PCOS is a medical condition that affects hormone levels in women, impacting 5%–20% of women of reproductive age worldwide and characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Women with PCO end up producing a higher amount of male hormones, like testosterone, and often experiencing resistance to the metabolic hormone, insulin. These imbalances can lead to issues with acne, and missed menstrual periods (impacting fertility), amongst other symptoms. The 2003 Rotterdam criteria are currently the internationally accepted criteria by which PCOS is diagnosed.
However, the pathogenesis of polycystic ovary syndrome (PCOS) is poorly understood. Part of the research conducted on the origination of the disease has shown that the likelihood of PCOS development in women may be determined at birth. Research in primates suggests that excess fetal androgen exposure may predispose the infant to later development of PCOS through alternations in the epigenome (1). If there is an imbalance of hormones from PCOS during pregnancy, then there is an increased likelihood the baby may also develop PCOS if the infant is born female. Additionally, exposure to testosterone prior to pregnancy could lead to PCOS even when women have children later.
Polycystic Ovarian Syndrome (PCOS) is one of the leading medical conditions now impacting women of reproductive age, and can also have substantial impacts on a woman’s physical and emotional well-being. We’ve already covered symptoms and diagnostic testing of PCOS here, but let's dive deeper into one key hormonal disruption that seems to be particularly troublesome for my patient population – hyperandrogenism.
Hyperandrogenism is common in PCOS, often seen as elevated testosterone and DHEA levels on blood work. And while these two hormones are often seen as synonymous when evaluating total androgenic burden, there is a significant difference between the two. Testosterone and DHEA are both classified as androgenic hormones, however some women with PCOS may have elevated testosterone, with normal DHEA levels, and vice versa. You also don't have to have cysts on your ovaries to present with hyperandrogenism (in fact, only about 20% of women with high androgens have cystic ovaries), and cysts on your ovaries don't always mean you’ll have high androgens. Have I lost you yet?
Hormone replacement therapy has become an increasingly popular option for women seeking relief from symptoms occurring in menopause, menstrual irregularities, PCOS, amenorrhea and hypogonadism. Furthermore, people have been moving towards bio-identical hormones in hopes of a more biologically similar therapy with fewer risks and side effects. However, before embarking on hormone replacement therapy, it is important to understand the pros and cons of this form of treatment.
Signs of Shifting Hormones
As women age, estrogen and progesterone levels start to decline. The decrease in hormones can be the cause of a number of the following symptoms:
The thyroid gland is a small butterfly-shaped organ that is responsible for some vital roles in the body, from controlling our metabolism to regulating our brain development. It also influences our heart rate, body temperature, muscle strength, body weight, and even cholesterol levels. The thyroid gland makes up part of the endocrine system, which is a combination of glands that produce, store, and release hormones into the bloodstream for the purposes of cellular communication. The three main hormones involved in thyroid function are TSH (thyroid stimulating hormone), T4 (triiodothyronine), and T3 (thyroxine).
Unfortunately for some, the thyroid ceases proper functioning and a whole host of symptoms often emerge. Determining what treatment will be best to treat a thyroid hormone imbalance begins by first determining what the root cause of the dysfunction is.
One of the core principles of functional medicine is to nourish the body and ensure it is getting the appropriate balance of nutrients to stay healthy. Traditionally, this was achieved in a hunter-gather diet by eating colourful whole foods and by practicing “nose-to-tail” eating of meat, which included the consumption of skin, cartilage, marrow, tendons/ligaments, and other parts of the animal that are now typically discarded. Unfortunately, much of this practice has been lost as a result of prepared meats, microwaves, and canned soups over homemade stocks. As a result, our diets have become deprived of an important protein, known as collagen.
There is a lot of noise in the health industry lately about collagen supplementation. The concept of supplementing collagen attempts to regain what we’ve lost from our primitive diet, but the question becomes if supplementation has any benefit.
Benefits of Collagen
I’ll admit that when I first heard about the trend of supplementing collagen, I wasn't on board. It made no sense to me. Collagen is a tissue found in our bodies made from amino acids, vitamin C, etc. So how could supplementingthe end product collagen benefit us? But as it turns out, research in mice shows that hydrolyzed collagen peptides (from gelatin) have a 95% absorption rate at 12 hours after intake, and it distributes in the body similar to that of raw amino acids, with the exception of cartilage (1). Collagen was seen to concentrate more than twice as high in cartilaginous tissue that raw amino acids (1), giving collagen some unique benefits. So, I jumped on the bandwagon.
Adrenal fatigue is a functional condition which can occur as a result of stressors of the body. We’re quick to identify with emotional stress, but we often forget that stress can also come from physical and environmental stressors. Adrenal fatigue occurs when the adrenals release higher levels of hormones into the body than normal as a response to a continues or persistent stimulus, resulting in an output of these hormones being greater than the production, and ultimate fatigue of the glands. They are considered fatigued since they are essentially drained of their active and stored hormones, and need time to recover.
Yet, recovery is limited and difficult when we continue to lead a busy and stressful lifestyle (which is what ultimately caused the problem in the first place). Rather than slowly starting to recover, the adrenals remain drained and strained. Furthermore, we add aggravators like limited and/or poor quality sleep (which prevents rebuilding and recovery), processed foods, alcohol and cigarettes (which create physical stressors to the system) and high caffeine intake to deal with the fatigue (which creates a further draining of the gland by increase cortisol output).
Bone broth is a rich source of nutrients. It contains protein, cartilage, gelatin, and minerals, especially calcium. It’s easy for our body to digest, tastes delicious and fills a home with an aroma of goodness while cooking. Bone broth is inherently calming, consoling, and restorative to our energy and spirit. The gelatin in bone broth also has been shown to have numerous benefits on the cartilage in our joints, the integrity of our gut membrane, the detoxification of our livers, and the health of our skin!
BASIC BONE BROTH MAKING
Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal health issues in women, affecting an estimated 1 in 10 women of reproductive age. Many women are first diagnosed when they are having difficulty trying to conceive, but PCOS presents with many other symptoms, like hair loss, acne, hirsutism, and weight gain. These symptoms can affect a woman's health even beyond trying to get pregnant.
What Causes PCOS?
The exact cause of Polycystic Ovary Syndrome is unknown, though it is thought that genetics play a major role. PCOS is a complex disorder that presents itself as a group of symptoms resulting from hormonal imbalances -- usually an excess of androgens like testosterone and high levels of insulin. These symptoms include:
There is a common misperception about progesterone (naturally occurring hormone) and progestin (the synthetic version) — namely that they are essentially identical. “Progesterone” and “progestin” are used interchangeably so often that patients may inadvertently think of them as one and the same, and put themselves at risk for health issues by not being aware that they are not, in fact, synonymous. So what is the difference between progesterone and progestin? The answer may surprise you.
What is progesterone?
Progesterone is a naturally occurring hormone that functions primarily to regulate reproductive processes. It is produced by the adrenal glands and ovaries or testes, and by the placenta in pregnant women. In women, progesterone is responsible for preparing the uterus for the implantation of an egg and maintains the lining of the uterus — the endometrium — during pregnancy.
Insulin Resistance: Is There a Link to Dairy Products?
A considerable amount of research has been aimed at isolating the contributing factors in the development of insulin resistance and looks to discover better ways of controlling and preventing the onset of this disorder.
We already know that diet plays a significant role. In fact, diet is the leading cause of type 2 diabetes: the outcome of unmanaged insulin resistance. Resistance to insulin can also occur in other metabolic/endocrine disorders, such as polycystic ovarian syndrome (PCOS) that affects up to 12% of the female population in North America. In more recent years, an increasing body of evidence is finding that dairy consumption has an adverse effect on insulin production, and may, in fact, be contributing to insulin resistance.
© 2018 Courtney Holmberg ND. All rights reserved. Dr. Courtney Holmberg, ND does not endorse or have professional affiliation with any discussed supplement or lab companies. All material provided is for general education and may not be construed as medical advice. The information is not intended to assist in diagnosing to treating a medical condition. Legal & Medical Disclaimer, sitemap