Unveiling the Hidden Truth of PCOS: Hyperinsulinemia, the Real Root Cause
Introduction
Polycystic ovary syndrome (PCOS) affects numerous women during their reproductive years and is linked to various health complications, including metabolic syndrome, cardiovascular disease, and type 2 diabetes. While hereditary and environmental factors contribute to its onset, insulin resistance emerges as a pivotal player in the pathogenesis of PCOS. This blog post, authored by Dr. Ken Berry, a seasoned family physician with 20 years of clinical experience, delves into the potential benefits of a ketogenic Mediterranean diet with phytoextracts (KEMEPHY) on PCOS management. We will explore the findings from a recent study and empower women with actionable steps to address the root cause of PCOS effectively.
The Real Issue with PCOS Diagnosis and Treatment
Navigating the journey of PCOS diagnosis and treatment can be arduous and frustrating for many women. Shockingly, it takes an average of 7 to 11 years to receive a proper diagnosis, leaving patients in the dark about their condition for far too long. Furthermore, doctors often focus solely on managing symptoms with medications, overlooking the vital aspect of addressing the root cause behind PCOS.
Misconceptions and Naming Confusion
The misnaming of PCOS adds to the confusion surrounding the condition. Originally termed as Polycystic Ovary Syndrome, it was named at a time when understanding hormones and endocrinology was limited. Contrary to the name, the so-called "cysts" are actually follicles and do not cause PCOS. Only a tiny percentage (1-5%) can be attributed to genetics, while a similar fraction can be linked to maternal metabolic health and diet during pregnancy.
The Missing Link: Hyperinsulinemia
Now, the spotlight shifts to the primary culprit: hyperinsulinemia. This condition involves chronically elevated insulin levels in the blood, disrupting the delicate hormonal balance. As a result, hormones like DHEA, total testosterone, estrogen, and cortisol go awry, triggering various PCOS symptoms such as irregular periods, acne, and hair issues.
The Overlooked Diagnosis: Hyperinsulinemia Testing
Despite its significance, hyperinsulinemia often remains undiagnosed by healthcare providers. Vital lab tests, such as C-peptide and fasting insulin, are often overlooked, depriving patients of essential information about their condition. Raising awareness about these tests can lead to a more accurate diagnosis and effective treatment.
Understanding the Role of Diet in Hyperinsulinemia
The connection between diet and hyperinsulinemia is undeniable. Certain foods, particularly highly processed carbohydrates filled with sugar and refined grains, lead to a rapid spike in insulin levels. This dietary overdose of carbohydrates contributes significantly to chronically elevated insulin levels.
The Impact of a Ketogenic Mediterranean Diet on PCOS
To address hyperinsulinemia and its effects on PCOS, a ketogenic Mediterranean diet with phytoextracts (KEMEPHY) has shown promise. Fourteen overweight women diagnosed with PCOS participated in a 12-week trial of the KEMEPHY diet, resulting in significant improvements in various aspects of their health and hormonal balance.
Positive Effects on Body Composition and Weight
Participants experienced a substantial reduction in body weight (approximately 9.43 kg) and BMI (approximately 3.35), along with notable decreases in fat body mass (8.29 kg) and visceral adipose tissue. Although there was a slight reduction in lean body mass, the overall body composition improvement was evident.
Improvements in Insulin Sensitivity and Blood Lipids
One of the key benefits of the KEMEPHY diet was its impact on insulin resistance. Glucose and insulin blood levels showed significant decreases, leading to a notable improvement in HOMA-IR. Additionally, triglycerides, total cholesterol, and LDL levels decreased, while HDL levels increased, which bodes well for cardiovascular health.
Hormonal Balance and Dermatological Aspects
The KEMEPHY diet had a positive effect on hormone levels in PCOS patients. There were significant reductions in LH/FSH ratio, LH, total and free testosterone, and DHEAS blood levels. Conversely, estradiol, progesterone, and sex hormone binding globulin (SHBG) levels increased. The study also observed a slight, though non-significant, reduction in the Ferriman Gallwey Score, indicating a potential positive impact on dermatological aspects of PCOS.
Reversing Hyperinsulinemia and Reclaiming Control
By embracing a therapeutic carbohydrate reduction approach, especially reducing processed junk foods, individuals can initiate the process of restoring insulin balance. The extent of carbohydrate reduction needed may vary from person to person, but patience is key as hormonal imbalances correct themselves over weeks or months.
To effectively manage PCOS, it is crucial to engage in open communication with healthcare providers, share knowledge about hyperinsulinemia, and discuss the possibility of adjusting medications as conditions improve. Collaborating with healthcare professionals empowers women to make informed decisions about their health.
Conclusion
Unraveling the complexities of PCOS requires addressing its root cause: hyperinsulinemia. By leveraging the potential benefits of a ketogenic Mediterranean diet with phytoextracts (KEMEPHY), women can start reversing their symptoms and regaining their quality of life. Armed with knowledge, collaboration, and a therapeutic carbohydrate reduction approach, women can pave the way towards a healthier future, embracing effective, holistic approaches to managing PCOS and improving overall well-being.
References
Bibliography
Alwahab, U. A., Pantalone, K. M., & Burguera, B. (2018). A KETOGENIC DIET MAY RESTORE FERTILITY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME: A CASE SERIES. AACE Clinical Case Reports, 4(5), e427–e431. https://doi.org/10.4158/accr-2018-0026
Barrea, L., Verde, L., Camajani, E., Cernea, S., Frias-Toral, E., Lamabadusuriya, D., Ceriani, F., Savastano, S., Colao, A., & Muscogiuri, G. (2023). Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS). Current Nutrition Reports. https://doi.org/10.1007/s13668-023-00456-1
Mavropoulos, J., Yancy, W., Hepburn, J., & Westman, E. (2005). The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study. Nutrition & Metabolism, 2(1), 35. https://doi.org/10.1186/1743-7075-2-35
Muscogiuri, G., Palomba, S., Laganà, A. S., & Orio, F. (2016). Current Insights Into Inositol Isoforms, Mediterranean and Ketogenic Diets for Polycystic Ovary Syndrome: From Bench to Bedside. Current Pharmaceutical Design, 22(36), 5554–5557. https://www.ingentaconnect.com/content/ben/cpd/2016/00000022/00000036/art00007
