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.

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 🙂