Here's a great summary of the effects of a high-fat diet on your hormones. A diet containing greater than 35% of calories from fat, in overweight conditions, in this study, was found to: --disrupt 24 hour rhythms of secretion of thyroid stimulating hormone, luteinizing hormone, testosterone, and to a small extent, progesterone. --lower total levels of thyroid stimulating hormone and testosterone. --increase cortisol levels and disrupt the normal 24 hour cycle of cortisol release. --induce higher blood glucose in relationship to high cortisol levels. --reduced the magnitude of melatonin release.
So if you've got thyroid problems, can't conceive, can't sleep, and/or feel anxious or overly stressed…or have unexplainable angry outbursts…
…maybe one of the very first and most important things you can do to start to feel better…
…is reduce the amount of fat in your diet. And when you DO choose to eat fat, be sure it's the kind you see consistently recommended in our blog--seafood, nuts, canola, avocado, flax, olives.
It's really pretty simple!
Cano P, Jiménez-Ortega V, Larrad A, Toso CF, Cardinali DP, Esquifino AI. Effect of a high-fat diet on 24-h pattern of circulating levels of prolactin, luteinizing hormone, testosterone, corticosterone, thyroid-stimulating hormone and glucose, and pineal melatonin content, in rats. Endocrine. 2008 Apr;33(2):118-25. Epub 2008 May 1.
I am on my way over to Los Angeles to work with Dr. John O'Dea on the webinar presentation he is doing for us. I'm super excited, because he loves PCOS, he loves to talk about hormones, and you all are always asking questions about the thyroid I wish I could better answer!
We'll be broadcasting live at 3 pm Wednesday May 19 (Pacific time) from his office. If you can't be there live, the recording will be available to purchase until December 31 of this year…simply click on this link. This is the same link to click to register live. Someone this busy with his practice is being extra generous by making time for us. If your thyroid is something you have questions about, it's worth making time to get answers from a great source.
Most of us assume that every calorie we eat goes directly to being metabolized by muscle and fat. Did you know that over half of the calories you burn are used to maintain your body temperature? When you severely restrict your calories, your body temperature drops. If you know anyone who is super lean, or anorexic, they are often wearing more clothing than others with regard to the ambient temperature, which illustrates this fact.
If you've been on a restrictive diet, and you are afraid to increase your calories, for fear you're going to gain weight, try this:
Take your body temperature. If it is less than 98.6 degrees, chances are, the main change you will see if you increase your calories, is an increase in your body temperature. It's usually best to increase your calories in 100 calorie increments at a time, and sit there for a week to evaluate the effect. If your weight stays stable or drops, but your temperature increases, your problem with weight may be that you're eating too little food. Try adding 100 calories a week until you get to 98.6 degrees and see where you land.
The only condition where this experiment may not work, is if you have a thyroid that is not working the way it should, as the thyroid directly affects your metabolism.
It's a very common sense tool to look at what you're doing vs. what you may need to be doing.
The topic for this blog post was suggested by a reader. I figured it was likely important, since many of you struggle with depression and arthritis or some sort of chronic pain, and you're self-medicating. The effects of THC, the active ingredient in marijuana, on hormones, is quite extensive. I am summarizing the findings reported in the reference I list at the end. Bottom line, it's probably not the greatest idea to be regularly introducing marijuana into your system if your hormones are out of balance and you're trying to correct that problem. Even if you're not trying to become pregnant but you're sexually active. The effects outside of your own self are potentially significant.
Interestingly, improving your omega-6 to omega-3 dietary ratio helps to correct some of your own human cannabinoid levels, which may help to decrease the desire to get them from an external source. It may also alleviate the depression and joint pain that you may be using marijuana for in the first place. Some experts suggest that this imbalance of our "natural THC" may be one reason women with PCOS have strong carbohydrate cravings--it's another form of the munchies!
Reduced FSH and LH levels. Suppressed prolactin, thyroid, growth hormone Provokes cortisol release and reduces production of adrenal steroids, which makes it hard to maintain hormone levels. Interferes with ovarian prostaglandin synthesis.
HCG-stimulated and FSH-stimulated progesterone secretion is inhibited. Inhibits estradiol release.
Inhibits cholesterol esterase manufacture, and cholesterol is the building block for many reproductive hormones. Hyperplasia and hypertrophy of the uterus Changes in vaginal cell thickness, character and mucoid presentation Reduced uterine weight Suppresses thyroid function.
A dose of LH that routinely caused ovulation in normal rats was only able to induce ovulation in 40% of the rats exposed to THC. Two to fourfold greater doses of LH were required to restore ovulation in THC-exposed rats.
The equivalent of one marijuana cigarette per day interfered with cell division and embryonic growth in fertlized eggs. It also reduced intrauterine weight gain by the fetus.
Offspring of rats exposed to THC had abnormal eggs, meaning the fertility of future generations was also affected.
Prevents reuptake of serotonin, dopamine, norepinephrine into the brain, increasing, not decreasing, depression over the long term.
You’ve no doubt noticed the onslaught of pharmaceutical company sponsored advertising flooding television commercials and magazine inserts. You can hardly glance at the media without hearing about side effects such as 36-hour erections (okay, we don't have to worry about that one!), loose, oily stools, nausea, cramping, bouts of mania, and unexplained bleeding. These same ads proclaim the medication’s benefits even more loudly – freedom from migraine headaches, depression, obesity, and erectile dysfunction. The message seems to be that there’s a pill to fix anything that ails you. Sometimes it seems like every kid you meet is on ADHD medication, and half your friends are on some form of anti-depressant – and it’s true that these medications are prescribed with far too much ease and far too little deep consideration. Yet on the other side, there’s a backlash from those who claim that the body is a self-regulating mechanism; that diet, supplements, and yoga can cure anything up to and including cancer; and that all drugs (prescription medications) are poisons that disrupt the system.
As a psychologist treating primarily patients who are dealing with a chronic or acute illness or medical condition, particularly PCOS and other endocrine disorders, my interest in pharmaceuticals relates to both the psychotropics (medications used to treat mental conditions) as well as the medications prescribed by my patient’s physicians to address the physical symptoms of their conditions. Very few of us actually want to be on medication, but there’s a special stigma still associated with the medications we use to treat our brains. People report feeling weak, broken, damaged, crazy, and worse when it’s suggested that psychotropic medication might be helpful in addressing their depression, anxiety, bipolar disorder, or other condition. Consequently, they often refuse to try the very medication that provides them with the support they need so that they can really achieve something meaningful in their psychotherapy.
The truth is that the mind and body are inseparable, and many mental disorders have a biological base – there is literally a chemical imbalance in the brain, and it can be helped with medication. Just like insulin helps the diabetic, or synthetic thyroid replaces thyroid hormone for someone with hypothyroidism, medications that enhance neurotransmitter functioning can fill in the gaps in brain functioning. Non-pharmaceutical approaches such as nutrition, supplements, and mindfulness meditation practices can be useful, but are often not inadequate, or work too slowly. They require dedication and persistence to work, and many patients suffering from a period of depression or facing significant stressors may not have enough time to implement these methods. Sometimes the"medication" you need to consider is something non-pharmaceutical — Chinese herbs, Sam-E, or St. John's Wort, for example.
My perspective is that medication can serve as a support for the brain while you’re learning better coping skills, allowing the brain to rebalance, and getting relief from your worst symptoms. Yet we continue to demonize Big Pharma as money-grubbing, disrespectful of natural processes, and potentially harmful when it is true that even natural substances can be harmful or fatal – to the patient who is allergic to peanuts, a taste of peanut butter may be far more harmful than a large dose of a medication, and in fact, it’s medication that may save that person’s life. For me personally, medication is always a last resort (unless I've got a serious infection, or acute pain, in which case, I say"bring on the meds — and pronto!"). If my clients are stable enough, I also support their trying other things first. But I feel like Big Pharma's part of my tool box — there when you need it, and I'm quite grateful for it when it lifts someone out of a long-term depression, alleviates suicidality, or decreases life-disrupting levels of anxiety.
Similarly, with pain, the old way of thinking is that you should suck it up, suffer, power through – anything but take painkillers. As it turns out, your body heals faster, your anxiety is lower, and there’s a lower incidence of depression when patients take painkillers as prescribed. For a limited time and a specific use, doesn’t it seem reasonable to use every tool at your disposal? I want my patients to feel better sooner rather than later, so we often have discussions about their ideas about taking medication, whether it’s for a medical or psychological condition. If you automatically reject the idea of medication, especially the psychotropic medications, I invite you to examine your attitudes to see if they’re outdated, impractical, self-destructive, or just flat-out wrong. As always, I advocate taking a proactive stance as a patient, whether that’s in your doctor’s office or the psychotherapist’s consultation room. Perhaps you’ll find that the enemy of wellness lies more within your own mind than in the face of Big Pharma.
Gretchen Kubacky, Psy.D. is a Health Psychologist in West Los Angeles, a member of the inCYST Network, and a frequent speaker and author on issues related to health psychology, women's health, PCOS, and other endocrine disorders. If you have questions for Dr. Gretchen, have a topic you'd like to suggest, or would like to learn more about her practice, please visit her website atwww.drhousemd.com.
The topic for this blog post was suggested by a reader. I figured it was likely important, since many of you struggle with depression and arthritis or some sort of chronic pain, and you're self-medicating. The effects of THC, the active ingredient in marijuana, on hormones, is quite extensive. I am summarizing the findings reported in the reference I list at the end. Bottom line, it's probably not the greatest idea to be regularly introducing marijuana into your system if your hormones are out of balance and you're trying to correct that problem. Even if you're not trying to become pregnant but you're sexually active. The effects outside of your own self are potentially significant.
Interestingly, improving your omega-6 to omega-3 dietary ratio helps to correct some of your own human cannabinoid levels, which may help to decrease the desire to get them from an external source. It may also alleviate the depression and joint pain that you may be using marijuana for in the first place. Some experts suggest that this imbalance of our "natural THC" may be one reason women with PCOS have strong carbohydrate cravings--it's another form of the munchies!
Reduced FSH and LH levels. Suppressed prolactin, thyroid, growth hormone Provokes cortisol release and reduces production of adrenal steroids, which makes it hard to maintain hormone levels. Interferes with ovarian prostaglandin synthesis.
HCG-stimulated and FSH-stimulated progesterone secretion is inhibited. Inhibits estradiol release.
Inhibits cholesterol esterase manufacture, and cholesterol is the building block for many reproductive hormones. Hyperplasia and hypertrophy of the uterus Changes in vaginal cell thickness, character and mucoid presentation Reduced uterine weight Suppresses thyroid function.
A dose of LH that routinely caused ovulation in normal rats was only able to induce ovulation in 40% of the rats exposed to THC. Two to fourfold greater doses of LH were required to restore ovulation in THC-exposed rats.
The equivalent of one marijuana cigarette per day interfered with cell division and embryonic growth in fertlized eggs. It also reduced intrauterine weight gain by the fetus.
Offspring of rats exposed to THC had abnormal eggs, meaning the fertility of future generations was also affected.
Prevents reuptake of serotonin, dopamine, norepinephrine into the brain, increasing, not decreasing, depression over the long term.
Braude MC, Ludford MP, eds. Marijuana: Effects on the Endocrine Reproductive Systems. 1984
We received a great hormone question about managing a hormone issue for a different stage of life--menopause. The question came because we so often advise against using soy, for two reasons. First of all, it can be detrimental to thyroid function. Secondly, whether it's in your diet or in your bioidentical hormones (bioidentical does NOT mean organic or GMO-free), the vast majority of soy is genetically modified. Unless you have confirmation from the manufacturer for food or pharmaceutical, you are best to stay away from it. But since phytoestrogens, the compound in soy that gives it such a reputation for menopause management, ARE helpful in easing the hormone transition, I looked up other sources. Here are your best bets. Ground flaxseed and flaxseed oil Rye. oats, barley, and wheat Think multigrain bread when you do have carbs! Hummous Garlic Mung beans and alfalfa sprouts Dried apricots, dates, and prunes Organic tempeh, miso, natto, and soy sauce. These are fermented sources of soy which are believe to be less problematic than tofu, edamame, and manufactured foods containing soy, such as soy milk.
As I mentioned in the first part of this series, vitex has its strongest effect on four hormones: estrogen, progesteron, luteinizing hormone (LH), and the one this post is dedicated to, prolactin.
Prolactin is primarily associated with lactation. It is also important for sexual arousal, sensing orgasms, and libido. So it's safe to say, you have to have good prolactin metabolism in order to successfully conceive and carry a pregnancy through to nursing!
One of the most important, and often overlooked, influences on prolactin function, is medication. I am most familiar with psychotropic medications because of my specialty, and I believe, with the very high incidence of anxiety, depression, and sleep disorders in women with PCOS, it is incredibly important to use these medications with discretion in order to not interfere with fertility, or successful PCOS management in women who are not in pursuit of conception.
Before considering any supplement, make a list of all the medications you've ever been prescribed and show them to a registered pharmacist. Ask them if any of those medications have any potential for disrupting prolactin function. And if you come up with a"yes" for any of them, ask for a list of alternatives that you and your prescribing physician can use to adjust your treatment plan.
When prolactin is out of balance, funny things can happen. You can produce milk when you're not supposed to (I once had a male client who started to lactate, and it turned out to be a symptom of a pituitary tumor.)
You might not be able to produce milk when you want to. Many, many, many women with PCOS find, much to their dismay, that they get pregnant, and cannot feed their babies. I am shocked at how many medical colleagues with PCOS write me to share that until they heard us mention this at inCYST…they never knew it could be a problem. And they themselves could not nurse their babies!!!
This lack of awareness and the incredible importance of healthy prolactin function to the overall health of mother and baby, is precisely why, our first outreach outside of dietitians, with inCYST, has been with lactation consultants. They understand this physiology best, and they are the most likely to pick up on problems as soon as they become apparent.
Bottom line, PCOS is not just about infertility. It is about successful reproduction, which includes being able to successfully create the next generation of healthy people.
But I digress. Back to prolactin.
Prolactin is controlled by the hypothalamus, the part of the brain we at inCYST are obsessed with learning and teaching about. The hypothalamus also regulates estrogen, progesterone, testosterone, cortisol, thyroid, and growth hormone. You can see why it's your BFF as a woman with PCOS. If you have problems with one of those, you likely have problems with more than one.
Most medical treatments address each of those hormone imbalances as if they are separate, requiring a separate medical treatment…better yet…a separate medication. So by the time you've made the specialist rounds, you've been given a birth control pill, an antidepressant, a sleep medication, a lipid lowering medication (since some of these hormones are made of cholesterol, when they're out of balance…cholesterol will be, too).
We like to think we start where the problem starts. Giving the hypothalamus what it needs to work efficiently. And the number one chemical you can focus on, which should help all of these functions, which I call our"Recipe for a Happy Hypothalamus (SM)"…is DHA, one of the fish oils.
1. DHA makes it harder for the hypothalamus to feel stress. Stress is a very selfish thing. It steals energy away from other things your body might need it for. With enough DHA in the system, the hypothalamus can put its energy into healing the functions that are NOT related to stress, mainly reproduction, sleep, and mood.
2. DHA increases dopamine receptor density. Prolactin is dopamine-controlled, meaning the more receptors there are to communicate with the dopamine that is there, the less prolactin your body needs to make.
An interesting aside--dopamine imbalance is common in people who crave and/or binge on sugar. So if you've got cravings AND your prolactin levels are not right…you just might be DHA-deficient.
I have one more post coming on chaste tree berry that will summarize important findings and recommendations.
But, with regards to prolactin, what I will say is that two very important things you can, and should, do, to move yourself back into balance, are:
1. Make sure your medications are not the source of the problem, and 2. Make sure your food choices are promoting healthy dopamine function.
Even if you DO decide to try an herbal formula, it is much more likely to work for you, if you provide it with an environment that allows it to do what it does best.
So many of you women with PCOS also have problems with your thyroids…I decided it was time for all of us to learn more about the issue. I asked Dr. John O'Dea to participate in our professional training, and he is going to talk about the topic.
John O'Dea, MD, was born in the south of Ireland. He was raised and educated in Dublin, where he received his undergraduate and medical education at the National University of Ireland. Upon graduation from medical school, he moved to the US. He served his internship and residency in Internal Medicine at St. Luke's Hospital in Cleveland, Ohio. He then went on to receive full training in Endocrinology and Metabolism through a NIH fellowship at Case Western Reserve University. Following the completion of this two-year endocrine fellowship, which involved both clinical and research experience, he moved to the Los Angeles area, where he is in private practice.
I met Dr. O'Dea through a client, who shared that after visiting many, many physicians, he was the one who finally helped her get back into balance. After meeting with him personally, I was excited to know someone was out there who could help the women of inCYST.
The webinar will be broadcast live on Friday, May 19, 2010, at 6 pm Eastern Daylight Time. If you cannot attend, we will be recording the presentation and that recording will be available for sale as well.
You may participate in this activity only, or if you register for the complete inCYST Professional PCOS Training, this lecture is included in the package. Early registration discounts are available for both options.
You ever have one of those days where everything just seems to come together in the right way? Your hair looks good, your face is clear and bright, your outfit is colorful and flattering, and people are just responding to you in a good way. You’re looking good, and you know it! You FEEL good.
On the flip side, thought, PCOS is there to drag you down when it comes to appearance. We’ve got moustaches, partial and full beards, hair loss, hair in inappropriate places, excess weight (or sometimes not enough weight), acne, skin darkening, skin tags, and other cosmetic indignities galore. How on earth are you supposed to feel good in this body when it’s presenting you with these problems on a daily basis?! Moustaches and muffin tops, indeed!
And that’s just the external stuff. Inside, there are the imbalances that lead to mood swings, depression, and even thoughts of suicide. Insulin resistance, thyroid problems, and other health concerns lurk in the background. All of this can be physically and emotionally exhausting. And when you’re exhausted, it’s easy to give up on appearance. One thing I’ve learned about PCOS is that, although it threatens your physical appearance with masculinizing and unflattering characteristics, you can use positive attention to your appearance to lift your mood.
Part of what I always focus on with my clients is self-care. This may be emotional, spiritual, or physical in nature. I’ve observed that taking time to tend to your appearance as much as reasonably possible (because we don’t want the opposite problem of busting out your budget on shopping, or spending all of your play time at the salon!) results in feeling better. The American Cancer Society sponsors a program called “Look Good, Feel Better,” for women with cancer – it’s a day of make-up application instruction, wig and other hair tricks, and so on – sounds trivial in the face of cancer, but it’s miraculous in how the women respond.
PCOS isn’t cancer, to be sure, but the principles are the same – look good, feel better! I won’t go so far as to say that I “prescribe” pedicures, but maybe I should, and I have in fact recommended them, along with shopping days and other beauty services. Well-tended toes, a pretty top, or some dangly earrings will spark up the girly-girl in most women. For women with PCOS, this is a place that needs a little extra attention. You deserve it.
If there’s something you’ve been neglecting – a haircut, shopping for new bras (yes, you in the stretched out ultra-comfy bra that you haven’t replaced since last year – the one that isn’t doing your breasts any justice at all — I’m talking to you!), doing a wardrobe clean-out and ditching all the unflattering items – it’s a great time to do it. Right now, this very moment. Call your stylist, grab a bag to be filled and donated to Goodwill, or make a call to find out about laser hair removal in your area. Whatever it is, the action will make you feel better.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.
Before the bathroom humor starts popping into your head, I want to say that I’m quite serious about this one. As a psychologist, over time, it is typical for people to feel quite comfortable telling me virtually anything that might be perceived as shameful, embarrassing, or humiliating. Confidentiality and acceptance are key to successful therapy, and creating an atmosphere that invites disclosure is important – if I don’t know what’s REALLY going on, how can I help you?
As a health and medical psychologist, I gather more than the usual amount of medical information from my clients. Many of them are dealing with PCOS, infertility, diabetes, and other endocrine conditions that can result in bowel irregularities. Anxiety often results in diarrhea, as do irritable bowel syndrome, Crohn’s disease, and related conditions. Thyroid disorders also alter bowel functioning. Cancer treatments affect regularity. And the list goes on and on.
What I usually hear is a client bringing up the issue by saying, “Um, you probably don’t want to really hear about this, but, um, I’m having this um, problem with, um, diarrhea… ” As they trail off, I reassure them that I’m used to hearing this stuff, and I actually want to hear it. Truly, I have heard it all in this department. This is an enormous relief to the client, who has often been too embarrassed to tell one of her doctors about it. Because I see the client weekly, there’s a much higher level of trust than with a doctor whom she seems every few months.
This information is helpful to me diagnostically, because I instantly know a great deal more about what’s driving stress and anxiety (if you’re prone to sudden loose stools, it can contribute to social anxiety and fear of leaving the house, for example). It helps me normalize certain behaviors or symptoms, and be alert to other things that might be troubling the client. Quite often, we are so used to having irregularities in our bodies – food cravings, random menstrual cycles and the like – that bowel irregularities get overlooked. When you can’t get pregnant, you’re generally not overly concerned with chronic constipation, right?
When a client is able to trust me with this type of information, I actually feel honored. I’m not a medical doctor; I can’t perform diagnostic procedures or prescribe medication to remedy the problem. But I truly do want to know every aspect of my clients, up to and including the quality and frequency of their bowel movements. I can make referrals to medical doctors who can help. And there are psychological treatments that are effective for bowel disorders, and of course for reducing stress and anxiety.
On a more interesting note, there’s a strong gut/bowel and brain connection. A significant percentage of our neuro-transmitters are produced in the gut – around 85% of the serotonin, for example. So, if you’re experiencing cramping, bloating, diarrhea, or constipation, not only may you have a medical disorder, but it may be contributing to depression, anxiety, or other psychological conditions. In a nutshell, that’s why I want the full scoop on your poop – so I can help you as comprehensively as possible!
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.
Important Lab Tests for PCOS Many women who have PCOS have not had the correct blood work done or don't know what blood tests to ask to have done.I would like to post some important labs used to diagnose and monitor PCOS 1. Total testosterone (elevated levels are > 50ng/dl 2. Free testosterone 3. Luteinizing Hormone (LH) (plays a role in ovulation and egg development) 4. Follicle Stimulating Hormone (FSH) (responsible for egg release from the ovaries) 5. LH/FSH ratio (results should be under 2) 6. DHEA-sulfate (this test tells how much androgens or"male hormones" your body is producing) DHEA sulfate converts into testosterone. 7. Prolactin 8. Thyroid Stimulating Hormone (TSH) this test will help to rule out hypo or hyperthyroidism (slow vs fast metabolism issues) 9. Liver Function tests (LFT's). Important since medications pass through the liver, to check for possible damages. Checking every 3-6 months is recommended. 10. Fasting Lipid Profile: Total Cholesterol (<>45 mg/dl is ideal)Low Density Lipoproteins (LDL) (<130 mg/dl is ideal)Triglycerides (fat in blood) (<150 mg/dl is ideal) 11. Fasting Insulin (results should be <10) difficult to do, it needs to be frozen when brought to the lab and tested before it reaches a certain temperature, expensive but would be very beneficial in determining and monitoring insulin resistance. 12. Fasting blood chemistry panel (includes glucose, electolytes and sometimes renal labs) 13. Fasting glucose to insulin ratio (used to diagnose and monitor insulin resistance, ratio under 4.5 usually indicated insulin resistance)
Ellen Reiss Goldfarb, RD 11500 W. Olympic Blvd, Suite 400 Los Angeles, CA 310-408-1770 info@ellenreissgoldfarb.com
I wanted to post a testimonial from a client. He volunteered to do this, I did not ask him for it. My sincere hope, in training inCYST professionals, is that this is the experience each and every woman has when reaching out and asking for help. We understand that you are not just patients or lab values, but rather individuals with your own sets of experiences, anxieties, and hopes, that must be respected and accommodated in our work together. The photo is of me at this baby's baptism.
B, thank you for the testimonial. I am not sure who benefitted most from our time together, as I learned an incredible amount from this collaboration! Being asked to come to the hospital to see baby Brianna, and to attend her baptism, was such an honor. I will never forget how it felt to look at her, and hold her, and tangibly experience the value of this work.
I have asked the other members of inCYST's network to share testimonials as well. They do wonderful work, and I want to use this forum to share their passions and how they benefit those who work with them for better health. I look forward to sharing their stories! Monika
It was two years ago when we first met Monika. I remember it like yesterday. We were desperate but also tired of the empty promises.
In the previous 18 months, my wife and I had been on an emotional rollercoaster. My wife had been tested for thyroid issues, infertility, hormone imbalances. Each doctor was confident they knew what was wrong and it was a simple fix. Take this prescription and diet. When that did not work it was go to this specialist or that one. Even at the mighty Mayo Clinic we were disappointed. During this time we had our first miscarriage. I remember the night vividly. We went to the emergency room knowing something was wrong. We were first triaged by an RN, she ordered a pregnancy test, a UA, ultrasound and every blood test she could think of. After six hours we were scared to death and still had not seen the ER physician. My wife’s pain was increasing. My wife started to bleed. We were reassured the doctor would be with us soon. She ended up miscarrying in the restroom of the ER. We finally had the ultrasound. We finally saw that doctor; he was abrupt and in a hurry. He spent five minutes with us explaining that we had miscarried and gave us a booklet for grieving. We were also to follow up with our OB/gyn for a D&C. In addition to a 3,000 dollar bill.
It took a few days for my wife’s physical pains to subside, but the emotional ones were just beginning. It almost tore us apart. She had the feeling that she was broken and tried to push me away. Everything reminded us of our loss. It is amazing how many sad stories you see about abused or abandoned children when you can not have one. Several months had passed and our OB diagnosed my wife with PCOS. Though the ultrasound showed no cysts, all the other symptoms were there. My wife was placed on metformin. This was to stabilize her insulin. She started the medication but her mood swings and frustration increased. She exercised two to four hours every day for four months. She was obsessed with losing weight and returning to “normal”. The weight did not come off and she was giving up. I decided to spend my spare time researching PCOS. The research was inconclusive as to the correct treatment course. Most suggested controlling insulin through diet and medication. There were several online programs and institutes which promised to have the answer. We were sucked in and for another few months we tried some different approaches. None seemed to be very effective. We had given up on the idea of having children and I just wanted my wife back. With every new promise was a disappointment. Unfortunately my wife was becoming frustrated with herself. We stopped spending time with friends and calling family. The thing most people do not understand is that it is not just your disappointment as a couple, but explaining to your friends and families that is devastating. I decided to continue my diligence with my research and found several dieticians and nutritionists who were publishing and focusing on PCOS. This is how we came to know Monika Woolsey. I did not even tell my wife about Monika at first. I did not want another false hope. Once I hung up the phone with Monika, I felt that she might be able to help. She did not promise results of pregnancy or a magic pill to fix everything. She said simply that every woman is different as is the approach. She continued to ask question after question. Throughout this entire rollercoaster I finally felt we found someone who is sincerely interested in helping us. We were not just another case. I did not know Monika’s intentions or if her ideas would work but we had a glimmer of hope. Monika surprised us a little when she wanted to visit our home. I did not understand but we agreed. When Monika arrived she was not what I expected she was “down to earth” and seemed very easy to talk with. She also was very knowledgeable about the disease process. I found her caring and very sensitive to what we have gone through. Though she was very nice I was not looking for a friend but a knowledgeable professional. I was put in my place very quickly after challenging her on a few topics. She had read all that I have and more. She has done her homework. She described this as a journey of trials and seeing what works because each woman is different and has different symptoms. Though our time was up she was truly invested and stayed an additional two hours. Till the time our questions were answered.
My wife started with fish oil and flaxseed oil in addition to a session of acupuncture. We also were educated on reading labels and identifying pure foods. I am in the medical field and did not put much stock in this approach. To put it mildly I was a skeptic. However after spending two months on the program my wife was getting back to her typical self and feeling much better. Some evenings we would call or e-mail Monika with questions. She was never to busy to take time for us. We were perfectly content with our changes. My wife’s moods were stabilizing and her menstruations were becoming more regular. Out of the blue we found out that we were pregnant. This was not expected or planned. Monika never promised or led us to believe that pregnancy would be the result. Her plan was simple. Make my wife feel better and regain control.
When Monika found out she was very happy for us but she did not seem to be surprised. She mentioned that this has happened with several couples that were told they would never have children. I can say that my wife will always have PCOS but at least we have the knowledge to control it. We had our beautiful daughter on July 21 2009. It was an amazing day. We have included a picture of Monika and our daughter Brianna. God gives us trials in life and we have had our fair share. In saying that I would not change a thing.
We're so excited about this! Not just that we have a fundraiser, but that our very first one involves two of our very favorite friends at inCYST, Craig Ramsay and Sandie West.
"Move" with trainer Craig Ramsay, a wonderfully compassionate women's health advocate who we met when he worked with Cyster Stacy Citron on Bravo's reality show Thintervention. He talks mostly about getting you into physical shape, but what we routinely hear from his clients is that his work helps to nurture their self-esteem into good condition as well. He is graciously offering his time to conduct four boot camps on the beach near Sandie's spa, which is where the"Move" part comes in. It's the perfect way to test drive Craig's popular boot camps if you've been thinking about participating but haven't gotten around to it.
Be sure to check out Craig's website and Facebook page to learn more about his"Ultimate Perfect Workout System". And look for him on Twitter at @craigramsay1.
"Soothing" Sandie West has a beautiful facility, Creative Chakra Spa, on the Pacific Coast, just south of the Venice Pier. She's known far and wide for her beautiful space, therapeutic spa treatments, loving spirit, and calming energy. You can't help but put your cares aside and focus on relaxation when you're at Sandie's place! It's perfect for someone who's feeling a little over the top with their diagnosis and in need of little R and R.
To learn more about Sandie's spa and the services and classes she offers, join her Facebook page and follow her on Twitter, @creativechakra.
Check out this video one of Sandie's beach yoga classes. Even the robot that programs our Twitter paper was enthralled…it kept including this video of her beachfront yoga class for several days after she Tweeted it!
These events would not be possible without our wonderful sponsors! Please check out their websites, Facebook fan pages, and follow them on Twitter. They are sponsoring because they are excited to support your journey to PCOS health, and we want to support them in return.
What would our first fundraiser be without one of inCYST's BFF's? The Zing Bars folks don't just support PCOS, they created their products with women with PCOS in mind. Years of combined counseling experience gave them first-hand knowledge about what kind of ingredients, flavors and packaging would be easiest to use and benefit from.
Be sure to"like" them on Facebook and follow them on Twitter at @zingbars.
Growing Naturals is a brand of organic brown rice protein that is vegan, gluten-free, soy-free, dairy-free, kosher, non-GMO, organic, and raw diet-compatible. It's a great option for anyone with PCOS, and especially so for anyone who is vegan and/or with food intolerances that make it hard to get enough protein.
When I first learned of them, I thought to myself…"That pretty much touches all bases…finally, I know what to recommend for even the most restrictive of situations." Turns out, their tag line is"Finally, Food For All People".
Be sure to check out their website and learn more about their original, chocolate, and vanilla rice protein isolate powders.
You can find Growing Naturals on Facebook, and their Twitter handle is @growingnaturals.
If you'd like to participate in person, please RSVP either here in the comments section, or on our Facebook event page with at least a"maybe" so we can send you the registrations later this week.
If you can't make it but you'd like to support this fundraiser, here's a link where you can donate. You'll be supporting research projects directly supportive of hormone disorders including PCOS, infertility, thyroid, and diabetes.
We are working out the details and will have complete registration options available at this link. Space is limited for each of the options so if this is something you're interested in doing, please grab your space as soon as possible.
Please, if you can't participate in our specific event but you're interested in the boot camps and/or the spas, check out Craig's and Sandie's websites for more information about their programs.
We'll have a website up and running soon with event details. Please be sure to join the RSVP list on our Facebook event page so we know where to find you when updates occur.
If you would like to donate but cannot make it to the live event, please click here for more information.
This past Wednesday, Sasha Ottey of PCOS Challenge interviewed Walter Futterweit, MD, a longtime PCOS researcher and advocate. He provided a great summary of the laboratory tests you should be getting and why. I'm providing that summary here.
If you'd like to listen to the interview with Dr. Futterweit in its entirety, please visit Sasha's Blog Talk Radio page.
Adrenal hormones--these test rule out an adrenal problem, necessary to do to be sure it's actually PCOS
17 hydroxy progesterone (drawn between 5 and 9 of a menstrual cycle)--rules out the diagnosis of nonclassic congenital adrenal hyperplasia.
(Normal levels are 15-70 ng/dl prior to ovulation, and 35-290 ng/dl during the luteal phase. )
DHEAS (dehydroepiandrosterone sulfate)
Typical normal ranges, according to NIH, for females, are:
Prolactin levels, which rule out a prolactin producing tumor, as well as the effects of some medications such as Risperdal, which can elevate prolactin levels
•Non-pregnant females: 2 — 29 ng/mL
•Pregnant women: 10 — 209 ng/mL
Tests to monitor thyroid function
T4
A typical normal range is 4.5 to 11.2 micrograms per deciliter (mcg/dL).
TSH
Normal values are 0.4 — 4.0 mIU/L.
SHBG (sex hormone binding globulin) — helps to evaluate how much of your testosterone is bound/inactive and how much is free and available to cause androgen-related symptoms.
Normal values:
Follicular phase of menstrual cycle 24 — 200 nmol/L Luteal phase of menstrual cycle 48 — 185 nmol/L Contraceptive use 89 — 379 nmol/L Postmenopausal 46 — 200 nmol/L
Insulin function
Fasting insulin level Normal values: less than 13 mIU/ml
2 h glucose tolerance test Depends on the laboratory's protocol. Typical values can be found at the link directly above.
***************************************************************************** Dr. Futterweit did not mention vitamin D testing but since low vitamin D levels are commonly found in women with PCOS, I'd recommend that as well.
So you've been told you need to clean up your nutrition act, and you've stopped eating the Fritos. You've decided to stop being the reason the stock price of your local fast food restaurant has weathered the Wall Street willies. Your salad dressing shelf in your refrigerator is now half of what's in your refrigerator.
Still no luck.
Hey, isn't eating better supposed to be the answer?
Depends on how you define eating better.
I'm noticing with my inCYST classes that a disproportionate percentage of women coming for information have adopted vegetarian practices. And I'm beginning to wonder if it isn't part of the problem.
No, the problem isn't that you're vegetarian. It's how you're defining vegetarian, and it's how you go about being one that matters. Here are my simple rules for being the healthiest (potentially fertile) vegetarian you can be.
1. Define your vegetarianism by what you DO eat.
Most people I know who become vegetarian after eating meat, define that practice in terms of what they DON'T eat. They DON'T do red meat. They DON'T do dairy. They DON'T do fish. DON'T, DON'T, DON'T.
Therein lies the problem.
A most important rule of nutrition is, when you eliminate an entire category of food, for whatever reason, be it meat or wheat, you are also eliminating crucial nutrients that this category contains.
My definition of vegetarian is someone who meets all of their complete nutritional needs without using animal products.
Do you know what fertility-related nutrients you're likely short on if all you've done is cut out meat? If not, read on!
2. Zap yourself with zinc!
Zinc is needed for oodles of reactions that keep your body running, from your brain to your ovaries. Are you eating whole grains? Beans? Pumpkin and sunflower seeds? Nuts? Oops…go get your shopping list, right now, and put them down!
3. Forgetting folate can be fatal
You likely know about this nutrient since there has been so much publicity about its role in pregnancy. Put spinach on your sandwich instead of lettuce…make sure your morning cereal is fortified…eat more beans and split peas…and become savvy with sunflower seeds!
4. Cultivate a copper attitude
It's not as famous as folate, but it still is important to remember. Outside of red meat, its vegan sources are rather random: molasses, green olives, cocoa, nuts, avocadoes, black pepper, sunflower seeds…hopefully at least one of these sounds tasty!
5. Try to remember tryptophan
Tryptophan is a building block for serotonin, one of the major neurotransmitters regulating the brain's hormone center. For vegetarians, there are still a lot of options even if you're not using dairy products or eating turkey. Does your pantry have…cocoa, mangoes, sesame seeds, pumpkin seeds, oats, dates, chickpeas, peanuts, bananas, and sunflower seeds? It needs to.
6. Allow for algae
If you're vegan, chances are you're not getting enough DHA and EPA, the omega-3 fatty acids primarily found in fish. Become friendly with an ingredient known as Life's DHA, a marine algae source of DHA (unfortunately not EPA), that is being added to vegan-friendly foods. The link I'm providing gets you to the most recent list of foods containing this ingredient that you may want to become proficient at finding.
7. Not all vegan products are created equally healthy. Be sure if you've gone vegan, that you are aware of oils that can interfere with healthy balance. These oils are all vegan, but tend to be pro-inflammatory: safflower, sunflower, soybean, corn, cottonseed, sesame. (Remember my"S and C" rule from previous posts. If you're eating absolutely no meat at all, but you're eating a salad doused with soybean oil-based dressing…that could be a problem. Become familiar with brands that are made with olive or canola oils, or learn to make vinaigrettes. (Canola is the"C" oil exception, by the way.
8. Be happy without hydrogenated.
Hydrogenated = trans fat. Enough said.
9. Forget the fructose…high fructose corn syrup, that is.
It's been connected to insulin resistance in more than one study. And despite what marketers would really like you to believe, more than one nutrition expert does not endorse its use.
10. Be pro-protein
This is the most obvious one…know your complementary proteins and be sure your diet includes them. One caveat…soy may be hard on your thyroid function and is not a good choice if you have a family history of breast cancer. Be sure you are reading labels, as soy is a filler in many, many foods.
I like to look for patterns that make nutrition recommendations easy to recommend. In this post, it didn't work out that way. A lot of these foods are random. If I'm not giving you ideas that seem easy to work into your food plan…think of consulting with one of our experts! That's what we excel at, and that's what we're waiting to help you with.
After all, you became vegan to be healthy, let's work together to do it correctly.
Polycystic Ovary Syndrome (PCOS) is a complicated, often frustrating condition that affects many women who are experiencing infertility, or may even be a primary cause of infertility. Symptoms typically include recurrent ovarian cysts, excess hair growth (or hair loss similar to male pattern baldness), acne, skin darkening, difficulty losing weight, and, of course, trouble getting pregnant. Often, the condition is not accurately diagnosed until failure to get pregnant results in referral to a reproductive endocrinologist, who has specialized training in PCOS and other endocrine disorders.
Any of these conditions taken singly are difficult to deal with – but the combination is often overwhelming for patients who have been diagnosed with PCOS. PCOS is particularly difficult because it’s under-diagnosed, so you may have years of vaguely troubling symptoms before the diagnosis is made and treatment begins. The physical side effects are unattractive and visible to the world — “I’m fat, pimply, and hairy,” as one of my clients stated tearfully. Friends and relatives may assume that you’re lazy or eat too much, and that’s why you aren’t losing weight. As a result, depression and low self-esteem are very common among women with PCOS.
I was diagnosed with PCOS in my early twenties, and, as both a patient and a professional, I have learned that there are many things you can do to improve the quality of your life and your health with PCOS. You can take control of your health and mood now by doing the following:
Get educated: Do some research on the web, ask your doctor a lot of questions, join a support group and use it, read the RESOLVE newsletter, and stay on top of developments in treatment.
Obtain skilled medical help: Although an internist or general practitioner may diagnose PCOS, it is more likely that a gynecologist, endocrinologist, or reproductive endocrinologist will do so. If you have PCOS, you will most likely want to have an endocrinologist who will prescribe appropriate medications, monitor you for the potential development Type II diabetes, and coordinate with your reproductive endocrinologist while you are trying to get pregnant. Because it is common to experience higher rates of thyroid disorder and heart disease when you have PCOS, it is a good idea to have frequent monitoring.
Your physician can also:
help you lose weight with the assistance of certain medications, and/or referral to a skilled dietician, who can teach you how to eat in a way that contributes to balancing your hormones and managing your symptoms;
refer you to a good dermatologist, who can help to control or eliminate skin conditions related to PCOS, such as skin darkening and acne, and even help with treatments for hair loss;
suggest a therapist or support group to help you cope with the stress of infertility, symptoms of depression, and frustration of dealing with a chronic disease;
Exercise: Yoga will resynchronize your brain, produce deep relaxation, reduce stress, and enhance your acceptance of your body, just as it is in the moment. The cross-lateral motion of walking is also highly effective in regulating PCOS-related insulin resistance, controlling weight – and, surprise! – resynchronizing your brain waves.
Look better so you feel better: In addition to seeking the help of a dermatologist for skin and hair conditions, you might want to actively manage excess hair growth cosmetically. There are many ways to do this, but electrolysis is the only method that has been proven permanent. A licensed electrologist will have a great deal of experience with PCOS patients. Your dermatologist can provide you with a reliable referral.
Although weight gain around the middle is frustrating and hard to overcome when you have PCOS, you can learn how to dress well, no matter your size or shape – and you deserve to do so! Seek out current fashions that are figure-friendly, and get help when you need it – if you’re just not good at putting outfits together, ask a friend who is good at it to go shopping with you, use the free services of a department store personal shopper, or spring for a stylist who will help you figure out what works on you.
Don’t forget your brain: Education is only one element of what your mind needs to effectively cope with the stress of PCOS. Sometimes friends, partners, and physicians aren’t quite enough to help you work through your anger, frustration, irritability, and sadness about having PCOS, not being able to get pregnant, or the difficulty you experience losing weight in spite eating well and exercising regularly. A licensed counselor or therapist can help you decrease stress, develop personalized coping methods, enhance your support group, and identify additional resources. Many therapists utilize mind/body methods that include meditation, guided visualization, mindfulness, and other ways of supplementing your good health practices.
By actively taking care of your physical and mental health and appearance, you can learn to feel better by knowing that you are doing the best you can with a challenging condition.
Dr. Gretchen Kubacky is a licensed clinical psychologist in private practice in West Los Angeles. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders. If you would like to learn more about Dr. HOUSE or her practice, please visit her website atwww.drhousemd.com, or e-mail her atGretchen@drhousemd.com.
Reprint permission granted by RESOLVE: The National Infertility Association, 2009.www.resolve.org.
Continuing on with yesterday's theme, I wanted to summarize options for anyone who, for whatever reason, chooses to drink milk alternatives instead of cow's milk.
The primary problems with these alternatives are:
1. They almost, without question, do not provide equivalent amounts of protein and raise your diet's carbohydrate to protein ratio.
2. They are often sweetened, increasing your simple carbohydrate to complex carbohydrate ratio.
3. Most of the alternatives, except for coconut milk, do contain vitamin D. However, check your label just to be sure.
If you choose to use these, in general, you are not substituting milk alternatives for milk. You are drinking a beverage that creates a need for you to increase your protein, vitamin D, and complex carbohydrates in the foods you also choose, in order to make up the deficiencies this switch inevitably creates. If you do not know how to do that, a consultation with one of our inCYSTers might be helpful. Many of them offer Skype consultations if you do not see on our list below and to the right who lives near you.
Here's the rundown. For comparison, per 8 ounces, 1% milk contains: 110 calories 8 grams protein 5 grams fat 12 grams carbohydrate 0% added sugar
One bias I do have which is reflected below, is toward soy milk. Too many women with PCOS have thyroid problems, for me to feel responsible presenting it as an option. So I have omitted it.
All information is for an 8 ounce serving.
ALMOND MILK This one appears to be the most popular. One benefit to almond milk is that since almonds are naturally sweet, there is not as much of a need to add sugar in order to make them palatable. The disadvantage to almond milk is that, consumed in large enough quantities, it may increase your omega-6 intake enough that you promote, rather than reduce, inflammation (almonds, while beneficial in moderation, are the only nut that contain absolutely no omega-3's and for that reason should not be the only nut you exclusively eat).
Almond Breeze Brand 45 calories 2 grams protein 3.5 grams fat 3 grams carbohydrate 0% of carbohydrate is added sugar Pacific Foods Vanilla Almond
45 calories 1 gram protein 2.5 grams fat 3 grams carbohydrate 0% of carbohydrate is added sugar
FLAX MILK
I do like flax milk's omega-3 fatty acid content. It's sweetened, but not to the same degree as many of the other milks. I could see using this in cooking, in any recipe that called for cream, or as coffee creamer, as a way to enhance your diet's overall omega-6 to omega-3 ratio. It still comes up short in the protein department.
Flax USA Flax Milk
50 calories 0 grams protein 2.5 grams fat 7 grams carbohydrate 100% of carbohydrate is added sugar
HEMP MILK One benefit to hemp milk is its omega-3 content. However, it is sweetened pretty significantly so consumers will drink it.
Living Harvest Hemp Milk
130 calories 4 grams protein 3 grams fat 240 grams carbohydrate 75% of carbohydrate is added sugar Manitoba Harvest Hemp Bliss
110 calories 5 grams protein 7 grams fat 7 grams carbohydrate 86% of carbohydrate is added sugar
OATMEAL MILK
Highest in calories, partially because it's sweetened. Eating the real oatmeal will give you better benefits.
Pacific Foods Oatmeal 130 calories 4 grams protein 2.5 grams fat 24 grams carbohydrate 79% of carbohydrate is added sugar
HAZELNUT MILK
The fat in hazelnuts is primarily monounsaturated, making the fat here healthy, but again, low protein and high added sugar are problematic
Pacific Foods Hazelnut Milk
110 calories 2 grams protein 3.5 grams fat 18 grams carbohydrate 78% of carbohydrate is added sugar
COCONUT MILK
I love this milk, but consumed in place of milk, the saturated calories will add up. Yes, the fat in coconut milk is different than the fat in meat, but even so, your overall intake of saturated fat, regardless of the source, should be no more than 10% of total calories. So I say save this one for cooking (as in Thai curries) or used sparingly on breakfast oatmeal or quinoa. It's not really the best choice for drinking by the glass.
Regular Canned Coconut Milk
445 calories 5 grams protein 48 grams fat 6 grams carbohydrate 0% of carbohydrate is added sugar Trader Joe's Light Coconut Milk
150 calories 0 grams protein 12 grams fat 12 grams carbohydrate 0% of carbohydrate is added sugar
So Delicious Coconut Milk (carton) 50 calories 1 gram protein 5 grams fat 6 grams carbohydrate 86% of carbohydrate is added sugar
Silk Coconut Milk (carton) 90 calories 1 gram protein 5 grams fat 10 grams carbohydrate 90% of carbohydrate is added sugar
RICE MILK
Until recently, rice milk was also an option that fell short in protein and in which sugar was added to sweeten and flavor. The first example here illustrates that point. The second option, which has recently come on the market, is a great advancement as far as milk alternative options go.
Both brands are made with brown rice, and both contain vitamins D and B12. However, safflower oil, one of the pro-inflammatory omega-6 fatty acids we encourage you to limit, is also listed as a Rice Dream ingredient. Just wanted to cover that base.
For women with PCOS, the addition of stevia by Growing Naturals is an added plus, as research is suggesting that regular consumption of stevia may help to improve pancreatic function, reduce cravings for sweets, and improve memory. All of those are chronic issues which make it hard to make the choices promoting hormone balance. In addition, Growing Naturals DOES contain vitamin D (in the vegan D2 form), and vitamin B12, often deficient in vegans.
Rice Dream Rice Milk
120 calories 1 gram protein 2.5 grams fat 23 grams carbohydrate 43% of carbohydrate is added sugar Growing Naturals Brown Rice Milk
110 calories 8 grams protein 1 grams fat 17 grams carbohydrate 0% of carbohydrate is added sugar So by now you know my bias, but now you also know why it exists. I use all of these milks in my kitchen. But I do so in different ways. Some as condiments and even coffee creamers, as I do enjoy their flavors, but not as a beverage choice I drink by the glass. The two I drink by the glass are cow's milk and Growing Naturals. Hopefully I've provided you with enough information to de what combinations are most hormone-friendly for you.
If you're interested in trying/using Growing Naturals yourself, and it hasn't arrived at your local store, here is information for ordering.
I just received an email from a client who noticed that every time she added flaxseed oil to her diet, she started to wheeze. We checked online, and sure enough, some people can be allergic to flaxseed. Here are some of the common symptoms of flaxseed allergy.
For anyone who is trying to increase their omega-3's, this can pose a challenge, since the vast majority of foods in the grocery store labeled as omega-3 supplemented contain flaxseed as the omega-3 source. If it turns out you are a flax-allergic person, be extra sure you read those labels!
ALA, the primary omega-3 in flaxseed oil, is not a substitute for fish oil; it has completely different and essential functions. A good way to think of it is that EPA and DHA from fish oil provide the"meat" of the structure of your brain and nerve cells, while ALA acts kind of like"rustproofing", keeping all that DHA and EPA in place that you worked so hard to get in the diet. They both need each other present in order for maximum effectiveness.
Here are some ideas for getting more omega-3's in the diet.
1. Other foods containing ALA include
Broccoli Brussels sprouts Cabbage Canola oil Edamame Kale Parsley Pecans Pumpkin seeds Spinach Spring greens Tempeh Tofu
One reason I have not included walnuts, which are typically the first vegetarian food recommended to increase omega-3 intake, is that the omega-6 content is so high that it is mathematically impossible to improve an omega-6 to omega-3 ratio when using them. I love walnuts and think they have some great nutritional benefits for PCOS, but in the rare and special case of a flaxseed allergy, it may not be a food that you would want to eat in large quantities. (I'm working on a pro-walnut post for a later date for you curious types!) Here are some practical ways to incorporate the foods above into your diet.
1. Know your nuts! The nuts with (a) the best omega-3 levels and (2) the best overall ratios of healthy to unhealthy fats include: macadamia, hazelnut, pecan, pine, and pistachio. Those are the nuts you should be using with the most frequency in your snacking and cooking. If you like nut-encrusted fish and pesto sauce…you're in luck! You can also throw nuts in your coffee grinder to make nut powders, which can be added to waffles, pancakes, baked goods, smoothies, and salad dressings. They'll give your creations a little bit of a gourmet twist!
2. Use shredded cabbage in your tacos instead of shredded lettuce. That's how they do it in Mexico…and it's the perfect topping for a fish taco!
3. Get in the habit of throwing a handful of dark greens--kale, spinach, parsley--into your smoothies. You won't even taste them.
4. Pumpkin seeds, like nuts, are easily added to trail mix, thrown on salads, soups, and hot cereals, and ground to include in your encrustings.
5. Cook with canola oil.
6. I've included the three types of soybean that are not tough on thyroid--edamame, tofu, and tempeh. Edamame is a fun snack when popped out of the shell, tofu and tempeh can be the basis for a meatless meal.
7. If you like pesto, you may want to try chimichurri, another parsley-based sauce that I call"South American pesto". It is wonderful on grilled meats and easy to make! I've seen ready made varieties in the grocery store.
8. Be extra careful about omega-6 fatty acids. The less of those in your diet, the less omega-3 you will need to counter their inflammatory influence. For review, except for canola, which is ok, minimize your use of oils beginning with the letters"s" and"c"…safflower, sunflower, soybean, corn, cottonseed. (The reason soy as a food is ok while soybean oil is not, is because the ratio of omega-6 jumps up when you extract and use only the fat and do not buffer it with the meat of the soybean.)
Here are a couple of recipes for you, one for chimicurri sauce, and one for a tasty squash/kale/whole wheat lasagna I tested out this week.
It just takes a little creative thinking to find ways around a flaxseed allergy. Hopefully some of the suggesstions I'm providing turn out to be favorites in your home!
Spinach Kale Whole Wheat Lasagna (from Sunset Magazine, February 2008)
Note: I couldn't find whole wheat lasagna noodles in my store so I bought whole wheat egg noodles and layered them with the other ingredients to make a casserole. It was great! Prep and Cook Time: about 2 hours. Notes: You can assemble and chill the lasagna a day ahead, but add 10 to 15 minutes to the baking time. You can also freeze the lasagna, wrapped well in plastic wrap, for up to 1 month and bake it frozen (add 1 1/4 hours to the oven time).
Yield Makes 8 servings
Ingredients 4 tablespoons olive oil, divided 1 medium red onion, peeled and sliced 3 peeled garlic cloves (1 minced, 2 left whole) 2 cans (14 oz. each) crushed tomatoes 1 teaspoon dried oregano About 1 tsp. each salt and freshly ground black pepper, divided 6 cups (about 2 lbs.) butternut squash, peeled and cut into 1/2-in. cubes 1/2 tsp. dried thyme 1 pound Lacinato kale (often sold as dinosaur or Tuscan kale) 9 whole-wheat lasagna noodles (about 8 oz.) (Often, whole wheat pastas are made with flax…be sure to read your labels!)1 container (15 oz.) part-skim-milk ricotta cheese 1/8 teaspoon ground nutmeg 2 cups shredded mozzarella cheese, divided
Preparation 1. Preheat oven to 400°. Heat 2 tbsp. olive oil in a 2- to 3-qt. pot over medium heat. Add onion and minced garlic; cook, stirring occasionally, until onion is soft and translucent, 5 minutes. Add tomatoes, oregano, and 1/2 tsp. each salt and pepper. Reduce heat and simmer until thick and flavors are combined, about 30 minutes. Set aside.
2. While sauce is cooking, in a 12- by 15-in. baking pan, sprinkle squash with thyme, remaining olive oil, and salt and pepper to taste. Add garlic cloves and toss squash mixture to coat with oil. Bake until soft, 10 to 15 minutes. Meanwhile, bring 3 qts. salted water to a boil in a large pot.
3. Reduce oven temperature to 350°. Transfer squash and garlic to a food processor and purée until smooth.
4. Tear kale leaves from center ribs and discard ribs. Boil leaves until soft, 5 to 8 minutes. Drain; let cool. Squeeze out as much water as possible and chop finely.
5. In the same pot, bring another 3 qts. salted water to a boil. Add noodles and cook until tender to the bite, about 10 minutes. Drain; rinse with cold water.
6. In a bowl, mix ricotta, nutmeg, 1 cup mozzarella, and remaining 1/2 tsp. each salt and pepper.
7. Coat the bottom of a 9- by 13-in. pan with 1/3 of tomato sauce (about 1 1/2 cups). Lay 3 noodles in a single layer over sauce. Top noodles with squash, spreading evenly. Sprinkle 1/2 of kale evenly over squash. Arrange 3 more noodles on kale and top with ricotta, spreading evenly. Top with remaining kale and noodles. Cover noodles with remaining tomato sauce and sprinkle with remaining 1 cup mozzarella.
8. Bake lasagna until juices are bubbling and cheese is melted, about 30 minutes. Let stand 10 minutes before slicing.
Grilled Halibut with Chimichurri Sauce from Epicurious.com
1/3 cup extra-virgin olive oil 1/4 cup fresh lemon juice 1 tablespoon water 1 tablespoon minced garlic 1 tablespoon minced shallot 3/4 teaaspoon hot red-pepper flakes 3/4 cup chopped flat-leaf parsley 4 (6- to 8-ounce) halibut steaks (3/4 to 1 inch thick) 1 tablespoon vegetable oil print a shopping list for this recipe
Preparation
Whisk together olive oil, lemon juice, water, garlic, shallot, red-pepper flakes, and 1/2 tsp each of salt and pepper until salt has dissolved. Stir in parsley. Let chimichurri stand 20 minutes.
Meanwhile, prepare grill for direct-heat cooking over medium-hot charcoal (medium heat for gas).
Pat fish dry, then brush with vegetable oil and sprinkle with 1/2 tsp salt and 1/4 tsp pepper (total).
Oil grill rack, then grill fish, covered only if using a gas grill, turning once, until just cooked through, 8 to 10 minutes total.
Serve fish drizzled with some of chimichurri; serve remainder on the side.
Cooks' notes: ·Halibut can be cooked in a hot oiled large (2-burner) ridged grill pan over medium heat. ·Chimichurri can be made 1 hour ahead and kept, covered, at room temperature.
6:30 a.m., Miami International Airport, feeling jet-lagged and just about destroyed from over 24 hours of travel, I looked through my stupor at the people who have come to reside in my head as “The Airport Couple,” a poignant lesson in what happens when you don’t take care of yourself. I love to people-watch at the airport, but this was not my usual people-watching.
They both have canes, are morbidly obese, and have extra-large sodas and pound bags of candy – plain M&Ms for her, peanut for him. The breakfast of champions, especially if it’s Diet Coke. They are struggling to breathe, to move, to walk, and even to eat the candy, yet they persevere. They both have an unhealthy pallor that comes more from poor health than bad airport lighting. Neither one makes eye contact with anyone else, not even their spouse. Their isolation, even in the midst of dozens of people, is profound.
Their misery and shame is palpable, and I feel like I should avert my eyes from their pain, and the practice of their addiction to food/sugar. It hurts to watch them, but I am unable to stop glancing sideways at them, in the way that children do when they notice a grotesquely fat or deformed person and simply cannot keep themselves from staring. I am wondering how they are going to make it onto the plane, and if they’ll even survive the flight, let alone whatever comes next. Selfishly, I hope I won’t have to spend the next six hours stuck sitting next to one or both of them. I feel intense sadness for the way that they’re trapped in their bodies, in their diseases, and their disconnection. I wonder which diseases they have, and how many. I make assumptions about diabetes, thyroid disorders, cholesterol problems, and heart disease. As time passes, and my flight is delayed, I add gout, emphysema, and of course depression to the list.
She is probably 52, but looks closer to 70. Walking is laborious, studied, and painful. Her thighs are so fat that her ability to walk a straight line is distorted. Yet she proceeds to the nearest shop to purchase more snacks for him; clearly, this is a form of care-giving. I think he is older, although it is hard to tell. He is almost immobilized, stuck in the confines of the narrow, hard-railed bench/chairs that are uncomfortable even for people of average size. I look for an oxygen tank, certain that must be part of their apparatus. He is wearing extra thickly cushioned diabetic shoes. I wonder about toe amputations. I think long and hard about this human catastrophe, and how preventable almost all of it is.
We struggle, day in and day out, to manage our PCOS, and whatever other diagnoses come with it. We get tired of eating right, limiting sugar and other carbs, avoiding alcohol and grain-fed meat, getting up at 5:30 a.m. to make it to the gym, taking supplements, and going to the doctor quarterly for check-ups. We complain that it isn’t fair that we’re stuck with this condition. We deal with, or don’t deal with, our depression, our anxiety, our obsessions and compulsions, or the thoughts that we might be bipolar. We adhere to diets and violate the diets. We struggle, and wonder why. I’ll tell you why – you don’t want to be The Airport Couple.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
