Wednesday, October 25, 2017

Insulin resistance, PCOS, Infertility



     This is mostly for the ladies, but insulin resistance applies to the guys, too. We all hear these terms a lot, and they are all connected.
     Insulin resistance occurs when we take in too much glucose over time (diet, carbs) and our bodies start working overtime to metabolize and use it. When we eat that cookie or donut or that handful of French fries, we are eating carbs (sugar). Our bodies were made to be able to keep our glucose levels in check. As we eat more carbs, our bodies produce enough insulin to keep our circulating glucose level in a normal range, so we don’t become diabetic.
     If we eat too many carbs over time, our bodies start struggling with the production of insulin. Insulin is produced by islet cells in the pancreas. They get tired when they are in demand all the time. As our insulin levels rise up to higher levels to combat the excessive circulating glucose in our bloodstream, we start storing more fat.
     Insulin causes us to store fat well, and it causes inflammation. So higher glucose leads to higher insulin, which leads to more body inflammation and weight gain. This is where a ketogenic diet can help. Lower carbs lower circulating glucose, which lowers the need for excess insulin. Inflammation is reduced and less fat is stored (you lose weight).
     For women, as the elevated insulin causes fat storage (weight gain), that fat also causes a rise in estrogen. Elevated estrogen disrupts the normal menstrual cycle and causes missed periods or irregular periods. Elevated estrogen disrupts the normal release of a dominant egg for fertilization. A normal cycle has an estrogen build and surge mid-cycle, which releases an egg (ovulation) for fertilization (pregnancy). If you are overweight, you have excess estrogen which disrupts this normal cycle. Instead, the elevated estrogen causes many ovarian follicles to grow and get big, causing large multi-cystic ovaries, but no dominant follicle is released (no ovulation). The other term for this is polycystic ovarian syndrome (PCOS).
     If you have PCOS, you are probably overweight, and you may have had gestational diabetes in a prior pregnancy. You may be pre-diabetic. This is why your doctor puts you on an anti-glycemic medication (usually metformin). The doctor is trying to help reduce your circulating glucose, to reduce your insulin level, to reduce your fat storage (weight loss), to reduce your excess estrogen, so 
you can get pregnant.
     Women who are overweight chronically also have an increased risk for uterine cancer. Why? Because elevated estrogen from their fat stores also causes the uterine lining to build and become thickened. It overbuilds and becomes unstable causing the lining to shed causing heavy, irregular bleeding. Over time, the constant building of the lining can cause the cells to become abnormal, just like any other cancer. There is no mechanism to shut down the overbuilding of the lining until a woman loses weight (fat stores). Ladies, if you are overweight, and you’re having one or two heavy periods a year, you need to see your gynecologist.
     I hope this quick explanation has been helpful. Go low-carb!

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