DOGMA – A new PCOS theory

So I was doing more Google research on PCOS. The latest results I got from the doc showed everything was ‘normal’ and I was not insulin resistant. Or have high testosterone levels. Or biochemical hyperandrogenism. I have symptoms but no apparent biochemical reason for it. PLUS all the current recommended treatments for PCOS focus on the traditional PCOS phenotype – obese, IR and looking to conceive.

Okay, that’s my mini rant and I promise it does become relevant soon. So I’ve just finished moving house with the high stress levels and my diet/supplements going straight out the window I’m now on a 61 day cycle. I also got a mild case of thrush and started looking on the net for links to PCOS and stress in cases of thrush.

In my search I found a little bit of new information I hadn’t previously read, mostly from testimonials of very happy PCOS cysters. Women were telling the world about their treatment of candida and the subsequent (successful) treatment of their PCOS symptoms. The scientist in me is always skeptical of personal testimonials however in my research of PCOS it seems most of the evidence is in this form. Clinical trials are mostly small and focused mostly on the typical PCOS phenotypes and traditional treatment options (lifestyle, OCP’s, Metformin etc).

Then I came across a single paper that intrigued me. It’s clearly research in it’s early stage but does describe a new possible theory as to the development of PCOS known as Dysbiosis of Gut Microbiota (DOGMA). I also found an application for a clinical trial to take place in Australia that has been submitted in Nov last year. So maybe there’s something to this link between gut flora and PCOS.

Anyways, I needed to treat my thrush so I decided to make myself a guinea pig and follow the pathway I read about from Cara here http://optimalhealth.homestead.com/pcos.html. Three days ago I took my single dose of fluconazole (diflucan) and started on Ethical Nutrients Inner Health Plus.

And my first cycle in 61 days started this morning.

Looking good so far…….

So I’m going to continue with the probiotics for another month and see how regular my cycles become. If it turns out that I get back onto 28-30 day cycles believe me I’ll be shouting from the rooftops the success of probiotics. But still need to establish a pattern to my satisfaction. It certainly shouldn’t do any harm.

And nothing else has been working so far.

Keep you all posted 🙂

P.S  I know I’m late on my 60 day update so I’ll post an update on my PCOS journey once I find my scales and measuring tape in my new house. I’m sure they’re in there somewhere.

Reference:

Tremellen, K. & Karma, P. (2012). Dysbiosis of Gut Microbiota (DOGMA) – A novel theory for the development of Polycystic Ovarian Syndrome. Medical Hypotheses, Volume 79, issue 1 (July, 2012), p. 104-112.

How I beat my sugar habit (almost)

Biscuit Plate (Photo credit: Caro Wallis)

One of the things I hear most about women with PCOS is we seem to be drawn towards all things sweet and sugary.  Seems to be part and parcel with all the other delightful things that come with this disorder.  Despite the fact I still indulge in treats from time to time,  I’d like to share how I tackled my sugar addiction.

1) Identify your weak spot.
There was always a time and place where my need for sugar was too easy to satisfy.  For me that was morning tea at work.  Even though I didn’t buy any biscuits or cakes for home,  there was daily temptation in the tearoom. I could easily have a couple of biscuits with a cup of tea and forget that I would suffer for it later when my blood sugar crashed or I was simply starving by midday. So this was one small area I felt I could work on.
2) Set a limit.
Rather than go cold turkey,  I decided to set myself a ration of one biscuit in the morning and one in the afternoon.  This worked to cut down my intake but my cravings weren’t curbed in the least. And I relapsed on more than one occasion.
3) Find a substitute.
Finally I decided that if I had something else to eat for morning tea that would keep me full till lunchtime and keep me away from the biscuits then maybe I can finally get some control over my biscuit habit. There are many Low GI cookbooks in my collection that have cakes and other tasty treats that substitute out flour or sugar with Low GI alternatives like oat bran and honey. So I made myself some lovely Banana and Sultana Bread and started bring a slice to work.

Well with my cake and tea, I still looked at the biscuits but didn’t NEED to eat them.  Saying ‘no’ became easier and I stopped being hungry so soon before lunch.

Today I still have the occasional treat and dessert now and then but don’t have cravings that make me head to the supermarket at 10pm in search of chocolate. So here are a few other tips others might find useful

:

This image was selected as a picture of the week on the Czech Wikipedia for th week, 2007. (Photo credit: Wikipedia)

• Don’t keep sweets in your house, out of sight out of mind right…..

• Be sure to have nice Low GI snacks available when the munchies attack. Some of my personal favorites include peaches with low fat yoghurt or a non-salted mix of seeds, dry fruit and nuts.
• Treat yourself occasionally. Have an ice-cream on the weekend once in a while but keep it small and special
• If you really need a chocolate hit, go dark. Chocolate with high cocoa content not only has a stronger flavour so it’s harder to over indulge but greater health benefits when compared to milk chocolate.

Hopefully these few tips help out. Now pass the Caramel Crowns ………… 😉

My journey – 30 days in

Can’t believe it’s been 30 days already since I started off this journey. I decided on monthly weigh-in/measurements since it takes forever to see any real changes and my weight can fluctuate week to week much more.

Here’s a summary of my weight-loss PCOS self-treatment to date:

• Low GI diet with some restriction of grain intake (no grains with evening meal)
• Crossfit 2-3 times a week (worked up to 3x week)
• Supplement with 4g myoinositol (will blog on this soon)
• At least 8 hours sleep a night, try not to sleep in too much

So here’s my numbers after 30 days –

Weight: 59.4kg (no change)

Bust: 98cm (no change)

Waist: 77.5cm (0.5cm loss)

Stomach: 88cm (1.5cm loss).

So as expected I didn’t lose any weight but I’m not too concerned with this. It would be rare for me to lose more than a kilo over a 6 month period so being stable is fine with me. Especially since I’ve lost some cm’s off my torso. So slowly but surely I’m losing fat but (hopefully) being replaced with muscle.

Pretty happy with this. Of course I would have loved to see a kilo come off the scales but I have to be realistic. Let’s see if I stick with this regime that I can see these results consistently 🙂

Crossfit Revisited

 

Image: Darla Hill
http://s372.photobucket.com/user/darlagrl/profile/

So I’ve decided to stick with Crossfit for the time being.

I finished up my beginner program and actually felt a sense of achievement with the last session. I was in with two other girls who were there for the first time, so my lovely trainer made me do EVERYTHING in the workout while the other girls got to go a little easier. I think that’s one of the best features of Crossfit, the trainers are really aware of what each individual is capable of, they will push you when they think you can handle it but also bring down your workload when you’re just starting off.

Today was my first real Crossfit session with other (much fitter) people. There was a huge cross section of people, mostly women but a few men there too. Ages ranged from twenties to those with grey hair. And I finished the workout without being sick or falling over.

Now I’ve actually begun to do Crossfit workouts I can talk more in details than I did in the last post. Each session goes for an hour but you’re not working at high intensity for the whole time (phew!). After a warm-up we do some strength training, this often involves trying to see how heavy you can lift for a particular exercise. Then the workout. This is pure high intensity, duration from 5 – 20 mins long. The workout can be either a set time where you do as many rounds as you can or you might do a workout for time and try to break your own record.

Every session is different and every Crossfit gym worth their salt will come up with their own WOD (Workout Of the Day). Individuals can look on the official Crossfit website http://www.crossfit.com to see their WOD or some gyms will publish their own WOD.

For those with PCOS, not a lot of research has been done that I can find for what kind of exercise works best for us but some have suggested that HIIT and weight training (both features of Crossfit) can be very beneficial for both fitness and for weight loss.

So if you want to push yourself with a friendly group of people and aren’t afraid of some big weights, then give Crossfit a go. It can be expensive but often they do subscriptions that give you unlimited access to classes. So going 3 times a week can be worth your while, certainly not less than that. Also be sure you go with an accredited Crossfit gym that offers a beginner program to get you started.

Now to go finish my protein shake and lie down 🙂

Needle sticks and sugar drinks – Testing for PCOS

I’m feeling a little tired, hungry and have several needle marks in my arms.

Yup, more testing for PCOS for me.

One of the reasons that PCOS is often so hard to diagnose is that it’s a condition by exclusion. There’s such a mixture of symptoms that people with PCOS can have some symptoms but not others. As a result there is no one simple test to determine if someone has PCOS.

I’ll use my own case as an example. When I went to my first doctor to discuss my range of symptoms, PCOS wasn’t considered a serious possibility because I wasn’t a ‘typical PCOS looking woman.’ Nicely put, I wasn’t obese. I’ve never been obese but have always had the belly fat so familiar to us cysters. I’ve also had the typical range of blood tests performed when PCOS is suspected and all my results have come back in normal range.

I think the only reason I got my diagnosis this time round is because I went to a fantastic women’s ultrasound imaging clinic who found my many many follicles that were missed in the first ultrasound. So my first tip from this post is this: get a good ultrasound, if possible go to a clinic that specialises in women’s reproductive imaging. I’m pretty sure I didn’t go from 8 to 25 follicles in two years.

My second tip: Don’t rely solely on blood work. Remember your physical symptoms (body hair, weight gain, acne) all matter, you can have healthy blood work and STILL have PCOS.

Both times I’ve sought advice for PCOS I was sent for the standard tests to help diagnose PCOS and to eliminate other possible options for some PCOS symptoms. There’s a few websites out there that give more details about testing for PCOS such as

http://www.labtestsonline.org.au/understanding/conditions/pcos/start/2

but I’ll include a quite summary here.

Blood tests typically look for common biochemical signs of PCOS. Blood glucose and insulin, lipid profile (LDL and HDL), cholesterol and sex hormone levels (FSH, LH, testosterones and estrogen) are all measured since the levels and sometimes ratios between various hormones (such as FSH:LH ratio) can be indicative of PCOS. Thyroid function and DHEAS are checked to rule out thyroid disorders or an adrenal secreting tumor. These tests are all performed in one go and require blood to be taken after fasting.

Some doctors may send you for an oral glucose tolerance test, which some believe is a more reliable way to test for signs of insulin resistance or impaired glucose metabolism than simply testing for blood levels at a single point in time. And that takes up to today.

I finally got around to getting my OGTT test done. It takes about 2 hours in total since you have blood sampled after fasting then you’re given a glucose drink to down in ~5 min. Some people think this drink tastes bad but mine was like flat lime soft drink. But it did make me feel sick, that much sugar on an empty stomach will do that to some people. Blood is taken after 1 and 2hrs so be prepared for lots of needles. The aim is to see how your body processes sugar over time hence the multiple samples taken.

So hopefully this test will make it clear whether all my blood sugar related symptoms I’ve suffered from for 20 years is due to insulin resistance. Here’s hoping 🙂

Can I eat that? What about that?

When I first discovered PCOS and it’s link to diet, I began looking into various dietary strategies to be used for weight loss and generally controlling the symptoms of PCOS. This next statement should come as no surprise to any of us cysters who have searched in vain for dietary advice:

Nobody can agree on what we can and can’t eat !!!

You would think for a condition that is affected so strongly by diet there should be a simple list of do’s and don’t as far as diet is concerned. Sadly for us, it appears that what works for one woman won’t work as well for another. I’ve seen in many other blog posts and websites that many people advocate certain dietary plans as THE plan that will work to treat PCOS. Low Carb seems to be the most popular from what I’ve seen. Then again from many of the books I’ve read, Low GI seems the way to go. These seem to be the two most popular dietary plans used for women with PCOS. For what it’s worth, here’s my two cents:

I’ve heard great things about Low Carb diets especially from the scientific perspective. Keeping your carbs low in theory should lower your body’s insulin response hence reduce many of the undesirable effects of high insulin levels. It also appears to be a great way to lose weight fast. When I tried it (twice) I found my blood sugar issues I’ve had for most of my life get WORSE on Low Carb diets. Even though I don’t crave sugar per say, it’s more that I get those lovely hypoglycemic attacks a few times a week when cutting out most carbs. And that’s looking at 120g carbs a day, forget the ultra low levels such as 40g per day some women get away with.

When I was first tested for PCOS, I purchased a book called “The Low GI Diet for Polycystic Ovarian Syndrome” by Prof Jennie Brand-Miller. She’s been a long time advocate for Low GI dieting and as written a series of books for Low GI dieters as well as co-authoring a few Low GI cookbooks. Firstly there’s a heap of helpful information for women with PCOS in easy to read language and covers most of the basics on the disorder. She also lays out some basic tenants on eating Low GI for treaing PCOS.

For a year I followed her tips on switching high GI carbs to low GI carbs and, even though I lost no more than a kilo within a year, my measurements at the gym showed I’d lost about 9cm off my stomach and 12cm off my bust. And I hardly noticed.

Unfortnately I went back to study and switched to Lite n Easy meals since I had no cooking time. And that weight has gone straight back on. That’s not a dig at Lite n Easy at all, just that meals with mostly potato and pasta just aren’t good for my body.

So, for me Low GI is the way to go. For some of you, this might work too. For some Low Carb might be your silver bullet. Best (non-medical) advice I can give you, try it and see how your body reacts. And give it time, these are lifestyle changes and not going to make you a supermodel overnight.

For those who are tempted into a low GI diet, here are my basic guidelines:

• Choose low GI carbs, especially lots of fruit and veggies (avoid potato though)
• Use Basmati rice or grains such as pearl barley or quinoa.
• Eat lean meat, fish, legumes, nuts (as snacks) and low-fat dairy (more on this in a later post)
• Keep processed food to a minimum (my doc advised me to avoid pasta even though it’s technically Low GI)
• Sugar is okay in small amounts, but suggestions involve switching to floral honey, Low GI cane sugar or natural alternative sweeteners such as Steevia (can’t stand this stuff myself)

One more suggestion from my doc is to limit my carbs from grains to earlier in the day and keep my evening meal to a meat/fish and veggie/salad mixture. Again these are just guidelines for myself. If you’re interested in reading more on Low GI I again recommended Jennie Brand-Miller’s books (Available on Fishpond or Amazon). There’s also a lot of web information if you want to try it.

For those on the Low Carb bandwagon, I’m a frequent visitor to Anne Seccombe’s blog My PCOS Info http://www.mypcos.info/1/ . She has a huge variety of PCOS infomation and does advocate a Low Carb diet as treatment.

Happy Eating all 🙂

Crossfit just kicked my arse

So I just got back from a introductory trial session at my local Crossfit gym. And as my title suggests, I’m knackered. My legs are sore already and I had a mild asthma attack due to my very poor cardio fitness right now. But I can certainly see this program working to improve fitness, that’s for sure.

For those of you who aren’t familiar with Crossfit, it’s basically a fitness program based on high intensity and constantly changing workouts using whole body, functional movements. No two sessions are the same and you work as hard as you can go with the program set for the class each session. If you’d like more information or a more specific (and accurate) description then visit http://www.crossfit.com or Google to find a local Crossfit gym.

Now if you’re like me you may have searched the Net looking for information on treatment of PCOS through various lifestyle changes. There’s a reasonable amount on diet but hardly any on exercise. (If anyone reading this happens to know of any resources on PCOS and exercise, please feel free to message me.) I’ll be posting a blog soon about PCOS and exercise but for now I’m sticking with Crossfit.

IMO, I think Crossfit could be greatly beneficial to women with PCOS. You would burn heaps of calories and build muscle which increases your resting metabolism. The downside is a) it’s expensive when compared to a gym and 2) it’s HARD to start off. I’m sure if I kept going back I’d get better and start to really enjoy it. So at this stage I think I’ll sign up for a beginner session (3 classes) and see how that flys.

Let’s just see if I can walk tomorrow and then decide on my course 🙂

The journey begins

Hi all,

Welcome to the first post of my new blog 🙂 This blog is intended to be more a diary of my ongoing self-treatment of my PCOS but hopefully over time I’ll include more general information of diet, exercise, lifestyle modification and recent research around PCOS that might be more useful to some of you. So if you’re interested in my story, read on. Otherwise, stay posted.

First off a little about me. My name is Carlie, I’m a 32 year old Aussie (settled in Melbourne), a recently unemployed chemist (the one makes drugs in a lab, not the ones that work in a pharmacy) and part-time student.

I was diagnosed with PCOS a few months ago after a 2 year wait, 2 doctors, 3 sets of tests, 2 ultrasounds and lots of internet research. I’d always had irregular periods which didn’t really bother me until I’d settled down into a long term relationship with my current partner. Having no period for 3 months can be unsettling when you’re not wanting children any time soon.

My first port of call was my reliable GP. She was the first that suggested PCOS but, after normal bloodwork and no sign of polycystic ovaries (PCO’s) her comment was to ‘come back when I wanted to get pregnant’. I didn’t want to get pregnant, I wanted to get healthy.

Two years later, more weight gain (it had been creeping up on me by about 1-2kg per year) and another 3 month period absence, I went to a women’s health clinic near my work. Same tests but this time my ultrasound showed 25 follicles per ovary (the threshold for PCO’s is 12). So despite my normal hormone, insulin and blood sugar levels I finally got my diagnosis.

Unfortunately, I realised my journey back to health was just beginning. The advice from my doctor was to ‘lose weight, about 3-5 kg’. No medication was recommended, which I’m not disappointed with, and she had a few dietary tips for me but nothing I hadn’t found on the internet before, even some that conflicted with what I had read.

I’m sure many of the cysters out there can relate to this frustration. Telling someone with this condition to ‘just lose weight’ can feel like a kick in the guts. What the hell do you think we’ve been trying to do??? It’s VERY difficult for us PCOS girls to just lose weight. It hangs around no matter how hard we diet or work out.

Okay, rant mode off and back to the present day. Lucky for me I’m considered ‘lean PCOS,’ so I’m not obese but still have a desire to lose a little bit of weight, to regulate my periods and to feel better about myself. So like most things in life, I’m doing it myself. And it starts with this blog.

With my sister getting married in a year I certainly have a motivating factor and a timeframe to make some lifestyle changes. But I want to do this for me, not for my family, boyfriend or anyone else. And I don’t want to be thin, I want to be healthy.

So here’s the plan as I see it now:

Currently I weigh in at 59.4kg, bust at 98cm, waist at 78cm and belly at 89.5cm. These measurements need to come down. The weight may not budge much but getting to 55kg would be fantastic.

I’ve been eating a low GI diet for a few years now but had eliminated pasta on advice from my doctor, as well as keeping any low GI grain to lunch rather than later in the day.

I’ll be signing up for CrossFit to get my lazy arse into gear and get some fitness happening. With no job I have no excuses anymore.

So for those of you who have made it this far, stay tuned for updates on my progress, in between other more general posts.

Smile and stay beautiful all xoxo