Picking apart PCOS (part 2)
One of the most common conditions I see is PCOS. 1 in 10 women are thought to have this condition. One of the reasons I have focused on PCOS in my studies and clinical practice is because it is probably the women’s health condition that can respond best to dietary and lifestyle changes.In my previous post I set out that there are eight key areas to consider when supporting women with PCOS. To recap those are:
Addressing inflammation
Treating insulin resistance
Balancing adrenals
Treating excess androgens
Addressing wider sex hormone imbalances
Supporting the thyroid
Reducing exposure to endocrine disrupting toxins
Balancing diet
There is considerable overlap between these key areas but it is helpful to have each of them in mind to ensure the intervention is as comprehensive as possible. Also, for different individuals the areas needing to be focused on the most will differ but this is where applying the whole body approach of nutritional therapy and the principles of functional medicine can be so beneficial. The role of a nutritional therapist or functional medicine practitioner is to take a detailed case history, consider the body as a whole rather than focusing on any one system or imbalance and unpick the various factors which might be at play in that particular individual.
As I mentioned in my previous post I am going to do a series of blog posts on PCOS, covering each of these eight key areas. This post covers the role of inflammation in PCOS. Each topic is huge and the latest scientific research could easily be an entire chapter of a book so I am going to necessarily cover only the key points. These are all areas we dig into much more deeply on my PCOS programme.
Inflammation and PCOS:
So first things first… what is inflammation? Inflammation is a completely natural and life saving immune response. If we have a wound or infection, the cells of our immune system secrete special chemicals called cytokines activate healing processes to help heal the wound or overcome the infection. You can see this acute form of inflammation at work when you have a cut which becomes red, warm and swollen. However, when that inflammatory process is activated too frequently a state of chronic low-grade inflammation can arise resulting in a whole range of unwanted effects from hormonal imbalances to anxiety and depression.
The effects most relevant to PCOS are that inflammation can directly act on the ovaries to cause the production of testosterone and on our fat cells to cause insulin resistance, thereby contributing to the symptoms of PCOS. As such, inflammation must be addressed first and foremost in any plan to reverse PCOS symptoms.
The first step in dealing with inflammation is to address the particular hormones, namely insulin, that trigger even more inflammation, perpetuating a vicious cycle. As such, helping women balance their blood sugar levels and increase insulin sensitivity often forms an important part of any PCOS programme. I’ll be covering insulin in greater detail in the next post.
In addition, increasing foods which are anti-inflammatory in nature and removing foods which are triggering an inflammatory response such as dairy and sugar will be key. Sometimes we will try an elimination diet to identify any particular foods which are triggering an immune reaction which can be hard to spot without such an elimination.
Considering the health of the digestive system is also key. An unhappy digestive system will be a major trigger of inflammation in the body, particularly if there are any issues with “leaky gut” (which essentially means your gut lining has been damaged and this is triggering an immune reaction). Symptoms of leaky gut include bloating, indigestion, food sensitivities, inflammatory bowel disease, autoimmune disease, thyroid disease, nutrient deficiencies (indicating malabsorption), inflamed skin (often in the form of acne, psoriasis or eczema), depression and anxiety.
Finally, considering PCOS-friendly supplements to minimise inflammation is often an important part of the programme.
So that’s a whirl wind tour of inflammation and PCOS. In the next post I’ll be covering insulin.
If you have any comments or questions I would love to hear from you…