Intermittent Fasting for PCOS

Intermittent Fasting for PCOS

“Intermittent fasting” seems to be popping up everywhere within the world of nutrition and weight loss lately.  It’s not a new concept. In fact, it has been used safely and effectively for many years, and in many cultures around the world.

The most popular use for intermittent fasting is weight loss. That said, considering the impact intermittent fasting has on insulin levels and inflammatory markers, it can be an effective treatment option in women with PCOS.

What is intermittent fasting?

Fasting, intermittent fasting, or timed eating simply means that you go for a period of time without food. In medical terms, it takes a minimum of 12 hours to be in a “fasted state” where your body has used up its stored glucose (AKA glycogen) and starts breaking down fat for energy.

There are several different fasting plans out there, here are some of the most popular ones:

  • 5/2 plan:  Limiting to 500 kcals 2x/wk and then eat as you please the other 5 days.

  • Alternate Day: Limiting to 500 kcals every other day and eat as you normally would on alternate days.

  • 16/8: Fast for 16 hours a day then have an 8-hour “eating window”.  This type of fasting can be used daily, every other day, or just a few times a week.

  • 24-hr or Eat Stop Eat: Water, tea or coffee for 24 hours and then eating sensibly on non-fasting days.  These longer fasts are challenging and only used a couple of times a week rather than daily.

 

How does intermittent fasting work?

Research shows a whole host of potential benefits of intermittent fasting. These include weight loss, blood sugar regulation, inflammation reduction, lowered LDL cholesterol, and improved cognition.

Intermittent fasting’s impact on weight loss is primarily due to its insulin-lowering effects1. Insulin is a hormone that’s produced and released by the pancreas in response to a rise in blood sugar. Every time we digest and absorb our food, blood sugar levels rise and insulin levels rise in response.

How Does Insulin Work?

Insulin works by binding to receptors on the cells, which open up mini gates that allow blood sugar to flow out of the circulation and into the cells. As such, insulin is an anabolic hormone, meaning it’s involved in building and storing sugar in the cells. Whenever insulin is high, we’re in storage mode: pushing energy into our cells.

When someone does intermittent fasting, they’re putting their body through prolonged periods of time without eating, thus lowering blood sugar. If blood sugar levels are lower, insulin is lower as well. In contrast, if insulin is kept low, the body can move out of storage mode and into fat-burning mode!

There are a few other mechanisms that contribute to intermittent fasting’s role in weight loss. It can also increase growth hormone2 levels, reduce pro-inflammatory cytokines such as IL-6 and TNF alpha3. Additionally, it increases circulating norepinephrine, which may enhance the resting metabolic rate

How does intermittent fasting help in PCOS?

Intermittent fasting can be a great treatment for women with PCOS because of its insulin-lowering effect.

Elevated insulin levels are a major driver in many PCOS cases. Women with this condition often have higher insulin baseline levels and an exaggerated insulin response to food compared to healthy subjects.

This high insulin can lead to increased testosterone production by the ovaries. In turn, this can contribute to the acne, facial hair growth, and hair loss commonly seen in PCOS. High testosterone also impacts the ability to ovulate properly, and contributes to long menstrual cycles.

How Does Fasting Help?

By incorporating intermittent fasting along with other dietary and lifestyle changes, women with PCOS can reduce their fasting insulin levels dramatically. In turn, they can move away from this fat-storage mode and into fat-burning mode. If insulin can be brought down, women with PCOS should experience weight reduction, improved skin, and hair growth, as well as increased ovulatory cycles.

PCOS is also associated with increased inflammatory markers. Since intermittent fasting reduces inflammation within the body, this could be another huge benefit to this population.

Proper testing needs to be done to confirm whether insulin resistance is a part of your PCOS picture. A thorough explanation of insulin resistance testing can be found here.

Should intermittent fasting ever be avoided?

Although intermittent fasting can be very helpful for women with PCOS, it’s not for everyone. If you’re struggling with extreme stress and insomnia, for example, intermittent fasting may cause increased cortisol secretion and worsen these symptoms.

Additionally, if you have any history of an eating disorder, intermittent fasting isn’t right for you.

If intermittent fasting causes you to binge and overeat during the day, then it’s also not right for you.

Finally, it must be noted that more extreme fasting isn’t always better. One study found that prolonged fasting windows could be associated with increased risk of gallstone formation5.

Key Takeaways

  • Intermittent fasting isn’t a diet, but rather a type of eating pattern, outlining when to eat and when to avoid food
  • It has been shown to reduce insulin, increase growth hormone circulating levels, reduce pro-inflammatory markers, and increase circulating epinephrine
  • This type of fasting can be an effective strategy in women with PCOS because it impacts insulin resistance and inflammation
  • It’s not right for everyone, and should be avoided if you have a history of eating disorders, are going through extreme stress, and/or if it causes binge eating or if you are pregnant.
  • Start slowly or get some advice from an experienced practitioner

References

  1. Sutton, E., Beyl, R., Early, K., Cefalu, W., Ravussin, E., & Peterson, C. (2018). Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metabolism27(6), 1212-1221.e3. doi: 10.1016/j.cmet.2018.04.010
  2. Hartman, M. (1992). Augmented growth hormone (GH) secretory burst frequency and amplitude mediate enhanced GH secretion during a two-day fast in normal men. Journal Of Clinical Endocrinology & Metabolism74(4), 757-765. doi: 10.1210/jc.74.4.757
  3. Faris, “., Kacimi, S., Al-Kurd, R., Fararjeh, M., Bustanji, Y., Mohammad, M., & Salem, M. (2012). Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells in healthy subjects. Nutrition Research32(12), 947-955. doi: 10.1016/j.nutres.2012.06.021
  4. Zauner, C., Schneeweiss, B., Kranz, A., Madl, C., Ratheiser, K., & Kramer, L. et al. (2000). Resting energy expenditure in short-term starvation is increased as a result of an increase in serum norepinephrine. The American Journal Of Clinical Nutrition71(6), 1511-1515. doi: 10.1093/ajcn/71.6.1511
  5. Sichieri, R., Everhart, J., & Roth, H. (1991). A prospective study of hospitalization with gallstone disease among women: role of dietary factors, fasting period, and dieting. American Journal Of Public Health81(7), 880-884. doi: 10.2105/ajph.81.7.880

Article by By / July 3, 2019

Which Supplements can help with PCOS?

Which Supplements can help with PCOS?

Before we jump into supplements, please understand that you cannot out-supplement a poor diet. Your diet is your best weapon for fighting PCOS. (see 10 steps to improving PCOS)

Inositol

Secondary insulin messengers helps insulin to function  inside your cells. It improves insulin sensitivity, reduces androgen and restores regular ovulation. There are two main types D-chiro-inositol and Myo-inositol (often known as just inositol).

Magnesium

Improves insulin sensitivity – natural metformin. 300mg daily with food. Magnesium available here

 

Vitamin D

The sunshine vitamin – this improves insulin sensitivity and promotes healthy ovarian follicular maturation.

Ideal you should test your vitamin D levels . Minimum dosage 1000IU daily more if deficient . Vitamin D available here

Zinc

Zinc is a key nutrient for ovarian health, promotes healthy ovulation and progesterone and also has an anti-androgen effects, improving hirsutism. Recommended dose 20 to 50mg daily with food as zinc on an empty stomach can cause nausea. Zinc available here

Peony and Licorice

Peony inhibits the production testosterone . Licorice lowers testosterone and blocks androgen receptors ( Licorice can raise blood pressure so do not take if you already have high blood pressure). This combination of herbs is powerful, so is best taken after seeking professional advice.

Saw Palmetto and Milk Thistle

Saw Palmetto help to reduce the production of  male hormones, especially DHT ,thereby protecting the hair of the scalp and preventing it from falling out.It also protects the follicles over the rest of the body to keep body hair from growing longer, thicker, and darker. Dose 160mg daily

Milk Thistle has been shown to protect the liver from stress and to help repair existing damage. The liver is the body’s clearinghouse and must be in good working order to maintain healthy skin Dose 200mg daily

Not to be used by women who are breastfeeding, pregnant, or trying to become pregnant, unless directed by your physician.

Available here

Inositol, magnesium,zinc and vitamin D are my first to go to especially if you have insulin resistance type PCOS

Articles of interest :4 types of PCOS

4 Types of PCOS

10 STEPS TO IMPROVING PCOS

10 STEPS TO IMPROVING PCOS

The biggest part of the problem with PCOS is insulin resistance. Resistance to insulin increases the body’s insulin levels, which can have a negative affect on ovulation by limiting the maturation process of an egg and in turn delaying or preventing ovulation from taking place. Insulin resistance also makes it difficult for the embryo to attach properly to the uterus for implantation and increases inflammation and the chances of developing type 2 diabetes

 

  1. Eliminate all sugars and reduce carbohydrates from the list attached. You should aim for about 60 to 100 grams of carbohydrates from the list below, this does not include green vegetables or root vegetables such as carrots , beets , turnips etc. there is no limit, look for hidden sugars in tomatoes sauce mayonnaise etc. Avoid artificial sweeteners.
  2. Always eat some protein and health fats and fibre with low glycemic carbohydrates; this can be animal protein or vegetable proteins. Adding protein helps to slow down the absorption of carbohydrates even further . Eat organic if possible, Healthy fats include coconut oil, ghee, organic butter, olive oil and avocado etc. Fat helps to keep you satisfied, important for absorption of fat soluble vitamins., for hormone production and absorption of minerals and protects cell membrane  Do not eat low fat products –as the fat is replaced with sugar
  3.  Make  breakfast  a high protein, fat and low carb one. Ideally do not eat between meals, but  if your hungry between meals eat a small snack containing fat and protein e.g small amount of mixed nuts, small apple with sugar free nut spread, humous and carrot/cucumber sticks
  4. Eat oily fish and foods rich in omega3 fats to make your body more sensitive to insulin and overcome insulin resistance. (Mackerel sardines salmon, trout and herrings about 3 portions a week or flaxseed/ linseed if you are vegetarian.
  5. Try cutting out all dairy products for three months to help reduce male hormone levels. Dairy contains substance called insulin-like growth factor (IGF-1), which has similar properties to insulin and often contains hormones which effect your hormone levels(not essential it helps some people) if you do eat dairy eat full fat and organic. Eat a gluten- free diet
  6. Eat more green vegetable and pluses, especially cruciferous vegetables (broccoli, kale, cauliflower, brussel sprouts and cabbages). These help to increase the levels of sex-hormone binding globulin (SHBG) produced by the liver, which help to reduce the amount of male hormones in your system. SHBG tends to be low in people with PCOS. Do not eat them raw if you have thyroid problems, lightly steam or stir-fry.
  7. Cut out alcohol to help improve liver function, which is very important in balancing blood sugar and insulin levels
  8. Reduce or eliminate caffeine to give your adrenal glands a rest and reduce the levels of cortisol produced by the adrenals and for the same reason reduce your stress levels – the stress hormone cortisol competes with fertility hormones
  9. Eliminate hydrogenated and trans fats found in processed and junk food, processed vegetable oils (corn, soya oil) and margarines to reduce the inflammatory response and damage associated with PCOS
  10. Exercise regularly incorporating cardiovascular training with exercise to build muscles (helps to reduce body fat). Avoid excessive exercise programs because too much exercise overworks the adrenal glands which increases inflammation and in turn makes PCOS worse. Restorative exercise programs are best. You could walk and lift weights, or take a Pilates class and run on the treadmill, or do some Zumba and then Fertility Yoga. Discover what you enjoy doing and do this 5 days a week for at least thirty minutes a day
  11. This an extra  one, but important INTERMITTENT FASTING- EAT IN 8/10 HOUR WINDOW ONLY- helps to improve insulin sensitivity

 

Carbohydrates that need to restricted or included in 60/100 grams daily allowance

 

Bread, cereals, crackers, snack or breakfast bars, oatmeal, pastries, cookies cakes, pasta , fruit, fruit juices, fruit smoothies, fizzy drinks, honey sugar, beer/wine, milk, rice potatoes / sweet potatoes, beans and corns

There is no limit on green vegetables or root vegetables ( squash, carrots swede, parsnips etc) because of the high nutritional content

Good fats ,protein and fibre with every meal.

Food should be as natural as possible with as few ingredients on the label

Eat a variety of food

Do not eat too much fruit , it contains fructose, a type of sugar (1/2 pieces portion of low carb fruit day such as berries or green apples)

 

 

 

 

 

 

If you would like to work with me to improve you PCOS contact me at www.ecotherapies.co.uk

 

Next article: Which Supplements can help PCOS

WHAT IS PCOS and HOW IS IT DIAGNOSED?

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a complex hormonal condition in women, affecting many aspects of their health, particularly the reproductive system.
It may present with a menu of symptoms including:

  • Polycystic ovaries(surface of ovaries covered in many follicles)
  • Irregular or absent periods
  • Infertility
  • Recurrent miscarriage
  • Acne
  • Hair loss
  • Weight gain
  • Excess body hair
  • Skin tags
  • Acanthosis Nigrican
  • Diabetes
  • Hypertension
  • Fatigue
  • Mood swings

The symptoms can be mild or severe and vary from women to woman.
These symptoms are due to abnormalities in some of the hormones
that control a women’s menstrual cycle. To understand how
these imbalances affect this cycle lets see what happens in a ‘normal’ cycle.

The Normal Menstrual Cycle

In a normal menstrual cycle, the first half, called the follicular
phase, starts on the first day of a period and lasts for about 14 days, in this phase the
pituitary gland in the brain, releases the hormone, follicle stimulating
hormone (FSH). This stimulates the follicles (tiny cyst containing
immature eggs) in the ovary to grow. As the eggs mature they produce another hormone oestrogen, which causes the lining of the womb to start to thicken in preparation
for pregnancy. When the levels of oestrogen are high enough, the pituitary gland release Luteinzing
hormone (LH) and the dominant matured follicle in the ovary releases its
egg in to the fallopian tubes in a process called Ovulation.

After ovulation the Luteal phase starts, here the cells from the ruptured follicle form a cyst, called Corpus Luteum. This produces the hormone Progesterone, which cause the thickened lining of the womb to secrete nutrients ready for the fertilised egg. If the egg is fertilized it will implant and the corpus luteum will continue to produce progesterone to support the pregnancy. If it is not fertilized
the corpus luteum stops producing progesterone. Progesterone and oestrogen levels
fall and the lining of womb breaks down and is shed as a period.

What happens in PCOS?

In PCOS there is an imbalance with the hormones that mature the follicles FSH and the hormone that triggers ovulation, LH, which means that periods are irregular or absent, which makes it difficult to become pregnant. Also because there
is no ovulation there is not an increase in progesterone to balance the hormone oestrogen in the second half of the cycle and you get symptoms such as fatigue, hot flushes, mood swings,
depression and no periods.

Because the body’s hormones system is interconnected, an imbalance in one hormone can affect the balance of others. PCOS affects the hormone Insulin, which is produced by the pancreas
to regulate the levels of glucose in the blood. Many women can become insulin resistant,  this means the body produce more insulin to push the glucose into the cells. Insulin also encourages the body to store sugar as fat.  This causes weight gain, difficulty in losing weight and often
development of type 2 diabetes.

The high levels of insulin, signals the ovaries to secrete testosterone and inhibit hepatic sex-hormone binding globulin (SHBG) production, which leads to an increased level of circulating testosterone. This is why many women with PCOS experience acne, facial hair growth and male pattern baldness (hirsutism). Excess insulin in the bloodstream also signals the ovaries to release more oestrogen, which can suppress ovulation.

PCOS women also suffer with low grade inflammation .

What causes PCOS?

Doctors do not yet fully understand what cause these hormonal abnormalities. It is thought that there is a hereditary link, whereby some women inherit a greater chance of having PCOS, but whether or not these women develop PCOS depends on a number of additional factors such as diet and lifestyle.

How is PCOS diagnosed?

The diagnosis is based on a patient’s symptoms and physical appearance and confirmed by ultrasound scan of the ovaries and blood test to check the levels of different hormones, these would include:

Pituitary and Ovarian Hormone serum levels:

  • Luteinizing Hormone (LH)
  • Follicle Stimulating Hormone (FSH)
  • Estradiol
  • Progesterone
  • Prolactin

Circulating Androgens:

  • Free testosterone
  • Free androgen index (FAI): 17-hydroxyprogesterone
  • Sex hormone binding globulin (SHBG): 24 hr. urinary free cortisol
  • Dehydroepiandrosterone sulfate (DHEA-S)
  • Some practitioners may include the following tests:

Glucose Tolerance Test
Thyroid Panel
Blood Lipid Profile

To be diagnosed with PCOS you will have to met 2 out of 3 criteria, known as the Rotterdam Criteria:

  1. Delayed ovulation or menstrual cycles (anovulation)
  2. Hyperandrogenism ( high androgenic hormone like testosterone/ signs of)
  3. Polycystic ovaries on ultra sound

 

As you can see PCOS is a complex endocrine condition, exhibiting itself differently in each women!

 

Next article: Conventional and Natural Treatment for PCOS

10 SIGNS THAT YOU MIGHT HAVE PCOS -Polycystic ovarian syndrome

10 Signs that You Might Have PCOS

  1. Irregular periods.

If your periods are irregular and in particular if they are far apart or if you skip periods altogether, you’ve got a major sign of PCOS. Women with PCOS have high levels of androgens (testosterone is the most well-known androgen). Too many androgens slow our ovaries down, stalling ovulation. When ovulation is inhibited, the period (which comes 2 weeks after ovulation) will also arrive late and in some cases, not at all. For women with irregular periods and PCOS, there is often irregularity right from the start of the periods in the teenage years. In some women, periods may start coming regularly and then after a few years become irregular. Women with PCOS experience irregular periods more often when they have gained weight or have experienced a lot of stress.

2 Hair growth on the chin, upper lip, stomach or chest.

The aforementioned androgens also cause excess hair growth in the areas of our bodies where hair is typically seen in males. This is known as hirsutism (pronounced HER-Soo-Tism). These hairs can be coarse in texture – removal can be a challenge and a major source of stress. If you are experiencing significant hair growth in these areas, it’s important to be checked for PCOS. It’s been estimated that up to 90% of women with hirsutism have PCOS.

3 Weight gain, particularly around the stomach area.

Women with PCOS tend to gain weight easily and losing weight can be exceptionally challenging. This is due to insulin and leptin resistance, two of the central factors involved in PCOS. Insulin resistance causes our bodies to store fat more readily, and leptin resistance makes our brains think we are in starvation mode – messing with our hunger and fullness signals. With insulin resistance, weight is easily gained around the abdomen- and we all know that this type of fat is the most risky when it comes to cardiovascular health.

4 Moderate to severe acne.

Moderate to severe acne is common in women with PCOS. It all comes back to those troublesome androgens again. Androgens cause excess sebum production in the skin, resulting in clogged pores and bacterial overgrowth. If a women has acne that started early compared to her peers as a teen, or if she has adult onset acne, it’s possible that PCOS could be the culprit. Other signs that acne may be related to PCOS: it is resistant to treatment or comes back after strong acne treatments. PCOS-related acne is commonly seen along the jawline.

5 Difficulty in conceiving .

Women with PCOS may have difficulty in conceiving for a variety of reasons. Firstly, if a woman is not ovulating regularly, it will definitely take a longer time to conceive as the fertile window can be difficult to detect. Ovulation tests are often ineffective in PCOS as the LH hormone it picks up can be too high across the cycle, causing false positives. Also quite simply, there are less fertile periods yearly. Women with PCOS also have egg quality challenges due to inflammation and hormonal shifts within the ovaries. The good news is that women with PCOS often have an abundance of eggs so it’s often just a matter of time until pregnancy is achieved, particularly with the right treatment.

6 Hair loss.

Hair loss is a common problem in PCOS. The pesky androgens once again are involved in this problem. Testosterone is converted into a strong androgen – known as DHT (Dihydrotestosterone) – within the scalp. DHT is the mortal enemy of your hair follicles – it shrinks and damages them, causing hairs to enter the telogen phase where they soon fall out. Hair loss in women with PCOS is often seen at the frontal area, just behind the hairline. It can also be diffuse, with loss all over the head and a widening of the part. Hair loss can also be caused by other common problems as well so it’s important to investigate these, too. Thyroid dysfunction and low ferritin (stored iron) levels can also cause hair loss.

7 Dandruff.

Oily scalp and dandruff are also commonly seen in PCOS due to elevated androgens and increased oil production. If you have persistent dandruff, and any of the other above signs, ask to be checked for PCOS.

8 Pigmentation in the folds of your skin and skin tags.

Known as acanthosis nigricans, this is a dark, velvety discoloration of the skin. It’s most commonly seen in the crease behind the neck, under the arms, or in the creases of the thighs. Acanthosis nigricans can make your skin look “dirty” but it doesn’t wash off – no matter how hard you scrub! Acanthosis nigricans is caused by insulin resistance and can be reversed when insulin sensitivity is improved.

Little tag-like growths of the skin can often be seen in PCOS. Skin tags are flesh coloured and small. They can appear on the neck, chest or other areas, and are related to insulin resistance.

9 Depression and anxiety.

Women with PCOS suffer with higher rates of depression and anxiety. Changes in mood are related to a variety of underlying causes including inflammation, emotional suffering due to the stressful symptoms of PCOS and hormonal imbalances.

10 Sleep apnea.

If you haven’t been getting restful ZZs, PCOS may be involved. Many women with PCOS suffer with sleep apnea and as such do not get the restorative deep sleep that they need. Research has found that women with PCOS who are the most insulin resistant are more likely to suffer from obstructive sleep apnea. Sleep apnea often results in daytime sleepiness and fatigue.

It’s been estimated that 50% of women with PCOS do not know that they have it Let’s increase awareness of this condition that affects 1 out of every 10 of us, by knowing and sharing the signs and symptoms. As PCOS is a lifelong metabolic condition linked to diabetes and cardiovascular disease, early intervention can prevent a multitude of health problems and safeguard a woman’s health for years to come.

Do you think you may have PCOS? Which of the symptoms do you have?

Next articles: What exactly is PCOS and how to get diagnosed, 4 Types of PCOS, 10 steps to improving PCOS