If you have PCOS it can be quite confusing. Nutrition and lifestyle can make a big difference in the appearance and severity of your symptoms. Which nutrition interventions, supplements and lifestyle adjustments work for you?
PCOS is a syndrome that is somewhat difficult to define in itself. According to the Rotterdam criteria*, you must meet two of the three characteristics:
- Irregular or no cycle (this applies from 10 cycles or less per year)
- Increased androgen levels
- More than a total of 26 visible follicles on the ovaries (also called cyctes wrongly)
There are different types of PCOS and the cause of your characteristics may be different from those of another woman with PCOS.
This means that you may feel that you are doing everything right and that you are living a very healthy life, but that you still have PCOS symptoms.
There are a number of possible disturbances in the body that are associated with PCOS:
- Low grade inflammation
- Insulin resistance
- Increased stress (hormones)
- Thyroid disorders
- Hormonal imbalances
- Toxic tax/disposal issues
- Food shortages (vitamins/minerals)
In order to specifically tackle your complaints, it is essential that you know which processes are disturbed in you and which ones are not. In this article I will discuss the test options at Blood Values Test for each possible disturbance, so that the results give you insight into what you can work on. Depending on your budget you can make a choice. Before you start measuring, it might help to do some research about your complaints, so you can filter which tests are most relevant for you. This can be done in a consultation with me, if you want to contact me click here.
For everybody: androgens
Although from the Rotterdam criteria elevated androgens do not appear to occur in everyone with PCOS, research is becoming increasingly clear that probably all women with PCOS have elevated androgen levels. However, it can differ which androgens are elevated. And sometimes values are elevated for the individual, but this is not reflected in the test results (because the result falls within the reference framework but in practice there is an increase).
If all goes well, when you were diagnosed with PCOS you were given insight into your androgen values. If these values are outdated or if you do not have all these insights, I advise you to re-test them anyway. Then you will know which values are too high for you, you can monitor this in the future and you can act accordingly. This is interesting by the way with many of the tests mentioned in this blog.
Androgens that give insight into your personal situation are:
- SHBG (the substance that binds free androgens and puts them out of function)
Low grade inflammation
Nearly all women with PCOS suffer from low-grade inflammation: a term that has a bit of a ring to it. It means that the body is in a moderate state of inflammation. When the immune system is functioning normally, there is either severe inflammation (swelling, sickness, malaise) or no inflammation. In low-grade inflammation, the immune system does not stop its function of attacking unhealthy tissue, so due to its chronic nature, it also attacks and damages healthy tissue. It is increasingly recognized that this is the root cause of PCOS and can also increase the degree of insulin resistance. Some of the values you can measure to determine the extent to which your body is suffering from low-grade inflammation are:
- Sedimentation (BSE)
A marker for the presence of (incipient) autoimmunity (e.g. due to an overactive immune system):
Low grade inflammation often starts in the intestines. A good test to get an idea of the permeability of the intestine and intolerances present
- IgG intolerance test (see the What Can I Eat test for this)
The tests that are routinely performed when blood sugar problems are suspected do not give a clear picture of the presence of and sensitivity to insulin (such as HbA1c and fasting blood glucose). However, insulin resistance is linked to testosterone increases, which can lead to PCOS symptoms such as:
- Hair loss
- Excessive hair
- Weight gain
- Irregular menstruation
It is important to carry out the correct tests and to read them correctly within the correct reference frameworks (and not the general reference frameworks).
Suitable tests are:
- Homa-IR: this value should be lower than 1.0.
- Insulin tolerance test
If you suspect blood sugar problems in addition to insulin resistance (due to obesity, for example), the following tests are interesting:
- Oral glucose tolerance test (sugar test. This must be done by your GP or hospital)
Increased stress (hormones)
Stress is strongly linked to the extent to which PCOS appears and takes different forms. To gain insight into whether stress plays a part in your form of PCOS, you can carry out the following tests:
- Burnout Saliva Test for Stress (measures both DHEA and cortisol from saliva)
Thyroid function is very much involved in PCOS. Often women with PCOS suffer from a sluggish thyroid gland and optimizing the functioning of the thyroid gland can reduce PCOS symptoms. Insight in the values gives guidance whether there is an overactive immune system, possible food shortages and which conversions are not going well. In addition to the regular TSH and T4, a total overview of all thyroid values is helpful, because then you can interpret the mutual relationships:
- TSH (optimal value is below 2.5)
- T4 total
- T3 total
The androgen hormones and insulin have already been discussed, but in PCOS a number of other hormones are often out of balance as well. When ovulation does not occur the progesterone level is lowered, which in addition to too little progesterone also causes a relatively high estrogen level and thus estrogen dominance. In addition, a disturbance in the function of LH and/or FSH results in a delayed maturation of the egg cell. LH is influenced by insulin resistance and excessive LH leads to an increase in testosterone. It's all connected!
The many immature follicles seen on the ultrasound in many women influence the AMH value, and finally prolactin provides information on whether the pituitary and hypothalamus (which control many hormonal processes) are doing their job properly.
In this way you can see with various tests where your attention should be focused. Measuring progesterone has little use when you have no or an unstable cycle: if you do not know where you are at the moment of measuring, you cannot interpret the progesterone correctly. The same goes for estradiol .
- Estrogen metabolites
Toxic tax/disposal issues
There is a clear link between toxic load from plastics (BPA) and PCOS. There is also a strong link between liver function with PCOS and many women with this diagnosis benefit from liver support and detoxification interventions. Some tests you can do to gain insight into whether this applies to you are:
- Hair Minerals
Food shortages (vitamins/minerals)
A well-nourished body has a better capacity for all metabolic processes. For your gonads and thyroid to function properly, a number of substances are essential, with many women with PCOS being seen to be deficient:
- Vitamin D
- B12 (combi b6 and folate) (homocysteine and active B12)
These substances can be tested separately. A hair mineral test also provides insight into the mineral status in addition to toxicity. Iodine and selenium can also be checked by testing thyroid values.
With PCOS there is often a genetic package that makes you more susceptible to the syndrome. Although the effect of epigenetics (lifestyle and diet) is increasingly recognized and scientifically substantiated, it can give insight into your DNA. Especially the cyp enzymes MTHFR, COMT and UGT1A1 stored in your DNA are interesting to know if you have PCOS. Bloodtesting.nl offers the DNA tests of the Dutch provider IGene, which records a total genetic profile including these cyp-enzymes. This can help you to be more aware of your blueprint and easier to stay motivated to apply appropriate interventions.
As you can see there is a lot you can do to gain insight into your health as a woman with PCOS. This can help you to get a grip on your health and to make the right food and lifestyle choices. You can influence the extent to which you experience your PCOS symptoms and some women succeed in getting rid of their symptoms completely. Know that you have much more influence than people usually tell you!
PCOS is your body asking to be heard. If you are willing to listen to it, your body will reward you with fertility, health and peace of mind.
You can find the tests mentioned in this blog by clicking the button below:
If you would like help in making a choice regarding which test could be of added value for you, click here for a consultation with me.
If you would like help interpreting the results and determining which follow-up steps are useful for you after taking a test, click here.
Lots of love,
Orthomolecular supplementation and nutrition advisor
Orthomolecular Epigenetic Therapist
Rotterdam criteria were established during an international congress on PCOS in Rotterdam in 2003.