Omega 3-6-9 supplements: Not the best choice for PCOS

In my quest to get more omega-3 fatty acids into the people I meet, one of the most common comments I hear is, "I'm taking my omega 3-6-9 supplement."

I have learned from this, that sometimes the more popular concept is the one that is best marketed, not necessarily the one that is the best choice.

Here's why this supplement deserves reconsideration.

Omega-6 fatty acids are essential fatty acids. However, the problem with our diet is that we already have an oversupply of those in our food. Essential as they are, they are so prevalent we do not need to supplement with them. We actually need to dial back on the amount we consume. One of the reasons you see on this blog, and you hear me say when I speak, to minimize your intake of oils beginning with the letters "S" and "C" (corn, cottonseed, soy, safflower, sunflower, sesame), is because it's an easy memory trick to use when you're grocery shopping. If you can move away from these oils and focus more on avocado oil, olives, olive oils, nuts...and the only exception to that rule, canola oil, it is very effective at reducing an oversupply of omega-6 fatty acids within your body.

Omega-9 fatty acids are not essential. Meaning, we can make them from other compounds in our body and we do not need to supplement with them. They are a major component of olive oil, which, if you're reducing omega-6 intake and focusing more on the fats I just mentioned, should provide you with sufficient omega-9 in your diet. You should not need supplementation.

The fatty acid we have a lot of trouble getting, is omega-3. It's primarily found in fish, but is also, in varying forms, found in marine algae and algal-supplemented products, flaxseed, nuts, edamame, dark green leafy vegetables, and pumpkin seeds, to name a few. The differences between the fish-based and vegetarian-based omega-3's are discussed elsewhere in this blog. The important thing to take away from THIS post, is that if there's anything you need to focus on getting in your diet, it's omega-3's, not omega-6's.

I'm hoping someday that my "S and C" mnemonic will be more memorable than the "3-6-9" version that appears to be causing confusion.

Reader question: Do I have to go to a gynecologist to get treated for PCOS? Or get medication for it?

This is a great question!

PCOS, because of the word "ovary" in its name, is often thought of as a gynecological disorder. However, it has symptoms affecting quite a few organ systems, many of which gynecologists may not be specially trained to treat.

Before you ask for help with your PCOS, be sure you know exactly what it is that you are wanting from that person.

Are you trying to become pregnant? Then a gynecologist is your best bet. Do you have acne or facial hair? A dermatologist is most likely to know the latest and best PCOS-friendly treatment options. Family history of diabetes? Consider a diabetes-specialized endocrinologist. Keep in mind, a specialist is trained to see your condition through a very finely tuned set of lenses, and that means the possible answers they provide will have some bias. Medline published a study a few years ago illustrating this bias, reporting that a gynecologist and an internist would have very different ways of diagnosing--and treating the same PCOS. So it is important to know what your goals are, before choosing the best person to help you reach them.

Despite those recommendations I just gave, consider that you may not actually need a "specialist". Some of the best physicians I've worked with on behalf of clients have simply been good listeners and willing to look for solutions even if they didn't have them, themselves. That person could be a country doctor, if you live in a rural area, or a family practitioner who has been your primary caregiver for a very long time. What matters most is that you get solutions in a respectful fashion!

I am biased because I am a dietitian and not a physician, but I strongly encourage you to find a physician who values a well-trained dietitian as part of your treatment. Nutrition is one of those topics everyone knows a little about. But it is also one of those things a lot of people think they know more about than they really do. I've encountered a lot of nutrition advice for PCOS given by health professionals that actually could have been counterproductive. It is important for each person taking care of you to excel in the part of your treatment they are trained to excel in...but also to refer out to others who excel in their own part of the picture. No one can possibly know everything about everything!

A strong nutrition program can often do the job that medications are prescribed to do. So making extra sure that nutrition and lifestyle are in good order before jumping into medications, surgeries, and treatments, can save a lot of time and frustration. Even if it turns out that medication and other treatments are needed in addition to medications and procedures, you may not need as much medication, and you may have better tolerance for and success with, the treatments your physician provides for you.

On that note, qualified naturopathic physicians and acupuncturists may have treatment options that work well for your individual situation. I have seen several of my own clients do very well with a team that included medical doctors IN ADDITION to specialists in these areas. What made it work, was a willingness on the part of each of these professionals, to work together with the other professionals.

One of the most important responsibilities you have, once you ask for help from a medical professional, is to follow their advice. And to follow it long enough to give it a chance to work. A very common tendency I see, unfortunately, is for a person to try advice, but not long enough for it to actually work. And then they blame the physician. Or, to spend more time on the Internet looking for reasons to NOT follow the doctor's or dietitian's advice than actually giving it a chance in real life. If you are asked to take medication, take it consistently. If you are advised to exercise, then exercise. It is not the physician's fault if the medication s/he prescribed was not used as advised!

Once you've found the person you feel fits you best, remember that a lot of the answers to the syndrome are about changes YOU can make for yourself. Doctors, dietitians, acupuncturists...can guide you toward those changes, but they cannot make them for you. It's important to remember how much of the responsibility for your success comes from other people, and how much of it actually lies within YOU.

Food of the week: Leeks

Anyone living out West has had a week of comfort food weather! Here in Phoenix we had as much rain in a week as we normally get in a year. I haven't felt like venturing out, and I want foods that warm me from the inside out.

And that has had me thinking about leeks.

Leeks are the onion's, unfortunately less popular and often forgotten, cousin. I say that because leeks are milder than onions, with a lot of the same health benefits. Many of those benefits are related to PCOS health risks.

Vegetables in the onion/leek/garlic family help to:
--reduce LDL cholesterol and raise HDL cholesterol
--lower blood pressure
--reduce risk of ovarian cancer
--stabilize blood glucose

Most of you probably think of leeks in leek potato soup...but there are so many more ways to cook them! Here's a great feature from Cooking Light to get you started.


So comfort food and PCOS help, unite!

What PCOS topics would you like us to write about?

Over the last week, I've received quite a few requests to write about specific topics. While I'm making up the list...I thought I'd throw out a call for questions.

What do you want to know? How can we help you?

I look forward to your questions!

Coming soon to your computer! Webinar: Nutrition vs. bioidentical hormone replacement therapy

If you've been intrigued by the concept of bioidentical hormone replacement therapy, and you'd like to learn more, please consider attending our upcoming webinar on the topic.

We'll be defining and understanding the treatment, and comparing/constrasting the potential benefits that a structured nutritional program has to offer.

The live webinar will be broadcast on Tuesday, February 23, 2010, at 6 pm Eastern Time. If you cannot make the live broadcast, you may purchase the recording.

Both live and recorded webinars cost $35.

Click here for registration information.

Hope you can make it!

Insulin sensitizers, d-chiro-inositol, and fertility

Here's an interesting Cochrane Review hot off the presses, evaluating the effects of insulin-sensitizing agents on fertility.

A group of 31 studies that compared the effectiveness of these agents to a placebo were evaluated for what they said overall about the potential benefit for their use in women with PCOS who are trying to conceive. Of these, 27 were studies about metformin (likely because it is the most widely researched/used and more studies exist in the first place).

What the researchers concluded:

There is no evidence that metformin improves live birth rates whether it is used alone or in combination with clomiphene. However, metformin does improve ovulation and pregnancy rates. (Interpreted, this suggests that metformin does not help to prevent miscarriage.)

Metformin was also associated with a significantly higher incidence of gastrointestinal disturbance, but no serious adverse effects were reported. (I don't know about those of you reading this blog post who have tried metformin, but I would question the assertion that the gastrointestinal disturbance this medication causes is not a "serious adverse effect"!

IN THE WORDS OF THE AUTHORS: "In agreement with the previous review, metformin is still of benefit in improving clinical pregnancy and ovulation rates. However, there is no evidence that metformin improves live birth rates whether it is used alone or in combination with clomiphene, or when compared with clomiphene. Therefore, the use of metformin in improving reproductive outcomes in women with PCOS appears to be limited."

D-chiro-inositol was not even mentioned in the abstract, suggesting that the findings were not significant.

As with any information shared in this blog, only you and your provider can make the ultimate decision. I can tell you what went through my own mind--and heart--as I read this, was that this medication may create a lot of false hope and hurt for those who trust that it has more power than it actually does. I wouldn't wish a miscarriage on anyone.

Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003053.

If only I had bet my money on whether Meridia would find itself in trouble...

In addition to PCOS, I specialize in the nutritional aspects of medications affecting the brain and nervous system. That includes psych meds, Parkinson's meds...pretty much any medication that has the potential to affect how the brain and nervous system function.

A few years ago, while compiling a series of fact sheets about the nutritional implications of these medications, I started reading about the anti-obesity medication called Meridia (generic name sibutramine). This drug appeared on the market after the famous phen-fen combination was deemed dangerous. It was supposed to be a kindler, gentler alternative. And it supposedly can reduce the severity of symptoms associated with PCOS.

I was floored by what was showing up, unedited, in the peer-reviewed literature about this medication. But not at all surprised with the announcement yesterday that this drug is potentially dangerous for people with heart conditions.

Repeatedly and consistently, researchers were reporting reactions. Some of the most common problems this medication seemed to incite, were anxiety, hypertension, and elevated heart rate.

If Meridia was a drug intended to treat cancer, or glaucoma, or hangnail, and it caused this battery of symptoms, I don't think the FDA would have tolerated consistent reports that it had the ability to send the cardiovascular system into a tailspin.

Yet, in the obese research subject, in the face of these observations, researchers continued to report some of the following conclusions:

**In a 21 patient study, 40% experienced sleep disturbances and 30% complained of irritability, unusual impatience, or "excitation".
RESEARCH CONCLUSION: Sibutramine, 5 and 20 mg, added to a multimodal program assisted participants in losing weight.
Weintraub M, Rubio A, Golik A, Byrne L, Scheinbaum ML. Sibutramine in weight control: a dose-ranging, efficacy study. Clin Pharmacol Ther. 1991 Sep;50(3):330-7.

**In a review study, the author reported, "In controlled studies, 84% of sibutramine-treated patients reported adverse events, compared with 71% of patients receiving placebo. The most frequently reported adverse events are related to pharmacological actions of sibutramine, and include dry mouth, decreased appetite, constipation and insomnia. Despite the high incidence of "side effects" in the control population, the author of this article attributed the problems in the tested population to "pharmacological actions of sibutramine".
Lean ME. Sibutramine--a review of clinical efficacy. Int J Obes Relat Metab Disord. 1997 Mar;21 Suppl 1:S30-6; discussion 37-9.

**In a study of 226 people comparing sibutramine to dexfenfluramine, researchers reported, "174 patients (77%) experienced adverse events; 17 patients withdrew due to adverse events. Pulse rate increased significantly in sibutramine-treated patients." Then they concluded, "Sibutramine (10 mg once daily) is at least as effective as dexfenfluramine (15 mg twice daily) in achieving weight loss in patients with obesity."
Hanotin C, Thomas F, Jones SP, Leutenegger E, Drouin P. A comparison of sibutramine and dexfenfluramine in the treatment of obesity. Obes Res. 1998 Jul;6(4):285-91.

**In a study of 235 people, the following was reported, "a significant increase in heart rate (about 4 beats/min) was noted for patients who received 10 mg or 15 mg sibutramine, compared with the placebo." Then it was concluded, "Doses of 10 mg and 15 mg once daily were shown to be similarly effective, well tolerated and significantly more effective than the placebo."
Hanotin C, Thomas F, Jones SP, Leutenegger E, Drouin P. Efficacy and tolerability of sibutramine in obese patients: a dose-ranging study. Int J Obes Relat Metab Disord. 1998 Jan;22(1):32-8.

**In a study of 11 men, it was observed that "the sibutramine-induced increase in energy expenditure was accompanied by an increase in plasma epinephrine, heart rate, blood pressure, and plasma glucose. The conclusion: "Sibutramine caused a significant increase in both energy expenditure and satiety, which may both contribute to its weight-reducing properties.
Hansen DL, Toubro S, Stock MJ, Macdonald IA, Astrup A. Thermogenic effects of sibutramine in humans. Am J Clin Nutr. 1998 Dec;68(6):1180-6.

As of 2006, I had found 14 studies reporting an elevated heart rate with use. You can easily find them yourself in http://www.ncbi.nlm.nih.gov/pubmed/; I encourage you to see for yourself. I've supported myself here with enough references and my Saturday has other obligations prohibiting me from using it to repeat work I've already done. I hope I've encouraged you to see for yourself what I've been talking about with colleagues for several years.

I like to call this the Biggest Loser Mentality. It doesn't matter if we make these people vomit, pull a muscle, or give them a bloody heart attack. This market of obese people is just too lucrative to ignore.

If you have PCOS and you are obese, you deserve better. You're not where you are because you have a deficiency of ANY kind of medication in your body. Don't let anyone convince you otherwise.

Webinar: Nutrition vs. Bioidentical Hormone Replacement Therapy

For anyone who is interested in the topic of bioidentical hormone replacement therapy, I will be presenting a webinar comparing this treatment to nutritional options.

This webinar will be held on February 23, at 6 PM Eastern time. The cost is $35.

Information can be found at our Facebook page.

You can register at this link.

There is an option to purchase the recorded version of this webinar if you are interested in the information but cannot attend the live presentation.

A PCOS-Friendly Recipe

Blog reader Renata Mangrum, a fellow dietitian, sent me this recipe. I am not a sardine lover myself, but I am always surprised at how many people really do enjoy them. On behalf of those who do...here is Alton Brown's sherried sardine toast. Enjoy!

www.foodnetwork.com/recipes/alton-brown/sherried-sardine-toast-recipe/index.html

January's PCOS-friendly Picks from the amazon.com grocery store

It was fun to see that our virtual grocery shopping tour was so popular! Here are some things to look for, either in your local grocery store, or through the provided links.

Bob's Red Mill Soup Mix, Veggie, 28-Ounce Units (Pack of 4) Bob's Red Mill is one of my favorite companies. Practically everything they sell is worth your consideration. Here's a soup mix you can throw into your slow cooker, with some favorite veggies.

Sensible Foods Organic Crunch Dried Snacks, Apple Harvest, 0.75-Ounce, 12-Count Pouches A great substitute for a bag of chips!

Tinkyada Brown Rice Penne Pasta with Rice Bran, 16-Ounce Packages (Pack of 12) Some high-fiber, gluten free pasta.

Kavli Crispbread, Garlic, 5.29-Ounce Boxes (Pack of 12) Crackers are a hard one. Here's one of my favorites.

Roland Feng Shui Edamamee Edamame is a type of tofu with lower potential to throw your hormones out of balance. It's great to throw on a salad or toss into a pilaf.

Bob's Red Mill Fig Nuggets, 18-Ounce Packages (Pack of 4) If you like Fig Newtons, why not figs? They are a great dried fruit to keep on hand!

Sahale Snacks Variety Pack of 3 Flavors, 0.75-Ounce Pouch (Pack of 30) Nuts, nuts, nuts...great source of healthy fats.

Westbrae Natural Vegetarian Organic Kidney Beans, 15 Ounce Cans (Pack of 12) A can of beans is a great basis for a quick dinner..in a salad, a quick soup or chili, or a burrito.

Honest Foods Granola Planks, Blueberry Vanilla Crackle, 3-Ounce Bars (Pack of 6) Just another "bar", but one with a nice combination of ingredients.

All things quinoa One of my favorite grains, it's high protein, low glycemic, and great for helping to balance hormones.

Happy Eating!

A great example of why too much focus on carbs may actually hurt your PCOS success

If cutting carbs was the only dietary strategy needed to help PCOS, this blog wouldn't exist. There are clearly thousands of women, based on the traffic statistics for this blog, who've tried that approach without success.

One of the food groups that gets cut out of the diet when we worry too much about carbohydrates, is fruit. And fruits are just loaded with antioxidants that are showing potential to help balance our biochemistry.

Resveratrol is one of those anti-oxidants. It is a compound well recognized for its benefits in reducing cancer risk, inflammation, cardiovascular disease, blood clotting, and other aging-related issues. It is actually a compound that some plants have the ability to produce to fight off pathogens that threaten their own health, that turns out to have the same ability in humans.

A recent study specifically done with PCOS suggests that it has potential for women with this syndrome.

In rats, resveratrol was shown to reduce the excess growth of ovarian tissue. It also inhibited the tendency for insulin to promote this type of excess tissue growth.

Where do you get this great stuff?

1. Red grapes, blueberries, bilberries, and cranberries. Bilberry extract is most commonly found in supplement form. The other fruits are often taken out of a low-carbohydrate diet. Don't make this mistake!

2. Red wine. For those of you who are trying to conceive, please exercise caution with this choice. It's best to pursue the nonalcoholic options provided here. But if you are not in that category, consider enjoying a glass of red wine with dinner tonight! Spanish red wines and New York pinot noirs are your best option, they've been found to have the highest resveratrol concentrations.

3. Peanuts and peanut butter. I love this one. Sometimes we think nutrition has to be complicated...but a PB and grape J sandwich is a perfect PCOS-friendly lunch!

4. Resveratrol supplements. These are primarily made from extracts of the kojo-kon root. Not that supplementation is bad, but I've been around long enough to see that when you isolate a compound from its natural source, you often miss out on other factors and compounds that either help make that compound more effective, or that may be the really important compound in the first place. So I'd encourage the other choices over supplementing. Another consideration that is important is potential conception. I just don't like to recommend supplements to anyone who might become pregnant when I don't know for sure if they have more potential to be helpful or harmful.

5. Dark chocolate and non-dutched cocoa powder. So now if anyone, anyone at all, questions why that really, really high-cacao bittersweet chocolate jumped from the shelf in the Trader Joe's checkout line into your grocery bag...just tell them "the inCYST blog made me do it".

Just a note, in addition to pure chocolate squares, think hot chocolate and mole sauce!

One important point I need to make here is that when resveratrol-containing foods are included in a balanced diet, they can have benefit. It's important to not eliminate entire categories of food. Resveratrol, however, has the ability to affect estrogen levels, in both directions. It's best not to overdose on the supplement because it's "good". Balance is always the goal in PCOS.

Wong DH, Villanueva JA, Cress AB, Duleba AJ. Effects of resveratrol on proliferation and apoptosis in rat ovarian theca-interstitial cells. Mol Hum Reprod. 2010 Jan 12. [Epub ahead of print]

Book review--Living With PCOS by Angela Boss and Evelina Sterling

I just received a review copy of Living With PCOS by Angela Boss and Evelina Sterling. I actually sold the original edition of this book in my bookstore for a time, so I was interested to see the new version.

Before I review, I want to qualify, I went into reviewing this book a little differently than many readers would. I am a dietitian who believes in the power of nutrition to help women with PCOS. In the process of building the inCYST network, I've also had the honor and pleasure of meeting and working with colleagues who use many different (and evidence-based) approaches to PCOS management that expand past what a medical doctor might offer. So I am most likely to connect with experts on the topic with a similar perspective.

What this book is very good at:
--putting the readers in the frustrated and invalidated shoes of a woman with this diagnosis, and advocating for better identification and syndrome management.
--providing a laundry list of qualities to look for in a primary care physician.
--summarizing lab values typically used to develop a woman's treatment plan.
--explaining medications typically prescribed for PCOS management.
--including an entire chapter on depression, an aspect of PCOS that medical professionals seem to not want to acknowledge, but which is very, very prevalent.

What this book could have been better at:
--advocating for as much discretion when choosing a nutrition professional as choosing a physician. Many dietitians say they treat PCOS when they haven't even pursued specialized training for the diagnosis.
--advocating for as much discretion when choosing an alternative care provider as choosing a physician. Again, there are many people who view women with this diagnosis as a revenue stream, not women who deserve evidence-based, ethical treatment.
--explaining why breastfeeding can be problematic in PCOS.
--describing and evaluating alternative therapies, supplements, and herbs. A very high percentage of women with PCOS are so desperate for help they are doing a lot of self-treating and self-medicating, which can be helpful...or very dangerous.
--broaching the topic of emotional eating, binge eating, and eating disorders. It's rampant in this population, it needs to be validated, explained, and destigmatized, as much as the rest of the symptoms do.

I was not entirely comfortable with the section on low carbohydrate diets. Even though it acknowledged that these diets are restrictive and difficult to maintain, it went on to make some general recommendations about how to pursue one. One of the most common problems we encounter at inCYST in our individual counseling, is a blanket carbohydrate restriction that eventually ends up with a binge. It's a noble goal, to reduce carbohydrates, but there are ways to do it that do not promote disordered eating. Perhaps including a dietitian in a future version of this book could help promote healthier eating patterns that are evidence-based.

Because I've been working with Dr. Van Dyke to better understand laser treatment for hirsutism, I was interested on the section regarding laser hair removal. There were some important facts about this treatment that were not included.

In general, for someone who is new to the diagnosis, it's a helpful rundown of what to expect when working with a medical doctor, but the slant is toward that relationship. If you have chosen, in your own personal situation, to prioritize medical treatment without using nutrition, naturopathy, acupuncture, or other complementary treatments, it is a good resource. However, if your treatment team includes other approachess, you will not find information in this book to enlighten you or guide you with regard to those issues.

Click here for more information on the book.

Food of the week: breadfruit

Why would I pick such an esoteric fruit for this blog? I've got several reasons.

1. I have been asked to be part of a committee here in Phoenix that organizes Get Your PHX, monthly events promoting local businesses. Because my specialty is nutrition, I've been assigned the task of finding food for these parties. It's a great opportunity to give my fellow Phoenicians a chance to try some of the principles promoted on this blog--eat a variety of foods, organic and locally grown when possible--and to see that it actually tastes great!

The restaurant I am working with for next week's event is called The Breadfruit. It's a small but very popular joint in downtown Phoenix that obtains quite a few of its ingredients from the farmer's market around the corner. I joined The Breadfruit's Facebook fan page, and Sasha Ottey of PCOS Challenge, who is originally from Jamaica, commented that the breadfruit is a staple of Jamaica. So, for Sasha, I'm highlighting this food.

2. Women with PCOS often cut back what they are eating to just a small list of foods that they've culled from the Internet, at the expense of their dietary variety. I worked with eating disorders before specializing in PCOS, and my observation is that there is a lot more fear about food with PCOS than with eating disorders. I would guess, it has to do with wanting so badly to conceive, or lose weight, or whatever, that (unrealistic) magical powers to help or hurt PCOS start to be attached to certain food. There is no such top ten list of PCOS cure foods. In fact, the more varied your diet, the more nutrients you can get. So I wanted to pick a food that challenged all of you to think outside of that top ten list.

3. Dietary regimens for PCOS take all the fun out of food. It becomes a chore, eating the same foods over and over becomes boring, and eventually the backlash is likely to become a binge on foods that are counterproductive to PCOS. I encourage you all to have fun with food! Even if you're not coming to Get Your PHX next week, if you have an opportunity to try Jamaican food, or Korean food, or Bolivian food...don't pass it up! You might find something you like that you can add to your routine.

Back to breadfruit. What is it? It's a starchy staple of tropical nations around the world. It is typically cooked before eating, and it gets its name from its bread-like flavor. It can also be stored, fermented, and turned into a paste.

In economically disadvanted countries, breadfruit is consumed in large quantities that would not be appropriate for someone trying to balance their carbohydrate, protein, and fat intake. As a side dish, in moderation, it does provide vitamin C, choline, thiamine, niacin, vitamin B6, folate, and a lot of dietary fiber--11 grams per serving! And even though it is starchy, its glycemic index is not high, likely due to its fiber content.

So if you're out having fun, and the menu includes something exotic, don't pass it up just because it's not salmon, broccoli, walnuts, or blueberries. Mother Earth has a bounty of options that are good for you, fun to try, and pleasing to your palate..

Today is a day to think far outside of our own worlds

Dear inCYST friends,

As much as I love what we do with inCYST, and the focus we have on helping all of you with issues that are near and dear...

...today I'd like to take a break from that and put the focus on people who need more.

Our neighbors in Haiti are devastated, without a lot of ways to recover from yesterday's earthquake without outside help. No matter how difficult and hopeless our lives may feel at times, they will likely never be what our Caribbean neighbors are experiencing right now.

I'm asking all of you to think of ways to help.

If you have money to donate, here is a list of organizations that will accept that donation and use it appropriately.

If you don't but know someone who does, please share this list.

And, prayers and thoughts are free and easy to contribute.

Thank you!

A word about d-chiro-inositol

OK. Today's the day. There was finally a quiet morning to read the research about d-chiro inositol. Ever since I posted a link to Sasha Ottey's interview on the topic on her PCOS Challenge radio show, traffic linking to us with that keyword has been very high. I've known we needed a blog post, but I just wanted to be sure it was scientifically accurate and presented information in a way that was beneficial, not hurtful.

What is inositol? It is a chemical that is necessary for several body functions, including: cell structure, insulin function, nerve function, fat breakdown, and maintenance of healthy cholesterol levels.

Inositol comes in nine different forms. Two of those types of inositol, myo-inositol and d-chiro-inositol, have been found to have therapeutic value. Myo-inositol supplementation has been found to alleviate symptoms of bulimia, panic disorder, obsessive-compulsive disorder, agoraphobia, depression, and bipolar disorder. d-chiro-inositol supplementation has been found to be useful for symptoms associated with insulin, high androgen levels, and menstrual irregularity. It is also reported that myoinositol can help prevent hair loss.

Both categories of symptoms are common in PCOS, so it appears that inositol levels and metabolism may be problematic with a high percentage of readers of this blog.

One thing you can do to help improve your levels of both myo- and d-chiro-inositol is to know their dietary sources. Myo-inositol is found in brewer's yeast, liver, milk, whole grains, brown rice, oats, nuts, citrus fruits, molasses, legumes, raisins, and bananas. The best sources of d-chiro-inositol are buckwheat and garbanzo beans (hummous, anyone?)

The theory is, that women with PCOS have trouble converting myo-inositol into d-chiro-inositol. So they need to bypass that metabolic bottleneck with a supplement.

I haven't had the opportunity to use d-chiro-inositol with my clients yet. I haven't wanted to recommend anything unless I'd researched it. But I had a client once, with severe OCD, who responded well to myo-inositol in a way medication and behavioral therapy never achieved. The only issue she had with the supplement was the large dose she needed to take (10 grams per day) in order to see benefit.

Fast forward to today, I've been wondering for awhile if maybe the symptoms attributed to myoinositol deficiency weren't actually myoinositol issues at all, but d-chiro-inositol issues, and the large dose needed was because the conversion in this population is so low.

So here's the best way I would think it would work to determine if d-chiro-inositol deficiency is your problem.

1. Be sure to include all the foods I mentioned above in your diet on a regular basis.

2. Try d-chiro-inositol. Give it three months of regular use to see if it helps.
--If it helps with your insulin levels, androgen levels, and menstrual cycles, then by all means continue using it!
--If it helps with the above, but doesn't help with binge eating, mood, or obsessive thinking, then consider adding some myoinositol to the mix.

3. And please, check back with us. I'm really curious to know what happens. If d-chiro-inositol also helps with mood, etc., that's very important information.

Recommended doses of each: myo-inositol 12-30 grams per day
d-chiro-inositol 100 mg, twice per day

I know, I know, if you're obsessive, you're going to want to take the higher dose of myo-inositol, or even double the dose I've listed. :) I strongly encourage you to resist the temptation and start low and titrate up as you need to.

I spent quite a bit of time in the supplement department at Whole Foods, to get an idea of what readers would find if they went to buy inositol. As you can see at this link, the options on amazon.com, as they are in most health food stores, are primarily myoinositol.

If you'd like to purchase d-chiro-inositol, the most popular source for women with PCOS appears to be www.chiralbalance.com.

A skin procedure for acne scars and skin discoloration

Our own Dr. Susan Van Dyke, in this video, demonstrates Fraxel, a type of laser treatment that is helpful for acne scars and skin discoloration, issues many of you readers face with your PCOS.



Dr. Van Dyke's office is located in Paradise Valley, Arizona.

For more information visit www.vandykelaser.com

Web page is up for 2nd PCOS Spa Week in Vermont

If you've had your eye on the PCOS week at Green Mountain in Fox Run...or if this is your first time hearing about it...the updated web page with all the information is now posted!

Hope you can come!

http://www.fitwoman.com/pcos-treatment-symptom-diet-program.htm

Some special offers for those of you wanting to keep your New Year's resolutions

If you'd like some help keeping those resolutions, and making 2010 a year of positive change, check out some of the counseling opportunities available from some of our inCYSTers!

Ann Arbor, Michigan
Terrie Holewinski (University of Michigan Medical Center) will be offering a "Gaining Control of PCOS" workshop on January 18th and 25th, as well as February 15th and 22nd, March 23rd and 30th, April 19th and 26th. The cost is $138 dollars for two 1 1/2 hour group sessions and a 1/2 hour individual dietitian consultation.

For more information women call 734-998-5679
Austin, Texas
Christine Marquette has two offers: (1) Through the end of January she is offering a 10% discount for all "new" clients on any of her services (packages and individual appointments), (2) she is offering Inherent Technology's DNA kit for weight management for $110 while supplies last. You can read more about the kit at http://www.inherenthealth.com/our-tests/weight-management.aspx

West Los Angeles, California
Gretchen Kubacky, Psy D (psychology) is offering a free in-person half hour consultation with prospective clients to determine if we're a good fit.

Phoenix, Arizona
Monika Woolsey (me) is offering a 10% discount on any consultation scheduled before the end of the month.

Food of the week: sauerkraut

You may not be familiar with this food if you're not from a German or Eastern European family. In my home, we eat it every New Year's Day to bring prosperity. This year I decided to look it up to see what other potential benefits it held. And I was surprised!

The obvious is that since sauerkraut is made from cabbage, a member of the Brassica family, it can help you to fight cancer. Furthermore, the production of sauerkraut from cabbage enhances its cancer-fighting potential. Researchers at the University of New Mexico report that compounds found in sauerkraut specifically fight breast, lung, colon, prostate, and liver cancer! Moms of teens, take note: apparently, it's especially important to eat sauerkraut during adolescence in order to derive the maximum benefit.

The fermentation process that creates sauerkraut from cabbage creates immune-boosting phytochemicals. It tends to be a cold-weather food, eaten with bratwurst or other comfort foods, so it's perfect to eat during cold and flu season.

In your digestive tract, sauerkraut can help to inhibit the growth of E. coli, salmonella, and candida. It can also help produce some powerful antioxidants, superoxide dismutase and glutathione.

Bavarian researchers report that wearing German lederhosen (see photo) can increase the power of Sauerkraut by a whopping 232%.

Ach du lieber! Just messing with you. :)

Not feeling very Germanic today? The Korean version of sauerkraut known as kim chee, has been found to have many similar benefits.

I don't know about you...but some German-apple potato pancakes with a side of sauerkraut are looking like a great possibility for dinner tonight!


http://www.nutraingredients.com/Research/Sauerkraut-consumption-may-fight-off-breast-cancer

http://blog.seattlepi.com/naturalnotes/archives/167346.asp

http://www.emuszine.com/Food/sauerkraut.htm

Who cares how well you eat and how much you move? If you're not respecting sleep, you've got a huge health risk

Why is it that we have a need to wear on our sleeves how little we sleep, as if it's a badge of honor?

People who don't sleep are physically hurting themselves in ways that diet and exercise can't always repair.

The large and famous nurses' study showed that women working night shifts had a greater incidence of breast cancer than those working during the day.

Accumulating research is connecting poor sleep with weight gain, insulin resistance, and diabetes.

What is it about sleep that is so crucial?

Melatonin. It's our body's most powerful antioxidant. It literally acts like a scrubbing bubble when we sleep, scouring that inflammatory damage from a day's worth of living, thinking, and stressing, leaving the brain and nervous system clean and ready to go the next day.

When we cut ourselves short on sleep, we don't give melatonin a chance to do its job.

We age ourselves much more quickly than we do when sleep is something we prioritize.

First thing you need to do to change things, is change your attitude about sleep.

You are not a better person because you deprive yourself of it.

You can't make up for what you lost during the week, over the weekend. Once it's lost, it's lost.

You may not be able to overcome the damaging effects of too little sleep with better eating and more exercise. In fact, it may be harder to achieve this while sleep deprived, because you are more likely to accelerate aging even more with the caffeine and sugar you're using to get through the day.

Want to get your weight under control? Reduce your cancer risk? Improve your fertility?

Sleep. It's that simple.

Looking for some PCOS information to start off your new year?

Why not try our PCOS e-booklet?

It describes the syndrome, diagnostic procedures, treatment options (including medications, exercise, diet, and complementary therapies), and additional resources.

It's a small investment for a lot of information. Perfect resource for getting started on those resolutions you're going to keep this year!

Click here for more information.