PCOS, Metformin Weight Loss And The Glycemic Index (Part 1)

PCOS is the most common cause of infertility in women of childbearing age. It is linked with various miseries including heart disease, diabetes, and obesity. None of this sent Carrie (name changed for privacy), then 27, to the doctor; it was something far more superficial. She grew a hair on her chin.

Though she didn’t know it, the ‘root’ of that hair could be tracked back more than a decade. At 17, Carrie lost consciousness for the first time because of low blood sugar. This problem was not unfamiliar; 3 close relatives also suffered from what they called ‘hypoglycemia.’ Through the years, Carrie learned to monitor her symptoms and eat when she felt woozy, which was pretty often.

Carrie’s blood sugar problems were an small part of a bigger picture she didn’t see. A ‘normal’ body’s pancreas will release insulin when blood glucose levels rise (after eating, for instance.) Insulin is a hormone the body uses to use glucose. Carrie’s body did produce insulin, but it’s ‘shutoff’ mechanism was faulty. So much insulin was released that her blood sugar levels fell drastically, starving her cells. What she and her family had always called hypoglycemia (low blood sugar) was, in fact, hyperinsulinism (high insulin) While low blood sugar caused immediate symptoms, the excess insulin her cells were bathed in worked its changes silently.

Excess insulin in the bloodstream creates a problem. Cells reduce their receptors in response to the excess, which makes them less able to absorb vital glucose. Glucose is then left circulating in the bloodstream so the body stores it as fat for later use, which is why weight gain is a common problem for PCOSers. The insulin, left unused by the cells, causes the ovaries to produce excess testosterone, often leading to abnormal hair growth, male pattern baldness and infertility.

Through her early twenties, Carrie didn’t notice any particular problems aside from her ongoing poorly managed blood sugar. At 25, though, things began to change. While she’d never been very thin, she’d also never had any difficulty controlling her weight. Now she began to gain about a half pound every month. On her 5’11” frame, half a pound wasn’t even noticeable, but after 12 months, she’d gained 6 pounds. It didn’t seem to matter what or how much or little she ate, she gained weight.

At 26, she began to notice that her always thick hair seemed to be thinning on the top and her weight gain continued. She mentioned the hair loss to her mother, who said she didn’t see anything. Since her hair wasn’t thin enough to be called ‘thin’ she didn’t give it too much thought. Not until she was seated at the table and her mother stood behind and finally, after a year of denials, agreed that Carrie was losing her hair. As bad as this was, she didn’t panic until two weeks later, when she found a hair on her chin.

“Then I panicked. I said, ‘I’m not going to be a woman with a beard! I’m only 27!'” Carrie recounts. “I made an appointment with my doctor that same day.”

Carrie was lucky, her doctor had a possible answer. She asked questions about other symptoms like weight gain, hair loss, missed periods and fertility. Then she sent Carrie for an ultrasound.

“I didn’t have to wait for the test results. I could see the screen as the technician did the scan and there were marble-like bumps all over my ovaries. I knew I had classic PCOS.”

PCOS is short for polycystic ovarian syndrome. A syndrome is a group of symptoms which often occur together. The symptoms common with PCOS include cystic ovaries, irregular periods, acne, infertility, thinning scalp hair, excessive body hair, uncontrollable weight gain or inability to lose weight, high blood pressure, skin tags, and hormone imbalances. Carrie’s doctor referred her to a gynecologist, which was normal procedure at that time. The gynecologist prescribed birth control pills to control the hair loss and told her to come back when she was ready to have a child. Carrie had tried birth control pills twice before and hated what they did to her body and mind. This time she stayed on them for 4 months. After spotting for the whole four months, she quit cold turkey. She had been told that the pills weren’t improving her health, only her symptoms, so she didn’t feel compelled to pursue that approach any longer.

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