Insulin causes the increased production of triglycerides, raises LDL
and produces the more atherogenic small particle LDL.
particles are associated with lousy genes, PCOS, Metabolic It’s called acanthosis nigrans. And insulin also causes the in-
Syndrome, and having too much insulin,” I explained. creased production of triglycerides, raises your LDL and pro-
Ursula’s 2-hour glucose tolerance test showed a normal duces the more atherogenic small particle LDL.
fasting blood sugar of 95, but her fasting insulin was already "Lastly, your LH/FSH ratio is high, consistent with PCOS.
elevated at 25. “Many authorities believe that a fasting insulin Women with PCOS tend to produce an exaggerated amount
above 10 suggests insulin resistance. At 30, 60 and 120 min- of LH. LH stimulates the ovaries to produce progesterone and
utes, your blood sugar initially went up, then came down, but testosterone. Not only is there more LH, but there is a mild
your insulin levels continued to climb from 25 to 100 then to chronic elevation of LH. For you to be able to ovulate and get
162 and fi nally to 260.” pregnant, you have to have a large midcycle LH surge, and a
"Ursula, you don't have diabetes yet, but you are on your mild chronic elevation of LH can blunt the effect of this surge
way to developing it. You have severe hyperinsulinemia, which so that you have anovulatory cycles, which means that you
is triggering the increased production of androgens in your don’t ovulate and you can't get pregnant. In this case proges-
body. This is causing the acne and hair growth along with the terone is frequently not made and you become more estrogen
weight gain around your waist," I explained. dominant because there is no balancing effect of progester-
"What does insulin have to do with testosterone?" asked one. This is what causes the fi broids, PMS, and the irregular
Ursula. heavy periods. If it is unchecked, it can lead to endometrial
"Insulin causes a decrease in production of certain bind- cancer, which is probably why your Mom got it," I explained.
ing proteins in the liver, one of which is called sex hormone "I wish my Mom had seen someone like you when she
binding globulin, SHBG. This protein usually carries testoster- was my age," Ursula said.
one around and allows only a small amount of it to actually be "Well, you can share the information with her that I am
‘seen’ by your body. The testosterone that your body can ‘see’ giving to you because many of the suggestions that I am going
is called free testosterone. If there is less of this carrier protein, to give to you may also be helpful for her, even though she has
then there is more free testosterone. The result is your body had a hysterectomy," I suggested.
sees a higher level of testosterone. I repeated her physical exam, which showed no changes
“Insulin contributes to a fatty liver and the darkened thick- over the past month. I gave her orders to get a progesterone
ened skin around your neck and on the front of your elbows. level drawn on day 21 after the fi rst day of her period.
"Ursula, I want you to stick with the low glycemic diet
that you are already on. By that, I mean eat lots of above the
ground vegetables, lean meats, and healthy fats. Only eat one
serving of fruit a day for right now and stay away from all
starches, sweets, and grains," I insisted.
"Yes, it’s a modifi ed Atkins with lots more vegetables. That
is the only way I have been able to lose weight in the past,"
Ursula agreed.
"That is exactly right," I said. "I don't want you to eat the
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unhealthy fats. I only want you to eat healthy meats like turkey,
chicken, very lean beef, and plant proteins like soy and other
Yoga
beans. You can start exercising again and I want you to use a
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drug called metformin. The brand name is Glucophage."
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"I did some research after you mentioned PCOS last
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month and that's the drug they say works really well for it,"
For class schedule,
today! said Ursula.
visit
275-1391 "That's correct. And, it’s a category B drug with respect
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to pregnancy, so that if you should get pregnant, and I don't
think you are going to in the next couple of months, but if
you should get pregnant in the future and you are still on met-
No experience
formin, it won’t hurt the baby. I want you to start at a low
necessary.
dose of 500 mg with supper. Take it each night for the next
All levels welcome
week or two and then go up to 500 mg twice a day. We may
slowly increase it up to a total of 2,000 mg total a day, but we
The Club at Green Valley
will do that over several weeks. The main side effect from it
Mind/Body Studio
is gastrointestinal upset; you may get some low-grade nausea,
vomiting or diarrhea. Go low and go slow with the drug. If
Lendew Street, Greensboro
you have to break it in half initially, that's fi ne. If you still can't
10
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