I released a long-held sigh of relief today when I came across an announcement from the National Institutes of Health, declaring their decision to rename polycystic ovarian syndrome (PCOS). A minor thing to get worked up over? I think not. PCOS is a leading cause of infertility in young women, and a significant risk factor for type 2 diabetes, high cholesterol, and hypertension. Despite the name, PCOS often presents without any ovarian cysts. Why is this a concern? A misleading name will do exactly that: mislead.
As a naturopathic physician specializing in women’s health and endocrine disorders, I’ve had the opportunity to see how prevalent PCOS is, and how frequently it goes undiagnosed. Without ovarian pain, or confirmed ovarian cysts, a focused diagnostic work up for the hormonal disorder is often overlooked. Sometimes this is an oversight by the healthcare practitioner, but in many cases, it is related to patients not knowing when to seek care. Of the women I have diagnosed with PCOS, most have responded to my first mention of its name with something along the lines of “PCOS? Not me, I don’t have any cysts.” They’re half right.
What is PCOS?
Polycystic ovarian syndrome is a complex metabolic and hormonal disorder that involves both hyperandrogenism (elevated levels of androgen hormones, such as testosterone) and insulin resistance. Hormone and blood sugar imbalances effect the entire body, causing a wide variety of symptoms:
Irregular menstrual cycle, or complete loss of cycle
Infertility (Unable to conceive after 12+ months)
Excess hair growth on the face, back and chest
Thinning hair (scalp)
Weight gain, especially around the trunk
Depression and anxiety
As you can see above, ovarian cysts are a very small piece of a very large puzzle. Their absence does not rule out a diagnosis of PCOS, nor does their presence guarantee one. In fact, single and even multiple ovarian cysts can exist women without any history of the condition.
With so many young women effected and at increased risk for life-altering diseases, early diagnosis and treatment of PCOS is invaluable. If you have irregular cycles in combination with any of the symptoms listed above, please do not hesitate to speak with your healthcare provider.
Are there natural treatment options?
There are many natural treatment options available to help balance your hormones, address insulin resistance and improve metabolic function. For my patients, I use a combination of dietary counseling, weight loss plans, bio-identical hormones, nutritional supplements and botanicals. Subclinical hypothyroidism is also present as well, and treatment with natural supplements or thyroid hormone replacement leads to significant improvement. Many women respond beautifully to these interventions, allowing them to avoid treatment through surgery, diabetes medications, birth control pills or anti-androgen medications.
Diet: Insulin resistance and elevated blood sugar are highly responsive to dietary modifications.
Weight Loss: Specific dietary changes, metabolic support and HCG Diet when appropriate.
Bio-Identical Hormones: Bio-identical progesterone in combination with aggressive treatment of insulin resistance (high insulin stimulates increased androgen production).
Nutritional Supplements: Specific to hormone metabolism, blood sugar balance and endocrine system support.
Botanicals: Specific to estrogen, testosterone and progesterone balance, as well as blood sugar metabolism.
Dr. Kaley Bourgeois
“Panel recommends changing name of common disorder in women.” NIH News. National Institutes of Health, 23 Jan 2013. Web. 25 Jan 2013. <http://www.nih.gov/news/health/jan2013/od-23.htm>.
~No grains~No dairy~No problem~
1 1/2 cups almond meal
1/2 cup flax meal
5 large eggs
2 tsp baking powder
1 1/2 tsp sea salt
2 tbsp melted coconut oil (76 °F)
Want to spice it up?
1 1/2 tsp ground ginger
1 tsp ground cinnamon
1/4 tsp ground clove
1 tbsp honey
1/4 cup crystalized ginger candy, chopped (optional)
Pre-heat oven to 350 °F
Combine almond meal, flax meal, baking powder, salt and additional spices (optional) in a large mixing bowl. Once mixed, blend in coconut oil, eggs, and honey (optional). Scoop dough into a medium sized bread loaf pan, pre-greased with coconut oil.
Bake for 25 minutes at 350 °F
Cool. Slice. Devour.
Dr. Kaley Bourgeois
For young women living with Lupus, becoming a mother can be a challenge both emotionally and physically. As the disease progresses, there is an increased risk of miscarriage and pregnancy complications such as preeclampsia. Furthermore, pregnancy has been known to increase the risk of worsening symptoms and disease flares for the mother.
A recent study, spotlighted by the National Institute of Health earlier this month, suggests a healthy pregnancy and birth may not be far from reach for hopeful young women. If general health is supported prior to conception, and antibodies are reduced such that there is low lupus activity, there is a significant decrease in risk of pregnancy complications. Disease flares, especially, were less likely to occur.
While decreased disease activity during pregnancy lessens risk to mother and child, how the Lupus is stabilized is equally important. The conventional treatment of Lupus involves immunosuppressive medications that my be harmful to a developing fetus. Methotrexate, commonly used to treat Lupus, is known to cause birth defects and cannot be used during and after conception. Corticosteroids, conventionally given to pregnant mothers to reduce a disease flare, have an unknown effect on the fetus and should also be avoided. Both medications increase the risk of infection for the mother, and therefore the child.
Complementary and alternative medicine are often used in treatment of Lupus and other autoimmune conditions, and offer fewer side effects for mother and child. Below is an example of some research-based treatment options that may be used to treat Lupus before conception:
High Dose Vitamin D
Another study shared by NIH revealed high-dose vitamin D therapy to boost general immune function, while reducing activity of autoimmune cells, thereby reducing Lupus activity levels. As vitamin D is known to play a significant role in the brain development of a fetus, assessing for adequate levels in any future mother is important.
Omega-3 Essential Fatty Acids
Dietary supplementation of omega-3 fatty acids has a therapeutic effect on Lupus activity, as well as offering cardiovascular protection and benefitting fetal development.
DHEA is a mild corticosteroid made naturally in the body, and found to be low in Lupus patients. Supplementation to balance hormone deficiencies prior to conception may help to reduce symptoms and disease activity by controlling excessive inflammation.
Work with your healthcare provider to create the appropriate treatment plan for yourself and your future child. There are many options available for addressing autoimmune disease and supporting your overall health.
Questions? Feel free to contact us at Restorative Health Clinic, (503) 747-2021.
Dr. Kaley Bourgeois
Pregnancy Safe for Most Women with Lupus: Study. Nov 7, 2011. MedlinePlus, US National Library of Medicine-NIH, http://www.nlm.nih.gov/medlineplus/news/fullstory_118393.html
Vitamin D, Interferon Alpha Vaccine Show Promise Against Lupus, Nov 7, 2011. MedlinePlus, US National Library of Medicine-NIH, http://www.nlm.nih.gov/medlineplus/news/fullstory_118395.html
A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus. Ann Rheum Dis. 2008 Jun;67(6):841-8. Epub 2007 Sep 17.
Dehydroepiandrosterone suppresses interleukin 10 synthesis in women with systemic lupus erythematosus. Ann Rheum Dis. 2004 Dec;63(12):1623-6.
A recently published study in this year’s edition of Proceedings in the National Academy of Sciences suggests that biochemical changes resulting from metabolic syndrome likely increase breast cancer risk, independent from the role estrogen plays.
The research findings, based on a mouse model using a modified diet to induce metabolic syndrome in combination with estrogen-blocking medication, demonstrated that increased breast growth and tumors can occur independent of the commonly assumed cause: excess estrogens or xenoestrogens (such as plastics).
The male and female mice were fed a diet with high levels of Linoleic acid (in the form of 10,12,CLA) believed to induce a state of metabolic dysfunction mimicking metabolic syndrome as it is seen in humans. Estrogen blocking medication was given to the females so that only the estrogen-independent effects of obesity and diabetes type II were evaluated (elevated cholesterol, blood sugar and insulin resistance.)
It is well established that estrogen is responsible for stimulating breast growth, and it has long been suspected that outside sources (hormones in meat, xenoestrogens, etc.) are partially responsible for early breast development and an increased risk for breast cancer in adulthood. We now know that early onset diabetes and obesity-related changes can also increase breast cancer risk, even in the absence of estrogen.
These findings are significant, because they establish additional independent risk factors for breast cancer, one of the leading cancers among women. Metabolic syndrome (characterized by central obesity, hypertension, high blood sugar and fats) is already suspected of playing a role in certain pathologies related to estrogen imbalance; we know that adipocytes (fat cells) which accumulate in obesity synthesize their own estrogen and other hormones. Based on this understanding, it has been theorized that metabolic syndrome’s relationship to breast cancer may result primarily from changes in estrogen levels.
We must now acknowledge metabolic syndrome, and even obesity or diabetes type II on their own, as independent risk factors in the development of breast cancer (primarily in early development, but likely in all age groups). An increase in estrogen levels, secondary to obesity, is no less concerning based on this research and should not be overlooked. Rather, these individual findings in a patient (obesity, insulin resistance, high estrogen exposure) should be viewed as multiple, individual factors which combine to produce a greater overall risk.
Dr. Kaley Bourgeois
1. Grace E. Berryhill, et al. Diet-induced metabolic change induces estrogen-independent allometric mammary growth. PNAS. September, 2012.
2. Starche, S., Vollmer, G. Is there an estrogenic component in the metabolic syndrome? Genes & Nutrition, Vol. 1, pp. 177-188. 2006
A beloved beverage throughout the USA and the world at large, coffee is often blamed for various health woes. While coffee is not appropriate for everyone, and there is such a thing as “too much” for even the most tolerant of sippers, research has shown a vast array of health benefits.
The abundant phytochemicals found in coffee beans are responsible for the various benefits, including potential prevention of diseases such as Diabetes mellitus type II, Alzheimer’s disease and even cancer. Of course, we cannot overlook the well-loved stimulant effect of coffee that reliably provides us with increased stamina during exercise, and temporarily improves our cognitive function. Moreover, coffee simply makes mornings tastier.
Following is a brief overview discussing a few of the benefits to coffee consumption. These are presented in defense of coffee and as a thank you to its many active phytochemicals, including caffeine, caffeic acid, hydroxyhydroquine, chlorogenic acid, cafestol and kahweol.
Coffee consumption has been linked with a lower risk for Diabetes Type II.
The leading theory is that active compounds from the roasted coffee bean, including caffeine and caffeic acid, help to decrease the low-level inflammation associated with diabetes mellitus through anti-oxidant action. Coffee may not directly alter how your body metabolizes blood sugar throughout the day, but it does decrease your risk by lowering inflammation!
Coffee may increase total cholesterol, but it improves the LDL to HDL ratio.
A 2010 study found that regular coffee consumption increased total cholesterol, but much of this rise in blood lipids was due to an increase in the “good” cholesterol, HDL. The LDL (“bad” cholesterol) to HDL ratio actually improved. This suggests that coffee intake may offer cardiovascular protection in those with low to normal total cholesterol, and low HDL. Cafestol and kahweol, the coffee compounds believed to cause these effects, are highest in unfiltered coffee.
Six cups a days may prevent colorectal cancer.
A study published 2012 suggested that 4 daily cups of coffee can decrease your risk of developing colorectal cancer by 15%, while 6 daily cups may decrease your risk by as much as 40%. The study looked at nearly 500,000 middle-aged Americans, comparing their reported coffee intake to cancer outcomes over a 10 year period. Sadly, 3 cups or less per day did not significantly decrease risks of colorectal cancer.
Coffee can lift your mood, thanks to caffeine and possibly chlorogenic acid.
Caffeine is already established as a reliable, short term enhancer for cognitive function and mood. Recent findings suggest that chlorogenic acid, a component found in both regular and decaf coffee, may be involved in the mood-lifting effects of coffee. Caffeine or no caffeine, coffee may brighten your day.
Stamina, mood enhancement, and cholesterol aside, there are individuals who should limit or avoid coffee. This includes:
1. Individuals with hypertension, especially uncontrolled hypertension
2. Women who are pregnant, suffering from infertility, or symptoms of menopause
3. Individuals with high cholesterol
4. Children and adolescents
5. Individuals with known coffee allergy or food sensitivity
For those limiting their intake, most studies suggest health-altering side effects (both negative and positive) are not experienced with 3 or fewer cups of caffeinated coffee per day.
Dr. Kaley Bourgeois
1. Butts, MS, et al. “Coffee and its consumption: benefits and risks.” Crit Rev Food Sci Nutr. 51.4 (2011): 363-73. Print.
2. Cropley, V. “Does coffee enriched with chlorogenic acids improve mood and cognition after acute administration in healthy elderly? A pilot study.” Psychopharmacology (Berl). 219.3 (2012): 737-49. Print.
3. Higdon, JF, et al. “Coffee and health: a review of recent human research.” Crit Rev Food Sci Nutr. 46.2 (2006): 101-23. Print.
4. Johnson-Kozlow, M, et al. “Coffee consumption and cognitive function among older adults.” Am J Epidemiol. 156.9 (2002): 842-50. Print.
5. Kempf, K, et al. “Effects of coffee consumption on subclinical inflammation and other risk factors for type 2 diabetes: a clinical trial.” Am J Clin Nutr. 91.4 (2009): 950-7. Print.
6. Sinha R, et al. Caffeinated and decaffeinated coffee and tea intakes and risk of colorectal cancer in a large prospective study. American Journal of Clinical Nutrition. Published online June 13 2012