What exactly is PCOS?
One of the most common endocrine disorders in young women and leading cause of infertility in American women of childbearing age is the condition known as PCOS (polycystic ovary syndrome). Like other syndromes, PCOS is actually a cluster of symptoms, most notable of which is an unusually high level of androgen hormones (male sex hormones) in women. The name originates from the presence of ovarian “cysts”, which are actually immature egg follicles that never descend into the uterus, remaining in the ovary and thus appearing as cysts. Ovulation does not occur in women with PCOS, so these follicles that normally turn into a corpus luteum (egg ready for fertilization) remain undeveloped and consequently, infertility results.
What role do androgens play in this unique syndrome?
The key diagnostic criteria for PCOS is high androgen levels, although the role of androgens in women is commonly misunderstood. The most potent androgen hormone is testosterone, and thus androgen hormones are typically thought of as male hormones, although androgens (including but not limited to, testosterone) exist and serve an important role in women as well. But in PCOS patients, the androgen levels have become too high relative to other hormones. DHEA and androstenedione (important precursor hormones to estrogen) are also androgens, existing in both male and females.
How does PCOS present clinically?
Clinical manifestations of PCOS include acne, oily skin, unusual facial hair in women from the high testosterone (also known as hirsutism), infertility, insulin resistance and obesity. From a hormone perspective, women with PCOS will have high testosterone levels. In addition, they tend to be obese. Since fat cells contain the hormone aromatase which converts testosterone to estrogen (this occurs in adipose tissue of both men and women and is called aromatization), PCOS women can have high testosterone and high estrogen. Another hallmark of PCOS is insulin resistance (precursor to diabetes) which contributes markedly to weight gain and obesity. Since insulin resistance is indicative to poor glycemic control, reversing the blood sugar regulation dysfunction that occurs in PCOS is paramount to treatment.
Other hormone indications in PCOS patients is high luteinizing hormone (LH) and low follicle stimulating hormone (FSH). Hyperandrogenic women (high testosterone) with PCOS tend to have low serum SHBG concentrations as well.
What role do micronutrients play in treating PCOS?
PCOS is first and foremost a hormone-linked syndrome. Micronutrients profoundly affect hormones, including insulin – the hormone responsible for shuttling blood glucose into cells. When insulin is chronically high, it becomes the key contributor to weight gain and metabolic dysregulation that is associated with PCOS.
Inositol is a B-complex associated nutrient that plays a very important role in cell to cell communications, which work hand-in-hand with hormone signaling. Studies indicate that exogenously administered inositol improves insulin activity (dosages of 1200 mg D-chiro-inositol were assessed).1 Evidence even goes to far as to suggest that insulin resistance in PCOS is due to inositol deficiency and that repletion of this key nutrient can significantly improve circulating hormone levels and ovulation rate.
Lipoic acid is another key nutrient in the treatment of PCOS. It enhances glucose uptake into muscles, improves insulin sensitivity and lowers triglycerides. Similarly, vitamin D deficiency is common in PCOS. This vitamin, which is actually considered a pro-hormone helps normalize the menstrual cycle. Chromium has been shown to benefit clinical manifestations of PCOS as well by facilitating the binding of insulin to receptors in the body, thus improving insulin sensitivity.
In reality, any nutrient that affects hormone production, weight management, fertility or glycemic control will potentially impact PCOS as well.
How to address the problem
Having a complete hormone panel run, along with a micronutrient analysis would be a good starting point in understanding what imbalances need to be addressed and how to correct them. Order your tests today!
Interested in learning more about PCOS? Register for our upcoming webinar on The PCOS Environmental Roadmap: How to Reverse PCOS and Begin Recovery.
1. Nestler JE, Jakubowicz DJ, Reamer P, et al. Ovulatory and metabolic effects of D-chiroinositol in the polycystic ovary syndrome. N Engl J Med 1999;340:1314-1320.
2. Masharani U, Gjerde C, Evans J et al. Effects of controlled-release alpha lipoic acid in lean, nondiabetic patients with polycystic ovary syndrome. J Diabetes Sci Technol 2010;4:359-364.
3. Fang F, Ni K, Cai Y et al. Effect of vitamin D supplementation on polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2017;26:53-60.
4. Lydic M, McNurlan M, Bembo S et al. Chromium pioclinate improves insulin sensitivity in obese subjects with polycystic ovary syndrome. Fertil Steril 2006;86:243-246.
Intracellular Micronutrient Testing,
Polycystic Ovary Syndrome,
PCOS and Micronutrients,
PCOS and Insulin Resistance
Epigenetics – the study of changes in organisms caused by modification of gene expression rather than alteration in the genetic code itself– has gained much attention in recent years. Environmental factors including diet, smoking and stress have been shown to impact gene expression through epigenetic mechanisms.
In a recent experiment involving the collaboration of several medical institutions, an experiment was performed on mice to determine how their immunity responded to a typical Western diet. When mice were fed a Western diet, systemic inflammation occurred which was entirely expected. However, what was particularly interesting was that the Western (inflammatory) diet fundamentally changed their immune system. After eating high calorie, low nutrient food, not only did the mice exhibit more systemic inflammation (not surprising), but their white blood cells became programmed to remain hyper-sensitive to inflammatory triggers. The cellular “memory” had changed.
Here is how it worked: a gene called NLRP3 (for Nucleotide binding domain Like Receptor Protein) makes a protein that is used by our immune cells to recognize harmful bacteria and viruses. This protein made by the NLRP3 gene recognizes “bad” cell remnants. These can be parts of bacterial cell membranes, or pieces of genetic material found in viruses, or even parts of a cell that are supposed to be contained but may leak out due to cellular trauma. It is a fundamental way our immune cells recognize something is wrong – bacteria are present or acute tissue damage occurred, for example – and thus launch an inflammatory response to deal with the biological crisis and take care of it.
In this study, the immune cells in mice fed a typical Western diet of high-calorie, low nutrient foods launched the same inflammatory response as if an invading bacterial infection were present. Furthermore, the immune cells became hypersensitive so that they continued their inflammatory attack, even when the mice’s diet was returned to normal. In other words, the immune cells responded to a Western diet in the same way it responds to infections. But instead of the infection clearing up, the Western diet seemed to reprogram the immune cells to stay in a perpetual hyperactive state. These results may help explain why chronic inflammation is behind so many lifestyle-related diseases such as heart disease, obesity and diabetes.
LINK to ABSTRACT Western Diet Triggers NLRP3-Dependent Innate Immune Reprogramming.
Diet and Immune Response,
Advanced Nutritional Testing
Vitamin K is often regarded as a nutrient for improving heart health, lowering cancer risk, and increasing bone density, but it also appears to improve fitness even in healthy athletes. Like most nutrients, it seems to have quite versatile roles.
In this small study, 26 trained male and female athletes were administered placebo or vitamin K2 supplements for eight weeks while they maintained their regular exercise routines. At the beginning of the study and after eight weeks, each person completed a fitness test on an exercise machine designed to quantify their physical work load, oxygen consumption, respiratory rate, cardiac output, and heart rate.
Vitamin K2 supplementation was associated with a 12% increase in cardiac output (volume of blood that the heart is capable of pumping per beat). The authors suggest that vitamin K2, which has previously been shown to play a role in energy metabolism (especially in tissues with high energy requirements such as skeletal muscle and heart) might be considered in healthy athletes to improve performance.
For more details on the cited paper, click here for a link to the abstract, “Oral Consumption of Vitamin K2 for 8 Weeks Associated With Increased Maximal Cardiac Output During Exercise,” published in the July 2017 issue of Alternative Therapies in Health and Medicine.
Nutrition and Sports Performance,
Vitamin K and Sports Performance,
Vitamin K and Heart Health
Using data from the government-sponsored research program National Health and Nutrition Examination Survey (NHANES), a group of researchers compiled data on seven vitamins from over 15,000 people in the US. They determined that 31% of the American population is at risk for at least one vitamin deficiency; 23% of Americans are at risk for deficiency in at least two vitamins, and 6% are at risk for three or more vitamin deficiencies.
The data came from a variety of sources: dietary recall, reported supplement use, and lab results – some information less quantifiable than others. Researchers concluded that the most common vitamin deficiency in the United States is vitamin B6, of which a staggering 20% of Americans are deficient. However, scientists concede that biomarkers of nutrient status are affected by inflammation, suggesting that deficiency rates may be even higher. In addition, nutrient status did not correlate with dietary intake (according to their data), which is not surprising given that determining specific deficiencies via dietary intake is notoriously difficult to quantify. Dietary recall is rarely accurate; even if intake is measured with precision (this is difficult to do and therefore unlikely), absorption of said nutrients is an entirely different problem (itself nearly impossible to assess). A review of the available literature supports the view that a one-size-fits-all approach to micronutrient requirements is both outdated and inaccurate.
The investigators stated that “sub-clinical deficiency symptoms for many vitamins and minerals are non-specific, and may include fatigue, irritability, aches and pains, decreased immune function, and heart palpitations,” all of which further complicate the quantification of micronutrient deficiency. Functional measurement of intracellular micronutrient status may gain attention as studies like this are published.
For details, click HERE for a link to the abstract. Read the full paper HERE.
vitamin B6 deficiency,
intracellular micronutrient status
Attention Deficit Hyperactivity Disorder (ADHD) has become an increasingly prevalent condition, afflicting children, adolescents, and adults. Some hallmarks of this brain disorder include an inability to focus and/ or a failure to see projects/ activities to completion. Unbeknownst to most, ADHD can be exacerbated by micronutrient deficiencies. Evidence of the relationship between micronutrient status and ADHD-associated behaviors is compelling; the list below represents some examples of the micronutrient status-ADHD connection:
Vitamin B6: Evidence suggests that high-dose supplementation of B6 is as effective as Ritalin for ADHD, probably due to its role in raising serotonin levels.
Folate (AKA Vitamin B9): Low maternal folate status during pregnancy has been linked to hyperactivity in children. Persons with the MTHFR (methyl tetrahydrafolate reductase) polymorphism are predisposed to folate deficiency, and are more likely to have ADHD.
Magnesium: A deficiency in this micronutrient is linked to poor functioning of the neurotransmitters that control emotion, social reactions, hyperactivity, and attention. Magnesium has a synergistic effect with vitamin B6.
Zinc: This nutrient is a cofactor required for the synthesis of dopamine, which impacts mood and concentration. Low zinc depresses both melatonin and serotonin production; this affects behavior and one’s ability to process information.
Carnitine: Reduces hyperactivity and improves social behavior in people with ADHD via its role in fatty acid metabolism. Some consider carnitine a safe alternative to stimulant drugs.
Serine: Administration of phosphatidylserine in conjunction with omega-3 fatty acids improved ADHD symptoms (attention scores) significantly more than omega-3 fatty acids alone, suggesting a synergistic effect. Phosphatidylserine increases dopamine levels.
Glutamine: A precursor to GABA (gamma-aminobutyric acid), the calming neurotransmitter that affects mood, focus, and hyperactivity. Disruption of glutamine-containing neurotransmission systems may cause ADHD.
Choline: A precursor to acetylcholine, the neurotransmitter that regulates memory, focus, and muscle control (hyperactivity).
Antioxidant status: Oxidative imbalance is prevalent in ADHD patients and likely plays a causative role. Glutathione, a very potent antioxidant, is commonly deficient in ADHD.
To evaluate your micronutrient status, order your micronutrient test today!
For a copy of SpectraCell's nutrient correlation wheel on ADHD, click here.
micronutrient deficiencies in ADHD,
mental health in children,
Why you should know about CoQ10 if you are taking a statin.
Most Americans have heard of statins, a group of drugs commonly prescribed to lower cholesterol levels. But many people are not familiar with coenzyme Q10 (CoQ10), the micronutrient that is known to be depleted by most people who take statins. In fact, the original patent for statins (AKA “HMG-CoA reductase inhibitors”) acknowledged this as early as 1990; however, this is still not widely known today. CoQ10 (AKA ubiquinone because it is so ubiquitous in the body) is a substance that creates energy, the most fundamental of all cell functions. Tissues with a high energy requirement – heart, liver and muscles – require CoQ10 to work. If these cells don’t have sufficient CoQ10, a person may eventually experience fatigue, muscular pains, or both.
Do you know your CoQ10 status? Get your SpectraCell Micronutrient Test today!
Triage Theory states that the body uses whatever nutrients are available to ensure that the most basic and pressing metabolic functions are fueled first; if a needed nutrient is not available, the body compromises long-term health to ensure short-term critical function. This is analogous to a triage situation in any emergency room: prioritizing a patient’s needs based on the severity of his or her situation/ condition. In the same way, our bodies naturally “triage” on a daily basis. Cells will sacrifice nutrients from non-survival functions for immediate physiological needs. For example, nutrients will be diverted from tissue repair to meet a more critical need such as fighting off an infection or secreting cortisol to deal with an imminent stressor. When an adequate supply of necessary nutrients is available to all cells, short-term and long-term health is preserved. However, when not enough of these nutrients are available – and this is often the case given the prevalence of a nutrient-poor diet, stress, and other lifestyle habits that impact nutrient intake and absorption - the stage for the development of chronic disease is set, negatively impacting long-term health.
- LINK TO ABSTRACT Plasma folate, vitamin B-6, and vitamin B-12 and breast cancer risk in BRCA1- and BRCA2-mutation carriers: a prospective study.
Pantothenate also called Pantothenic acid, or vitamin B5(a B vitamin), is a water-soluble vitamin. Pantothenic acid plays vital roles in energy production from foodstuffs.
Pantothenate is a component of coenzyme A, which is indispensable for two-carbon unit metabolism (acetyl groups). Acetyl groups are involved in the release of energy from carbohydrates, fats, proteins, and other compounds, as well as synthesis of fats, cholesterol, steroid hormones, porphyrin and phospholipids.
Pantothenate deficiency symptoms are thought to be uncommon because of widespread distribution in all foodstuffs. However, human deficiency symptoms may include fatigue, depression, burning feet, dermatitis, burning or pain of arms and legs, anorexia, nausea, indigestion, irritability, mental depression, fainting, hair loss, increased heart rate, and susceptibility to infection.
Dietary sources richest in Pantothenate (per serving) include:
- Nutritional supplements
- Whole Grain Products
- Nutritional Yeasts
- Wheat Germ
Download your very own copy of the Nutrient Correlation Chart on Fatigue and a case study on 54 year old with primary symptom of depression.
To find out your micronutrients levels, click here!
Dr. Ron Grabowski,
Oxidative imbalance is prevalent in ADHD patients and likely plays a causative role; Deficiency of glutathione common in ADHD.3,4,5,6
Low folate status in pregnancy linked to hyperactivity in children; People with the MTHFR (methyl tetrahydrafolate reductase) gene are predisposed to folate deficiency and more likely to have ADHD.1,2
Evidence suggests high dose supplementation of B6 is as effective as Ritalin for ADHD, probably due to its role in raising serotonin levels.7,8,9
Deficiency linked to poor function of the neurotransmitters that control emotion, social reactions, hyperactivity and attention; Synergistic effect with vitamin B6.8,9,10
Cofactor for dopamine synthesis which affects mood and concentration in ADHD; Low zinc depresses both melatonin and serotonin production which affect information processing and behavior in ADHD.11,12,13,14
Reduces hyperactivity and improves social behavior in people with ADHD due to its role in fatty acid metabolism; Some consider it a safe alternative to stimulant drugs.15,16,17
Administration of phosphatidylserine with omega 3 fatty acids improved ADHD symptoms (attention scores) significantly better than omega 3 fatty acids alone, suggesting a synergistic effect; Phosphatidylserine increases dopamine levels.18,19,20
Precursor for the calming neurotransmitter GABA (gamma-aminobutyric acid) that affects mood, focus and hyperactivity; Disruption of the glutamine-containing neurotransmission systems may cause ADHD.21,22,23
Precursor to neurotransmitter acetylcholine, which regulates memory, focus and muscle control (hyperactivity).24,25,26
Oxidative imbalance is prevalent in ADHD patients and likely plays a causative role; Deficiency of glutathione common in ADHD.3,4,5,6
To download a copy of the ADHD Nutrition Correlation Chart, click here.
Is carnitine the answer for male infertility?
A group of men (n=96) who had been diagnosed as infertile for at least 18 months were given the following nutritional formulation daily for four months: L-carnitine, acetyl-L-carnitine, fructose, citric acid, selenium, coenzyme Q10, zinc, vitamin C, vitamin B12 and folic acid (see abstract for exact dosages). At the end of the study, sperm motility improved and 16 of the patients had achieved pregnancy. The authors concluded that carnitine may be the key component of the supplement cocktail for improving sperm quality. (Italian Archives of Urology and Andrology, September 2012)
LINK to ABSTRACT Prospective open-label study on the efficacy and tolerability of a combination of nutritional supplements in primary infertile patients with idiopathic astenoteratozoospermia.
Vitamin D helps leg ulcers heal
In this double-blind, placebo controlled trial, 26 patients with leg ulcers were given either placebo or 50,000 IU vitamin D weekly for two months. Leg ulcer size, blood levels of vitamin D and pain was measured before and after the two month trial. In the vitamin D group, leg ulcers were reduced in size by 28% while the placebo group had only a 9% reduction in ulcer size. The authors stated “there was a trend toward better healing in those with vitamin D reposition.” (Journal of Brazilian College of Surgeons, October 2012)
LINK to ABSTRACT Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers.
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Complexity of methylation reactions gains insight
This review emphasizes how methyl donor nutrients such as choline, folic acid and methionine interact and how consumption (via supplement or food) of one can have sparing effect s on another – such as choline’s sparing effect on methionine, for example. (Current Opinion in Clinical Nutrition and Metabolic Care, January 2013)
LINK to ABSTRACT The nutritional burden of methylation reactions.
LINK to FLYER on NUTRIENT INTERACTIONS in METHYLATION
For more journal articles by disease or nutrient please click here
lipoprotein particle profile,
Omega 3 Fatty Acid,