The Hemp Connection:
sex hormone binding globulin

Practically every time I hear a health professional explain, on the Internet or in person, why a woman with PCOS has carbohydrate cravings, they blame it on insulin resistance. The rationale is, that because glucose is not getting into cells, the cells are hungry and asking for sugar.

Did you know, as rational as this explanation sounds, research does not support it?

A study published in 2004 (and one of the few I've ever even seen that acknowledged that women with PCOS crave sugar) compared several appetite hormones to appetite measures in 16 pairs of women with PCOS matched with controls. They could find no statistically significant correlation between reported appetite and insulin levels. Rather, it was testosterone levels that seemed to be the problem.

Because insulin resistance has some effect on how much free testosterone is available to affect appetite, it could be argued that the effect is still there, but more indirect. However, another study reported that it is the eating of too much sugar and the resulting change in liver function that ultimately determines free testosterone levels, not insulin. (In this particular study the diet was up to 70% sugar, to be sure the desired metabolic effect was achieved and could be studied.) The resulting fat production by the liver was correlated with reduced levels of sex hormone binding globulin, the blood protein that binds to testosterone and inactivates it.

So while the cravings are there, be sure not to blame their cause on a solution that may not help. Our philosophy at inCYST is that balancing fatty acids helps calm down the nervous system and reduce its need for sugar. It also helps the liver better process fats, thus preventing the testosterone issue described above.

I know, I know, you're getting tired of hearing about fish oil.

I won't belabor the point, today I'll just challenge you to think outside the same old test tube.: )

Hirschberg AL, Naessén S, Stridsberg M, Byström B, Holtet J. Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome. Gynecol Endocrinol. 2004 Aug;19(2):79-87.

Selva DM, Hogeveen KN, Innis SM, and Hammond GL. Monosaccharide-induced lipogenesis regulates the human hepatic sex hormone–binding globulin gene. J Clin Invest. 2007 December 3; 117(12): 3979–3987.

Here's a study about lean women with PCOS--the women who I like to call"the forgotten cysters". I have lost track over the years of the number of women who have written me to share that they went to their physician asking for help with a list of PCOS symptoms they had…only to be told they couldn't possibly have PCOS because they were not overweight. Up to 70% of women who have this disorder are not overweight!!!

My belief is that many women who have adopted extreme eating and exercise behaviors to manage their weight, quite possibly many women who have been diagnosed with and who are being treated for eating disorders, actually have undiagnosed PCOS.

We need to get over this belief that thin equals healthy, and that a person cannot have PCOS if her BMI and weight are within normal limits. If you have to adopt extreme measures to stay within your recommended weight range, that is a serious problem and your physician needs to listen to you.

Now for this study to illustrate. Eight lean women who actually had been diagnosed with PCOS ("cysters") were compared to 7 lean women without PCOS. The cysters had higher testosterone, and prolactin levels. They also had lower sex hormone binding globulin levels (this protein binds and inactivates testosterone).

There you have it. You can be thin AND out of balance. Sisters…and cysters…it is your right to be heard and to not be told that nothing is wrong with you when you know there is. That is where my program name, inCYST, came from. You have the right to inCYST on the appropriate treatment for the appropriate problem and not to be told you do not need treatment just because you may not fit the common profile for PCOS, or for any disorder.

Grimmichová T, Vrbíková J, Matucha P, Vondra K, Veldhuis PP, Johnson ML. Fasting insulin pulsatile secretion in lean women with polycystic ovary syndrome. Physiol Res. 2008 Feb 13 [Epub ahead of print]