Polycystic ovarian syndrome is a condition that is affecting more and more women and girls – it affects 1 in 7 women worldwide making it one of the most common endocrine disorders to affect women of reproductive age.

This is one of the most common conditions that I see in our clinic, as women are usually frustrated by the lack of conventional treatment options available to them.  Unfortunately, this condition is often incorrectly diagnosed and misunderstood in a lot of women. It is also being increasingly diagnosed in young girls – often unnecessarily

It really seems that PCOS is becoming an epidemic, and information about this condition is greatly lacking!  PCOS is a 20th century condition, along with the increase of heart disease, diabetes and obesity.  And the reason they are all increasing together is because they are all being (mostly) caused by the same things.  We’ll get into what that is later, but first we should cover what PCOS actually is.

The name poly-cystic ovarian syndrome implies that the main feature of the condition is the presence of small cysts on the ovaries, however with current diagnostic criteria this is actually not required for a diagnosed, and not all women with PCOS have cysts on their ovaries.  This is just one of the possible symptoms that makes up this condition.

In this article I wrote for Western Sydney Mum’s Hub I discuss what PCOS actually is, as well as outline the symptoms of PCOS and debunk some myths. I also talk about the causes of PCOS, and my key natural treatments.

PCOS SYMPTOMS

Symptoms may include:

·       Irregular or absent periods

·       Insulin resistance (high insulin levels picked up in a blood test)

·       High testosterone (androgen) levels in a blood test

·       Hirsutism (Excess hair growth, usually in areas such as the lip, arms, lower back)

·       Acne

·       Sugar cravings

·       Blood sugar fluctuations (e.g. feeling irritable or dizzy if you skip a meal)

·       Weight gain or difficulty losing weight, especially from around the middle

·       Ovarian cysts (picked up by ultrasound)

·       Thinning head hair

·       Painful periods or pain on ovulation

·       Fertility problems including difficulty conceiving and increased miscarriage rates

·       Skin tags

·       High cholesterol levels

Diagnosis

The condition is diagnosed differently according to different criteria, however most commonly it is by the presence of 2 of the following 3 factors:

·      Irregular or absent ovulation/periods

·      High androgen levels (the male hormone) found in blood tests

·      Symptoms of high androgen levels such as hirsutism and acne.

·      Other conditions which cause these symptoms must be ruled out.

LET’S CLEAR UP SOME PCOS MYTHS

1. 1. Having cysts on the ovaries is not the main way of diagnosing PCOS. Not all women with PCOS have cysts, and as a stand-alone symptom having cysts on the ovaries isn’t enough to diagnose PCOS.
   2. It’s normal for cysts to grow on the ovaries – these are actually your ovarian follicles (or eggs) growing and releasing, however in PCOS these do not grow properly and this is what can result in the typical appearance of a PCOS ovary.
   3. PCOS doesn’t always affect your fertility negatively. This understanding is mostly based on people with severe cases of PCOS and so the understanding of to what degree it affects the fertility of those with milder forms of PCOS is lacking.
   4. You aren’t always stuck with PCOS for life. Many young girls who are diagnosed with PCOS can grow out of this condition by the 30s.
   5. The oral contraceptive pill is not the best way to treat PCOS. Yes it can bring on a regular, predictable bleed, but remember that this is not a true period, and the pill can make the condition worse after stopping.
   6. If you get period pain it is not due to PCOS – there is likely something else going on that is contributing to the period pain such as endometriosis or primary dysmenorrhea (the fancy term for period pain not attributed to an obvious cause). It is possible to have both endometriosis and PCOS.
   7. Thin women and girls can have PCOS too, and can still have insulin resistance.

Top causes of PCOS

Insulin Resistance

Nearly all cases of PCOS have insulin resistance.  Insulin resistance is when the cells have difficulty taking up glucose from the bloodstream, often resulting in an increased secretion of insulin, which worsens the symptoms of PCOS.

Even if your blood sugar levels are normal, you can still have insulin resistance. It is vital that insulin levels are tested too, but they aren’t always automatically done, so you may need to ask.

As I was mentioning earlier, I believe that insulin resistance is the link between these 20^th century conditions.   Insulin resistance can be a genetic problem, but the food choices that we make play the biggest role in the development of this condition.  Highly processed foods, refined carbohydrates and excess sugar are the evil culprits that lead to the development of insulin resistance by causing our blood sugar levels to be elevated over a long period of time.  Insulin is a hormone that is secreted by the pancreas in response to high blood sugar levels.  Its job is to put the sugar into the cells.  When the levels of sugar in our blood are high for an extended period of time, insulin is produced more and more, and our cells begin to ignore it (like in The Boy Who Cried Wolf).  This leads to high circulating insulin, and this is where the problem comes from.

Insulin is known for its ability to lower blood sugar levels.  The way that insulin does this is by storing the sugar in the form of glycogen – but the body can only store so much of this, and when it’s full the sugar gets stored as fat (most commonly in the abdomen, causing the typical apple body shape).

High androgen levels

Androgen are a group of hormones that includes testosterone. They may be called ‘male hormones’ but both men and women produce androgens, just in different amounts and with different actions.

There are a few different types of androgen markers that are tested in blood tests, including total testosterone, SHBG, androstenedione and DHEA.

For most women with PCOS the insulin resistance is usually the biggest issue which causes high androgen levels. However, for some (approximately 20%), high androgen levels may be present unrelated to insulin resistance, and this is most often due to stress.

Other causes

Sometimes there can be some less common causes of PCOS. This can include nutritional deficiencies (such as iodine or zinc), inflammation and thyroid disorders. For some women they may have developed PCOS because of taking the oral-contraceptive pill. Often this will resolve within about a year (herbal medicine can reduce this time frame to 3-4 months).

Key Natural Treatments for PCOS

What treatment is used for PCOS depends on the underlying cause and a practitioner can guide you further on this. These are some of my favourite treatment tools:

1. Test for and treat insulin resistance, typically with an exercise regime and a low-GI diet (you can read some tips for a Low GI, Nutrient Dense Diet here).
2. Cut out/down sugar in the diet.
3. Cut out/down dairy.
4. If androgen levels are high without insulin resistance, herbs and nutrients that can reduce the excess of this hormone include Saw Palmetto, Peony and Licorice, and the mineral Zinc.
5. If DHEA is high or there is a lot of stress around the time of puberty or currently, herbal medicine to support the nervous system such as nervine and adaptogen herbs, the mineral magnesium and B vitamins can be helpful.
6. The amino acid myo-inositol is helpful for supporting blood sugar levels and reducing anxiety and can be a great tool in the kit to treat PCOS.

If you or your daughter has been diagnosed with PCOS or you suspect that this may be an issue for you, seek advice from a naturopath experienced in this area as there is much that can be done to help.

The post Busting the PCOS Myths appeared first on Alison Mitchell Naturopath.

This article follows on from the previous article, which discussed the thyroid gland and the differences between and over and underactive thyroid. In this article I am talking about how an issue with the thyroid can cause imbalances in the rest of the endocrine system, in particular the endocrine system.

Thyroid Health

 The endocrine system

Endocrine is the term used for the complex system of glands and their secretions (hormones).  The endocrine system includes the glands (pituitary, thyroid, para-thyroid, adrenal and pineal) as well as organs and tissues which are able to produce hormones (fat tissue, the hypothalamus, ovaries, testes, pancreas, thymus, kidneys, stomach, liver, small intestine, skin, heart and placenta).  There is a cross-over between different systems such as in the digestive system which includes organs also classed as endocrine.

 In the previous newsletter I gave you an overview of the thyroid and the differences between hyperthyroidism and hypothyroidism.  In this newsletter I want to give you some information about the ways in which the thyroid can affect the endocrine system over all.

 The endocrine system is all connected and an imbalance in one particular organ or gland can disrupt everything else.  One of the biggest ways that we can see this is looking at the impact of stress.  Have you noticed that when you’re stressed you’re more likely to catch a cold (remember the thymus is an endocrine organ and has a big role in our immunity), break out (the skin is responsive to hormones, pumping out more oil to feed the bacteria that causes acne) and your digestive system can get upset too(the stomach, pancreas and liver are all endocrine organs)!

Thyroid health and the reproductive system.

The thyroid gland is another big player in keeping our endocrine system balanced.  One of the most common things that an unhappy thyroid will affect is the reproductive system.

In both men and women hypothyroidism can affect libido. In men, they may experience infertility and mpotence.  In women they may experienced an irregular menstrual cycle or irregular bleed.  Fertility is also greatly affected by the thyroid gland especially in women with autoimmune thyroid disease.  It may result in not being able to conceive altogether or an increase in miscarriages.  In women of fertile age, autoimmune thyroid disease is the most common cause of hypothyroidism.

How?

• A reduction in thyroid function will leave to elevated TSH, and depressed secretion of dopamine, leading to elevated prolactin levels.
• Elevated prolactin levels, also known as hyperprolactinaemia is implicated in 1-3% of women with problems ovulating.
• Hypothyroidism interferes with an important hormone for the development of the egg and ovulation – gonadotrophin-releasing hormone (GnRH).
• Hypothyroidism can lead to a delay in luteinising hormone (LH) which causes ovulation and stimulates the secretion of progesterone.  Because of this is can cause a reduction in progesterone synthesis.
• Thyroid antibodies which can be present in both hyperthyroidism and hypothyroidism can affect fertility due to it’s impact on implantation and increasing the risk of miscarriage.  In some people antibodies
  can be present without having any signs of thyroid dysfunction.  Thyroid antibodies can be managed with herbs that modulate the immune system.

Thyroid dysfunction affects the hormones needed for healthy egg development and ovulation, which affects fertility and creates an imbalance in other reproductive hormones.

If you are having difficulty conceiving it is important to assess thyroid function and screen for the presence of antibodies to rule out any complicating involvement from this gland.

If you believe that you have a thyroid problem, don’t despair.  We can assess for and manage a thyroid imbalance using safe, effective natural remedies.

The post Thyroid Health – Part 2 appeared first on Alison Mitchell Naturopath.

This article discusses the thyroid gland and the differences between and over and underactive thyroid.

Thyroid Health

The Butterfly-Shaped Gland

 The thyroid is a butterfly-shaped gland, situated in the front part of your neck, which produces hormones needed for normal metabolism. Essentially, you can think of your thyroid hormones as the drums in an orchestra or band; thyroid hormones set the rhythm and the pace for most of our body functions – they regulate our metabolic rate and how fast or slow our organs and tissues function. Disordered thyroid function, therefore, upsets the whole rhythm of the body.

The Highs and Lows of Thyroid Function

Dysfunction of the thyroid can cause a number of different symptoms. Thyroid problems can affect weight, energy levels, appetite and mood; but the effects will be different depending on whether the thyroid gland is over functioning or under functioning.

Hyperthyroidism is a state of over-activity of the thyroid gland with excessive production of thyroid hormones and an increased metabolic rate – it’s as if the drums that set the rhythm for our bodies have sped up too much and are making everything function too fast. Symptoms of hyperthyroidism can include:

• Feeling hot and intolerant of hot weather
• Weight loss
• Anxiety, restlessness and insomnia
• Excessive sweating
• Increased heart rate
• Fine tremors of the fingers
• High blood pressure

Hypothyroidism, on the other hand, is a state of under-activity of the thyroid gland with an underproduction of thyroid hormone – it’s as if the drums have slowed down and the beat that is running how our body functions is too slow. When your body does not produce enough of the thyroid hormone, the body’s metabolism slows so much that you can experience symptoms such as:

• Tiredness and fatigue
• Depression
• Irritability
• Weight gain
• Intolerance to cold weather
• Brittle hair
• Slow heart rate
• A croaky, hoarse voice

Herbs to Calm The Thyroid

An overactive thyroid can make you feel anxious and restless and can also be a contributing factor to insomnia. A combination of traditional calming herbs may help to manage these symptoms and slow that beating drum that is increasing your metabolism too much. Lemon balm, Rehmannia, Bugleweed and Phyllanthus emblica are traditional herbs with anti-anxiety actions which can help to calm an overactive thyroid. They also provide anti-inflammatory and anti-oxidant protection, reducing the negative effects of oxidative stress and inflammation on the thyroid. Lemon balm is easy to grow and makes a delicious tea. (It’s also great for a nervous tummy!)

Eat more of these foods to calm your thyroid:

Photo by Disiana Caballero on Unsplash

Cabbage, brussel spouts, cauliflower, broccoli (all raw)
Radish
Apples
Almonds and walnuts
Soy milk, tofu and soy fibre

Herbs to Balance The Thyroid

On the other hand an under-active thyroid can make you feel tired, cold and depressed. To increase the rhythm of the drum and improve the activity of the thyroid gland, you can use a combination of herbs traditionally used to energise and warm the body. Ginger, goji berry and rosemary are energising herbs which improve circulation, warm the body and are a great source of antioxidants. Ginger and rosemary are easily included in meals as spices, and goji berries are a great snack. Other herbs that help to balance the thyroid which care available with prescription are Withania, Bladderwack and Bacopa.

As well as these herbs to stimulate thyroid activity, there are some vital nutrients required for an under-active thyroid, including:

• Iodine – Iodine is an essential element for the production of thyroid hormones. Iodine deficiency is common in many areas of the world, leading to depletion of iodine stores and reduced production of thyroid hormones.
• Selenium – This trace element has many important roles in the body, including crucial roles as a cofactor in enzymes essential for production of thyroid hormones.
• Zinc – Low zinc levels are associated with poor thyroid hormone production and reduced basal metabolic rate.

These foods can assist in balancing underactive thyroid function

• Apricots, dates, egg yolks, parsley, molasses, potatoes, prunes, raw seeds, and whole grains.
• Make sure all foods from the brassica family (cabbage, broccoli, cauliflower and brussel sprouts are well cooked).
• Iodine rich foods such as seaweed.

Testing for thyroid problems

Blood tests

These are the most commonly performed and well known forms of testing done, and you can get these tests done by your GP.

The thyroid has a few different hormones and common practice is to first test TSH (thyroid stimulating hormone), and if that is out of balance they will then go on to test the main hormones T3 and T4. If these are out of balance, they will then go on to test for thyroid antibodies, which are an indicator of an issue where the immune system attacks the thyroid, being responsible for the imbalance. Another less frequently tested hormone is rT3 (reverse T3).

 Below is a brief guide to thyroid tests:

• TSH: High in hypothyroidism | Low in hyperthyroidism
• T4: Low in hypothyroidism (may appear normal) | High in hyperthyroidism
• T3 (tested less frequently): Low in hypothyroidism | High in hyperthyroidism
• rT3: Higher levels may lead to hypothyroidism symptoms.

 Symptoms

 Symptoms are a good indicator to a practitioner to investigate further. As well as the symptoms listed above, a sign of thyroid imbalance can be a combination of the following:

• Dull facial expression (drooping eyelids)
• Cold intolerance (with cold extremities)
• Poor circulation
• Dry skin, elbow keratosis, brittle nails
• Prolonged Achilles tendon reflex time
• Diffuse hair loss and lateral 1/3 eyebrow
• Slow speech, movement, heart rate
• Puffy face, swollen eyelids
• Fluid retention (body, legs, feet, hands, belly)
• Low body temperature
• Acne
• Fibrocystic breast disease

Basal body temperature

Basal temperature is controlled by the thyroid and can be a good indicator of how much T3 is active inside cells.

1.  Shake down a thermometer to below 35°C and place it by the bed before going to sleep.

2.  Upon waking, place the thermometer under the armpit for a full 10 minutes.

3.  Remain as still as possible, resting with the eyes closed.

4.  Record the temperature for at least 3 consecutive mornings, preferably at the same time of day. Menstruating women must check basal body temperature on the second, third and fourth days of menstruation. Men and menopausal women can check on any 3 consecutive days.

 Ideal basal temperature: 36.5°C- 36.8°C

 Scanning

The thyroid gland itself can be scanned with a radioactive isotope or radioactive iodine scan. This will show whether the gland is enlarged, whether there is a goitre on one or more nodules, and whether particular areas are ‘hot’ (that is, are active and take up the isotope or iodine). An ultrasound can also show up a goitre or nodule and whether it is solid or not. In some cases a needle biopsy of a goitre or nodule may be needed and tissue sent to a pathologist for examination to determine whether it is benign or malignant.

The post Thyroid Health – Part 1 appeared first on Alison Mitchell Naturopath.