Nutrition IV - Common Ailments in Clinic - Polycystic Ovarian Syndrome

Question 1

Polycystic ovarian Syndrome

Answer 1

Polycystic ovarian syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age and is a major cause fertility issues
* It is characterized by insulin resistance an excess androgens
* Overweight and obesity with central distribution of adipose tissue is common and more strongly associated with infertility
* Central obesity is linked with increased levels of hormones including insulin, LH and oestrone which impacted ovarian function
Androgens = Male sex hormones

Question 2

Insulin resistance and excess androgens

Answer 2

Insulin resistance and hyperinsulinaemia contribute to access androgens because:
* Insulin inhibits the liver’s production of SHBG
* Decreased circulating SHBG increases levels of ‘free’ (active) testosterone
* Insulin stimulate ovarian and adrenal production of androgens
* Luteinising hormone (LH) activity is generally disrupted with impaired maturation of follicles and a lack of ovulation. Excess insulin further drives the imbalance
* Nutritional guidelines: reflect those outlined for Type II diabetes, in an effort to address insulin resistance
SHBG = sex hormone binding globulin. Renders testosterone inactive

Question 3

Myo-inositol

Answer 3

Myo-inositol (2-3 g / day).
Can be synthesised in the human body

• Food sources:
  o Whole grains
  o Beans
  o Nuts
  o Fresh fruit and vegetables
  o Grass fed meats
  o Eggs
• Functions:
  o Myo-inositol improves insulin sensitivity and supports a healthy body weight
  o It decreases total serum testosterone and increases SHBG to reduce bioavailable testosterone
  o Also improvements menstrual cycle regularity, oocyte (egg) quality and overall female fertility

Question 4

Spearmint tea

Answer 4

Spearmint tea: 1 - 2 cups per day
* Functions:
o Has been shown to decrease free testosterone levels

Question 5

Alpha Lipoic Acid (ALA)

Answer 5

Alpha Lipoic Acid (ALA): 600 – 1200 mg / day)
ALA Is a short chain fatty acid that can be synthesised in the human body
* Food sources:
o Brassicas (e.g. broccoli, brussels sprouts)
o Spinach
o Potato
o Carrots
o Beets
o Tomatoes
o Peas
o Brewers yeast
o Lamb
o Beef
o Organ meats
* Functions:
o Useful for PCOS and Type 2 Diabetes
o ALA is a potent antioxidant, reducing inflammation
o ALA supplementation improves insulin sensitivity and markers of diabetes severity
o Supports fertility by protecting oocytes (egg cells) from oxidative damage
o Has an immunomodulatory effect and can be helpful for implantation

Question 6

Maitake Mushroom

Answer 6

Maitake Mushroom (Grifola frondosa): 3 – 7 g / day

• Functions:
  o Maitake is crowned by the Japanese as the ‘king of mushrooms’.
  o Maitake contains a proteoglycan that improves insulin sensitivity
  o Useful in cases of insulin resistance – type 2 diabetes and PCOS
  o It can also help to induce ovulation in PCOS
  o The fatty acids in Maitake inhibit the inflammatory COX-1 and COX-2 pathways, subsequently reducing inflammation
  Proteoglycan = Part protein, part carbohydrate)