The Natural Medicine Approach to dealing with PCOS

My name is Renée, I am the proud owner of a large Midlands based health shop. My interest in health began at a young age. I can recall being teased by my teenage peers about always eating homemade muesli and yoghurt for breakfast and consistently choosing ‘the healthy option’. Although I originally studied Environmental Science, I always had an absolute passion for natural health. As a young mom, I recall reading every book on nutrition which I could lay my hands on. At the age of 30, I trained as an Ozone Therapist and shortly thereafter, decided to take the leap and study Clinical Nutrition.

At the end of 2006 I decided to relocate my health business to larger premises in Howick, KZN. The ample space gave me the excuse I needed to expand my offerings to include wholefoods and some herbal teas. It wasn’t long before this grew into a small health store, with a range of natural supplements and some herbal tinctures. At that point I started a small health coaching practise within my health shop, with the vision to help people to adopt healthier lifestyles. The next step was to identify a tool which could remove the guess work commonly associated with nutritional consulting. Live Blood Analysis was and still is my tool of choice for assessing the ‘terrain’ of one’s health for nutritional deficiencies and imbalances. I later decided to further my studies beyond my Diploma in Clinical Nutrition and chose Naturopathic Nutrition, enrolling with the College of Natural Medicine in Ireland. I embraced the Functional Medicine approach taught to me by CNM wholeheartedly and still enjoy observing the benefits my clients continue to derive from this progressive healing model. When St. John’s launched the new shopping centre, it was the obvious progression for my business to take up space in the new Lifestyle Centre, which is focused on clean, healthy living.

Now nearly 14 years since our humble beginnings as a small health shop, we proudly carry the largest selection of carefully chosen health products in KZN. Each range has been selected by me personally for its purity and although we carry products from all over the world, we are currently on a drive to prioritise our locally sourced ranges.
With a special interest in the power of herbal medicine, I have started to formulate my own blends of herbs to support specific health issues, which I commonly encounter in practice.

I am absolutely passionate about furthering my knowledge in all things health related and believe in practicing what I preach. I live in the beautiful Karkloof Valley with my husband and two teenage sons, in the KZN Midlands and am an avid mountain biker, trail runner and hiker. To me, outdoor and natural living go hand in hand with healthy living and I advocate this whole-heartedly to all of my clients.

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder affecting about 10% of women between the ages of 18 and 45 worldwide. Despite the fact that it is the most common form of hormone imbalance, conventional medicine has little success in treating it. The main hormone disruption we see in PCOS is elevated levels of androgens in women. Androgens are “male hormones” such as testosterone and DHEA. Although these hormones are always present in women, higher levels can result in numerous unwanted manifestations, such as dark facial, arm or chest hair.

Common symptoms associated with PCOS

The symptoms associated with PCOS are fairly diverse, this is due to the fact that there are dozens of hormones which are governed by the endocrine system and this syndrome is essentially characterised by a dysfunctional Endocrine System. It is not unusual to see anything from 4 to 10 of the below symptoms in a woman living with PCOS:

• Ovarian cysts
• Excess hair growth, frequently on face and chest
• Menstrual irregularities
• Infertility or fertility difficulties
• Acne
• Obesity or excessive weight gain
• Fatty liver
• Irritable bowel syndrome (IBS) – food intolerance
• Insulin resistance
• Male pattern baldness
• Increased risk for autoimmune thyroid disease
• Blood tests showing elevated testosterone levels and increased LH to FSH ratio

Diagnosis and Tests

Recognising PCOS in the early stages is valuable and can save a lot of heartache and discomfort down the line. It is important to recognise that PCOS is really a collection of signs and symptoms, which result in different manifestations in different women, depending on their individual physiology. An ultrasound alone is insufficient for diagnosing PCOS as the absence of cysts on the ovaries can’t be used to rule out PCOS, because irregular periods and excess androgens with normal ovaries on ultrasound can still indicate PCOS.

Diagnosis can be tricky because no two women will present with exactly the same symptoms. As a result, many women go undiagnosed for years or get misdiagnosed, which can be so disheartening.

One of the most important things we should be looking at is a blood panel which includes Glucose, HbA1c, a fasting Insulin level (75% of women with PCOS are Insulin resistant), and a Lipid Profile. Sex hormone levels are also valuable, the most essential being Lutenising Hormone (LH), Follicle-Stimulating Hormone (FSH), total and free Testosterone and DHEA. In the absence of periods, testing Prolactin should be considered, as elevated levels, often caused by a traumatic event, can raise DHEA, negatively impacting ovulation. Thyroid tests (T3 and T4) may be useful too as Hypothyroidism has been shown to worsen insulin resistance and interfere with ovulation. I personally like to conduct a live and dry blood analysis to asses for imbalance in the general terrain of one’s health. This can be particularly useful in assessing for inflammation, heavy metal toxicity, and various nutrient deficiencies. I also find tremendous value in doing an Essential Fatty Acid test, which shows levels and ratios of Omega 3 to Omega 6 and levels Eicosanoids. Eicosanoids are key mediators and regulators of inflammation.

Last, but not least, Vitamin D levels should be established, as low Vitamin D can exacerbate PCOS symptoms due to it playing a crucial role in ovarian function and insulin sensitivity.

Product featured: Better You Dlux 1000 Vitamin D

What causes PCOS

There is no one cause of PCOS, but certain lifestyle factors and situations need to be given consideration as possible causes for increasing the risk of developing PCOS. Studies show that genetic susceptibility puts one at risk, but as with most chronic conditions, genes express themselves based on their environment, so lifestyle, diet and stress will be the ultimate deciding factors here. A diet high in processed foods, sugar and simple carbohydrates is known to increase one’s body weight. This can leading to insulin resistance and other hormonal changes, which could contribute to PCOS. Another contributor is hypothyroidism, some studies show that low thyroid function may also contribute to an increased risk of developing PCOS. Numerous studies have demonstrated a link between BPA (a chemical commonly found in plastics) and susceptibility to PCOS, as has the presence of heavy metal toxicity.

Research has found PCOS to be an inflammatory condition. Elevated insulin can lead to chronic inflammation, as can poor quality or inadequate sleep, high levels of stress, certain foods and food sensitivities, lack of physical activity, gut dysbiosis (imbalance in bacteria), presence of parasites, exposure to toxins, excess alcohol consumption and smoking. Chronic inflammation (when it has prevailed for longer than 2 weeks) is problematic as the cytokines released interfere with hormonal communication throughout the body, potentially causing the endocrine system to produce more androgens (male hormones), further exacerbating the PCOS cycle. Beyond hormonal interference, typical signs and symptoms of chronic inflammation often include digestive symptoms (like bloating), skin conditions such as dermatitis or acne and joint pain. Women who suffer from any of these, plus irregular cycles and evidence of raised androgens, should be addressing the root cause of their individual chronic inflammation as this is the best place to start in addressing the environmental factors driving their PCOS.

Conventional approaches to treating PCOS

Oral Contraceptive Pill

This is the most common approach offered by mainstream medicine. The OCP stops ovulation, so this is rather counter-productive. Although the pill suppresses androgen production, it only lasts for as long as you are on the pill. Typically, once the pill is discontinued, androgen production is worse than ever. The pill has also been shown to worsen insulin resistance – one of the main drivers of PCOS. Finally, the pill is associated with Dysbiosis (imbalance in gut flora), which can lead to an imbalance in the ratio of sex hormones. There is a group of microbes within the gut microbiome which plays a crucial role in the regulation of hormones. These microbes are referred to collectively as the Estrobolome. Research suggests that an imbalance in the Estrobolome may promote increased androgen biosynthesis, contributing to hormonal imbalances characteristic of PCOS.

Metformin / Glucophage

This is the drug typically given to Type 2 Diabetes patients so as to reduce absorption of glucose and to increase sensitivity of cells to insulin. Although addressing insulin resistance is useful, studies show that improving diet and lifestyle are more beneficial for managing PCOS. Side effects of these drugs include digestive issues and Vitamin B12 deficiency.

Aldactone

This diuretic is commonly prescribed in the instance of PCOS to block the effects of androgens. It takes up to six months to notice the impact and is only effective whilst taking it. It can lead to irregular and abnormal periods, which is also somewhat counter-productive when dealing with PCOS.

Natural ways of dealing with PCOS

There is no quick fix, nor band-aid solution to PCOS. Diet and lifestyle interventions are most effective, the sooner they are embarked upon, the better. Tackling the root cause of PCOS is essential and I focus largely on nutrition (diet and supplements) and exercise, not only because they are ‘hands-down’ my own personal favourite tools, but they happen to be the most effective too. Having said that, the approach one takes to overcoming PCOS should be highly personalised. For example, if a woman is obese and highly insulin resistant, then I am going to recommend moderate, frequent exercise and a relatively low carb diet, but if she is not overweight and severely stressed, burning the candle at both ends and doing CrossFit 5 times a week, I am going to address adrenal function first. There is no one diet, nor exercise plan which will resolve PCOS for all sufferers.

Nutrition

Most importantly, whole, unprocessed foods full of fibre, colours and loaded with anti-inflammatory properties should be prioritised. Adopting a predominantly plant-based diet, which focuses on a broad variety of colourful fruits and vegetables, is essential.

Brightly coloured fruits and veggies: The anti-oxidants and anti-inflammatory components of our foods are concentrated in the pigment of fruits and vegetables. Foods such as berries, beetroot, turmeric, cinnamon and red onion come to mind. Due to the fact that PCOS is so strongly associated with inflammation, an effort should be made to improve the ratio of omega 3 to omega 6 fatty acids. Including a couple of portions of oily fish (salmon, mackerel, sardines etc.) on a weekly basis would help, but as this is often not possible, I always recommend a good quality Omega 3 supplement. I cannot emphasize enough the importance of correcting your ratio of Omega 3: Omega 6. This ratio governs systemic inflammation, which is the driver of virtually all chronic disease.

Cruciferous vegetables: this family of vegetables, which includes broccoli, cauliflower and Brussel sprouts, assists in combatting insulin resistance by slowing down digestion and reducing the impact of sugar on the blood. Sulforaphane is a sulphur rich compound found in high concentrations in cruciferous vegetables and available as a supplement. Sulforaphane enhances detoxification pathways and activates Nrf2 activation, increasing fat burning potential, reducing inflammation, increasing energy production and preventing obesity.

Grow your own Broccoli Sprouts

Sulforaphane is most potent when broccoli is sprouting before it matures into the plant you see in the produce section. The best part? You can easily and cheaply grow these at home.

Ingredients/supplies:

• 3 tbsp. organic broccoli sprout seeds
• 1 large (32-oz.) mason jar
• Sprouting top
• Small bowl for draining
• Filtered water

Directions:

1. Add seeds to your clean mason jar.
2. Cover with about 3 inches of filtered water.
3. Leave the seeds to soak in water for about 12 hours (in a cool, dry place, not in the fridge or in direct sunlight).
4. After about 12 hours, drain the water and rinse and drain your seeds into the draining dish.
5. Rinse and drain your sprouts twice per day (once in the morning, once at night) until your seeds sprout (usually 5-6 days).
6. When your jar is full of fresh sprouts, they’re done.
7. Rinse and pat dry with paper towels. Store in the fridge.
8. Enjoy in salads, soups, and smoothies!
9. Recommended dose: Eat ½-1 cup of sprouts daily on salads or in soups or stews, along with some raw radish.

There are many potently anti-inflammatory ingredients in your kitchen, which should be incorporated into your diet as often as possible. Here are some of the most valuable: rosemary, ginger, aloe, green tea and turmeric.

It is a great idea to make yourself a jar Golden Paste and to consider supplementing with Curcumin.

Golden Paste Recipe

Ingredients:

• 1/2 cup (125 ml / 60g) turmeric powder
• 1 cup water (250 ml) plus extra water in reserve, if needed
• 1/3 cup (70 ml) coconut oil (use raw, unrefined, cold-pressed)
• 2 – 3 teaspoons freshly cracked (ground) black pepper

Recipe:

1. Bring the turmeric and water to a boil in a saucepan, then lower heat and simmer until you have a thick paste. This should take about 7-10 minutes and you may need to add the extra water along the way for good consistency.
2. Add the freshly cracked (ground) pepper and oil AFTER cooking, when it has been removed from heat and cooled down (still warm to touch but not burning), about 10 minutes later.
3. Stir in well to mix the oil in everywhere and allow to cool again (if coconut oil is hard, it should melt in the mixture).
4. Do not add honey or any sweeteners. Sugars are not necessary and they provoke inflammation.
5. Try 1/4 of a teaspoon, twice a day (with food), and build up to 3 – 4 times a day, for the first 4-5 days.

Supplements

As hormone imbalance essentially underpins PCOS, it is no surprise that Agnus Castus (also known as Chaste Berry) is useful in balancing hormones.

Product featured: Sfera Nutrition Agnus Castus

NAC (N-Acetyl Cysteine) is a supplement form of cysteine, a semi-essential amino acid. NAC replenishes glutathione, the most powerful anti-oxidant in your body. NAC may improve fertility in women with PCOS by inducing ovulation. In addition to this, it plays a valuable role in stabilising blood sugar by decreasing inflammation in fat cells, thereby improving insulin resistance.

Product featured: Kirkman NAC (N-Acetyl Cysteine)

Berberine is another phytochemical with potent therapeutic activities. This plant extract with a deep yellow colour and intense bitter flavour is commonly extracted from Goldenseal, Barberry and Oregon Grape Root. Modern research shows that Berberine Hcl benefits four areas of human physiology, all of which have an effect on PCOS: lipid metabolism, glucose metabolism, gastrointestinal health and cellular health.

Product featured: Coyne Bio-Berberine Advanced

Magnesium is a common deficiency in women with PCOS. Magnesium supplements have been shown to improve insulin resistance and improve inflammation. As adrenal stress can be a driver of PCOS, and adrenal glands require a lot of magnesium, it is important that a daily magnesium supplement be priorotised.

Products featured: Good Health Organic Magnesium Ultra & Coyne Biomax Magnesium Berry

Summary of Supplement plan daily:

• Sulforaphane: 600mg daily
• Omega 3 (EPA 800, DHA 600)
• Vitamin D3: 1000iu to 8000iu daily, depending on test results. Take with a meal containing fat.
• NAC (n-acetyl-l-cysteine): 600mg daily
• Agnus Castus: 400mg daily
• Magnesium: 220mg elemental, take at bedtime.
• Berberine: 500mg twice daily, with meals.

Exercise

Exercise is a fundamental cornerstone to improving your overall health and quality of life if you have PCOS. It is important that you part-take in some exercise as regularly as 4 to 5 times per week, but it should be relaxing, enjoyable and not too protracted. Try Swimming, Yoga, Walking, Cycling or Zumba. Exercise can help restore fertility, improve weight loss and improve your outlook overall.

If you suffer from PCOS, you absolutely deserve the endorphin release gifted to you as a reward for exercising. The more you do it, the easier it becomes. Try to ‘’kill two birds with one stone’’ by ensuring that your exercise time is pleasure-time too.

Sleep

Good quality sleep is as essential as getting an adequate amount of sleep. A bad sleep pattern encourages systemic inflammation, blood sugar imbalance and insulin resistance. A single night of poor sleep can result in poor food choices the next day, which contributes to and perpetuates the cycle of blood sugar imbalance, weight gain and inflammation.

Here are some pointers to help you achieve a better quality sleep:

• Practise a bedtime routine. Have a bath, read a book etc.
• Make your room as dark as possible.
• No blue-light after 6pm
• No chocolate, coffee, regular tea, sweets or alcohol (for 10 days), once you re-introduce these stimulants, avoid caffeine and sugar after midday.
• Exercise each day.
• Get some sunshine daily (sunshine is the perfect anti-dote to blue-light).
• Learn to meditate or do breathing exercises to help you fall asleep

PCOS can be a devastating condition, with a broad range of extremely undesirable symptoms. Living with it is often depressing, frustrating and disheartening, but there is much hope for bringing about balance and healing by addressing PCOS from as many aspects as possible. By implementing the lifestyle interventions discussed here, you may just surprise yourself when your body responds by coming back into balance. It never stops trying to restore balance, but the tools to achieve this lie in your hands and the decisions you make.

 

Be kind to yourself, be patient and listen to your body.

Yours in health,

Renée (Clinical and Natropathic Nutritionist)

Photography & Styling by Project Flash Photography

Disclaimer: Each person’s physical, emotional, and spiritual condition is unique. The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your doctor for matters pertaining to your specific health and diet. The author of this article is not held responsible for any adverse effects or consequences resulting from the use or misuse of any information, suggestions or procedures described herein. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.