PCOS and Insulin Resistance: Part 1
You may have read in my history somewhere, on a previous blog, or heard me on a podcast talk about how I got into LCHF (low Carb High Fat). You may also know that I am one of the newest additions to the IDM (Intensive Dietary Management) team. A Couple of summers ago, I met Dr. Jason Fung at a conference in San Diego, and was invited to join IDM. The thought of joining Dr. Fung and Megan, and the potential of helping THOUSANDS of people with Diabetes and Obesity was astounding! And in fact, in less than 2 years, I have, through IDM, been able to reach hundreds of people with Metabolic Syndrome. Helping these people on their journey to reverse Diabetes and battle weight gives me an immense sense of professional accomplishment. But...I was always very clear to Megan and Dr. Fung that my passion, my "calling" if I can call it that, is to help women conquer infertility.
I’ve been a Naturopathic Doctor for about 15 years now. I’ve only ever dealt with Nutrition, Diet and weight loss throughout my entire career. I always had a desire to help improve people's health by using food as my medicine, but as I have just told you, my special passion is helping women get pregnant.
My journey into the Low Carb world began 8 years ago. I didn't start eating keto 8 years ago, and fasting came a long time after that, but that's when I, personally, experienced infertility...and everything that comes with it. In my struggle to get pregnant, and after my two successful attempts, I believe I learned a few things. I might not know everything, some may even challenge my beliefs, but the truth is, under my care, and guidance, a lot of women have gotten pregnant. I didn't quite know how this happened at first, but now I believe that, at least in part, I understand why when women facing infertility go on a diet, specifically a Low Carb Diet, their chances of getting pregnant improve.
Long story short, I was diagnosed with PCOS (Polycystic Ovary Syndrome), in 2009/2010. My Gynecologist, at the time, gave me fertility pills (Clomid-Clomiphene). He also told me that because of the PCOS, the next time he saw me, I would probably be OBESE. Up until then, I had never weighed more than a buck ten (110 lbs) at 5'2". My BMI had always been under 19.5 (at the low end of normal), but at this time, at 32 years of age, in early 2010, I had already gained 25-30 lbs in 3 months. My focus after this doctor's appointment was:
1) Get pregnant, and
2) Don't become obese!
So, I went on "my diet". At the time, I gave people a "Base Diet" and a whole bunch of "Detoxes" to start losing weight. These were all based on "healthier carb alternatives". Some of these detoxes (7-day plans), were very low-carb. I was very determined to get pregnant and to lose weight (I knew at the time that many of my patients became pregnant just by losing a bit of weight). Low and behold, within a month or two, I got pregnant! Before that, we had been actively trying to conceive for over a year. Once I got pregnant, I threw the diet out the window (of course, as many of my patients do). I later had complications: Preeclampsia and Postpartum depression. A little aside here, the medication I was on for Postpartum depression, I now know, added to my already insulin resistant condition. I gained 8 kg (18 lbs) after 3 weeks of being on those meds...that was on top of the baby weight. Truthfully, the last thing I was concerned about, after having my first baby, was my weight or even my health.
Two years later, my doctor found a large ovarian cyst, removed it, and told me that if I wanted a second child, this was the time: "Now or never", he said. With PCOS, and the added weight, he recommended Clomid again. This time, I didn't go on any “diet”...I didn't even attempt it or think about it. Six months later... and lots of crying in between...I still was not pregnant. I went to another doctor (a friend of mine) who said to me, "Well of course you won't get pregnant. Not even on Clomid. You are INSULIN RESISTANT: you have PCOS! You need to take Metformin (a Diabetic drug)." *Another aside here, Metformin has not been approved as a Fertility drug by the FDA, but it is already commonly used as an adjunct therapy for PCOS and infertility. This, the diagnosis of INSULIN RESISTANCE made so much sense to me! I think this woman, Dr. Carolina, is an Angel! Thinking back now, I should have named my second child after her! I want you all to know that up until that exact moment, I had NEVER made the connection between PCOS, infertility, central obesity (excess fat stored in abdominal area), diet and insulin resistance, let alone all that this entails. If PCOS is an Insulin Resistant condition (which it is) then I was at risk for Diabetes, Coronary Heart Disease, Cancer, and a whole lot more... I took the Metformin … and I got pregnant, again, within a month or two.
During my second pregnancy, I had similar complications, except this time, the preeclampsia was prolonged. I now was diagnosed with Chronic Hypertension (High Blood Pressure).
This time around, my mind was more clear. I decided that it was time I gather all my info and do something about this. That was 4 years ago. I felt like I knew what was going on, I just had to implement it. Oh, and I got another large cyst. At this point I weighed about 140-150 lbs, my BMI was 25.6. I was now considered Overweight. This is important to note because not all PCOS women are overweight, and not all overweight women have PCOS. More on this later. After much deliberation, I decided to go Low Carb full time. And in a couple of months, I lost all the weight, got off hypertension meds, my skin cleared up, and all the other PCOS symptoms were gone (as well as many other symptoms like IBS, cravings, emotional eating...). Eventually I convinced myself that Keto (a strict low carb diet) and IF (intermittent fasting) was the way to go, for me, for life. And I still believe that.
Thanks for sitting through my story. Stay tuned for Part 2: What is PCOS, and how does it relate to all the other Insulin Resistant/Metabolic Syndrome Conditions.
Part 3: What are the causes of PCOS?
Part 4: How to diagnose PCOS?
Part 5: How to "treat" PCOS?