Eating fresh vegetables and oils help reduce risk of cardiovascular disease

Eating Fresh Vegetables and oils help reduce the risk of cardiovascular disease

A recent edition of the Journal of the American Heart Association stated that eating healthy fats lowers the risk of a cardiovascular event just as much as the use of statins does .

In most cases, I do not recommend statins, particularly for women with no history of a cardiovascular event, such as a heart attack or a stroke. There are definite downsides to the use of statins, including muscle pain, increased risks of diabetes and dementia, and rarely muscle breakdown – a condition known as rhabdomyolysis. That event can lead to renal failure and permanent kidney damage.

However, no such risks occur with eating fresh vegetables and their oils. I’d like to make a plea, however, to refrain from buying non-organic oils or oils chemically extracted. Only organic expeller-pressed oils should be eaten … or better yet … eat the whole food … like whole olives! I am a big believer in whole foods, so even oils are second-rate compared with the entire food entity, which has all the wonderful fiber and nutrients still within it!

It’s great to see a published article in a mainstream journal extol the benefits of food, and compare favorably the benefits of eating food with a pharmaceutical!! Hooray!!

Reference:Replacing Saturated Fats With Healthy Fats Lowers CVD Risk

Prolong Use Of Oral Contraceptive, Higher Risk Of Risk Of Hypertension

Prolong Use of Oral Contraceptives, Higher Risk of Hypertension

Nothing should be “too big to fail,” including the mega-industry of female contraceptives! It must be openly acknowledged that female hormones are essential for overall female health and that interfering with them – at any age, but particularly in young teens – is fraught with risks, both known and unknown.

Oral contraceptives and implantables with “pseudo-hormones” are chemical endocrine disruptors, specifically developed to interfere with the normal functioning of the female body. We must be honest in our discussion of these drugs – they are NOT HORMONES! There is not a hormone to be found in any oral contraceptive. They all contain endocrine disruptors – artificial chemicals designed to interfere with the normal functioning of the female body.

Sadly, reproduction and reproductive hormones are intimately linked to every function of the female body – metabolic, immune, cardiovascular, cognitive, mood, and more. Interfering with reproductive hormones disrupts and compromises much more than reproduction – in fact, their interference impacts every single body system – and for the worse.

The sad fact is that no one will openly broach this topic, as the use of oral contraceptives and such chemicals in a variety of formats has become ingrained into our social fabric. There are almost no long-term concerns being voiced about their use.

This article at least broaches the topic of oral contraceptive use and hypertension. It concludes that for every 5 years of pill use, the risk of developing hypertension increases by 13%. The limitations of this meta-analysis are significant, but at least this much was deciphered.

We must truly research other contraceptive options that are both reversible and that do not place toxic foreign chemicals in the bodies of women. While we do not want undesired pregnancies, the cost cannot be the health of the entire population of young women.

See article: Association between duration of oral contraceptive use and risk of hypertension: A meta-analysis

Health Professionals Radio Interview with Dr Gersh on Integrative Gynecology

Health Professionals Radio Interview with Dr. Gersh on Integrative Gynecology

Dr. Gersh’s interview with Neal Howard is live on Health Professional Radio, you can listen to the interview here on the blog.

In today’s Health Supplier Segment, Dr. Felice Gersh, MD, board certified OB/GYN and medical director of the Integrative Medical Group of Irvine, CA discusses the field of integrative gynecology.

 

 

Dr. Gersh did a great job of explaining her expertise in functional and integrative gynecology and how the approach delivers optimum results for her patients. In addition, Dr. Gersh was able to speak about Pure Encapsulations and her contribution to the development of the PureWoman product line!

B’s Block Smog’s Damaging Effects

B’s Block Smog’s Damaging Effects

Air pollution is bad for you, and while most of us think in terms of coughing, wheezing, and watery eyes; the effects go way beyond this. In fact, exposure to high levels of air pollution are associated with significantly increased rates of obesity, diabetes, heart disease, asthma, dementia, and cancer. According to the World Health Organization (WHO) air pollution kills approximately 3 million people per year and is considered the greatest environmental risk to health.

While we may not know how air pollution does all its damage on the cellular and molecular levels, we are beginning to understand how it does some of its dirty work – and we’re finding ways to fight back!

A case in point is a new study just published by researchers at Columbia University’s Mailman School of Public Health. It showed that at least some of pollution’s harmful effects are the result of inflammation and oxidative stress induced by epigenetic changes made to genes involved in mitochondrial oxidative energy metabolism. (Epigenetics refers to the “turning on and off” of specific genes through the methylation process, and not the mutation, or changing, of the underlying DNA.)

Basically, they exposed ten healthy adults to three different levels of air quality for 2-hour stretches of time while also giving them sham or vitamin B supplementation. First, the subjects breathed clean air and received supplementation placebos. Next, they were exposed to “hazardous” levels of polluted air and again given supplementation placebos. Lastly, the subjects were instructed to breathe polluted air, but this time were given supplements containing three different B vitamins – folic acid, B6, and B12.

So, what did they find out? First, they confirmed that breathing polluted air increased epigenetic changes to the genes controlling mitochondrial oxidative energy metabolism. It seems that compromising mitochondrial function in this way leads to inflammation and oxidative stress. Second, they discovered that giving B vitamins was an effective way to prevent and, in fact, reverse this epigenetic damage.

What does this mean for you?

While it’s certainly true that most of us don’t live in areas with hazardously high levels of pollution, over 90% of the world’s population lives in areas where pollution exceeds the WHO’s recommended level for healthy air. We start from a base of bad quality – Southern California is no exception – and things get worse. If you get stuck in traffic on the freeway, if your office building (or your children’s’ school) backs up to a highway, if you fire up the grill this summer, or if you decide to visit cities in India, China, or Iran (just to name a few); you’re probably way over the limit of safe exposure.

What should you do?

While the best advice is to eat a healthy diet with lots of B vitamins – leafy green vegetables and beans are rich in folic acid, B6 can be found in fish, beef liver and starchy vegetables, and B12 is abundant in fish, meat, eggs and milk – sometimes this isn’t enough. To be on the safe side, especially if you have genetic issues with methylation – you may want to take a high-quality B vitamin supplement. Check with us to see which one suits your specific needs best.

How Much Exercise is Needed to Maintain Weight Loss?

I have some bad news and some good news. But, as always, the bad news comes first.

If you have lost a significant amount of weight, it will undoubtedly be harder for you to maintain your new weight than it is for someone of the exact same weight and body composition who was never overweight.

What do I mean by this? Let’s assume that you’ve just lost 50 pounds and now weigh 150 pounds with 30% body fat – a reasonably “good” percentage for someone your age. Your friend, who may or may not have PCOS, also weighs 150 pounds with the same percent body fat. For ease of comparison, we will assume that you also do the same amount of daily physical activity – you sit, you walk, you sit some more – pretty typical for the twenty-first century.

Let’s guesstimate that your resting metabolic rate (the number of calories you burn, if you’re sitting at rest all day) is around 1500 – we multiply your bodyweight in pounds by 10 for a rough estimate. Then we multiply that by 1.6 to account for the additional calories you burn from a day’s worth of average physical activity for a total of 2400 calories per day.

Here’s the problem. Your friend can eat her 2400 calories per day and her weight bounces up and down the normal 2-3 pounds, but long term it stays the same. You, on the other hand, for reasons we don’t fully understand, can only eat 1900 calories per day to keep from gaining weight. If you eat the same diet as your friend, you’ll gain an extra pound every week (500 calories per day x 7 days = 3500 calories, which is the energy content of a pound of fat) and within a year will have regained every pound you lost.

You didn’t overeat; your body has simply become super-efficient and now under-burns calories. This is exactly what the Persistent metabolic adaptation 6 years after “The Biggest Loser” competition study showed us. Contestant metabolic rates averaged 500 calories per day lower than similar sized people who had never lost weight.

It doesn’t seem fair, but that’s the way it is. This problem is further compounded by the fact that when you’re only eating 1900 calories per day, you will most likely be hungry almost all the time. Except in rare cases, your appetite center doesn’t adjust well to this fact and still expects to consume 2400 calories to maintain your 150-pound body. This is absolutely, unequivocally unfair, right?

So, what can you do? What’s the “good” news promised at the beginning?

It turns out that you can exercise the 500-calorie daily deficit away, rather than starving for the rest of your life. How much? Roughly an hour per day at moderate intensity – oh, come on, it’s not that bad! And the only side effect is that you’ll be even healthier than you ever imagined. In a future post, I’ll show you just how easy this can be.

Acne and PCOS

Just thinking about “acne” makes my stomach churn, since it is one of the most hated of all the PCOS symptoms. Acne affects a large percentage of women with PCOS and is something you simply cannot ignore. It stares at you with every glance at your reflection. I am fully aware of the pain experienced by those with acne; I suffered for much of my adult life with it. I want to up-front tell you that I cannot give you a magic pill to clear your acne, but I will share my most effective approaches, and let you know of some exciting up-coming research.

The sad thing is that there are many dermatologists who believe they have the magic pill in the form of Isotretinoin (Accutane), a drug originally formulated as a chemotherapeutic agent. I must issue a serious warning concerning this medication for PCOS women. The success rate in this group is much lower than for others; only about one in three has long term benefit. Some see short-term improvement, followed by the acne’s return with a vengeance a short time later. Isotretinoin also has many side-effects such as headaches, dry eyes, cracked lips, bleeding gums, and fatigue. Among the more serious ones are birth defects, increased suicidal feelings and suicides, liver injury, elevation of blood lipids (fats), and permanent irritable bowel syndrome.

The other issue I want to address immediately is the use of oral contraceptives for PCOS acne. Oral contraceptives do sometimes help reduce acne in PCOS women, though often it does not. Oral contraceptives are chemical hormone mimics and are not good for the gut health. They deplete the body of B vitamins as well. They increase blood clot formation, which can be life-threatening. Long term use can increase breast cancer risk. They also can increase headaches and depression. These effects make me hesitant to prescribe them, though I will at times.

Spironolactone is another conventional drug often prescribed for acne, with mixed results. Although technically approved as a diuretic, it seems to work by blocking the action of testosterone in the skin. My patients have had less than stellar results with this treatment, but it can be tried.

I’d like you to understand why you have such stubborn acne. Your acne is the outward manifestation of inner inflammation combined with an elevated level of androgens (male type hormones)! Those of you who have read my previous article on PCOS and inflammation understand that a cardinal issue with PCOS is systemic (generalized) inflammation. This inflammation is also occurring in your skin, and so you must tackle this problem for what it truly is – a terrible SYMPTOM of an underlying inflammatory situation. The high levels of inflammation trigger still higher systemic levels of testosterone and DHEA (adrenal androgen), further aggravating the acne in an emotionally aggravating feed-forward scenario.

In PCOS women, the bacteria on the skin have been demonstrated to be different from that of “normal” women. Additionally, the sebum, or oily material which protects our skin, is also unique in PCOS women; its constituent fatty acid components are not the same and have reduced capability to fight off infection, hence the development of cystic, recalcitrant acne.

So what shall we do? We must douse those fires! We first must measure your inflammatory status and then must lower it. Your acne will dramatically improve once the flames are out. Start by getting your inflammatory lab tests performed. Contact me if you need help on this. Over the past few months, I’ve worked out a system to help all get these important tests performed at a network of draw sites. Next, we must get that inflammation down. As this is a short article on a very complex problem, I can only provide an overview of my program. If desired, I am happy to help you individually, simply contact me.

The treatment of PCOS related acne starts with your food choices. You must eat an anti-inflammatory diet. Avoid all dairy, in all forms! Dairy increases levels of IGF-1, which increases testosterone, increasing acne! Also, avoid all wheat and gluten, all sugars and sweeteners, alcohol, white rice and corn, and all chemical and processed foods.

There is no diet which is perfect for all PCOS women, so please feel free to do some experimentation to discover what works best for you. We are all unique in our immune systems, our toxic load, and genetics. The unifying theme must, however, be a diet to reduce inflammation! For those who enjoy it and can handle it, I suggest trying initially, for three to six months only, an organic vegan diet consisting of 10 servings (1/2 cup each) of vegetables, including at least 4 servings of a variety of root vegetables such as beet roots, turnips, rutabagas, parsnips, and carrots. Add in 2 fruits, particularly tart apples and berries. The other vegetables should consist of many different varieties of vegetables – all the colors of the rainbow! The phytonutrients and anti-oxidants in these foods fight inflammation and the resistant starch fibers in the vegetables, particularly in the root vegetables, provide nourishment to those critically important bacteria living in your intestinal tract. Add in organic beans, lentils, a handful of organic raw seeds and nuts, small amounts of whole grains such as millet, buckwheat, quinoa, and brown rice, along with lots of green and spearmint tea. This diet is high in nutrients, anti-oxidants, and gut-nourishing fiber. A healthy gut lowers generalized inflammation, which in turn lowers circulating testosterone and DHEA levels, which then reduces inflammation in the skin and improves acne! But if not eating animal products is more than you can handle, go ahead and add in some organic eggs, chicken, red meat, and fish.

Another option exists for women without disordered eating. Published data has revealed that testosterone and inflammation can be reduced by eating most of the day’s calories at breakfast, a third at lunch and fewer than a hundred calories at dinner. In one study, testosterone and insulin levels were reduced quickly by 50%! Although this was an incredible achievement, please recognize that this regimen was only tested in one study, and this way of eating is definitely neither suitable nor feasible for everyone!

You also must control stress! High stress causes increased output of cortisol, and that causes more acne! I hope to write an article on stress and PCOS in the upcoming months, but for now I would recommend buying guided imagery CDs for stress, take a course in meditation, learn progressive relaxation or tapping, get massages, or all of the above! There are studies showing that hypnosis can actually improve acne. The mind controls your stress level and your immune system’s responses, and YOU can control your mind with practice!

Sleep is a critical element related to inflammation. Just one night of sleep deprivation results in elevated markers of inflammation. Maintaining your Circadian Rhythm is a key element of health and the management of your acne. Wake and sleep consistently and get 7-8 hours of sleep nightly.

There are a few key supplements I recommend to reduce acne. They work by improving detoxification functions in the liver and by improving the metabolic functions of the body. In turn, generalized inflammation is reduced. Myo-Inositol, resveratrol, N-Acetyl Cysteine, and berberine are all very helpful. Taking a high potency B complex, containing methylated B vitamins is important. There are also published studies showing benefit from taking Vitamin B5, at a dose of 2 grams, 3 times daily, along with CoQ10, and L-Carnitine at a dose of 1 gram twice daily. Spearmint tea has been shown to lower testosterone levels and reduce acne.

Healing acne is slow going, so expect it to take 6 months to see very significant improvement.

In terms of topicals, several are helpful. Organic essential oils can help to control the skin bacteria. Blends with Thyme and Tea Tree are great. We use an excellent blend called Clear Skin by Simplers Botanicals. I recommend an organic acne line from Sophyto. In a study pitting ProActiv against Sophyto, Sophyto won! It incorporates antioxidants from organic fruits and vegetables grown on a farm on the British Isles. There are also several prescription topicals I have made up at my local compound pharmacy which I utilize. I have also found that acne peels can be very beneficial by exfoliating the skin. I have had success with a peel called ViPeel, designed specifically for acne skin.

I also want to emphasize that I am vehemently against the use of antibiotics for the treatment of acne. Actually, they rarely work for PCOS patients anyway, and from a long-term view, they are incredibly harmful to the GUT microbiome. Remember, there are supposed to be bacteria all over our bodies and within our bodies. The “right” bacteria in our guts reduce inflammation, and hence, reduce acne. Bacteria also typically grow resistant in time to the antibiotics and cease working at all, and so the antibiotics can create more harm by killing off our GOOD bacteria, those which are actually protective!

In terms of future hope, I am currently working to begin a study of the effects of a five-day diet which mimics the effects of fasting on the state of acne in PCOS women. It has been shown that this program reduces markers of inflammation, IGF-1, and insulin levels, all of which are associated with acne. The hope is that this dietary program will substantially reduce acne.

In summary, as you have seen, there clearly is no magic bullet for the treatment of PCOS acne, whether cystic or not. As my imperative is always to do no harm, I avoid Accutane and antibiotics, and prescribe oral contraceptives judiciously. My ultimate hope is to reduce the underlying generalized inflammation and lower androgen levels (testosterone and DHEA levels), while also healing the gut of PCOS women. Then the fire in the skin will be calmed, and the acne will finally fade away.

 

PCOS and Gallbladder Issues

PCOS and Gallbladder Issues

As if women with PCOS don’t have enough on their plates to deal with already, add another to the list-gallbladder dysfunction and gallstones! Yes… it’s true… many women with PCOS also have problems with the workings of their gallbladders. But please…don’t despair as there are many options to help your gallbladders function better…and when they work better…all of you will work and feel better!

Let’s begin with some gallbladder basics. Do you even know why you have one? And is it even important, as many women have their gallbladders removed and no one seems to bat an eye! There reality is that, like all organs we were are born with, the gallbladder serves a very important purpose. Should yours have been removed already or truly must be removed in the future, please don’t think that it doesn’t matter and then make no accommodations for its loss.

The gallbladder is a very important part of digestion … don’t part with it lightly or readily. The gallbladder is a storage vehicle. It holds cholesterol and bile, secreted by the liver. Bile is truly a fascinating creature. It, like many things in the human body, is an amazing multitasker! Bile is vile! Well… just sort of. Bile is the toxic waste material created by the liver in the process of detoxification, also known as biotransformation, of your body’s own old hormones and neurotransmitters, and of environmental toxins and pharmaceuticals. It really is toxic waste!! But it’s amazing stuff. It is also an emulsifier.

When you eat fat, you need to break it down into its little component pieces and then digest and absorb it. Please don’t think fat is evil. Actually it is essential to life, which is why fats are called essential fatty acids. You truly cannot live without fats in your diet. You need a proper balance of the different types of fats, and many are deficient in the type called Omega 3, which is primarily obtained from fish and somewhat from plants like flax seeds and walnuts. And many of you have probably heard that olive oil and coconut oil are healthful fats. And so is the fat in the yolk of organic eggs. We will talk more about fat another time…for now take me at my word that fat is essential to life and you need bile to help you digest it.

Back to bile… it is a natural emulsifier. That means it can take a fat and turn it into being water soluble, so it can mix with water! This is truly like a miracle. You probably know that if you have greasy hands and simply run them under the water faucet, the hands stay oily. If, however, you rub in soap, the grease will be able to be washed off your hands without a problem! Soap is an emulsifier-it makes fat able to be washed off with water.

Without bile, you simply can’t digest fats, and with the fats come the fat soluble vitamins… like Vitamin E, A, K, and D! These vitamins are essential to proper functioning! If you don’t have a gallbladder or the one you have doesn’t work well, you will naturally have difficulty with your digestion of fats and of fat soluble vitamins!! If that’s the case, you need to actually take bile at the beginning of each meal. This bile comes from an ox! It’s the closest we have to human and it works well. You also need to take digestive enzymes as well as that nearly always becomes a problem when the gallbladder is gone or malfunctioning. The gallbladder triggers the pancreas to release it digestive enzymes. It is very important that you do this or you’re quite simply not going to digest your food properly! Women with PCOS have enough issues…malnutrition shouldn’t be one of them!

So why do women with PCOS have problems so often with their gallbladders? It’s related to gastrointestinal problems in general, and women with PCOS are renowned for what we term “gut problems.”  Many have irritable bowel syndrome (IBS) with constipation or diarrhea and general gut issues, acid reflux (GERD), dysbiosis (the wrong gut bacteria), and sometimes even more serious inflammatory bowel disease. There are quite a few theories as to why PCOS women how so many gastrointestinal problems, but it is known for sure that many have what is called “leaky gut” and  small intestinal bowel overgrowth, along with many food allergies, sensitivities, and autoimmune states as well. Because of these issues, the proper signals to the gallbladder don’t occur and it becomes sluggish, and can actually get sludge in it, and it can even progress to gallstones. Just because you have sludge or stones does not mean the gallbladder must go! Only if you’ve had recurrent pain, pancreatitis, or infection, is it then absolutely necessary to have it removed… but remember you’ll absolutely need a bile and digestive enzyme supplement.

Some PCOS women get gallstones or sludge because she goes on a low fat diet for a long time. I don’t recommend a woman go on such a diet!! That is not the way to get healthy! You already know that fat is essential to life!!

I believe strongly that all women with PCOS should have their GI tracts checked out for overgrowth of bad bacteria, small intestinal bowel overgrowth (SIBO), issues with low levels of stomach acid and digestive enzymes, constipation or diarrhea, stomachaches, and the like. And please…do not go on a low fat diet…nor go on a prolonged very low calorie diet…as that too will make you more prone to gallstones.

If you do have gallstones and you haven’t had severe pain, infection or pancreatitis, get another opinion before having your gallbladder removed. Often women can live a long and normal life with gallstones. With gallstones, you’ll want to do a liver detox regularly, eat a healthy amount of good fats, work on stress as that is so unhealthy for the gut, and you can even consider medication to try to dissolve your gallstones, if you meet the criteria. In general though, my first choice, as always, is to try to work with you simply with a lifestyle approach.

The key take-home points are that we should try hard to maintain good gallbladder health by eating healthy fats and getting the GI tract checked out by a good doctor who understands what is needed for PCOS women, and if you have gallbladder issues already or have had yours removed, get on bile and digestive enzymes right away!! And remember, stay positive and focused on doing the right things to maintain your health, at most of the time!!! Good luck and give your gallbladder a virtual hug today!!

 

Flagship Project on Precision Medicine

March 1, 2016
Flagship Project on Precision Medicine for Underserved Women Will Advance Learning Health System

Washington, D.C. – On February 25th , President Obama participated in a panel discussion at the White House Precision Medicine Summit Initiative (PMI), marking the one year anniversary. The panel featured remarks from inspiring patients, researchers and others working in the PMI field.

More than 40 private-sector organizations and a variety of federal agencies are making commitments to new actions and principles that are spearheading the Precision Medicine Initiative. One such flagship project, “Precision Medicine for Underserved Women with Polycystic Ovary Syndrome (PCOS),” aims to align precision medicine with the vision embodied by the Learning Health System (LHS) Core Values. The PCOS genetic disorder causes infertility that eventually ends up in a disease state of diabetes, heart disease or cancer creating an enormous cost to the healthcare system.

The Learning Health Community, a grassroots, multi-stakeholder movement aimed at transforming our nation’s health system into one that is capable of engendering learning from every experience of every consenting patient, and rapidly feeding back lessons learned to empower better decisions that improve people’s health.

President Obama said, “The (PMI) goal is to create a common database of ultimately a million people that is diverse. Ultimately we can take a disease that may be rare and start seeing patterns we may not have seen before.”

Marc Wine, a supporter of the LHS – Precision Medicine PCOS Project and participant in Learning Health Community initiatives, who attended the summit hosted by the president said, “One goal is to seek collaboration with underserved communities in genomics, open data and integrative medicine. This will result in engaging individual patients in ways that will move them from dependency on fragmented healthcare to the point where patients can use their own evidence-based genetic information to make the very best health decisions.”

The Precision Medicine PCOS Project is aimed at developing a protocol for women with PCOS while employing an integrative medicine approach to treatment based on the participant’s molecular makeup, clinical data and available scientific knowledge.

The PMI includes ongoing efforts through the Department of Veterans Affairs (VA), the Department of Defense (DOD), the Food and Drug Administration (FDA), the Office of the National Coordinator for Health IT and the Office for Civil Rights, all in line with Vice President Biden’s Cancer Moon-shot initiative.

“The LHS is the fabric that weaves together and enables various use cases aimed at improving health including precision medicine, Patient-Centered Outcomes Research (PCOR), public health surveillance, patient engagement, quality improvement, patient safety, and further uses not yet envisioned,” said Joshua C. Rubin, JD, MBA, MPH, MPP, a leader in the LHS movement.

The LHS vision has been the subject of over 16 reports of the Institute of Medicine since 2007, and now represents the pinnacle goal of federal health IT strategic planning for the coming decade.

Through aligning the LHS – Precision Medicine PCOS project with this larger vision, the project team is working to ensure that infrastructure and key components created to advance this flagship project will support future use cases.

The Precision Medicine PCOS Project was recently launched in Atlanta at Medici Medical Arts Clinic, with Chief Medical Officer, Dr. Sonny Dosanjh and a group of 37 women who have PCOS, a complex and chronic syndrome that affects 7 million women in America. Ten of these initial women will form the Patient Advisory Team resulting in ongoing involvement in systems design, learning and education systems and participating in the use of their molecular data. This provides unique involvement so women with PCOS will have access to not only their data, but also how the clinical support and care is delivered individually.

By building such efforts upon a sturdy foundation of Learning Health Systems “Core Values,” this Precision Medicine PCOS Project will collaboratively build the big data, Artificial Intelligence infrastructure large enough to include all individuals and populations through open knowledge sharing.

The Precision Medicine PCOS Project with LHS, aligning with the president’s PMI and the underserved, has taken the initiative to launch its innovation in Atlanta, phasing-in a large cohort of women with PCOS which is the number one cause of infertility in women. As a complicated endocrine and metabolic disease, PCOS has received limited attention by the medical community.

Of the estimated 7 million women with PCOS, less than 0.1% of the NIH budget is focused on research to help these women. This Precision Medicine PCOS Project was started in December 2015 and may be the largest ever project to use state of the art genetic and molecular research, science, evidence-based integrative medicine and technology to help this growing underserved community of women.

The Precision Medicine PCOS Project is acting to build a nationwide collaborative to empower women with PCOS to manage this complex genetic disease throughout their lifetime.

The project’s leader and Founder of Open Source Health, Inc., Sonya Satveit, said, “As women, we have been underserved in healthcare for too long, if I can make a difference, I have accomplished my life-long dream. To have such an incredible team, that shares my passion, come together around this critically underserved area of women’s health, gives me confidence that we will make a difference and give hope to women with genetically caused infertility. “ The project expects to see the first results in late 2016.

For more information see:
Open Source Health, Inc.: http://opensourcehealth.com/
Learning Health Community: http://www.learninghealth.org
The White House Precision Medicine Summit: https://www.whitehouse.gov/blog/2016/02/25/precision-medicine-health-care-tailored-you

Depression and Anxiety in women with PCOS

Depression and Anxiety in women with PCOS
December 25, 2015

January is a month when many feel the effects of the holiday season coming to a sudden end. The decorations must all be put away; there is often a big mess of discarded wrappings to deal with, thank you notes calling to be written, and health resolutions to write – and often to discard just as quickly. For many, unfortunately, January is a “down-mood” month, one with long, cold days and long, dark nights; when we are often faced with a stark reality, without the joyous festivities to hide behind!

And for those with PCOS, to add to the general “down-ness of January,” is the fact that mood disorders are increased in women with PCOS compared to women without this condition. In fact, all women with PCOS, at all times of the year, should have an initial evaluation to include assessment of mental health disorders. The prevalence of depression in women with PCOS is high and varies from 28 to 64%, while the prevalence of anxiety in women with PCOS ranges from 34-57%.

In recent years, the complex relationship between PCOS and psychosocial issues has come to the forefront, with a prominent link found between specific features of PCOS and mental well-being. The fact that many women with PCOS experience menstrual dysfunction and infertility, hirsutism and obesity, along with cystic acne, creates a situation which can clearly result in profound psychosocial distress. In one interesting study from South Asia, researchers found that in comparing hirsutism and obesity, more depression was related to the presence of hirsutism. The scientific literature now shows clearly that anxiety levels, psychological distress, depressive feelings, and social fears are all markedly higher in women with PCOS.

The reasons for this increased vulnerability to depression and anxiety and for women with PCOS to develop psychiatric disorders are still unclear. But in addition to the negative mood reactions to the visible symptoms of PCOS, there are others which likely involve pathways independent of these visible symptoms. In one study of 300 women, nearly a third had anxiety, and quality of life was lowest in those with a combination of stress and depression.

Stress is one of the common mechanisms that induce psychological disorders. This occurs via the hypothalamic-pituitary-adrenal (HPA) axis and involves circadian rhythms. With significant stress, there is alteration of the HPA axis and disruption of the circadian rhythm, altering the functional relationship of the brain with the endocrine systems, resulting in adverse impacts on health. Women with PCOS have a higher level of sympathetic output from their adrenal glands. They tend to have higher outputs of cortisol and adrenaline, and to have dysfunctional melatonin, and therefore more inflammation and poorer sleep.  The higher levels of cortisol and adrenaline make those women more prone to anxiety and sleep dysfunction, adversely affecting mood.

Women with PCOS have an exaggerated response by the sympathetic nervous system, with a heightened response to negative stimuli compared with non-PCOS women. They have an abnormally increased cortisol response to physical and psychological stressors which cannot be explained by their BMI, increased percent of body fat, fasting insulin, or elevated androgen levels. Indeed, there is an independent and inherent mechanism exaggerating the stress response, in a negative way, for PCOS women. Additionally, there is evidence of an increased incidence of eating disorders and suicidal behavior among PCOS women. Sadly, they are at an increased risk of social phobia and suicide attempts.

But none of this means that women with PCOS can’t have full and wonderful lives. All this means is that it must be recognized that PCOS women have an added risk for adverse reactions to normal stressors and are more prone to anxiety and depression. Therefore, more active and proactive management is necessary. Women with PCOS need to cultivate coping mechanisms, and there are many to choose from. The maintenance of the emotional well-being of women with PCOS needs more nurturing than what is needed for the average woman. But with such support, every woman with PCOS can achieve mental, emotional, and spiritual health.

The ways to achieve emotional happiness are many, and all can be combined to satisfy each individual woman’s unique needs. Some of the effective methods are the varying forms of meditation, hypnosis, the Emotional Freedom Techniques, including tapping, Tai Chi, Chi Gong, yoga, massage, baths, acupuncture, cognitive behavioral therapy, essential oils, and my own personal favorite, guided imagery. I utilize several techniques for my own stress therapy, emphasizing baths, essential oils, and guided imagery, but all can be amazingly effective! Each woman must try out several and discover what works particularly well for her.

If you feel especially down or stressed, be sure to seek assistance and find your personal path to emotional, spiritual, and mental well-being. Do not delay even a minute getting help if you have any tendencies towards self-harm! Please contact me if you are seeking PCOS medical care and do not know where to turn.

 

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