Healing PCOS. Amy Medling
mutation, your body is less efficient at making the conversion and therefore utilizing the folic acid in multivitamins and prenatal vitamins, which is important in preventing serious birth defects. A lack of folate may also result in lethargy, mood disorders, and impaired cognitive function. MTHFR is also responsible for converting homocysteine into methionine, which you need for growth, cell repair, and metabolism. High levels of homocysteine in the blood may negatively affect mood and mental health and are associated with cardiovascular disease, high blood pressure, depression, migraines, and more. A high-quality supplement containing folate instead of folic acid can help. I suggest all women with PCOS be tested for the MTHFR mutation.
Delta-6-desaturase (D6D). Foods such as flaxseed, leafy greens, and walnuts are high in an omega-3 fatty acid called alpha-linolenic acid (ALA). Omega 3s are widely recommended for their many health benefits, especially for the brain, eyes, and heart. For women with PCOS, sufficient amounts of omega 3s can improve fertility, regulate hormones, improve insulin sensitivity, stave off inflammation, reduce hirsutism, and reduce the risk of fatty liver and heart disease. Unfortunately, for ALA to be used in the body, it must first be converted by an enzyme called delta-6-desaturase (D6D) into one of two other omega-3 fatty acids, docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA). This transformation is very inefficient and is further inhibited by elevated cholesterol, caffeine or alcohol consumption, saturated fat or trans-fat consumption, vitamin and mineral deficiencies, and hormonal abnormalities, insulin resistance, and hypothyroidism. Even when D6D functions normally, only about 8 to 20 percent of ALA is converted to EPA and 0.5 to 9 percent to DHA (this may be slightly higher in women of childbearing age or who are pregnant). The omega 3s found in fish (and fish oil) are already in the form of DHA and EPA, so they do not need to undergo this conversion and are more bioavailable. Still, it is hard to safely eat enough fish to meet the daily requirements.
Inositol. Inositol is a vitamin found in whole-grain foods and made by your body from glucose. Myo-inositol and D-chiro-inositol are two of the nine naturally occurring inositols that people need. These two inositols help with insulin sensitization, and women with PCOS commonly benefit from supplementation.
Found in meat, myo-inositol is critical for properly functioning insulin receptors. It has also been linked to the activation of serotonin (a “feel good” hormone) receptors, which could relieve depression and improve appetite, mood, and anxiety. Supplementation may help with inducing menses and ovulation and reducing acne and hirsutism. Myo-inositol is found in food, but women with PCOS often have a defect in their insulin pathways, which are heavily reliant on inositols. Adding myo-inositol supplementation seems to alleviate the problem.
Not abundant in our diets, D-chiro-inositol (DCI) needs to be converted from other inositols (myo-inositol and D-pinitol) by the body in order to be used. Studies suggest that women with PCOS may not be able to efficiently convert other inositols to DCI. Low levels of DCI have commonly been observed in women with impaired insulin sensitivity and PCOS. DCI increases the action of insulin, improves ovulatory function, and decreases serum androgen, blood pressure, and triglycerides. It may also help decrease testosterone and improve IVF outcomes.
Check Your Vitamin D
Three out of four women with PCOS have a vitamin-D deficiency. This may exacerbate the symptoms of PCOS and increase the risk for multiple sclerosis, inflammation, type 1 diabetes, osteoporosis, high blood pressure, heart disease, insulin resistance, and breast and other cancers. A vitamin-D deficiency may be caused by a genetic variation or a nutritional deficit.
Vitamin D works to inhibit inflammation. In a recent study, researchers at National Jewish Health found a DNA receptor specifically for vitamin D. They discovered that a lack of vitamin D will cause suboptimal activation of the receptor and put patients at risk for inflammatory diseases. Moreover, they discovered improvement with vitamin D supplementation. Since vitamin D is critical to the absorption of calcium, a deficiency causes a cascade of related issues.
I encourage all women to have their vitamin D levels checked right away. It is a simple test, and a deficiency is usually a straightforward thing to fix and can make a world of difference throughout your body. If your doctor does recommend a supplement, choose one like PCOS Diva Super D, which combines a high-quality vitamin D with vitamins K1 and K2 to facilitate absorption.
Medications. Many medications sap your nutrients. Women with PCOS are almost always prescribed either the birth control pill, metformin, or both. Each of these depletes important nutrients, which must be replaced.
Studies show that women who use the birth control pill have lower levels of B2, B6, B12, and folate compared to women who do not use oral contraceptives. This is of particular concern, because the body needs these critical B vitamins for metabolizing fats, proteins, and carbohydrates, and deficiency can cause anemia and depression. In fact, low levels of B6 may explain the increased risk of blood clots in women who take the pill. Low folate can cause birth defects. Other studies indicate that the pill may deplete vitamin C, vitamin E, magnesium, selenium, zinc, and coenzyme Q. Unfortunately, zinc and magnesium deficiencies are a common cause of unexplained infertility and recurrent miscarriages. Hair loss is often an indicator of a zinc deficiency.
Meant to lower insulin levels, metformin also depletes the body of Vitamin B12 and other nutrients in 30 percent of patients. B12 has recently taken center stage, and rightly so, as a shortage of B12 is associated with nerve pain, cognitive dysfunction, and anemias. B12 is also critical for many of the detoxification pathways and for DNA stability.
Recommended Supplements
There is no “PCOS supplement.” Every woman is unique. That said, there are a few supplements that I strongly advise women with PCOS to try. These supplements are certainly not the only ones that can help, but they are a good place to start. For a more complete list of supplements appropriate for women with PCOS, visit PCOSDiva.com/supplements and download the Complete Supplement Guide. Before beginning any supplements, natural or otherwise, check with your doctor for any possible interactions.
A multivitamin: A highly bioavailable multivitamin, like my PCOS Diva Essentials multivitamin, containing methylated B vitamins and insulin sensitizers such as chromium, vanadium, alpha-lipoic acid, zinc, and magnesium will support your metabolism. I take six capsules of PCOS Diva Essentials per day, three in the morning and three at lunch.
A prenatal vitamin: If you are thinking about getting pregnant, already are pregnant, or are breast-feeding, you need a high-quality prenatal vitamin. Be sure it contains folates (not folic acid), calcium and magnesium (for healthy bone development), iron, zinc (for reducing the risk of preterm birth), and iodine (for reducing the risk of birth defects).
Fish oil (an omega 3 with EPA and at least 1000 mg DHA): Most important for us, fish oil promotes normal insulin production and a healthy inflammation response. It can also support