Inositol

Kimberly Singh, Julie’s resident nutrition grad student {{ also affected by PCOS! }} is back to blogging on PCOS topics. Enjoy!

What is inositol?

Inositol is a natural compound found in plants, animals, and humans. Inositol provides the foundation for inositol phosphates, which have many important roles in your body.

Fun fact: Inositol was once known as vitamin B8. It lost its vitamin status when scientists realized the body makes enough inositol that you do not have to worry about eating it, which is a requirement to be considered a vitamin.

How are inositol and PCOS related?

Research has found something fishy going on with inositol in people with PCOS. The exact occurrence is unknown, but there seems to be an imbalance or deficiency of inositol in people with PCOS. So, it’s no coincidence that some of inositol’s key functions overlap with PCOS symptoms. People with PCOS are likely to have insulin resistance and ovulatory dysfunction, and inositol is important for promoting healthy insulin-response systems and ovulatory function.

Inositol supplements are insulin sensitizers, making the cells more sensitive to insulin, allowing glucose to enter the cells. This is really important for people with PCOS, who are likely to be insulin resistant and have cells that are not sensitive to insulin, preventing glucose from entering the cells (more on PCOS and insulin here, background on insulin here).

Want to find a way to treat your PCOS without dieting?

Julie can show you how!

It seems like inositol will be a major player in the future of PCOS treatment. Research has already found inositol to also have the following benefits in people with PCOS:

  • Reduce insulin resistance
  • Reduce androgen levels (such as testosterone)
  • Decrease cardiovascular disease risk
  • Increase ovulation frequency
  • Improve oocyte and embryo quality
  • Reduce metabolic syndrome
  • Regulate menstrual cycles
  • Reduce Hemoglobin A1c

Can you get inositol from food?

Yes, but it is difficult to get the correct dose from your food. The benefits of inositol in people with PCOS have been found with inositol supplementation. If you are still interested in foods that contain inositol, some great options are: Brazil nuts, almonds, walnuts, cantaloupe, citrus fruits, bran, oats, beans, and peas.

Are all inositol supplements the same?

NO! I don’t mean to shout, but really, they aren’t!

There are nine different forms of inositol, and two of those nine are most abundant in our bodies. These two inositol superstars are myo-inositol and D-chiro-inositol. Most supplements will contain either one of these or a combination of the two.

The benefits listed above were found with combination of the two forms of inositol in a 40:1 ratio of myo-inositol and D-chiro-inositol.

Which brand of inositol should I take?

Unfortunately, the supplement industry is not well regulated. This means that you have to be careful to use trusted brands. Julie recommends Theralogix Ovasitol inositol powder. This powder has that ideal 40:1 ratio that has been proven to help people with PCOS.

Ovasitol can be ordered in 3 month supplies here. Save $12 by using Julie’s Provider code: 127410. (In the nature of full disclosure, please know this is not an affiliate code so she is not compensated for the referral, rather just an easy way to save money.)

How do I consume inositol powder?

The inositol will be proportioned in individual packets that contain 2,050 mg inositol in the 40:1 ratio. Consume two packets per day by dissolving the powder in a hot or cold liquid. The inositol powder is tasteless and odorless (thankfully).

Are there any side effects?

Research has not found side effects to inositol supplements.

Inositol has an exciting role in the future of PCOS treatment. Inositol is a great option for people who had negative side effects with Metformin. Some research even finds it to have better ovulation and pregnancy outcomes than Metformin.

Let’s continue this conversation in the Facebook PCOS Support Group. Click here to join! Do you take an inositol supplement? What changes, if any, have you noticed?

References

Bizzarri, M., & Carlomagno, G. (2014). Inositol: history of an effective therapy for Polycystic Ovary Syndrome. European Review for Medical and Pharmacological Sciences, 18, 1896-1903.

Clements, R., Jr., & Darnell, B. (1980). Myo-inositol content of common foods: development of a high-myo- inositol diet. American Journal of Clinical Nutrition, 33(9), 1954-1967.

Colazingari, S., Treglia, M., Najjar, R., & Bevilacqua, A. (2013). The combined therapy myo-inositol plus d-chiro-inositol, rather than d-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Archives of Gynecology and Obstetrics, 288(6), 1405-1411. doi:10.1007/s00404-013-2855-3

Hamid, A., Mohamed, A., Madkour, I., & Wail, A. (2015). Inositol versus Metformin administration in polycystic ovary syndrome patients: a case-control study. Evidence Based Women’s Health Journal, 5(3), 93-98.

Kalra, S., Kalra, B., & Sharma, J. (2016). The inositols and polycystic ovary syndrome. Indian Journal of Endocrinology and Metabolism, 20(5), 720. doi:10.4103/2230-8210.189231

Minozzi, M., Nordio, M., & Pajalich, R. (2013). The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. European Review for Medical and Pharmacological Sciences, 17(4), 537-540.

Monastra, G., Unfer, V., Harrath, A. H., & Bizzarri, M. (2016). Combining treatment with myo-inositol andD-chiro-inositol (40:1) is effective in restoring ovary function and metabolic balance in PCOS patients. Gynecological Endocrinology, 33(1), 1-9. doi:10.1080/09513590.2016.1247797

Pintaudi, B., Vieste, G. D., & Bonomo, M. (2016). The Effectiveness of Myo-Inositol and D-Chiro Inositol Treatment in Type 2 Diabetes. International Journal of Endocrinology, 1-5. doi:10.1155/2016/9132052

Sortino, M. A., Salomone, S., Carruba, M. O., & Drago, F. (2017). Polycystic Ovary Syndrome: Insights into the Therapeutic Approach with Inositols. Frontiers in Pharmacology, 8. doi:10.3389/fphar.2017.00341

Unfer, V., & Porcaro, G. (2014). Updates on the myo-inositol plus D-chiro-inositol combined therapy in polycystic ovary syndrome. Expert Review of Clinical Pharmacology, 7(5), 623-631. doi:10.1586/17512433.2014.925795

Watson, R. R., & Dokken, B. B. (2015). Glucose intake and utilization in pre-diabetes and diabetes: implications for cardiovascular disease. Amsterdam: Elsevier/Academic Press.

Metformin + PCOS

This article was written by my previous Nutrition Grad Student, Kimmie Singh. She is a fat woman of color who experiences PCOS. You can find out more information about her work now as a dietitian here.

“But I don’t have high blood sugar? Why am I on the diabetes drug Metformin?”

Metformin, aka Glucophage, is a common treatment option for PCOS and many wonder why it is chosen.

{Side note: in order to understand the role of Metformin, you might want to review the previous post on PCOS and insulin.}

The state of insulin resistance so common with PCOS promotes an environment where extra glucose and lots of insulin hang out in the bloodstream. That glucose wants to get in your cells to give you energy (and that’s why you are so tired all the time!). Those very high insulin levels seen in PCOS drain you even more and are behind the acanthosis nigricans, carb cravings, irregular periods, and even affects your sleep.

 

 

 

 

Want to find a way to treat your PCOS without dieting?

Grab a FREE download from Julie here.

Metformin steps in making your cells more sensitive to insulin: that’s why it’s referred to as an insulin sensitizer. It helps the glucose actually get in your cells, giving you the energy you need. Many report having more energy and less carb cravings after starting metformin.

Metformin has another job: it stops the liver from making and sending out so much glucose. Most people connect Metformin with blood sugar since it is a common diabetes drug.

Although it affects blood sugar, most people with PCOS on metformin have normal blood sugar levels. Also, insulin levels are MUCH higher in PCOS than diabetes so more Metformin is necessary compared to people with diabetes.

Metformin affects more than just insulin and glucose.

In addition to reducing blood glucose and insulin levels, Metformin has been shown to improve menstrual irregularities, fertility, and ovulation rates.

Metformin may also slow the progression of type 2 Diabetes and improve blood pressure and cholesterol levels.

When taken at it’s current therapeutic dose of 1500-2000 mg, Metformin can play a major role in managing PCOS. A lot of people swear by it, yet others can’t tolerate it.

I’m one of those people that can’t tolerate Metformin. It left me with GI distress, energy crashes, and dry skin. If Metformin doesn’t work for you, supplemental inositol is another great insulin sensitizer.

To reduce the side effects of Metformin, Julie recommends:

  • Take it with a meal (like a whole meal not a snack)
  • Follow your doctor’s instructions
  • Start at a smaller dose and build up
  • Stay hydrated

Want to explore more non diet options to help manage your PCOS, promote health AND healing?

Click here for details on Julie’s PCOS and Food Peace course.

food-peace-pcos-300x300.jpg

 

Campbell, R., White, J. R., & Saulie, B. A. (1996). Metformin: a new oral biguanide. Clinical Therapeutics, 18(3), 360-371. doi:10.1016/s0149-2918(96)80017-8

Diamanti-Kandarakis, E., Economou, F., Palimeri, S., & Christakou, C. (2010). Metformin in polycystic ovary syndrome. Annals of the New York Academy of Sciences, 192-198. doi:10.1111/j.1749-6632.2010.05679.x

Mathur, R., Alexander, C., Yano, J., Trivax, B., & Azziz, R. (2008). Use of metformin in polycystic ovary syndrome. American Journal of Obstetrics and Gynecology,596-609. doi:10.1016/j.ajog.2008.09.010

Ozcimen, E. E., Uckuyu, A., Ciftci, F. C., & Zeyneloglu, H. B. (2009). The effect of metformin treatment on ovarian stromal blood flow in women with polycystic ovary syndrome. Archives of Gynecology and Obstetrics, 280(2), 263-269. doi:10.1007/s00404-008-0904-0

 

 

PCOS + Insulin {Part 1}

This article was written by my previous Nutrition Grad Student, Kimmie Singh. She is a fat woman of color who experiences PCOS. You can find out more information about her work now as a dietitian here.

Are you are excited to learn about insulin and glucose?

😂😂😂😂😂😂

I appreciate the excitement meter will be low for this one. In fact, I may have completely lost your attention at insulin. Before writing this I asked my friends and family what comes to mind when they hear “insulin and glucose,” and they suddenly seemed extremely uninterested and unenthusiastically mumbled, “I don’t know…diabetes?”

You may be feeling similar feelings of boredom, and to be frank, I don’t blame you.

I felt pretty uninterested in learning about insulin and glucose until I realized how much they impact my PCOS. 

If you are reading this, then you have insulin and glucose to thank, literally. They are crucial to fuel everything you do. Whether it’s lifting a finger to click “play next” on Netflix, reading an awesome series on PCOS *wink*, or running a marathon, insulin and glucose play a role.

But please, don’t just take my word for it. Continue reading and learn for yourself.

Want to find a way to treat your PCOS without dieting?

Grab a FREE download from Julie here.

So, let’s take it back to basics. Insulin is a hormone. If you have PCOS, you are probably sick of hearing about hormones by now. I know the feeling, but insulin is a little different from the hormones that may come to mind.

Insulin plays a key role in getting energy from food. 

After you eat a meal, your body absorbs the glucose from the digested food. So whether you are eating carrots or a piece of cake, your body will absorb glucose from your food. This glucose will be transported through your blood to reach the cells that need energy.

So after you eat, your blood glucose level will increase as glucose travels to your cells for energy. In response to this surge in blood glucose your pancreas will release insulin. Insulin and glucose go hand in hand. Think of insulin as the gatekeeper for the cells- it allows the cells to take up glucose for energy.

So, in a nutshell, your body needs energy to think, move, and function. The primary source of energy for your cells is glucose. Insulin allows glucose to enter your cells. 

You may find yourself wondering why I’m explaining insulin and glucose in a series about PCOS. Well, people with PCOS tend have more insulin in circulation, and this affects how your body gets energy and stores fat. A little insight: people with PCOS have MUCH more insulin than folks with diabetes so the experience is different and more intense.

These super high insulin levels are behind the massive cravings PCOS is known for and most don’t understand. 

Now that you get the key roles of glucose and insulin, the next post will explain how they work differently for people with PCOS.

Want to explore more non diet options to help manage your PCOS, promote health AND healing?

Click here for details on Julie’s PCOS and Food Peace course.

food-peace-pcos-300x300.jpg

 

Stop the Yo-Yo! Diets Behind Weight Cycling Negatively Impacts PCOS

Have PCOS? You can make peace with food too. Let's navigate this.
Have PCOS? You can make peace with food too. Let’s navigate this.

This week’s blog is doing cartwheels around the possibility of PCOS and food peace. This is the third of five posts. I hope you find this information invigorating and revolutionary. If you have PCOS, please know you don’t have to punish yourself anymore. You can find health without diets!

Weight loss, Weight Regain Hurts Health

PCOS weight loss often includes drastic measures that are impossible for 95% of the population to continue. Because of our human physiology, weight loss is followed by a period of rapid eating and weight regain. Have you ever lost weight only to regain more? I have heard many women with PCOS describe losing 50 to 100 pounds only to regain 100 to 150 more within the next few years.

If this is your history: it isn’t your fault.

On behalf of medical and health science, I apologize that we gave you the wrong solutions. We don’t have many good ones yet, regretfully. We do know that continuing the weight loss weight regain cycle will only make you sicker.

Because weight regain is the rule not the exception, weight cycling studies–the research word for yo-yo dieting–come in handy. Weight cycling studies suggest this process ends up making a body with more inflammation and higher insulin levels 1, 2, 3, 4. Remember, PCOS already includes astronomically high insulin levels. Why contribute to this?

Even more, the higher insulin levels rise, the more intense the carb cravings. When I say craving, I don’t mean a lurking thought. I mean an experience where every cell in your body screams: EAT CARBS AND EAT THEM NOW! Carb restricting may seem like a good idea yet please reconsider. We have neuropeptides that release messages to cells when carb or calorie intake is low or perceived to be low that further enhances this screaming. Carb abstinence only enhances binges. This hurts in 3 ways:

  • Further increases insulin levels from high carb binges
  • Places the woman at higher risk for eating disorder pathology
  • Contributes to weight cycling insulin and inflammation increases

If you have PCOS and want to lower insulin levels, do not diet. Don’t even think about it.

Women with PCOS: Don’t touch diets with a 10 foot pole

Have PCOS? You can make peace with food too. Let's navigate this.
Have PCOS? You can make peace with food too. Let’s navigate this.

PCOS sucks. PCOS = polycystic ovarian syndrome. Never heard of it? Most people haven’t although the TLC reality series My Big Fat Fabulous Life is changing that. PCOS is poorly understood and takes over the whole body (more on that here). It causes facial hair, male pattern baldness, mood disorders, infertility, insulin resistance with ensuing intense carb cravings, and can lead to diabetes. The icing on the cake? PCOS makes some women fat especially around the stomach 1.

Women with PCOS often tell me the pressure they feel to lose weight. It’s no secret our world judges fat people as lazy, stupid, and without self-control. Do you know how hard clients with PCOS try to lose weight? Harder than you can imagine. Most of the time, women with PCOS see the scale go down only after extreme diets (read: eating disorder behaviors) that are impossible to continue. This is not lack of will power or self-control. This is human physiology. Even more, this sets up a human body with more disease.

I will break it down over the next few days why diets don’t help PCOS rather make it worse. First up:

Diets don’t work.

A fat person walks into the health provider office. She is given a diet.
No matter why they are there.

This is not a joke.

I am known to be a non-diet dietitian and many people try to convince me when diets are necessary: diabetes, high cholesterol and very fat bodies are common examples. And, I agree at times a person can eat in a way that is harming his or her body and possibly causing the body weight to be higher than his or her body would like it to be. Without fail, upon meeting a person with a very fat body, I find diets have been a central part of their eating experiences. Fat people seeking to lose weight are in a constant rotation of one of these:

  1. Preparing to go on a diet.
  2. On a diet.
  3. Bingeing after a diet.

The length of time may vary and yet for most of the population this cycle continues as long as diets are pursued as an answer. My question: if diets work, why do we need to keep going on them?

There is no research to date that shows any diet keeps weight off for more than one year. Not one. Almost every scholarly journal publishing articles on a diet stops at one year or earlier. Those looking further out have incredibly high drop out rates (the eating or exercise plans are too tough to stick with) or correlational. And my college stats class taught me correlation does not equal causation. You too? We should expect more out of modern medicine and research.

We know diets don’t help health 2. Rather, they are the greatest predictor of weight gain 3 and 95% of dieters regain all of weight lost 4. Wait. What???

Say no to diets. Choosing diet free living is not neglectful rather healthful. It’s not letting yourself go, it’s letting yourself be.

Click here to see Part 2 of this series: PCOS + Diets Can Promote Eating Disorders