C - has been found to reduce blood sugar levels as well as having protective effects on the kidneys, eyes and nervous system. In people with high blood sugar, it has been shown to prevent accumulation of a kind of sugar known as sorbitol that can lead to serious complications with these organs. Diabetics accumulate high levels of sorbitol, which results in the cells leaking important molecules including nutrients. Researchers have found vitamin C to be superior in normalizing sorbitol levels to drugs designed for the same purpose.
Vitamin E - has been shown to reduce insulin resistance as well as protecting cells against the damage caused by high blood sugar levels. Studies have shown that a dose of between 400 – 800 i.u. depending upon the weight of the subject is effective for this purpose.
B-vitamin - group nutrients are all vitally important for energy regulation and frequently at less than optimal levels in women with PCOS, particularly if they have taken the drug metformin.
Co-enzyme Q10 - is a very powerful antioxidant which may improve pancreatic beta-cell function and enhance insulin sensitivity.

Step 16. Supplement with herbs and nutrients which support healthy hormone balance: Liquorice, Paeony, Vitex, Dong Quai, Blue Cohosh, Saw Palmetto

Liquorice and Paeony - are the two ingredients in the traditional Japanese herbal formulation Shakuyaku-Kanzo-To (TJ-68) which has been found in studies to normalise the hormones which are dysregulated in PCOS. It is suggested that TJ-68 acts directly on the ovary first, increasing the activity of aromatase, which promotes the synthesis of estradiol from testosterone, thus lowering serum testosterone levels. Furthermore, the effect on catecholamines results in gradually improving the dissociate phenomenon of LH/FSH ratio.
Vitex agnus castus - is one of the most popularly taken herbs for female hormonal and menstrual disorders in Europe with a solid body of clinical evidence supporting it’s 2500 year history of traditional use. It has a gentle and effective mechanism of action, working to stimulate the hypothalamus-pituitary axis to secrete the right hormones in the right amounts at the right time to restore hormonal balance naturally. The timing of hormones released from the pituitary governs menstruation, fertility and other processes. It is through Vitex’s subtle action on the pituitary gland that it can encourage the restoration of hormonal balance and regulate the female reproductive cycle.
Dong quai (angelica sinensis) - is a herb which has been used in traditional Chinese medicine for over 1000 years. It is sometimes called "female ginseng" for its ability to relieve painful periods, cramps, irregular menstrual cycles, infrequent periods, premenstrual syndrome (PMS), and menopausal symptoms. It also improves circulation, relieves pain, particularly to the female reproductive organs and stimulate and relax the muscles of the uterus. In combination with other herbs it is frequently used in the treatment of PCOS.
Blue cohosh - is a herb that is used to tone the uterus, ease spasms and regulate the menstrual cycle. It is particularly helpful for amenorrhoea, or bringing on delayed or absent periods. It is a herb that is frequently used in combination with other herbs in the treatment of PCOS.
Saw palmetto - can be helpful in regulating the hormones oestrogen and testosterone which are frequently disordered in PCOS. Saw palmetto has been shown in studies to inhibit the production of dihydrotestosterone (DHT), increase the rate at which DHT is broken down and inhibit the ability of DHT to bind to receptor sites in the body where it causes problems like hirsutism and hair loss.

Step 17. Practice stress management techniques: Meditation, Yoga, Exercise

The effects of stress on the human body are profound. Stress is an essential part of the human experience and some forms of stress are beneficial, for instance, strength training, cardio, a challenging career are all forms of stress.
Too much stress, or the wrong kind of stress, however, as many of us suffer in today's hectic modern lifestyle, can contribute to all sorts of negative effects from high blood pressure, to thinning hair, a low sex-drive, weight loss or gain, digestive problems, chest pain and a rapid heartbeat or palpitations. Stress can also wreak havoc on our hormones causing changes in the serum level of many hormones including glucocorticoids, catecholamines, growth hormone and prolactin.
Of particular importance to women with PCOS is one of the glucocorticoid hormones, cortisol, sometimes called the stress hormone as it is produced under times of stress. The primary role of cortisol is to prepare for fight or flight by increasing blood sugar, suppressing the immune system and inhibiting bone formation. Although cortisol is necessary for health, as with most things, balance is the key.
Meditation, yoga and physical exercise are all excellent ways to control stress. Find something you enjoy doing and make it a habit, for your health's sake.

Step 18. Minimise your exposure to chemicals which may have a negative effect on hormonal balance: bisphenol-A (BPA)

Most people have heard about bisphenol-A (BPA) in recent years due to the media coverage it has received since it was discovered in baby formula in China, making over 50,000 little babies very, very sick and killing 3.
BPA is an oestrogen-mimic – it attaches to the same receptors in the body that oestrogen does and has a similar effect. Women with PCOS tend to have elevated levels of oestrogen in the first place, so compounding this with a synthetic hormone-analogue is not going to help at all. Scientists have also found that BPA can decrease sperm count and increase the rate at which breast cancer cells grow. The incidence of breast and prostate cancer is increased, fertility is reduced along with menstrual cycle disturbances and the risk of diabetes is increased.
In 2004 the US Centers for Disease Control (CDC) collected samples of urine from 2,157 people between the ages of six and 85 to test it for traces of BPA. 93% of those tested had detectable levels of BPA, in amounts ranging between 33 and 80 nanograms per kg of bodyweight, as well as the metabolic products of BPA as it is broken down. Children have the highest levels, followed by adolescents, then adults. Mice that were given a dose of BPA 10 times smaller (per kilogram) than the average 6 year old has today developed cancers and other diseases.

Step 19. Get the right amount of sleep each night. An average of 8 hours' sleep each night is the optimal amount

Getting a good night's sleep is one of the cornerstones of good health. We are all familiar with the effects of too little sleep, but not everyone is aware that too much sleep can also be bad for your health and energy levels. The human body needs an average of 8 hours sleep each night to repair itself from the previous day and prepare for the day ahead. Much less than this, especially on an ongoing basis, can negatively impact health. Although you will never persuade a teenager of this fact, it is possible to have too much of a good thing. More than 9 hours of sleep a night can make you lethargic and increase your risk of diabetes as does napping during the day.
A study of 1486 men and women published in the Archives of Internal Medicine in 2005 has shown that people who get either less than 6 hours sleep a night or more than 9 hours have a higher risk of developing Impaired Glucose Tolerance, which is defined as a fasting plasma glucose level of more than 5.3 mmol/L or 95 mg/dL and is particularly prevalent amongst women who have PCOS or Diabetes Mellitus, another disease for which women with PCOS have a significantly increased risk of developing.
Don't nap during the day
I am sad to have to report that the odd afternoon nap also appears to significantly increase the risk of blood sugar elevation and diabetes.
For a while now we have known that getting less than the optimal 7-8 hours of sleep at night can have a negative effect on insulin resistance and blood sugar levels, but now it appears that napping during daytime hours is also bad for our health.
A study published in Diabetes Care has found from a prospective study of nearly 175,000 people that those who napped for less than 1 hour a day increased their long term risk of developing elevated blood sugar levels by 23%. Those who napped for more than 1 hour a day increased their long term risk of developing elevated blood sugar levels by 55%! Even more recent research by Dr Shahrad Taheri of Birmingham University has found from studying 16,000 people that as little as one afternoon nap a week increases the risk of developing elevated blood sugar by 23%.
The bottom line is that we need to make certain that we get a good night's rest of around 8 solid hours overnight and resist the temptation to nap during the day.

Step 20. Consume probiotics to ensure a healthy environment in your gut

“Supplementing with probiotics such as acidophilus, bifidus and lactobacilli may assist in maintaining a normal weight or losing weight in overweight or obese individuals”

There are two major phyla or families of bacteria which inhabit our intestines and help to digest the food that we eat. They are Firmicutes and Bacteroides.
Researchers have discovered that obese people have a different ratio of these gut flora to lean people. It turns out that the microbes in the Firmicutes family have a larger arsenal of enzymes at their disposal to digest complex carbohydrates, making them much more efficient at what they do and allowing for more energy to be derived from the same amount of food. So this lends credit to those people who eat less than their acquantainces, whilst doing the same amount of exercise and still tend towards the heavier end of the scale. We have traditionally put this down to individual rates of metabolism, however gut flora may also play a large part.
A related study found that lean people had a larger population of Bacteroides group microbes, comprising 20% of their gut flora, than obese people who only had 5% of these less efficient microbes.
All is not lost, however, whilst we share a core variety of gut microbes with our family even amongst identical twins there are differences and it is these deviations from the core set of microbes that can influence whether a person is lean or obese. It is also possible to alter the composition of the gut flora through dietary changes. When obese people followed either a low fat or a low carbohydrate diet for a year, the amount of Bacteroides microbes increased from 5% to 15% of total stool volume. This means that if you follow a reduced fat/carbohydrate diet for a year you significantly improve the ratio of gut flora to be more in line with that of lean individuals and in theory, will then obtain less energy from carbohydrate-based foods. Unfortunately researchers in the UK have failed to find the same effect with a shorter term study of 4 weeks, so it is likely that to obtain the benefits described the diet would need to be followed strictly for at least one year.

“There is a lot of uncertainty as to whether individual probiotic supplements are effective. There is a lot of variability between the strains both in terms of their effects in the body, their care prior to ingestion and whether or not they can survive the acidic environment of the stomach and remain alive in the intestine for long enough to do their job. Some strains need to be stored in the refrigerator. A simple way of increasing the numbers of beneficial bacteria in your digestive system is to reduce the amount of sugar and refined carbohydrates in your diet and eat lots of fresh vegetables, a moderate amount of fresh fruit, whole grains and legumes (which often contain d-chiro inositol). You can also use fresh fermented milk products such as kefir and naturally fermented, unpasteurised soy products such as tamari, tempeh and natto to re-seed your gut with beneficial micro-organisms“

Kirsi Laitinen, a nutritionist and senior lecturer at the University of Turku in Finland presented findings at the European Congress on Obesity in 2009 which found that supplementing with lactobacilus and bifidobacterium, commonly available probiotics, when a woman is pregnant from the first trimester continuing until she stops breast feeding exclusively (or 6 months post-partum) reduces excess fat around the abdomen in particular and total body fat percentages in general. Women who received probiotic supplements and nutritional counselling specific to pregnancy had 1-2 % less body fat on average than women who received either a placebo and nutritional counselling or no counselling or probiotics whatsoever. In fact, the study found that only 25% of the women who received the probiotic supplement were found, on review one year later to have central obesity (a BMI of 30 or above or a waist circumference of 80cm of greater) compared with 43% in women who received only dietary counselling but no probiotics and 40% in women who received neither nutritional counselling nor probiotic supplements.
Another Finnish study, this time on children, found that disturbances in the gut flora actually preceded children becoming overweight. Children who had a greater percentage of bifidobacteria in their gut remained of normal weight, whilst overweight children were found to have only half the amount of bifidobacteria as their leaner cohorts. In addition, overweight children were found to have more than twice the amount of staphylococcus aureus bacteria in their stools as their leaner cohorts.
Studies have found that probiotics may be beneficial to many aspects of our health, including:
Managing Lactose Intolerance – Some strains of bacteria convert lactose into lactic acid, so supplementation can increase the threshold of lactose that a lactose intolerant person can tolerate).
Lowering Risk of Colon Cancer – Population studies have found that cultures that consume fermented dairy products such as kefir have a lower incidence of colon cancer. Laboratory studies indicate that this may be due to lactobacillus bulgaricus’ ability to bind to heterocyclic amines, carcinogenic substances which are formed when meat is charred and by inhibiting an enzyme called beta-glucuronidase which can form carcinogens in the gut.
Lowering cholesterol
Lowering blood pressure
Improving Immune System Function – Increasing the number of Ig-A containing plasma cells, T-lymphocytes and Natural Killer cells and increasing the rate of phagocytosis.
Preventing Infections – It is thought that this occurs through competitive inhibition. Studies have found that probiotic supplementation reduces the number of dental caries in children as well as the number of respiratory infections.
Treating Peptic Ulcers - Through inhibiting the bacterium heliobacter pylori which causes the ulcers.
Reducing Inflammation – Through down-regulating bacteria-produced inflammatory cytokines. Studies found that probiotics caused a reduction in C-Reactive Protein (CRP) a common inflammatory marker which is commonly elevated in women with PCOS.
Reducing the Risk of Allergy Development – Probiotics help to train your immune system distinguish between good proteins (antigens) and bad proteins (pathogens) and to respond appropriately – killing pathogens but not over-reacting to antigens. It is when this process goes awry that allergies can develop.
Improving the Absorption of Trace Minerals – especially in those whose diets are high in grains, legumes and nuts.
Producing Vitamin K and some B Group Vitamins – B Group vitamins are very important for carbohydrate metabolism, so of particular importance to women with PCOS.
Relieving the symptoms of IBS and ulcerative colitis, reducing the severity of antibiotic-associated diarrhorea and the severity and duration of rotavirus in children and acute diarrhoea in travellers.
If you decide that you do want to take a probiotic supplement, you may want to consider the bacillus coagulans strain as it is available as a spore so it has a long shelf life, doesn’t need refrigeration and can even tolerate warm temperataures. They are also robust enough to survive the acidic environment of the stomach and reach the small intestine and remain active there for long enough to do some good.
Another good option is kefir, which can be made at home using a culture incubated in fresh milk for 1-2 days. Kefir contains a multitude of beneficial organisms in large quantities.
  16329482
February 16, 2013 11:25 AM
Thank you for sharing!
  1537893
February 16, 2013 12:52 PM
Lovely Thanxxx a zillion :)
  9022349
February 16, 2013 2:02 PM
Bump
February 16, 2013 2:13 PM
Thanks! Great article!
February 16, 2013 2:48 PM
Thanks!
  1749492
February 16, 2013 2:55 PM
Oddly, this is pretty much what I've ended up doing. The exercise routine my PT has set is very similar to that and I cut my carbs and increased protein (40c/30f/30p) based on advice on here and I've felt much better since.
  3239266
February 16, 2013 3:08 PM
I've just begun a book called Metabolism Miracle to manage the insulin resistance factor that causes or coincides with PCOS. Really, I just want to get healthy, but the diet is supposed to reset the liver to process insulin more correctly... It is limiting the net carbs. First 8 weeks are under 5 net carbs every 5 hours with 0 carb freebies in between like natural peanut butter and celery...
  38134753
February 16, 2013 3:20 PM
Personally for my pcos I've learned that as I decrease my weight, my periods come back NO MEDS NECESSARY! Like it states pcos does seem to be more weight related then anything but the bad thing..........pcos along with hormones make the weight reduction seem like HELL!

I tried vitex for over a year and never ever got to where I needed to be but so far my extra hair has slowed down, weight is going down, and I feel overall healthier thanks to diet and exercise.
  37968375
February 16, 2013 5:46 PM
This was AWESOME! Thanks for sharing!!!
  37046447
February 16, 2013 10:07 PM
THANK YOU for sharing! I knew a lot of this stuff but hearing the science behind it was really helpful and motivating!!!
February 16, 2013 10:20 PM
I haven't read every word of it, but (just skimming) it looks very reasonable. Thanks for sharing!

I actually can't tolerate Metformin (it makes me quite ill even with extended release and gradual increase of dosage) and I can't take birth control because of a family history of cancer. That said, I've been on MFP (even though I joined earlier) for 41 days. I've lost 24lbs and 25 inches--from 340lbs to 316. I've competed in three 5ks (yes, even while morbidly obese) and have constantly increased my strength and pace. And I've stuck very strictly to a 1200-calorie diet (restricting carbs to roughly 100g). Here is one interesting study on how low the BMRs are for PCOS women who have IR: http://www.ncbi.nlm.nih.gov/pubmed/18678372.

I also take several of the supplements mentioned (Alpha Lipoic Acid, Cinnamon, D3, Calcium, Vitamin B, Coq10, and a multi). However, I don't think they've been a drop in the bucket compared to the strict diet and more active lifestyle.

If I could be of any help or if anyone wants to friend me--please do! My diary is open to friends.
  997885
February 16, 2013 10:30 PM
thanks!
  15002915
February 17, 2013 8:54 AM
QUOTE:

I haven't read every word of it, but (just skimming) it looks very reasonable. Thanks for sharing!

I actually can't tolerate Metformin (it makes me quite ill even with extended release and gradual increase of dosage) and I can't take birth control because of a family history of cancer. That said, I've been on MFP (even though I joined earlier) for 41 days. I've lost 24lbs and 25 inches--from 340lbs to 316. I've competed in three 5ks (yes, even while morbidly obese) and have constantly increased my strength and pace. And I've stuck very strictly to a 1200-calorie diet (restricting carbs to roughly 100g). Here is one interesting study on how low the BMRs are for PCOS women who have IR: http://www.ncbi.nlm.nih.gov/pubmed/18678372.

I also take several of the supplements mentioned (Alpha Lipoic Acid, Cinnamon, D3, Calcium, Vitamin B, Coq10, and a multi). However, I don't think they've been a drop in the bucket compared to the strict diet and more active lifestyle.

If I could be of any help or if anyone wants to friend me--please do! My diary is open to friends.


I've now lost 45 pounds and have seen improvements, I don't run but I'm a zumba freak. My biggest issue is carbs, I'm working on reducing carbs, but I'm very attached to pasta, rice, bread, I love it! Never been a fan of fruit or veggies, but I am forcing myself to eat more and more of them nasty veggies. I love meat, so I have no problem getting my protein in, in fact I was eating too much protein prior to dieting and have cut that back a little bit. I struggle big time with the diet part, but exercise and taking my vitamins is the easy part :-) With 6 people living in the house it's hard for me to keep super strict on my food intake.
  16329482
February 17, 2013 9:15 AM
bump for further reading later

Thanks you for sharing this article. From what I've read so far, most of these things ring true for me. Regular exercise and controlling my diet brought my monthly cycles back into existence. I would go MONTHS on end with no period. They are actually normal now, every 26-28 days with no medications! My gyno previously had me on birth control to regulate my periods. Since my lifestyle change over a year ago, I don't need it anymore! smile When I have time I'm going to read this in more detail. Thanks again!!!
February 17, 2013 9:38 AM
Thanks for sharing
  30691852
February 17, 2013 3:13 PM
bump

can't wait to read
February 17, 2013 4:44 PM
I have been doing all of this since April of last year (down 70lbs so far!) I cant say how helpful this article really is! Most of this stuff took me hours and hours to find out in medical journals/and doctor visits. I highly recommend anyone with PCOS read it, it explains so much!

I guess I am a special snowflake :p
  21767105
February 17, 2013 4:51 PM
For years I've realized that lowering my carbs seemed to help with my PCOS problems, but not everyone felt cutting carbs was good for you. So I was especially happy to see this spelled out so clearly:


"People with insulin resistance, including most women with PCOS, have a reduced capacity to tolerate carbohydrates."
  7490192
March 4, 2013 6:37 AM
bump to read later. Thanks for sharing!!
April 23, 2013 12:34 PM
Thanks for posting happy
April 29, 2013 9:47 AM
Excited to read - thanks for sharing!
April 30, 2013 6:59 PM
Thanks for the good read!
May 11, 2013 6:15 PM
Will probably come back to. Thanks!
  21095687
May 14, 2013 11:44 AM
Bump
  41374675

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