A Friend's Story - Infertility and PCOS

My Friend Before (33% body fat) & After (25% body fat)

Imagine yourself in this scenario...You are a newlywed woman in your mid 20's.  You have been diagnosed with Polycystic Ovary Syndrome (PCOS) which causes you to lose your period thereby threatening your hopes of ever conceiving a child naturally.  Imagine the sadness of having finally married your high school sweetheart but believing that you two may never be able to have children.  Imagine too that you are also at a high risk of developing cardiovascular problems at an early age as a consequence of PCOS.  Not only may you lose the chance of ever having children but you may be separated from your life's love at a tragically young age.

This is the situation my friend found herself in.  To hear her tell the story, she verbalized that she was resigned to the cards that she had been dealt regarding infertility.  But to see her, there was a blueness that belied the acceptance.  Shortly after her honeymoon, she decided to lose weight via conventional means.  It was an eight month struggle but she eventually lost 15 lbs.  After going on the TNT Diet, she lost a further 15 lbs in ONE MONTH!  Spontaneously, her period returned and has appeared regularly for the past handful of months since reaching her present weight.  Her MD tells her that her PCOS may be reversing itself as her hormones are regulating themselves.  Here is her story in her own words:

This low carb diet helped me lose weight but not only that, it
reversed my PCO syndrome. My hormone levels regulated itself after
losing 8% (33% to 25%) body fat! I am no longer in risk for high
cholesterol and triglyceride, praise God! The first week I lost 6 lbs
due to shedding water weight. In total I lost 15 lbs in 1 month (145
lbs to 130 lbs) and have kept it off since January! I just maintain
low carb dieting with 2 days per week of allowing healthy carbs such
as brown rice and whole wheat bread instead of white and sugar filled
items. It's all about making healthy choices but in order to do so we
have to learn all the hidden names for sugar and cut that out of our
diets. If you have a sweet tooth like me, don't worry! There are many
alternative recipes on the internet including in this low-carb blog!

PCOS is a condition where the ovaries form lots of fluid filled cysts instead of the one egg filled follicle shortly before a menstrual period.  The woman with PCOS has higher than normal levels of insulin (too much insulin causes the ovaries to produce more testosterone than normal) and testosterone (male hormones which prevent ovulation when elevated).  This abnormal hormonal milieu often results in the lack of egg production and therefore the inability to get pregnant.  Women with PCOS may also have high triglycerides, LDL (bad cholesterol), & blood pressure leading to an enhanced risk of heart attack.  There is also a greater chance of getting endometrial cancer because of an overgrowth of the uterine lining in response to decreased progesterone levels.  The following links discuss normal ovulation and PCOS in detail, respectively.  http://en.wikipedia.org/wiki/Ovulation   http://www.womenshealth.gov/faq/polycystic-ovary-syndrome.cfm

If you have PCOS, there is indeed hope for reversing your condition.  http://www.fertilitychicago.org/2569/how-does-a-low-carb-diet-help-to-reverse-pcos/  A 2005 pilot study from Duke University showed that a low carbohydrate ketogenic diet lowered free testosterone levels, leutenizing hormone to follicular stimulating hormone ratio (LH/FSH), and insulin levels while also reducing percent body fat in obese women with PCOS.  Two of the study participants who completed the 24 week course even conceived after previous infertility.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334192/pdf/1743-7075-2-35.pdf 

A 2006 study from the University of Alabama demonstrated that women with PCOS can decrease their insulin concentrations, both fasting and post-eating, by following a reduced carbohydrate diet.  The hope is that the reduction in insulin will allow for improvements in the hormonal/fertility area as demonstrated in the study cited above.  http://www.ncbi.nlm.nih.gov/pubmed/16500338

In 2009, the Harvard School of Public Health found that even in normal women without PCOS, high carbohydrate intake and high glycemic load foods are associated with infertility which results from the lack of ovulations.  http://www.ncbi.nlm.nih.gov/pubmed/17882137

I will let this other 2006 study from the University of Alabama speak for itself.  I quote from the Results section: "the PCOS group consumed significantly more white bread (7.9 +/- 4.4 vs. 5.5 +/- 2.9 servings over 4 days) and tended to consume more fried potatoes than did the control group (1.0 +/- 1.5 vs. 0.4 +/- 0.7 servings over 4 days). The PCOS group had a significantly greater fasting insulin concentration (22.5 +/- 14.9 vs. 15.1 +/- 8.3 muIU/mL) and a significantly lower glucose-to-insulin ratio (4.7 +/- 2.1 vs. 7.6 +/- 5.2) than the control group."  http://www.ncbi.nlm.nih.gov/pubmed/16762348

Acanthosis Nigricans (darkened skin folds)

Acanthosis nigricans (AN) may sound like the scientific name for an exotic South American bird, but it is a common sign of insulin resistance that people outside of the medical field may not recognize.  AN is a darkening of the skin commonly observed around the neck and in the armpits.  The following links are very educational but be warned that there are some graphic photographs of skin lesions.
http://dermatology.cdlib.org/DOJvol6num1/original/acanthosis/katz.html
http://emedicine.medscape.com/article/1102488-overview#showall

AN is significant not because of the rare malignant state but because it is a common sign of insulin resistance.  Why is that important?   In non-diabetics, insulin resistance/ hyperinsulinemia is an independent predictor of atherosclerotic buildup in the aorta, i.e. blockage that could lead to heart attack or stroke or peripheral vascular disease.  http://www.atherosclerosis-journal.com/article/S0021-9150(05)00580-0/abstract  The implication is that without being a diabetic, who are know to have an increased risk of heart disease, frequently eating refined carbohydrates may be clogging your arteries.  And we all know that is bad news.

The first time I became aware of this condition was during a discussion with a friend several years ago.  She was complaining about the darkening of the skin on the back of her neck and in her armpits, which led her to avoid sleeveless clothing and to wear her hair long to cover the embarassing marks.  This friend also revealed to me that it is a very frequent condition seen in pregnant women back in her Asian homeland.  She also remarked that she was surprised that I did not develop it when I was pregnant with my son because this darkening was strongly believed to indicate a pregnancy carrying a male child.  She in fact attributed her skin darkening to having bourne two sons, and she tried every conceivable skin lightening or exfoliating product to remedy it.  It makes me just shudder to think about all the women experiencing this skin darkening during pregnancy back in my friend's homeland, who may be suffering from gestational diabetes unbeknownst to them and its health implications for them and their children.  Another topic for another day!  http://care.diabetesjournals.org/content/31/5/e30.full.pdf+html

But it is not just ladies in a faraway land who suffer this condition.  AN is today used as a screening test for  children in the state of Texas to identify early those children who may have obesity related insulin resistance or Type 2 diabetes but who do not receive regular medical care.  http://www.infocusonline.org/acanthosis.pdf

AN can be misleading since it is not itchy or painful but merely unsightly.  My hope is that this discussion may prompt you to visit your doctor if you suffer from this condition so that you can start on the task of reversing this stealth killer - insulin resistance.

Recipe #3: Pasta Serendipity

Pasta Serendipity

This dish was the result of happy happenstance, hence the name, "Serendipity."  While preparing dinner, I was actually fighting some massive cheese curls cravings (the kids just got some for the lunch bags).  There were just some random bits of this & that in the fridge when suddenly I got a brainwave along the lines of fettuccini alfredo and spaghetti carbonara.  Using leftover Dreamfields spaghetti (see my previous posting on products that our family loves), I came up with this recipe.  Not so exact, kind of like a recipe you might find in your great grandmother's little recipe notebook.

Ingredients:

• 1 package Dreamfields spaghetti prepared per label
• 1 package bacon
• 1-16 oz package of baby spinach
• 3 cloves minced garlic (1 heaping teaspoon if using prepared garlic from a jar)
• 1/4 cup shredded mozzarella or 1 slice provolone per serving
• grated Parmesan or Romano cheese, 1 tbsp per serving
• full fat cream, 2-3 tbsp per serving

Procedure:

1. wash spinach & drain in a colander
2. prepare bacon to desired crispness & reserve rendered bacon fat
3. saute spinach & garlic in the bacon fat over medium-high heat until spinach is wilted
4. place the following on a microwaveable plate in layers: single serving of spaghetti; 3/4 cup wilted spinach; mozzarella/provolone cheese; drizzled cream; sprinkled Parmesan/Romano cheese
5. cover with a paper towel & microwave on high to melt cheese
6. sprinkle with 1-2 slices of crumbled bacon

YUM-E!!!

NOTE: the bacon fat is plenty salty, so you don't need to salt your spinach.  Also, if you choose to use turkey bacon, you should add 2-3 tbsp olive oil to the pan before wilting the spinach.