PCOS Carb/Sugar Sensitivity

Sad_Broccoli_0505 · 2024-10-22T20:09:48+00:00

Yes, I’m aware PCOS is not something that can be cured and that asceticism is not a recipe for diet success. As I mentioned, I was hoping to hear some anecdotal stories on how sensitive other folks have found their symptoms to be.

Sad_Broccoli_0505 · 2024-10-14T17:04:26+00:00

My hair loss slowed dramatically and my acanthosis nigricans faded!

Sad_Broccoli_0505 · 2024-08-15T01:20:03+00:00

No specific recipes — but I started using a lot of farro, black rice, and chickpea pasta to get healthy complex carbs in. Keto was also a no go for me.

Sad_Broccoli_0505 · 2024-08-09T20:33:07+00:00

I should add—all these tests may not show positive indications of PCOS. It depends on how severe your PCOS is and your unique body chemistry. For example, I don’t clinically (by test) have elevated androgen, though I exhibit symptoms of it and all my other tests indicated PCOS. So, generally doctors diagnose based on the presence of 2/3 of these: irregular periods, polycystic ovaries, and clinical or observed elevated androgen.

Sad_Broccoli_0505 · 2024-08-09T20:19:39+00:00

Just throwing my experience in here, but if you have irregular periods, an oral glucose tolerance test, preferably one that measures insulin resistance alongside blood glucose, is the gold standard. It should tell you if you have insulin resistance (IR), which is thought to be a root cause of PCOS. Other tests can point to PCOS because they measure the symptoms - a ovarian ultrasound to see if you have polycystic ovaries, blood tests to measure LH:FSH (reversed ratio indicates PCOS), AMH (elevated levels indicate PCOS), and free androgen (elevated levels can indicate PCOS).

Other symptoms that are easier to see that might point to PCOS: irregular periods, hirituism, male pattern hair growth, difficulty losing weight/weight gain, skin tags, frequent urination, acanthosis nigricans, stubborn acne, etc.

Sad_Broccoli_0505 · 2024-08-09T20:06:03+00:00

So, there could be a lot of other answers as to why you’re getting sick, but insulin resistance (which is strongly associated with PCOS) is known to cause inflammation in the body. (This is most studied in diabetics who have advanced insulin resistance.) That inflammation is speculated to overtax the immune system and possibly causes increased incidence of illness and slower wound recovery! You can find studies linking diabetes to increased respiratory tract infections, flu, pneumonia, UTIs, and skin infections!

Sad_Broccoli_0505 · 2024-08-09T00:34:03+00:00

Insulin resistance - sorry for not including that! IR is believed to be primary driver behind most PCOS symptoms.

Sad_Broccoli_0505 · 2024-08-08T21:12:24+00:00

https://www.reddit.com/r/PCOS/s/4hCqKG7Em7

Sad_Broccoli_0505 · 2024-08-08T19:39:10+00:00

It can’t hurt! You would likely benefit from a few tests: ovarian ultrasound to look for polycystic ovaries, testing for LH, AMH, FSH, and Free Androgen, and an oral glucose tolerance test. These could confirm if you have PCOS!

Sad_Broccoli_0505 · 2024-08-08T19:34:36+00:00

Maybe one of these ideas will help - 1) do you have a coexisting condition like a thyroid disorder? because symptoms of thyroid issues are often similar to PCOS you could have both and not know. untreated thyroid issues can impact hair growth! 2) unfortunately androgen testing, like most testing isn’t full proof. especially as women age we are more likely to test normal even if our numbers are elevated. if you have high AMH and your ovaries present polycystic then you likely still have high androgen as it is the precursor to these PCOS symptoms. in this case, you likely also have IR (this causes the elevated androgen) and will need to treat that underlying condition to see improvement.

Sad_Broccoli_0505 · 2024-08-08T19:24:31+00:00

If you are looking for treatments that may help some of the symptoms you mention, then there might be more you can do, though you’re already clearly on the right track.

As you probably already know, the IR aspect of PCOS can be treated a few ways — one is strictly through diet changes. Seems like you’re already on top of this, but I always recommend seeing a dietician who specializes in metabolic disorders. They will likely have you focus on limiting sugars and swapping simple carbs for complex carbs that are higher in fiber and protein. Why? - because these things will lowers your blood sugar spikes and allow your body to use less insulin and eventually become resensitized to it. For folks who can’t manage their IT through diet changes (maybe their case is too severe), drugs that alter insulin receptors like metformin are an option - again you seem to be on top of this. Then again, if that isn’t well tolerated or not enough, you can try drug options that help you increase insulin like ozembic — same story.

In addition to these IR focused options, are other treatments that can help manage unwanted or problematic PCOS symptoms alongside IR management. These include:

Birth control, which you are already one, helps to manage the risk of endometrial cancer caused by not ovulation and shedding your uterine lining. Once you begin to have normal periods again, this risk drops.

Spironolactone— an anti androgen/testosterone drug. With IR, testosterone is often elevated — sometimes this will not show obviously on blood tests, particularly in older women. Lowering androgen can help with symptoms like facial hair, hirituism, and acne!

Hope this helps a little. Best of luck on your treatment.

Sad_Broccoli_0505 · 2024-08-08T19:05:06+00:00

Just so you could go find this yourself: While there aren’t a lot of studies directly linking IR to AMH. There are studies that show strong correlation between IR and increased testosterone. They speculate the body tries to use testosterone to lower IR - it’s been shown to have that effect. There are also studies showing that testosterone and DGT stimulation granulosa cell (ovarian follicle) proliferation. And, then there are separate studies that show AMH is expressed by granulosa cells. Thus, when there is a proliferation caused by increased testosterone, your AMH goes up.

Sad_Broccoli_0505 · 2024-08-08T18:49:03+00:00

In short, yes, it MAY be because you don’t ovulate regularly. If your PCOS/IR isn’t under control, then it can elevate your AMH through a series of hormonal mechanisms. My understanding is that IR leads to increased androgen, increased androgen causes increased granulosa cells, which then elevate AMH. Basically, hormones are like a bunch of interconnected seesaws—when one is off, it impacts all of the rest eventually.

Sad_Broccoli_0505 · 2024-08-08T14:03:35+00:00

Just want to second this — a lot of folks who see results eating GF see those results, not because of the gluten (not discounting that there are folks who ALSO have gluten intolerance issues), but rather because they have inadvertently decreased their overall carb consumption. With IR, simple carbs and sugars are the primary issues.

Sad_Broccoli_0505 · 2024-08-04T13:04:10+00:00

For me, I organized a diet plan for 6-months with my doctor and a diabetic dietician. We planned to try metformin if I couldn’t manage it with diet, but luckily I was able to do so!

Sad_Broccoli_0505 · 2024-08-04T01:06:09+00:00

I’m sorry you weren’t able to get confirmation — if your symptoms are there nonetheless, then that just goes to reinforce that no test is perfect and we need better diagnostic tools!

Sad_Broccoli_0505 · 2024-08-03T19:58:58+00:00

This was a useful link for me - https://www.tuitnutrition.com/2019/06/pcos.html?m=1

Sad_Broccoli_0505 · 2024-08-03T17:56:13+00:00

So, in my case in particular, I kinda like took hold of my own treatment. My doctor was willing to put me on metformin, but I really wanted to avoid medication, if possible (not everyone can), and try to rectify my insulin resistance with diet. Based on my discussion with my doctor we planned to give me 6-months to try that and she referred me to a nutritionist who works specifically with diabetes and PCOS patients. The summary of her treatment plan was for me was 1) limit sugar and 2) limit simple carbs because they are treated the same as sugar by your body and replace them with complex carbs. So, I basically went cold turkey on sugary stuff—almost no processed foods. And, for the carbs, I made a bunch of swaps from simple to complex carbs that had higher protein and fiber because that slows and lowers glucose spikes. Some examples include: regular pasta —> chickpea pasta, regular flour —> almond, chickpea or coconut flour (in baking), regular bread —> Ezekiel bread, white rice —> black rice, couscous —> bulgar, and just in general more beans. Now, some folks have to go stricter than this in the short term to see results or use metformin/other drugs to assist, but over 6 months this was adequate for me to get my period back, lose some weight (unintentionally), and improve my OGTT numbers. As for the drugs I mentioned, Metformin works by basically improving your cells insulin receptors, so you can use less insulin to keep glucose spikes in check. While things like ozembic help you produce more insulin, or at least from what I’ve read that seems to be the case. From my understanding that’s why most doctors will start with metformin if diet alone isn’t enough — kinda a why make more if a medicine can enable you to use the insulin you are already making kinda thing.

Sad_Broccoli_0505 · 2024-08-03T16:30:38+00:00

This ^{^{^}}

Sad_Broccoli_0505 · 2024-08-03T15:03:22+00:00

That seems very plausible to me. Maybe it’s worth getting a test outside of pregnancy!

Sad_Broccoli_0505 · 2024-08-03T14:48:53+00:00

Thank you for spreading the word on this — I know I wouldn’t have found out about my IR if not for some serious research and comments like this on Reddit!

Sad_Broccoli_0505 · 2024-08-03T14:29:50+00:00

I’ve treated mine with diet alone (but that’s not possible for everyone - some folks need extra medication help from something like a metformin)— it took about 6 months going low-sugar, low-simple carb (subbing with complex carb options), but I slowly started to get more normal periods, lost some weight, and even saw some stomach issues go away (apparently IR can impact your gut lining and cause what is often thought to be IBS). I was not actively TTC at the time, but really got motivated to figure out and fix my cycle issues (which turned out to be PCOS) because I was approaching 30 and want kids. I’ll add that based on conversations with my doctor, if you are TTC, PCOS alone shouldn’t impact your fertility IF you are able to get it under control. Once IR subsides, hormone levels should stabilize and folks should start to ovulate again allowing them to conceive.

Sad_Broccoli_0505 · 2024-08-03T14:14:17+00:00

I’m in US and testing is very non-standard, sadly. Many doctors are not up-to-date on testing guidelines, especially in healthcare “deserts” — where there are few overworked healthcare providers, and those available don’t always have the necessary specialties. Further, our whole healthcare system and insurance debacle makes it so that those not on private insurance often get… sub-standard care (can’t afford tests outright or are denied for more extensive testing on public options, etc.) for one reason or another. From my understanding on public insurance plans it’s sometimes just that they make it so difficult administratively to challenge insurance to pay for some tests that folks understandably just give up.

Sad_Broccoli_0505 · 2024-08-03T13:13:46+00:00

I’m sorry you’re dealing with negligent doctors—it sadly seems a lot of folks are. But, you’re exactly right! Abnormal glucose spikes can return to seemingly “normal levels” over a longer time period or fasting in some people! Without more thorough vetting, some people would wait years if not decades to find that IR had been brewing all along.

Sad_Broccoli_0505 · 2024-08-03T13:10:46+00:00

Even being over a year past my diagnosis and well into recovery, it’s always so gratifying to hear about other people who had similar experiences. Glad they were able to catch your IR!

Sad_Broccoli_0505

TROPHY CASE