PCOS Cure Diet
A woman with elevated androgen levels is at a higher risk for developing breast cancer and other hormone-dependent diseases. Specific correlations with deleterious androgenic effects have been associated with increased levels of dehydroepiandrosterone (DHEA), DHEA sulfate,3 androstenedione,4 and testosterone concentrations. However, the correlation of DHEA and breast cancer has not been substantiated in other research, and it appears that testosterone has an indirect effect on breast cancer risk, via its influence on the amount of bioavailable estrogen.5 Hyperandrogenism is associated with decreased SHBG, polycystic ovary syndrome, and insulin resistance.6 (See Chapter 29 on polycystic ovary syndrome.)
Oral contraceptives are commonly used to treat symptoms associated with hyperandrogenism, such as acne, hirsutism, and hair loss. An estrogen-progestin combination suppresses LH, which, in turn, decreases androgen levels and increases SHBG levels. Increasing SHBG decreases the amount of bioavailable testosterone. Estrogen also suppresses sebaceous cell function directly. The form of progestin is an important consideration because some forms are more androgenic than others. Desogestrel and norgestimate are both low androgenic forms of progesterone and are commonly used for women with PCOS.45
Nutrient and Herbal Interventions for Polycystic Ovary Syndrome Chromium is a trace element commonly used for blood-sugar balancing. Chromium in the trivalent form is found in many foods such as whole-grain products, egg yolks, coffee, nuts, brewer's yeast, meat, green beans, and broccoli. Chromium deficiency often presents with impaired glucose, insulin, and lipid metabolism. Research has demonstrated that chromium supplementation reduces glucose intolerance and relieves symptoms of type 1 and type 2 diabetes, as well as those of gestational diabetes.47 The proposed mechanism of action for the insulin response to chromium is focused on the insulin receptor. Chromium activates the insulin receptor tyrosine kinase and inhibits the insulin receptor phosphotyrosine phosphatase enzyme. This causes increased phosphorylation of the insulin receptor and increased insulin sensitivity and may facilitate glucose transport into cells.48 In addition, chromium may augment insulin...
Essential fatty acids cannot be made by the body and thus need to be consumed in the diet. Omega-3 fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) and omega-6 fatty acids such as gamma-linolenic acid (GLA) are often taken as supplements because of their strong anti-inflammatory action. EPA and DHA are present in high amounts in fish oils and produce anti-inflammatory and antithrombotic effects. Specifically, EPA has cardioprotective effects, such as decreasing triglycerides and increasing high-density lipoprotein (HDL).60 As previously mentioned, women with PCOS often have hyperlipidemia with elevated triglyceride levels and low HDL levels. EPA and DHA decrease inflammatory ei-cosanoids by competing with arachidonic acid (AA) in the lipo-oxygenase and cyclooxygenase pathways. GLA is commonly found in borage (Borago officinalis) seed oil, evening primrose (Oenothera spp.) oil, and black currant (Ribes nigrum) oil. GLA metabolites decrease the inflammatory...
Levels of sex-hormone binding globulin, as previously mentioned, play a role in numerous conditions. Low levels are associated with hormone-related conditions such as breast cancer, polycystic ovary syndrome, and insulin resistance. Furthermore, decreased levels of this protein are associated with cardiovascular risk factors as well. A recent study showed that low SHBG is significantly associated with metabolic syndrome, increased triglycerides, and decreased high-density lipoprotein (HDL) in men and women. In women, decreased SHBG was also associated with elevated apolipoprotein B and diabetes.10 SHBG has also been shown to inhibit the estradiol-induced proliferation of breast cancer cells.11
The mechanism of a plasmid-encoded copper resistance 200 in E. coli is based on an efflux mechanism. The efflux proteins are expressed by plasmid-bound pco genes (structural genes, pcoABCDE and the regulatory genes pcoR and pcoS), which in turn depend on the expression of chromosomal cut genes. Two cut genes, cutC and cutF, were shown to encode a copper-binding protein and an outer membrane lipoprotein 201-206 . In Pseudomonas syringae, resistance to copper via accumulation and compartmentalization in the periplasm and outer membrane is due to four proteins encoded on the plasmid-borne cop operon.
Many studies have indicated that either insulin resistance or endocrine dysfunction can cause the symptoms associated with this condition.2 Many theories have been suggested to explain the primary defect that causes PCOS pathology. They include abnormal insulin action and secretion, endocrine abnormalities causing an increased luteinizing hormone (LH) pulse frequency and amplitude, increased androgen production from the ovaries, and abnormal cortisol metabolism.2 There is also evidence that genetic factors play a role in PCOS.3 Eating disorders, such as bulimia and binge eating, have also been associated with this condition.4
PCOS involves metabolic, endocrine, and clinical manifestations. Studies have suggested that 75 -80 of women with PCOS have irregular menstrual cycles. These women typically have five to nine menstrual cycles per year, ranging from 40-65 days in length. Increased androgens cause hirsutism in 60 -80 as well as alopecia in 40 -70 of these women. Acne is also increased and prevalent in 40 -60 of women with PCOS. Obesity is common in this condition, and studies have suggested that 75 of women with PCOS are overweight or obese.5 These women often have increased abdominal adiposity with an average waist-to-hip ratio of 0.86.6 Of these overweight women, an estimated 10 have acanthosis nigricans, commonly found in the axilla, nape of the neck, and skin folds. Increased prolactin can also cause breast discharge in 8 -10 of affected women. Finally, sleep apnea may also occur in approximately 8 of women with PCOS.5 Other endocrine diseases with similar symptoms must be ruled out in order to...
Metformin hydrochloride is commonly prescribed to treat insulin resistance and glucose intolerance. This drug reduces fasting glucose levels and improves oral glucose tolerance in patients with type 2 diabetes, possibly by reducing glucose output from the liver. Studies performed on women with PCOS showed that metformin not only improved glucose tolerance but also reduced total testosterone and free testosterone, and increased the levels of SHBG.39 However, conflicting results in similar studies demonstrated that weight and obesity also play roles in the effectiveness of metformin, showing decreased effectiveness with increasing weight.40 A study on women with PCOS and oligo-ovulation showed that treatment with metformin caused 23 of the patients to ovulate.41 When metformin was combined with clomiphene citrate, the ovulation rate jumped to nearly 90 compared to 12 of women who took a placebo.42 Continuing metformin while pregnant has also been shown to decrease the rate of...
Saw palmetto (Serenoa repens) is an herb commonly used, because of its antiandrogen and antiinflammatory properties, for treating benign prostate hypertrophy (BPH). The lipid portion of the berries is used medicinally to produce these effects. Studies have shown that saw palmetto inhibits 5 alpha-reductase in the prostate, which decreases conversion of testosterone to the more potent form dihydrotestosterone.67 Although saw palmetto has not been studied as a PCOS treatment, the herb's antiandrogenic activity may be beneficial for patients with the condition. Soy (Glycine spp.) protein extracts and isoflavones produce many beneficial effects to treat PCOS symptoms. There is evidence that using soy products as supplements to treat individuals with type 2 diabetes decreases fasting glucose, fasting and postprandial insulin, insulin resistance, triglycerides, low-density lipoprotein, and hemoglobin A1c.68-70 In addition, studies have indicated that increased soy intake decreases risks of...
Dietary changes and weight loss have been shown to have profound effects on the symptoms of PCOS. Research has indicated that even modest weight loss improves insulin sensitivity, menstrual-cycle regularity, and fertility increases SHBG and decreases circulating androgens.77 In addition, weight loss has been shown to decrease ovarian volume, number of follicles, and spontaneous abortion rates.78 PCOS.79 Fasting and postprandial insulin levels were improved in women with PCOS on a moderately low carbohydrate diet.80 Another study with women with PCOS showed that a low-carbohydrate ketogenic diet for six months led to a decrease in fasting insulin levels, percent of free testosterone, LH FSH ratio, and weight.81 Diets high in fiber have been shown to decrease insulin resistance in overweight or obese women as well as in healthy adults.82,83
Antiandrogens, such as spironolactone, are used to treat symptoms such as acne and hirsutism. This drug can cause menstrual abnormalities thus, it is commonly used in conjunction with oral contraceptives. Other antimineralcorticoids, such as flutamine and cyproterone acetate (not available in the United States), have been effective for treating symptoms associated with androgen excess.45 Newer oral contraceptives, such as Yasmin, which contains
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