Skinny with PCOS
My daughter has always been skinny, and yet she does suffers with PCOS, since the age of 18.
Everywhere I look, the problem refers to overweight women.
The question is; what should slim and underweight women do to follow your suggestions while managing to maintain their weight, and in my daughter's case, even gain some weight.
She is 35 years old, 5foot 3 inches, and is 100 lbs.
Her cortisol level is 1.5. She is following a Low Glycemic, organic diet, takes supplements, vitex, saw palmetto and everything else you suggest.
Where can we find physicians that treat PCOS naturally, in Northern New Jersey 07043?
I look forward to hearing from you.
Editor's comments: In the PCOS population, lean women are a significant and under-recognized minority.
It is especially difficult for a health professional to determine the best course of action.
You might try consulting with an endocrinologist in your area. Lab testing will at least reveal some possible hormone imbalances that can be treated in some way.
I have no magic solutions for lean women, such as "lose weight". I can only offer some thoughts. It sounds like she is already doing most of the right things.
1) Regardless of overweight or lean, always have your vitamin D levels assessed with a lab test. Vitamin D must be normalized. Ideally, the vitamin D level would be in the middle of the range of "normal". Not at the bottom of the normal range. The middle.
2) In spite of not being overweight, lean PCOS women may have excess belly fat. This is a tipoff for possible insulin resistance, chronic inflammation, and/or chronic stress. All of these possibilities should be investigated.
Insulin function can be tested.
Chronic stress is trickier. It is hidden and very subtle. It should NOT be underestimated! It's important that she reduce all sources of stress. That includes self-esteem issues, which are a source of stress. The Natural Diet Solution for PCOS and Infertility has a fairly extensive chapter on stress.
The (stress hormone) cortisol reading of 1.5 doesn't mean much to me. What time of day was it taken? Cortisol goes up and down over a 24 hour period. It's more valid to take a series of four cortisol readings over the 24 hour span. Was the sample based blood, urine or saliva?
3) Chronic inflammation can be present in lean as well as overweight women with polycystic ovary syndrome. Chronic inflammation causes the ovaries to increase production of male hormones (example testosterone). The high levels of male hormones cause many of the symptoms that comprise polycystic ovary syndrome. Her diet -- what she eats and drinks -- has a profound effect on inflammation.
4) If she is lean -- but is found to have insulin resistance -- she needs to start an intensive exercise program. Exercise, the more intense, the better (within health limitations), is critical for reducing insulin resistance. Reduction of insulin resistance relieves all symptoms.
Don't worry that a healthy diet and lots of exercise will make her lose weight. Weight is not the primary issue. Her hormone balance and health is the primary issue. If she combines diet and exercise, she may lose some weight -- or maybe none. Remember, as she loses fat and gains muscle mass, her weight should stabilize, because muscle is much heavier than fat.
Please keep in mind that "lean" women may have too much fat. In other words, relatively sedentary women frequently have fat that has infiltrated into the muscle tissue. As muscle cells atrophy, fat fills those spaces. So a lean person can have a body fat percentage that is way too high. Just because someone "looks" lean does not mean that it is a "healthy lean". A woman can be lean and have too much fat.
The way to determine this is to get a body fat percentage test.
5) Just like overweight women, lean PCOS women can also have problems metabolizing a B-vitamin called "inositol". Supplementing with inositol or d-pinitol (a cousin of inositol) has been shown to improve symptoms and help restore a normal cycle.
6) She could have an environmental chemical overload. For example, lean women with PCOS have 1.6 times the amount of BPA than other lean women do. BPA (bisphenol A) is a known estrogenic hormone disrupter. There are lab tests for identifying possible environmental chemical overload, but not every doctor knows about them or how to use them. Even if they are identified, it is very difficult to remove them. A detox specialist would need to be consulted.
Please note that BPA passes from the mother to the fetus. Environmental chemicals are a serious threat to your health and a hidden cause of PCOS symptoms that nobody is talking about. Almost nothing is being done to actually reduce the total chemical pollution burden that we are all carrying.
7) If insulin resistance is identified in lean women, the doctor is likely to prescribe metformin. However, according to research evidence, metformin is less effective in lean women. And -- metformin has side effects, like a vitamin B12 deficiency.
8) If she is following the recommended diet in our PCOS diet e-book, she can add legumes and beans to the diet, which would increase her carbohydrate intake. The increased carb intake should help her to maintain weight. Quinoa and brown rice are other possibilities. However, the higher the carb-to-protein ratio, the more difficult it may be to reduce insulin resistance, which is a root cause for the majority of cases of PCOS.
Considerable experimentation is required in order to find the best dietary balance for her.
These are just some thoughts that occurred to me, based on what little you've said.