In addition, one receptor change on the cell membrane triggers another, which changes another. Women with insulin resistance often have cortisol resistance, thyroid resistance, progesterone resistance, etc. Once insulin resistance reverses (usually takes six months), response to all hormones improves.
The diagnostic criterion is a laboratory finding that shows abnormal ratios of the pituitary hormones, leutinizing hormone (LH) to follicle-stimulating hormone (FSH), as stated above.
Symptoms of PCOS can be one or more of the following, yet can be silent for many years:
- Tendency to gain weight (10 to 200 pounds)
- Mood swings (anxiety, depression)
- Excess hair growth on face
- Thinning hair
- Irregular menses
- Poor fertility
- Cystic ovaries
Not all patients have all these symptoms. Some patients don’t have any of these symptoms and they just begin to manifest around perimenopause. A telltale sign that PCOS exists in perimenopausal women is when they have an atypical response to bioIdentical hormone replacement therapy by getting acne or not having relief from hormone therapy of current symptoms.
As mentioned earlier, stress is the most common cause to receptor site changes. Poor sleep, poor nutrition, habitual caffeine and/or alcohol use, synthetic birth control pills and chronic antibiotic use are some main contributors to stress.
To properly treat PCOS, we have to address cellular health:
- Stress triggers must be identified and addressed
- Nutritional optimization
- Vitamin or medication use to reverse insulin resistance
- Gluten-free carbohydrates
- Up to 80 gm/day of carbohydrates (gluten free) in one day
- Protein – at least 90 gm per day
- Eat small amounts of food every three hours rather than large, infrequent meals
- Keep something sweet (hard candy) with you in the event that you feel your blood sugar dropping
B12 is used for both options. Sublingual (dissolved under the tongue four times daily or injections given at home two to three times weekly).
Metformin - 500 mg XR (increase dosage slowly):