PCOS and Fatty Liver - The link between grows stronger!

PCOS and Fatty Liver: The Link Between Grows Stronger!

The incredible link of the gut microbiome and overall gut health with the metabolic manifestations of PCOS just keeps growing more clear! A new study was just recently published, the key points shown in the attached below piece, indicating that women with PCOS do indeed carry a higher risk of developing fatty liver.

The intestinal tract links directly with the liver, through a passageway called the enterohepatic circulation. Inflammatory products from the gut head right to the liver. This connecting passage exists to allow the liver, in concert with the brain, to regulate the glucose and fat levels in our blood and to regulate our appetites.

Never did Mother Nature anticipate that humans would eat huge amounts of animal fats and transfats, inordinate quantities of sugar, and high fructose corn syrup in particular, eat nonstop and late into the night, and eat chemicals toxic to our intestinal microbial guests! The outcome of this unfortunate gut environment is gut dysbiosis (the wrong sorts of bacteria living in the gut) and impaired gut barrier function (also called Leaky Gut).

Leaky gut occurs when the wrong gut composition of bacteria develops and toxic particles are produced by them, called Lipopolysaccharides (LPS) – also called endotoxin – which pass through the gut lining and into the adjacent immune cells, called the Gut Associated Lyphoid Tissue (the GALT). These immune cells feel that they must defend the body against these toxins, as they are assuming the body is undergoing a serious infection, and a severe inflammatory reaction develops in the liver and a chronic state of inflammation develops throughout the body.

This occurs as the immune cells release their own inflammatory products, designed to protect us from invading bacteria, fungus, parasites, and such, but in this case, these “helpful” immune cells are actually furthering the damage being done by creating an unremitting state of chronic inflammation in the liver and throughout the body. This also manifests are severe inflammatory acne!

The occurrence of this inflammation in the liver worsens insulin resistance, causing more testosterone to be made and further interfering with the natural hormonal functions of the ovary.

The first thing all women with PCOS must do is to change the diet to help heal and restore a healthy gut. Food can and indeed should, be thy medicine!!

And that will be the topic of my next PCOS blog!

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.

Risks of Conventional Hormone Replacement Therapy

This is data from rats but shows that periodic, as opposed to continuous, treatment with estradiol, is protective for the brain from ischemic damage. This article urges research be done in human females to investigate a more physiological approach to estrogen therapy than what is currently being done.

This is what I absolutely believe – hormones must be replaced in a physiological manner for there to be maximum benefit and minimal negatives.

The conventional manner in which female hormones are given to menopausal women simply makes no sense, as it is not consistent with physiology. Women are cyclic, beautifully rhythmic creatures … not static ones … and must receive hormones consist with how they were designed for them.

I know I’m an outlier now, but time will bear me out. The functions of estrogen are well known and highly protective … and after menopause women suffer in varying degrees from hormonal deprivation. Yes … It is natural … but it is so very negative to a woman’s very being.

After menopause … women simply dry up! They can get dry eyes, dry bladders, dry vaginas, dry skin, dry arteries, dry brains, dry muscles, dry hearts, dry mouths, dry guts, dry bones, and on and on … And yes … I use the word dry a bit loosely … but it’s really quite close to the truth!!

Women must demand that proper research be done for them! Women are wondrous and rhythmic and should live their lives in harmony with nature!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625208/

Artificial Sweeteners Absolutely do not Belong in Your Food!

Most women with PCOS suffer with being overweight or obese, living in a constant battle with their weight and food. Many have binge eating disorder, some have bulimia, and some even have anorexia nervosa. With the exception of the weight problem, lean women with PCOS have most of the same issues as their heavier “sisters,” and should follow the same dietary rules, one of which is: absolutely no chemical sweeteners, or really, sweeteners of any sort!

In the desire to achieve good health, weight loss, or weight maintenance, many women with PCOS choose non-caloric sweetened foods and beverages (those containing chemical sweeteners with few or no calories) in the mistaken belief that these are wise and healthy choices.

Sadly, there is now clear evidence to the contrary. In fact, more and more data is clearly indicating that these nasty chemicals actually lead to further weight gain and insulin resistance, thereby increasing the risk of pre-diabetes and diabetes. Additionally, by disrupting the normal functioning of the gut microbiome (the bacteria that live in our gastrointestinal tracts) these sweeteners can foster cognitive decline, as well as increase anxiety and depression, worsen or initiate irritable bowel syndrome, and elevate the risk for problems affecting the cardiovascular and immune systems.

A likely reason for these terrible effects is the negative impact artificial chemicals have on the different species of gastrointestinal bacteria, upsetting their natural balance by suppressing the growth of some populations, which then allows for the overgrowth of others. These bacteria, collectively called the microbiota, play an enormous role in our metabolic, emotional, cognitive, immune, and cardiovascular states by producing metabolites and signaling molecules that are absorbed and then circulated throughout our bodies. Altering the microbiome alters the natural balance of these chemical messengers and metabolites, resulting in a host of ill effects which no one, and certainly not women with PCOS, can afford to deal with.

The take-away message is, as I see it, to avoid all processed foods, as they often contain chemicals harmful to our microbiome and other aspects of our health. Try hard to eat only real and unaltered food … the food your great, great grandmother could and would have eaten! And though she may on occasion have had a special sweet treat, try to avoid those as well, unless and until you regain the health and vitality you seek and deserve.

What’s for Dinner?

When you sit down at the table to eat, what do you think makes for a great meal?

My first rule of thumb is quite simple – all food must taste good and be good for you! Those rules simply cannot be broken. Next, once it meets those qualifications, it is really important that it is truly scrumptious. If given a choice, why go for food you don’t really love, and who doesn’t love to eat? Eating is one of the true joys of life, and it makes me, and actually everyone, happy and satisfied when eating wonderful food.

Second, we should think about nutrition – is the food we’re eating supporting our long-term health. If it isn’t, then we’re setting ourselves up for all the dangerous health consequences that plague PCOS women: obesity, pre-diabetes and type-2 diabetes, cardiovascular disease, inflammatory bowel disease, and more.

And of course we will think about the toxin content of the food. Is it organic or not? What chemicals are contained in it or is it a processed food, which, by the way, I never will eat! And is it fresh and full of nutrients, or old and wilted.

Rarely, however, do we think about the food we eat in terms of feeding the 30-40 trillion (that’s right, trillion!) bacteria that inhabit our GI tract, call the gut microbiome. This is a lot more important than you might think, because the latest scientific research is telling us that these little fellows – who have been part and parcel of who we are for the past several million years – have an incredibly powerful impact on virtually every organ system in our bodies.

They help digest and process our food and create a vast range of metabolites that we absorb and use all over our bodies. They also produce neurotransmitters that control our feelings of anxiety and depression and also help regulate our blood glucose levels through several mechanisms – and that’s just scratching the surface.

So, the bottom line is: when you sit down to eat, remember that you’re not just eating for yourself, the 20-30 trillion (yup, there we go with the trillion again) human cells that make up your body, but also for the gazillion microbial guests, who are also seated at the table.

And exactly what, you may ask, would they like to eat?

Fortunately, the answer to this is relatively straightforward and not at all discouraging. They like to eat high-quality, whole foods, and they like variety. They love lots of vegetables, both above ground and root vegetables, and a slightly lesser amount of fruit, especially when they are organic and not tainted by residues of herbicides and pesticides. They prefer plant-based sources of protein (beans, lentils, quinoa, and amaranth) over animal-based sources and do well with good doses of the fatty acid, Omega 3. And please avoid simple sugars and sugar substitutes, as they are quite toxic to the microbiome. It is simply much better to be focusing on carbohydrates containing lots of fiber. Fiber is the foundational food for the microbiota which dwells within our gut.

If you give these single-cell companions what they want, they will reward you in spectacular ways. Your weight, blood pressure, body fat percentage, cholesterol levels, and fasting glucose level will drop, all of which will lead to substantial reductions in inflammation and oxidative stress. And, if you stay tuned to this blog, we’ll give you wonderful recipes and cooking advice that will make your new diet every bit as delicious as it is good for your health!

How PCOS affects Depression and Anxiety

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 times to discard quite 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%, and 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, including the impact of infertility, hirsutism, and acne on mood. The fact that many women with PCOS experience menstrual dysfunction, 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, they found that in comparing hirsutism and obesity, the most 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 the population of women with PCOS.

The reasons for the increased vulnerability of depression and anxiety in women with PCOS as well as for PCOS women 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 several pathways independent of the visible symptoms of PCOS, such as obesity, acne, and hirsutism. 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 wellbeing. 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.

*This is a repost of a guest post Dr. Gersh orginally posted on PCOS Diva at: Depression and Anxiety in Women with PCOS http://pcosdiva.com/2015/12/depression-and-anxiety-in-women-with-pcos/

Diagnosis and Treatment of PCOS in Young Girls

Most doctors and patients alike believe that PCOS is a condition which appears in the teen years or with young adulthood, following the advent of puberty and the onset of periods. In reality, shocking as it may seem, PCOS begins with birth!!

Now how, you may ask, can that happen? Doesn’t puberty herald the onset of the all the medical challenges faced by young women with PCOS? The answer to that question is…. mostly so… but there are signs and symptoms early on, and there can be early detection!

Here is the story of the beginnings of PCOS, and with this knowledge comes the capability to predict with reasonable, if not perfect, accuracy whether or not your daughter will develop PCOS. With that knowledge comes the power to begin treating it BEFORE all the misery that you know all too well ensues, following the completion of puberty.

While in utero, because of the ubiquitous toxins surrounding us all, everyone becomes exposed to numerous chemicals, including ones which act as endocrine disruptors, particularly Bisphenol A (BPA). Such exposures alter the very foundational development and function of hormone receptors. What happens is that these chemicals enter the pregnant woman’s body through various means and then cross the placenta, thereby entering  the baby’s body, where it actually concentrates in greater quantity than in the mom’s body! This sad fact has only been recently realized! Researchers, measuring the chemical levels in the moms, often found low levels and concluded they were below the threshold to cause problems, while being unaware that the levels of that chemical were actually much higher within the baby.

Chemical endocrine disruptors are like cheap knock-off imitations of real hormones. They can attach to receptors and act in one of many ways-mimicking the real hormone, blocking the action of the hormone, or something in between. And estrogen has three different kinds of receptors, so the end result can be hormone chaos and the various organs of the developing baby’s body simply do not get the right exposure to hormones, particularly estrogen.  The baby is born with a “confused” hormonal system, unable to respond properly to the hormones due to the abnormal function of their receptors, as well as the inability to manufacture them properly.

When there is a problem with the functioning of the estrogen receptors, systemic inflammation occurs. This occurs because estrogen functions as the master of metabolic homeostasis. What that means is that estrogen controls a female’s appetite, energy usage, metabolic rate, location of fat deposits, and how fat functions. Estrogen is truly the mastermind of all that is female and metabolic!

Young girls born to PCOS moms have about a 50% chance of developing PCOS themselves. Given those odds, it is really imperative for us to diagnose, with some reasonable probability, which of those daughters will and which won’t have to deal with PCOS. And there are ways to reasonably identify young girls as having a high predilection to develop PCOS.

From a physical point of view, here are the suspicious symptoms. If a very young girl, from approximately age 4 to 12 years of age, has an unusual amount of waist and belly fat, yet she eats quite well… that is a powerful clue. Estrogen regulates where fat is deposited and how it functions, so young girls destined to get PCOS may be showing signs of abnormal fat deposition and already have difficulty maintaining a healthy weight, well before puberty sets in.

There is also a blood test which has good predictability for detecting PCOS prone girls and which can be administered as early as age 6 to make a likely diagnosis! This test is called Adiponectin. I order it through the Cleveland HeartLab, a very prestigious cardiovascular laboratory, affiliated with the renowned Cleveland Clinic. Adiponectin is a type of hormone made by adipose (fat) tissue, called an Adipokine. Adiponectin is an extremely important and vital hormone to prevent inflammation, insulin resistance, and obesity. It is involved in managing how fat tissue functions, the level of inflammation in the body, how energy is produced and stored, and the transport of glucose from the blood into cells, impacting insulin resistance. Estrogen controls the production of Adiponectin. In girls prone to develop PCOS, the Adiponectin levels will be unusually low.

The finding of low Adiponectin levels raises a big red flag that the girl is at high risk to develop PCOS. The potential for Adiponectin to be used as an early screening tool means that girls at high risk to develop PCOS can be identified as young as age 6! Once identified, proactive therapies can be initiated to lower the chance of PCOS becoming severe. Lifestyle changes involving diet, sleep, stress, exercise, and nutrition can all be implemented to greatly soften the blow to health which occurs with the passage through puberty.

I would be happy to assist any who have daughters they would like evaluated for PCOS risk status. I can see and examine them and order Adiponectin, as well as all indicated inflammation testing. I strongly advocate for a proactive approach to all diseases in order to prevent the devastating effects of an advanced disease state. This philosophy is particularly applicable to PCOS to ameliorate the suffering so many with the condition must endure.

*This is a repost of a guest post Dr. Gersh orginally posted on PCOS Diva at:  http://pcosdiva.com/2015/11/diagnosis-and-treatment-of-pcos/

PCOS Diet: 7 Tips for Timed Eating, Weight Loss Gut Health and Better Sleep

We are “what” we eat, that remains true. But just as correct, is the very new notion that we are “when” we eat! 

The newest data now shows that when you eat can determine how long and how strongly your heart will beat. Incredibly, the timing of meals may be as important for health as is diet composition and amounts of calories.

Research now shows that there are clocks in our bodies which are very involved in cardiovascular function and risk, and that this relates to the time of eating. One research study with fruit flies showed that limiting their eating to only 12 hours of 24 led to healthier hearts compared with allowing fruit flies to eat whenever they wanted to eat.

The body’s master clock is located in the brain, in the section called the hypothalamus, and sits atop the optic nerve so it can glean whether it is day or night, based on the light received to the retina. But there are other peripheral clocks located in all the cells of the body which are regulated by the master clock, the only clock which sees light and dark. Although the peripheral clocks cannot see light or dark, they can sense when there is feeding happening, and that is an important component of how they can be set!

Previous research has shown that timed eating, limiting all food intake to a maximum of 12 hours per day, can protect mice from obesity and other metabolic problems. Mice’s hearts do not easily get altered, and so studies with fruit flies were done, with dramatic results. Two groups of fruit flies were used. They both ate the same amount of food, but one group ate for only 12 hours a day and the other group had 24 hour access to the food and snacked at night. Both groups had the same amount of activity, but the flies who did all of their feeding within 12 hours did most of their moving during the day and slept better at night.

The hearts of the flies were examined at different times. At 3 weeks of age, the flies in both feeding groups had similar regularly beating, healthy hearts. At 5 weeks, which is the fly’s middle age, the 12 hour eaters had hearts which maintained a steady rhythm of one beat per second. The other group which ate at any hour of the day or night, had hearts with irregular beats, sometimes skipping a beat, and sometimes quivering. By 7 weeks, the anytime eaters had hearts which beat with badly damaged heart function.

In other studies, restricted timed eating helped stave off the harmful impact of high-fat diets.  And also interesting, when the researchers disabled the clocks throughout their bodies, restricting the feeding times did not help the hearts of the flies, suggesting that functioning clocks are important for heart health.

The researchers also looked at the effects of timed eating on gene expression and activity. Circadian rhythms are powerfully expressed in genes, which peak in activity at certain times of the day. The flies which ate only during 12 hours had peaks of gene activity which maximized right before breakfast and just before the final bite. The flies which could eat around the clock had several smaller peaks of gene activity throughout the day, suggesting that timed eating led to better coordination of gene activity. Tightly controlled gene activity may permit more efficient energy use and prevent the build-up of metabolic byproducts which can damage tissues.

Additionally, it is now recognized that the bacteria within our colons have their own clocks, and when eating is done properly, their clocks are perfectly synchronized with the clocks in our own cells. The only way for the bacteria to synchronize their clocks with our own, is through timed feeding. And we clearly know that it is necessary for the microbiome to be happy and healthy if we are likewise to be happy and healthy.

My advice is easy. Begin with this simple plan:

  • Eat no more than three meals a day
  • Avoid snacking
  • Stop eating at 7 pm, but at least by 8 pm
  • Have at least a 12 hour fast between dinner and breakfast
  • Eat mostly plants with many vegetables, beans, lentils, and whole grains
  • Avoid or limit grains which have been pulverized (aka-bread and crackers)
  • Eat at the same times every day

By eating the timed way, you will lose weight and feel better, even if you consume the same number of calories. I am not going to say that calories don’t count, but they count far less than once was thought. Eating at the right times matters as much, and likely more.

The gut microbiome requires timed eating to properly care for them. Focus on caring for the microbiome with lots of fiber and plant based foods. By finally nurturing the microbiome with the right food choices and with timed/restrictive eating, it will take care of you.

*This is a repost of a guest post Dr. Gersh originally posted on PCOS Diva at: http://pcosdiva.com/2016/06/pcos-and-circadian-rhythm-part-2/

PCOS: Resetting Your Circadian Rhythms

All living creatures throughout evolution have developed biological clocks to better adapt to the 24 hour day called the Circadian Rhythm. These are called Circadian Clocks and they regulate physiology, metabolism, and behavior. In humans, many aspects of physiology are subject to circadian regulation. These include sleep-wake cycles, cognitive performance, cardiac and renal functions, digestion and detoxification. Overall, about 10% of all genes express in a Circadian manner. These peripheral genes, sometimes referred to as peripheral oscillators, are controlled by the master clock located in the brain.

It has been known for over 40 years that all humans have such a master clock built into their bodies, controlling numerous functions, such as when hormones are released, the level of one’s appetite, metabolic functions, mood, and cardiovascular health. The master clock regulates a myriad of cellular, physiological, and behavioral 24 hour rhythms. This master clock is located in the hypothalamus of the brain, at a spot called the superchiastmatic nucleus (SCN). This location is on top of the optic nerves, allowing it to sense light and dark!

There are also clocks in most of the cells of our bodies called peripheral clocks, and all are regulated by our genetics by what are called clock genes!

The discovery of clock genes has led to a revolution in our understanding of how Circadian Rhythms are generated in individual cells. Light signals detected by the eyes are interpreted by the SCN which then sends out synchronization signals to other cells of the body via hormone secretion, sympathetic innervation, and indirect cues such as body temperature, feeding times , and activity rhythms. The regulation of these clock genes is extraordinarily complex, involving many types of receptors and proteins for signaling, and also include hormone receptors such as glucocorticoids (like cortisol), thyroid, and estrogen.

Women with PCOS have documented dysfunction of their Circadian Rhythm systems. They simply do not keep proper time by the master clock in the brain, nor synchronize all the cells of the body as they should. Circadian disruption is associated with insulin resistance and obesity, as well as with intestinal problems, and mood and cognitive issues. A broken clock increases one’s risk for cancer, a heart attack, a stroke, and dementia. But do not get all stressed out! Over the upcoming months, I will take you through the issues of the Circadian Rhythm as they relate specifically to PCOS, discuss the special clocks within us all, and explain  in-depth how they relate to gut health, sleep, mood, the immune system, the cardiovascular system and more!

So stay tuned! We have a great journey ahead of us, as we explore the nature of our biological rhythms, how we can work to get them working properly again, and aid you in your quest to return to a state of optimal health and happiness!

*This is a repost of a guest post Dr. Gersh orginally posted on PCOS Diva at:  http://pcosdiva.com/2016/05/resetting-clock-series-part-1-circadian-rhythm/

How Much Calcium is Necessary for Your Health?

Calcium is the most abundant mineral in the human body and is a crucial factor in numerous body functions and structures. But what should a woman do to ensure she is consuming the correct amount of calcium to maintain a healthy body? Does a woman with PCOS need to drink milk?

Until recently, the dogma of consuming large amounts of calcium went unchallenged, but it is now recognized that the studies used to create that advice were poorly done, and the data is less than clear on the value of calcium supplements. Most data are now not in support of calcium supplements, or at least suggest consuming them only in small amounts!

The Pros and Cons of Calcium

Previously, it was thought that calcium supplements provided a large array of metabolic benefits: improving cardiovascular wellbeing, lowering blood pressure, and reducing diabetes risk. Of course, it was also thought that it would help bones stay strong. Certainly, calcium itself is important for those functions.

The current state of knowledge is that calcium supplementation in small amounts may be beneficial, but larger quantities of calcium supplements do not seem to provide those desired benefits after all and actually may increase the incidence of kidney stones! There is even concern that excessive calcium supplementation may cause calcium deposits to develop in the artery walls.

What is the Best Source of Usable Calcium?

It turns out that the best way to get calcium into your body, to ensure a healthy set of bones and a healthy cardiovascular system, is through the diet. The dairy industry has made it seem absolutely necessary that large amounts of dairy products be consumed daily, and the newest US nutrition guidelines also advise a glass of milk with each meal!

Not only is this unnecessary, it is downright harmful, most particularly for women with PCOS. Dairy is an acid producing food, and calcium will not get into bones if the blood is acidic, making dairy products an inferior source of calcium.

Calcium is a natural antacid. Removing it from the blood would make the blood even more acidic, and calcium cannot move out to the tissues from an acidic environment. Only in an alkaline situation can calcium leave the blood to move into tissues. The only foods which alkalize the blood are vegetables!

Did you know that there is much more usable calcium in a cup of collard greens than in a cup of milk? Most people don’t realize the calcium content of greens is so high. Best of all, the calcium in greens is usable by the body and doesn’t just pass out with the urine or cause stones!

So what do I recommend?

Eat large quantities of green vegetables and lots of greens. As a side note- chard and spinach are very healthy, but the oxalates in them bind with the calcium and preclude their use, so be sure to include a variety of vegetables each day.

I also recommend only a small amount of calcium as a supplement in most cases. Keeping the supplement dose to 500 mg daily is safe and may help.

Women over 50 or those with low stomach acid should avoid calcium carbonate. It is poorly absorbed. In general, keep calcium carbonate to a minimum and choose other forms.

Remember that calcium, like all minerals and vitamins, doesn’t work in isolation. Be sure to get plenty of sunlight for Vitamin D production and magnesium from walnuts and sunflower seeds, and include supplements for them as well, if needed.

In summary, fresh green vegetables should remain your primary source of calcium. And please avoid dairy, it is inflammatory, increases acne, and it is associated with weaker (not stronger) bones. That is truly what the data shows!

Now go eat a wonderful green salad and some sautéed greens!

Good luck and good food choices always!

*This is a repost of a guest post Dr. Gersh orginally posted on PCOS Diva at: http://pcosdiva.com/2016/04/step-away-from-the-calcium-supplement/

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