PCOS and underweight?

[Amy D]

Hi all,

I was recently diagnosed with PCOS, a diagnosis which came about because of my struggles with infertility.  I have many of the symptoms of PCOS (infertility, painful periods, polycystic ovaries, excess hair growth).  However, I tend to be underweight (rather than overweight, as is more common with PCOS) and have had a very difficult time gaining weight.  My cholesterol is low, my blood sugar is low and my fasting blood sugar is low.  I have not yet had a blood glucose tolerance, so do not have the results of that test.

Is it possible to be underweight and also insulin resistant (which, as I understand it, is at the root of PCOS)?  I eat very little refined sugar, very few grains (and only gluten-free, when eaten), and avoid soda and juice (although I did eat a typical SAD diet up until a couple of years ago). 

I read the other very helpful forum posts on PCOS, but didn't see a lot of information regarding lean PCOS people.  Is there anything I can do to address this condition and improve my fertility given that I am already eating a high-protein, high-fat diet with very little refined carbs, I do get 8-9 hrs of sleep per night, and I am working hard to manage stress?  The docs are suggesting drugs, but I'd like to find another way. 

Thanks!
amy

[jodi f.]

I've had two very lean PCOS clients, both of whom were trying to get pregnant and couldn't. They both made significant dietary changes (doesn't sound like you need to), and both took clomiphene citrate to boost their fertility. One of them now has a healthy baby of about a year old, the other's first baby is due in June. Each of them got pregnant within just a few months of dietary changes plus the drug. My guess is that you HAVE been insulin resistant and your body is still rebalancing itself. Two years isn't all that long a time after a lifetime of the SAD.

Whether to use drugs or not is a personal choice. If your biological time clock isn't ticking too loudly, you can allow your body more time to rebalance. There are also botanicals you can use, both to help the PCOS and to boost fertility. I highly recommend the following article for more information: http://findarticles.com/p/articles/mi_m0ISW/is_256/ai_n6258842/print

Would love for you to update us as you embark on this journey. It would be instructive for us all. Good luck.

[Amy D]

Thanks, Jodi!  Great article. 

One thing I'm curious about is dairy, fertility and PCOS.  I quit dairy entirely four months ago (I was eating whole-milk organic yogurt and occasional ice cream) as it seemed to be causing nasal congestion and a few other mild symptoms (I also quit gluten).  Up until that time, I was having regular periods.  Since stopping the dairy and gluten, my periods have become very irregular (38-40 day cycles) and I'm not ovulating.

I've read studies indicating that high-fat dairy can enhance fertility.  However, the studies compared women who were eating high-fat dairy with those eating low-fat diary (there was not a no-dairy group).

It seems unlikely, but I'm wondering if changes in my cycle could be related to my recent diet changes...the elimination of dairy, in particular.  That said, everything I've read about PCOS says to avoid dairy.

Any thoughts on this?  Thanks so much! 

[jodi f.]

I have a feeling that raw, full-fat dairy might be a good choice for you, but I'm not well informed about this where PCOS is concerned. Thomas Cowan, M.D. wrote an article for the Weston A. Price Foundation website that I think will be interesting to you. It's here: http://www.westonaprice.org/ask-the-doctor/pcos    He's a big fan of animal fats for regulating hormones. Also, he's in San Francisco and might be a good medical practitioner for you, if you're in that area.

[Amy D]

Thanks, Jodi!  The deeper I get into learning about PCOS, the more confusing it becomes.  My glucose tolerance test came back completely normal, so insulin resistance doesn't seem to be part of the equation...at least not at the present time.  I'll keep reading and exploring...

amy

[jodi f.]

Amy, here's a brand new study abstract for you to check out. Note that while the results achieved only "near-significance," the authors seem to feel that the effect was large enough to note in the Conclusion. Statistical significance is a technical term, and non-significance doesn't always mean what it sounds like. Also, it doesn't say what form the calcium or D were in. My sense is that the D was D3, given the dosage. D also appears to be the important nutrient here.

Firouzabadi, R.D., Aflatoonian, A., Modarresi, S., Sekhavat, L., and Taheri, S.M. (2012, May). Therapeutic effects of calcium & vitamin D supplementation in women with PCOS [Abstract]. Complementary Therapies in Clinical Practice, 18(2):85-88. DOI:10.1016/j.ctcp.2012.01.005

Abstract
Objective
To evaluate the efficacy of calcium & vitamin D supplementation in infertile women suffering from polycystic ovary syndrome (PCOS), and to assess levels of 25-hydroxy vitamin D in these patients.

Methods
In a case control study, 100 infertile PCOS women based on a randomly divided into two groups. Group I (n = 50) were treated with metformin 1500 mg/day, and group II (n = 50) treated with metformin 1500 mg/day plus Calcium 1000 mg/day and Vitamin D 100000 IU/month for 6 months. Patients were followed by transvaginal sonography at first, 3 and 6 months later for evaluating dominant follicle.
BMI, menstrual regularity, follicle diameter, pregnancy, serum 25-OH-vitamin D level were matured and compared in two groups.

Results
BMI decreased almost significantly (25.49 ± 1.88 vs 26.28 ± 2.15, p: 0.054) in group II. A better improvement was gained in regulating menstrual abnormalities (70% vs 58%, p: 0.211), follicle maturation (28% vs 22%, p: 0.698), and infertility (18% vs 12%, p: 0.401) in group II compared with group I, but these results were not statistically significant. Eighty three percent of all the PCOS patients showed vitamin D deficiency while 35% were severely deficient. The serum 25-OH-vitamin D mean levels were 13.38 ± 6.48 ng/ml. Vitamin D deficiency was recompensed in 74% of the PCOS patients who had taken calcium & vitamin D supplementation. There was no correlation between BMI and 25-OH-VD before and after the treatment (p ≥ 0.01).

Conclusion
This study showed the positive effects of calcium & vitamin D supplementation on weight loss, follicle maturation, menstrual regularity, and improvement of hyperandrogenism, in infertile women with PCOS.