Polycystic Ovary Syndrome: Lessons learnt from Atkins Diet & Alternative Medicine

PCOS is a common condition that affects up to 10% of all women of reproductive age. It is characterized by enlargement of the ovaries, irregular menstrual cycle, failure to ovulate, obesity, high levels of insulin in the blood and insulin resistance, excessive hair growth (due to increased testosterone), and infertility. More than 50% of all women with PCOS have high insulin levels, which may be a risk factor for diabetes, high blood pressure, blood clots, and heart disease.
Simply following a low carbohydrate diet can offer effective relief from distressing symptoms. In a report to the Endocrine Society 2005 meeting, Dr James Hays demonstrated that polycystic ovary syndrome (PCOS) is linked to a phenomenon called insulin resistance, which can be successfully reversed by reducing carbohydrate intake. Continually eating high carbohydrate meals and snacks can make your body's cells become less sensitive to insulin, so that more and more is required to do the job. Having a high level of insulin in your bloodstream eventually makes your ovaries and adrenal glands over-produce male sex hormones. These high levels of male hormones can cause the symptoms of extra body hair, acne and moodiness and increase your risk of heart disease. They also interfere with the normal release of hormones from the pituitary gland in your brain, which regulate the process of ovulation and the production of female sex hormones in your ovaries. This can cause absent or irregular periods and infertility.
The first step one should take to relieve symptoms of polycystic ovary syndrome (PCOS) should involve cutting down on carbohydrates. Doing so will mean that your insulin levels will naturally fall and other hormones in your body will gradually begin to balance out again. In his book, Dr Atkins' New Diet Revolution, Dr Atkins identifies a low carbohydrate diet as being central to the natural treatment of polycystic ovary syndrome (PCOS). He says, "It all goes back to lesson one in don't cause your metabolism to struggle incessantly with high insulin levels, weight gain and looming health tragedies". So remove all refined sugar products from your diet, such as cakes, confectionery, sweet drinks, honey and starchy foods such as bread, pasta, rice and potatoes. The good news is that you won't feel hungry since you can eat all the chicken, fish, seafood, omelettes, rich creamy sauces, crisp salads and green vegetables you want. Just make sure that you drink at least 2 liters of water a day, to flush away harmful toxins that will be released as your body breaks down fat. Dr Atkins also views nutritional supplements as an essential part of his diet plan, particularly in the treatment of polycystic ovary syndrome (PCOS). One that has recently proved its worth is N-acetyl cysteine, or NAC. Women with polycystic ovary syndrome (PCOS) and high insulin levels who took between 1.8 and 3 grams of NAC a day for five to six weeks, were found to have a significant reduction in their insulin levels and improved insulin sensitivity (Fertility and Sterility 2002; 77: 1128-35). Dr Atkins also recommends the amino-acid glutamine to prevent sugar cravings. Animal studies have shown that it helps combat insulin resistance too. Researchers at Vanderbilt University in the US found that glutamine improved blood sugar control so dramatically that they concluded "glutamine has potential benefit as a nutrient adjuvant during clinical situations associated with insulin resistance" (J. Nutr. 1996; 126: 273-79). A daily dose of 500mg is recommended. Chromium is a very important mineral if you have polycystic ovary syndrome (PCOS), since it encourages your liver to produce a substance called glucose tolerance factor (GTF), which increases the effectiveness of insulin. Chromium deficiency has been shown to produce symptoms of insulin resistance and diabetes (Health and Nutrition Breakthroughs, Sept 1998). In one study, chromium supplements combined with an exercise program reduced insulin and cholesterol levels (J Nutr Biochem 1998; 9: 471-475). Take 200mg to 400mg of chromium picolinate a day. The B vitamins are also important in helping to correct the symptoms of polycystic ovary syndrome (PCOS). B3 is a component of glucose tolerance factor (mentioned above), B5 helps to control fat metabolism and B6 balances hormone levels. A relative of the B vitamins, called d-chiro-inositol, increases the effectiveness of insulin in patients with polycystic ovary syndrome (PCOS), reduces male hormone levels and restores normal periods (NEJM 1999; 340: 1314-20). This compound is not available yet in the west as a nutritional supplement, but it is present in soya lecithin. Dr Atkins advises patients to take a B-complex supplement and one tablespoon of lecithin granules a day. In India, a traditional Indian ayurvedic drug being advocated for hyperinsulinemia in PCOS called Hyponiid (Charak Pharmaceuticals, India) also contains large amounts of D-chiro-inositol and could be used as a supplement.
There is no cure for PCOS, but doctors often recommend birth control pills, which help decrease the levels of testosterone, estrogen, and progesterone, thereby reducing hair growth and shrinking the cysts in the ovaries. However, birth control pills have not been shown to improve insulin resistance. N-acetyl cysteine may be useful in picking up where birth control pills leave off, by increasing insulin sensitivity. While it is possible that birth control pills and NAC could work in conjunction with one another, the interaction between the two treatments is unknown.
In this preliminary study, 31 women with PCOS were given 1.8 to 3 grams per day of NAC for five to six weeks. Blood measurements for glucose and insulin were taken before and after a glucose tolerance test, both at the start of the study and at the end of the treatment period. No dietary modifications were made during the study.
Initial measurements showed that 14 of the 31 women had normal insulin levels, while the remaining 17 had abnormally high levels of insulin. Women with high initial insulin levels who took NAC had a significant reduction in insulin levels following the glucose tolerance test and also showed improved insulin sensitivity. On the other hand, those with initially normal insulin levels had no improvement in any measurement. This suggests the benefit of NAC in women with PCOS may be restricted to only those women who already have high insulin levels to begin with.
NAC is an amino acid that has commonly been used as a treatment to break up mucus in the lungs. It is also a precursor to glutathione, a powerful antioxidant in the body, which has been shown in other studies to improve insulin sensitivity. Although glutathione levels were not measured in this study, the improvement in insulin resistance seen in the group taking NAC may have been due to increased amounts of glutathione; however, future studies will need to clarify this issue.
Some physicians recommend taking NAC on an empty stomach, so it does not compete with other amino acids in food for absorption. People taking single amino acids should also make sure they eat adequate amounts of protein, to prevent upsetting the balance of amino acids in the body. In addition, some doctors recommend that long-term supplementation of NAC (more than a few weeks) be accompanied by 15 mg of zinc and 2 mg of copper per day, because preliminary evidence suggests that NAC might deplete these minerals.
N-Acetyl Cysteine (NAC), an antioxidant with insulin-sensitizing properties, may boost the effectiveness of other pharmaceutical treatments for polycystic ovary syndrome (PCOS), according to a new placebo-controlled, double-blind, randomized trial (Fertil Steril. 2005 Feb;83(2):367-70). Researchers studied 150 women who suffered from PCOS that was resistant to clomiphene citrate, one of the drugs used to treat this condition. The subjects, ages 18-39 years, were all undergoing therapy for infertility. The researchers randomly assigned the patients to receive either 1.2 grams of NAC per day or a placebo. Each of the two groups also consumed 100 mg per day of clomiphene citrate for 5 days starting at day 3 of the cycle. The combination of clomiphene citrate and NAC significantly increased both ovulation rate and the pregnancy rate in women with clomiphene citrate-resistant PCOS. The NAC-treated subjects experienced a 49.3% increase in ovulation compared to only a 1.3% increase in placebo-treated subjects. The NAC treated subjects also experienced a 21.3% pregnancy rate whereas none of the placebo-treated subjects were able to conceive. Two of the NAC-treated patients who were able to conceive, however, did eventually miscarry. Although agents that stimulate the ovaries sometimes cause ovarian hyperstimulation syndrome (OHSS), a serious condition that causes pain and potentially life-threatening consequences, no cases of ovarian hyperstimulation syndrome were reported in the NAC group. The researchers concluded that NAC is safe and well tolerated.
Even in the West & the rest of the developed world, researchers & doctors & health authorities are looking at alternative medicine with an open mind. Dr HS Palep is presently lecturing American Universities on the benefits of Ayurveda. I wonder why such draconian laws have been passed in a country like India against Gynecologists using traditional Indian medicine!