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Old 05-29-2008, 11:18 AM   #1
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Exclamation FAQ's - Newcomers Come Here First!

So, What Is This Thing Called PCOS, Anyway?

PCOS is really a hormonal imbalance caused by a metabolic issue,usually Insulin Resistance. IR can be tricky to diagnose, as the blood work is really designed to detect Diabetes. IR can be diagnosed from symptoms alone, such as excessive hunger (especially when you feel that you "shouldn't" be hungry), dizziness, headache, nausea, irritability, mood swings, the "shakes", exhaustion, especially if you skip a meal. Also, if you look at your neck where it meets your body, and notice that the skin is thicker, creased, and perhaps looks "dirty" even after having a shower, it is highly likely that you do, in fact, have IR.

Other women seem to have a thyroid issue as the main factor for their PCOS. There are also "thin cysters" who do not have a weight issue, but still can benefit from IR treatment.

The other things to keep in mind about PCOS are that it is not "just a fertility issue". It is a whole-body endocrine imbalance that can cause an increased risk of heart disease, diabetes, and some cancers. This is why it is important to make sure you treat the PCOS beyond just symptoms control such as Birth Control Pills (BCP). Also, if you do not have a menstrual cycle (absence of AF or Aunt Flow), make sure that you get one induced at least every 3 months to reduce your risk of endometrial, uterine, or cervical cancers.

What Is Insulin Resistance (IR)?

Insulin Resistance (IR) occurs when the body's cells do not use insulin effectively. Insulin is the "key" that allows glucose from the blood to enter cells to be used for energy. Think of Insulin Resistance like a slow-running drain - the insulin does get through, it just takes longer to do so, and in the meantime, the body produces more because it thinks that you need more. This over-production can cause Reactive Hypoglycemia (low blood-sugar) in some people, and can eventually wear out the pancreas, leading to Type 2Diabetes. In the meantime, the extra insulin affects the other hormones in the body, causing many of the PCOS symptoms. IR also causes the body to become very efficient at storing fat, which leads to the excess body fat which many of us suffer from, as well as the inability to lose weight.

The good news is that if you better manage the IR, you reduce the amount of insulin in your system, and things start to go back to normal. This is one reason why Metformin can work so well for some people.

I've Heard That Women With PCOS Aren't Able To Have Children. Is This True?

While it is true that untreated PCOS is a leading cause of infertility, once it is properly treated, many women go on to become pregnant. In fact, many women find that diet & exercise and using Metformin, an insulin re-sensitizing medication, may be enough to stabilize their PCOS symptoms and can return their fertility quite suddenly! Other women require further levels of medication and intervention, but the main thing to keep in mind is that there IS hope!!! Also, if you are not planning to become pregnant currently, remember that you will still need to practice a reliable method of birth control.

So, What Now? What Do We Do?

Firstly, get a thorough check-up from your doctor, that includes hormone levels, cholesterol levels, thyroid, and see if your doctor will do a 2 or 3 hour Glucose Tolerance Test. You should also make sure they take a Fasting Insulin level and Sex Hormone Binding Globulin. These tests are necessary because with PCOS, you have a much higher risk of developing heart disease, bad cholesterol levels, and diabetes. Quite often, you will have an elevated insulin level, which is a better indicator of IR.

You should start on a low-er/good carb diet with 3 main meals and 2 - 3 healthy snacks/day. Focus on high-fibre, low-starch veggies and protein. You should also get lots of good exercise!!! If you haven't exercised for quite some time, start where you are now, and increase a little more each day. Even walking will do wonders, and will "get the juices flowing"!!!

A good supplement schedule should include Chromium (good for insulin/blood sugar issues), Fish Oil (good for cholesterol, metabolism, heart health, mood swings, heart rate, and overall brain function), and a good multi-vitamin/mineral.

You should also look into taking an insulin re-sensitizer such as Metformin and/or Cinnamon (herbal alternative). Base levels that seem to work for those of us with PCOS are 1,500 - 2,000 mg/day for the Met, and 500 - 1,000 mg/day for the Cinnamon. With both of them, you will want to work your way up to those doses, and allow your body to gradually adjust.

An Endocrinologist (endo) or Reproductive Endo (RE) are more likely to know and understand PCOS, but as there is a definate issue with finding a doctor who has thorough knowledge of PCOS, ANY doctor who takes you seriously, and is at least willing to do the research is more than worth his (her) weight in gold!!!

So, How Does She Lose Weight And Change Her Lifestyle?

There are many ways to make lifestyle changes, but there are some key elements you need to include.

1) She needs to limit highly processed, sugars and starchy carbs. Change the carbs that she does eat to a healthier, higher-fiber version - so brown bread, brown rice, whole wheat pasta, etc. Also, try to pair a protein with your carbs - it helps to even out your blood sugar.

2) She NEEDS to include exercise of some kind as IR is based in the muscle cells, so working the muscles helps to improve insulin sensitivity.

3) Take it one step at a time. Don't try to change everything overnight.

4) Track her progress. This means more than just the scales, as your body is made up of muscle (which weighs more than fat), water, fat, and all the other "stuff" (organs, bones, cartiledge, etc.). Learn how to take proper measurements, and chart that as well as weight. Celebrate when she goes down a size. Keep maybe only one pair of "fat pants" so you have something to compare to - and get rid of the rest!!! Sell them, burn them, give them away - just get rid of them!!!

www.sparkpeople.com has come up with a really good system put together by dieticians, doctors, fitness professionals, etc., and it's naturally geared towards preventing and controlling IR and Diabetes. It also has nutrition and fitness trackers, recipes and recipe calculators, and TONS of info and it's 100% FREE!!!!!! You can use their program, or just use it to track what you do on your own.

The Insulite System is also available. They take all of the same elements, but put it together for you in one package, including your supplements. This is a program that is a little bit more specific in treating IR and PCOS. It can get a little pricy, but it is a good system. You can check out their system at pcos.insulitelabs.com, or from the main page of the PCOSA website.

But She Doesn't Have All The Symptoms!!! Does She Still Have PCOS?

As PCOS is a syndrome, you can have some, all, or only a few of the many symptoms. Classically, it is diagnosed by having 2 out of the following:

1) a history of PCOS, Insulin Resistance, Diabetes or Hypoglycemia in your family, or having these issues yourself.

2) blood work which shows certain hormonal imbalances such as a reversed LH:FSH ratio or elevated testosterone levels.

3) "PCOS-type" symptoms such as: weight gain (especially around the middle) and inability to lose weight, acne/bacne, irregular/absent AF, hair loss, body/facial hair, skin tags, dark skin patches (may look "dirty"), mood swings, lack of energy, elevated cholesterol levels, and also ovarian cysts. By the way, in spite of it's name, not all PCOS women have ovarian cysts.

She Can't/Won't Take Metformin. What Else Can She Do?

While Metformin is the most common insulin resensitizer, there are other options out there. Certainly, if the side effects (nausea, diarrhea, etc.) are too intense to realistically deal with, she can try the extended version. Always take it with a meal, and be aware that eating starchy/sugary/fatty foods tend to make the side effects worse. Lettuce seems to be a bad idea, too, for some reason. Also, there is Cinnamon which, while they are only just beginning to do studies about it, shows some strong promise in terms of treating Insulin Resistance! Avandia is another medication that will improve insulin sensitivity. It can be used by itself, or in combination with Metformin or Cinnamon. Actose has just come on the market as a Metformin replacement that has fewer side effects. And don't knock the effects of diet and exercise!!!

More Information Is Found In Part 2
Registered Massage Therapist
2200-hour program in Canada
Focus on women's health and managing chronic health issues

DS (1992)
Diagnosed PCOS 1994
Cannot tolerate BCP
No treatment for 12 years
Now, Metformin 1,500 mg/day, Fish Oil, D3, good multi

Last edited by sweetsunshine72; 05-31-2008 at 11:11 AM.
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Old 05-29-2008, 11:21 AM   #2
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Join Date: Apr 2006
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Default FAQ's - Part 2

I Want To Try Cinnamon. What Do I Get, And How Do I Take It?

The Cinnamon you get is powdered Cinnamon bark, like what you buy at the grocery store. The variety is called Caissia Cinnamon. Some people prefer capsules, as it is easier to measure and more convenient. If you do get capsules, be sure that it is the powdered bark, or at the very least, a water-soluble product. You want to be careful NOT to use Cinnamon Oil, as it is difficult to process and flush from your body, and it does not have the insulin-sensitizing effect. If you are using regular Cinnamon from the store, a teaspoon is about equivalent to 500 mg. You can take it sprinkled on cereal, in tea, on desserts, mixed in applesauce, and so on. While previously, dosages were recommended up to 4,500 mg/day, due to the discovery of Cumarin (a powerful blood thinner) in Cassia Cinnamon, we no longer recommend this. Now, dosages of 500 - 1,000 mg/day are recommended. It may take a little longer to be effective, but some studies show that a lesser dosage can be just as effective long-term. This also reduces the need to gradually work up to your dosage.

Remember to take your Cinnamon with an adequate amount of liquid, as you can get "Cinnamon burps". Some women have even burped up a cloud of Cinnamon!!! While funny, it can burn, so it's a good idea to avoid it!

I'm Interested In Herbal Remedies. What Can I Take?

One important thing to keep in mind is that HERBAL REMEDIES ARE MEDICATIONS, TOO!!! Not all of them are safe to self-medicate with, and not all of them are OK to use while TTC. Always run your supplements list through your doc, and if you can see a licensed Naturopath or herbalist, please do so before taking something new. Also, beware of adds which promise a "miracle cure" or "instant fertility". Many of them are "snake oil", and are not based on science or true herbal knowledge. It's definitely "Buyer Beware" out there!!!

OK - So This Is What SHE Does - Why Do I Have To Do It, Too?

Well, while she's the one who needs to make the lifestyle changes, it's MUCH easier to make them if the people she's around are making them, too. Besides, many of the common chronic health issues around today are improved with the same kind of diet and exercise changes that she will need to make, so you are improving your own health, too. If you get a really bad grease and starch craving, that's fine - just find a way to satisfy it that won't tempt her too much or "shove it in her face". If you really want to eat differently, then don't argue if she wants you to prepare a meal or two, or eats at different times!

Also, realize that healthier food will cost more. No matter what, spending a little extra on the grocery bill is still better than ending up with a medical issue like Diabetes - the cost of blood testers, test strips, needles, insulin, etc. is easily in the thousands, not to mention doctor's visits!

What Else Can I Do To Help Her?

Basically, encourage her to make (and stick to) the lifestyle changes. If she seems to get emotional, she may be getting low blood sugar, so get her to eat something. The snack should NOT be junk food, but needs to include protein. Remember that she will need to eat about every 2 - 3 hours, so if you're going somewhere, give her time to grab a snack to take with you. If she's taking medication, help her to remember to take her pills.

Most of all, let her know that you love and appreciate her. Many women with PCOS feel "fat and ugly", and she may feel like you don't desire her anymore. She may also have a lower (or higher) sex drive due to the hormonal imbalances. Be open and honest with her, and if there's a problem, talk with her about it.

Is There A "Quick List" Of Meds And What They're For?

Things Taken To Control Blood Sugar/IR
Metformin - a medication that reduces IR and directs the liver to not produce as much glycogen.
Cinnamon - an herbal medication used to improve IR. Also has a pseudo-insulin effect and can lower blood sugar suddenly if not used to current dosage.
Chromium - a mineral used to improve IR. Chromium can also lower blood sugar when first taking it.
Alpha Lipoic Acid - very promising supplement to aid in reducing IR. Is contained in Flax Seed and Fish Oil

Fish Oil - heart health, mood, IR, & cholesterol
B-Complex - energy and to combat anemia occasionally caused by metformin
Pre Natal - taken by those Trying To Conceive (TTC) because of the extra folic acid. Can also contain a multivitamin/mineral
Multivitamin/mineral - to fill in nutritional gaps

Fertility Drugs
Clomid - used to induce folicle maturation and growth. Can cause thining of uterine lining with prolonged use
Femara - used to induce folicle maturation and growth. Does not cause thining of uterine lining. Has shorter half-life than Clomid.
Gonal F - injection of Folicle Stimulating Hormone used to induce folicle maturation and growth
(Trigger Shot) - injection used to trigger ovulation

Hormonal Controls
Yaz, Yasmin - are birth control (BC) with aniti androgens
Spiro (Spironolactone) - is an anti-androgen that requires you be on BC
Provera/Prometrium - Progesterone supplements used to trigger a proper bleed.

I Want To Research And Get More Information On PCOS. Do You Know Of Some Good Resources?

- The Savvy Women's Guide to PCOS by Dr. Elizabeth Vliet
- Fertility for Dummies
- New Glucose Revolution Guide to Living Well with PCOS
- The PCOS Diet Book: How You Can Use the Nutritional Approach to Deal with Polycystic Ovary Syndrome
- A Patient's Guide to PCOS, Understanding and Reversing Polycystic Ovary Syndrome by Walter Futterweit
- PCOS: The Hidden Epidemic, by Samuel Thatcher
- PCOS: A Woman's Guide to Dealing with PCOS, by Colette Harris, Dr. Adam Carey

- www.pcosupport.org
- www.fertilityfriend.com
- www.tcoyf.com
- www.inciid.org/faq.php?cat=infertility101&id=2
- http://www.nichd.nih.gov/news/releas...l_diabetes.cfm
- www.sparkpeople.com
- www.pcos.insulitelabs.com
- www.tomvenuto.com
- http://www.aace.com/pub/pdf/guidelin...nstatement.pdf
(Position Statement by the American Association of Clinical Endocrinologists)
Registered Massage Therapist
2200-hour program in Canada
Focus on women's health and managing chronic health issues

DS (1992)
Diagnosed PCOS 1994
Cannot tolerate BCP
No treatment for 12 years
Now, Metformin 1,500 mg/day, Fish Oil, D3, good multi
sweetsunshine72 is offline   Reply With Quote

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