Picking apart PCOS (Part 3)
Do you have a tendency to gain weight around your middle? Or intense cravings for chocolate, bread, cakes, caffeine and alcohol? Do you feel tired a lot of time and particularly suffer with a mid afternoon energy slump? Or do you have brain fog and difficulty concentrating? Or perhaps you have noticed dark patches of skin or skin tags? These are all signs of insulin resistance. The majority of women with PCOS suffer some degree of insulin resistance but before explaining this link I’ll just run through the basic science on insulin.
Insulin is a hormone which helps us store energy. When we eat carbohydrates, they are broken down into sugar which is absorbed into our bloodstream causing the level of sugar in our blood rises. Highs and lows of blood sugar are not good for us so we have a mechanism to regulate the level. When then level becomes high, our pancreas notices the increased blood sugar level and releases insulin which moves the sugar into our cells to be used stored or used as energy, thereby lowering our blood sugar level again. Effectively, insulin knocks on the cell door asking the cell to let the sugar in.
However, in a state of insulin resistance our cells stop responding to the insulin. The pancreas continues to pump out more and more insulin in an attempt to move glucose into the cells. The result is high levels of blood sugar and high levels of insulin. This is associated with weight gain and inflammation (see previous post). Inflammation also increases insulin resistance so a vicious cycle can take hold. Increased insulin = increased inflammation = increased insulin resistance = increased insulin…
Increased insulin levels is also very bad news for your other hormones and this is where the link with PCOS comes in. Insulin aggravates your ovaries and adrenal glands causing them to produce more androgens and stimulates the pituitary gland to produce luteinising hormone, LH (higher than normal levels of LH is one of the hormonal imbalances in PCOS). Increased insulin also causes a drop in production of a protein called sex-hormone-binding globulin (SHBG). Normally this protein ‘binds’ to sex hormones like testosterone but when its production drops because of increased insulin levels it can lead to uncontrolled levels of testosterone.
Therefore, every PCOS programme focuses on balancing insulin levels. A diet low in sugar and refined carbohydrates is key to balancing insulin levels but so is exercise. Studies have shown that just seventy five minutes per week or vigorous exercise can significantly improve metabolic health for women with PCOS. I recommend starting with this seventy five minutes weekly as a baseline and increasing from there. A number of supplements can also be very effective for balancing insulin levels. There are too many important nutrients to mention them all in this post to name a few…
Vitamin D is directly associated with insulin resistance so checking you have optimal vitamin D levels is important and supplementing if you don’t. Chromium and selenium are important nutrients for treating insulin resistance. A good multi vitamin should contain chromium and selenium. Cinnamon is also a favourite supplement of mine for insulin resistance. A dose of 1.5 grams per day has been found to significantly improve insulin sensitivity in women with PCOS. A lot of the breakfast ideas that I recommend incorporate this important spice.
The changes made on a PCOS programme to support insulin sensitivity usually result in weight loss in a natural, sustainable and healthy way. This then further improves insulin sensitivity (since increased weight results in increased inflammation which results in increased insulin resistance).
In the next post, I’ll be covering the role of our adrenal glands in hormonal harmony and how we can better support these important glands.