The PCOS and Gut Health Connection

Up to five million women in the U.S. have Polycystic Ovary Syndrome (PCOS), but this condition remains frustratingly difficult to diagnose and treat. One study found that 70% of women with PCOS haven’t been diagnosed, so they continue to experience debilitating symptoms.

With a wide range of symptoms, PCOS can have a profound influence on a woman’s life. In fact, studies have found a high incidence of anxiety and depression among women with PCOS. 

The health of our gut microbiome– the trillions of living organisms found in the intestine– plays a large role in overall health. This is especially true for women dealing with Polycystic Ovary Syndrome. Conventional treatments often fall short in treating PCOS and any treatment plan for PCOS must take into consideration gut health among many other hormone-balancing solutions.

Let’s take a look at the connection between PCOS and gut health and ways to manage and treat this condition naturally to get back to feeling your best.

What Is PCOS? 

PCOS is a complicated hormonal condition that affects women’s ovaries, causing them to produce an excess of androgens, or male hormones. This can lead to a variety of symptoms such as:

• Cysts in the ovaries

• Irregular menstrual cycles 

• Infertility 

• Acne 

• Insulin resistance

• Thinning hair on the scalp 

• Excess face & body hair 

• Chronic inflammation 

• Obesity & weight gain

PCOS is the leading cause of infertility in women. It can also lead to numerous serious health problems like diabetes, heart disease, and high blood pressure. 

Traditional treatment usually involves starting hormonal birth control to “balance” hormonal levels. However, this tends only to mask the condition and overlooks the crucial importance of gut health. As soon as women stop taking the pill, symptoms can reappear worse than before.

Studies have found that women with PCOS have a different gut microbiome composition than those without the condition. Making changes to improve your gut health can therefore have a huge impact on PCOS symptoms and your physical and mental well-being. 

What Causes PCOS? 

There is no clear cut answer as to why some women develop PCOS. Many factors can contribute –  including your genetics and your environment. One of the leading theories is that PCOS can be caused by an imbalance in the gut microbiome. 

What is the gut microbiome?

There are many types of bacteria living in our gut. Most are beneficial strains of bacteria that help produce essential vitamins, regulate our immune system, impact metabolism, alter hormone levels, muscle strength and even regulate our mood.

A diverse gut microbiome with the proper balance of good and bad bacteria is optimal for health. However, when there is an imbalance of good and bad bacteria, this is referred to as dysbiosis. 

How is gut dysbiosis linked to PCOS? 

Women with PCOS are shown to have higher rates of dysbiosis and less diversity in the gut microbiome than those without the condition. They present higher levels of harmful bacteria which contribute to inflammation and metabolic dysfunction. 

An excess of bad bacteria leads to inflammation in the body, which can then increase insulin levels in the blood. Excess insulin then triggers an increase in androgen production from the cells of the ovaries. 

Restoring The Gut Microbiome To Treat Symptoms Of PCOS

Now that we have explored the link between gut imbalance and PCOS, it is time to focus on some of the ways you can promote gut health. The good news is that small tweaks to your diet and lifestyle can improve the functioning of your gut in as little as 24 hours. Some simple steps include: 

1 - Eat more fibre.

A diet rich in fibre is highly beneficial for supporting the good bacteria in the gut. The recommended amount of fibre for women is 25 grams per day, which can be found in plant foods like beans, lentils, vegetables, and whole grains. 

2 - Increase prebiotics + probiotics in the diet.

Prebiotics are non-digestible, fermentable components of foods that help kick start digestion and promote beneficial gut bacteria. They have also been shown to help reduce insulin resistance and lower androgens. They are found in foods like garlic, onion, bananas, and apples. 

Probiotics are found in fermented foods. They contain live bacterias that help your gut microbiome flourish. They can be found in foods like tempeh, kimchi, sauerkraut, and yogurt, and are also available in supplement form. There are many different kinds of probiotic supplements, with varying degrees of effectiveness, so it’s important to work with a practitioner to determine the best one for you. 

3 - Avoid artificial sweeteners.

Artificial sweeteners are known to have a harmful effect on the gut microbiome and can worsen insulin resistance. Opt for natural forms of sweeteners such as raw honey, maple, or date syrup. 

4 - Sleep more.

Lack of sleep causes a great deal of stress to the body, which can in turn promote inflammation and gut dysregulation. Sleep also factors in how our body is able to handle blood sugars by altering insulin levels. You should aim to get at least 7-9 hours of sleep per night. This might mean adjusting your sleep hygiene, avoiding caffeine and limiting screen time before bed. 

5 - Manage stress.

Researchers have found a link between psychological stress and dysbiosis. While reducing stress in your life can feel sometimes like an impossible task, develop ways to manage it. For example, you could take a close look at the stressors surrounding you, and work to create boundaries to protect your peace of mind. Relaxing activities like yoga, meditation, and walks in nature also help.

6 - Exercise regularly.

Exercise helps with sleep and stress, and studies show it can actually improve the state of your microbiome. Moderate exercise can reduce inflammation and improve biodiversity in your gut. However, it’s important not to overtax your body, which can lead to harmful cortisol production. Steady state cardio, strength training, and mobility training can be the foundations to a good routine, but don’t hesitate to get some guidance if you’re not sure where to start. 

Many areas of health, including your hormonal health, begin in the gut. For women with PCOS, maintaining gut health is especially important and can help alleviate unwanted symptoms and prevent serious health issues.

Eating a variety of whole foods, avoiding artificial sweeteners, and prioritizing sleep are a few simple steps women with PCOS can take to optimize the diversity of their gut microbiome and overall health. If you have any questions on the best treatments for PCOS, please give me a call!

Sources

Centers for Disease Control and Prevention, “PCOS and Diabetes” https://www.cdc.gov/diabetes/basics/pcos.html

Balikci A, Erdem M, Keskin U, Bozkurt Zincir S, Gülsün M, Özçelik F, Akgül EÖ, Akarsu S, Öztosun M, Ergün A. Depression, Anxiety, and Anger in Patients with Polycystic Ovary Syndrome. Noro Psikiyatr Ars. 2014 Dec;51(4):328-333. doi: 10.5152/npa.2014.6898. Epub 2014 Dec 1. PMID: 28360650; PMCID: PMC5353166.

Guo Y, Qi Y, Yang X, Zhao L, Wen S, Liu Y, Tang L. Association between Polycystic Ovary Syndrome and Gut Microbiota. PLoS One. 2016 Apr 19;11(4):e0153196. doi: 10.1371/journal.pone.0153196. PMID: 27093642; PMCID: PMC4836746.

References: 

González F. Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012 Mar 10;77(4):300-5. doi: 10.1016/j.steroids.2011.12.003. Epub 2011 Dec 8. PMID: 22178787; PMCID: PMC3309040.

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Prescription Meds & Nutrient Depletion: Warning Signs, Risks, and Natural Solutions

Prescription medications provide relief for various conditions and illnesses. For some people, they’re an important part of maintaining health and vitality. However, many come with the unwanted side effect of depleting your body of key nutrients.

Our bodies require sufficient vitamins and minerals to function properly– these micronutrients support healthy cell growth, immunity, and metabolism. In theory, we should get all the nutrients from the food that we eat. However, most North Americans don’t eat a balanced diet and despite advances in agricultural technology designed to enhance desirable traits such as size, growth rate and pest resistance, the nutritional quality of our food is diminishing. The unfortunate news is that certain prescription medications can exacerbate this nutrient deficiency even further.

Over time, nutrient deficiencies can cause unwanted symptoms, such as fatigue, brain fog and poor sleep. You may even develop another underlying condition caused by nutrient deficiency, resulting in more doctor’s visits than you’d probably like!

Thankfully, there are practical steps that can be taken to reduce the risk of nutrient depletion. 

How Does Nutrient Depletion Happen?

Some medications simply suppress your appetite, such as adderall or vyvanse. Antidepressants, on the other hand, can make you crave more “junk” foods that contain scarce nutrients. Others impact the absorption of nutrients in the digestive tract, or accelerate their metabolism.

Medications can also increase urination and therefore flush nutrients from your body at a faster rate than normal. 

Watch Out For These Symptoms Of Nutrient Deficiencies

Potential symptoms of nutrient deficiencies include, but are not limited to:

●       Fatigue

●       Weakness

●       Poor sleep

●       Changes in appetite

●       Dry brittle hair and nails

●       Dandruff and hair loss

●       Pale skin, dry eyes and dark eye circles

●       Poor digestion - diarrhea, constipation, bloating

●       Tingling or numbness

●       Irritability/moodiness/brain fog

Many of these symptoms can be associated with other conditions, or can be dismissed as fatigue from our busy lifestyles. But if you notice any of the above symptoms, it may be time to review the medications you’re taking with a healthcare practitioner.  

So, Which Drugs Deplete Nutrients?

More than 66% of US adults take at least one prescription medication, and this number is increasing.  

Here are some commonly prescribed medications that often lead to nutrient depletion:

• Antacids. Often prescribed for gastrointestinal (GI) disorders, antacids can be temporarily helpful for reducing uncomfortable heartburn by reducing stomach acid production. However, stomach acids also play a large role in your body’s absorption of nutrients. Research shows that long-term use of antacids deplete key vitamins like B12 and magnesium.

• Antibiotics. These tend to disrupt the gut flora, killing off “good” bacterias that are needed to absorb nutrients in food. It is common to see low levels of B vitamins, potassium, and biotin as a result of disruptions to the gut flora.

• Antidepressants. Prescribed to help with mood disorders, these medications can also cause changes to your appetite and food cravings. In turn, this will impact the quality of nutrients your body is getting. Selective serotonin reuptake inhibitors (SSRIs) have also been associated with folic acid depletion.

• Blood Pressure Medications. Prescriptions that lower blood pressure can also lower nutrients. For instance, beta blockers can disrupt the biological pathway of coenzyme Q10, which is essential for cellular processes. Diuretics are also commonly associated with deficiencies, as they increase urination, flushing out potassium, zinc, and magnesium at a higher rate than normal.

• Biguanides. These are used to improve glucose tolerance in patients with type 2 diabetes. They also tend to reduce the absorption of vitamin B12.

• Cholesterol lowering drugs. Often categorized as statins, these medications work by inhibiting an enzyme involved in the liver’s cholesterol production process. This enzyme is also crucial in the production of Coenzyme Q10, so deficiency is often an issue.

• Hormone Replacement Therapy. Certain hormonal prescriptions, especially those containing estrogen, have been found to deplete folic acid, magnesium, and B vitamins.

How To Prevent Nutrient Depletion From Prescription Medication

Now that we’ve covered some of the popular prescriptions associated with nutrient depletion, we can move on to prevention.

While in many cases these medications can be crucial, you also shouldn’t have to sacrifice your overall health to manage a condition.

1 - Eat a whole foods diet.

Ensuring that you are getting enough nutrients through your food is key in avoiding nutrient depletion. Many nutrient deficiencies that people experience when they start a new prescription occur because they already had deficits in their diet. Make sure to eat:

• Fresh fruits and vegetables daily. Antioxidant rich berries, vitamin and mineral rich leafy greens, and nutrient dense complex carbs like sweet potatoes are all incredibly nutritious and very versatile. 

• Quality meat and eggs. Aim for organic and pasture-raised, as these will have the most abundant nutrients.

• Healthy fats. Think olive oil, avocado oil, nuts, and fatty fish. These will keep you full longer and help curb junk food cravings.

2 - Address gut health.

Proper nutrient absorption begins with the gut. It is not just how you eat that is important, but how well your body can digest and eliminate that food. You may not feel the benefits of your balanced diet if your gut health is lacking. We recommend:

• Working with a practitioner to get to the root of any gut related problems like poor digestion or absorption.

• Eating probiotic rich foods, such as yogurt or kefir, especially if you are taking pain medications, antibiotics, or oral contraceptives. This will help replenish the “good” bacteria that gets killed from these medications.

3 - Supplementation.

Supplementation can be a great way to replenish nutrients lost as a result of medication, though it is important to work with a practitioner to determine the proper dosage for your needs.

Addressing The Root Cause

While prescription drug use has become incredibly common in North America, it is important to be aware of the side effects that come with so many of them. And it’s important to note that prescription medication does not always have to be the answer, in fact it’s often more of a band aid solution to manage a symptom rather than a plan for long term health. Working with me can help determine if the prescription you are taking could be making other symptoms worse. As a naturopathic doctor, I strive to find the root cause of my patients’ imbalances to get them back to their best state of health in the most natural way.

Your body needs crucial nutrients to function at its best; they are vital for energy, cognition, bone health, and more. Failing to replenish the nutrients lost as a result of medication may lead to further health complications down the road. Eating a balanced diet, focusing on gut health, and supplementing where needed will help ensure your health does not suffer as a result of your medications.

There is no reason to settle for suboptimal health! If you suspect your health is being impacted by medications, come in to review your medications and formulate a plan to get your health back!

Sources

Drake, V (2020), Ph.D.Linus Pauling Institute Oregon State University Retreived from https://lpi.oregonstate.edu/mic/drug-nutrient-interactions

Cass, H. (2019, May 22). A practical guide to avoiding drug-induced nutrient depletion. Nutrition Review. Retrieved from https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/

Mathieu, L. (2018, January 22). Drug-induced nutrient depletion: The warnings not listed on your RX label. Coastal Pharmacy & Wellness - Compounding Pharmacy and Vitamins and Supplements Store in Portland, Maine. Retrieved from https://www.coastalpharmacyandwellness.com/drug-induced-nutrient-depletions-not-listed-on-rx/

Mohn, E. S., Kern, H. J., Saltzman, E., Mitmesser, S. H., & McKay, D. L. (2018, March 20). Evidence of drug-nutrient interactions with chronic use of commonly prescribed medications: An update. Pharmaceutics. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/

Morea, J. (2017, February 10). 6 ways to boost your nutrient absorption by improving your gut health. Medium. Retrieved from https://medium.com/@moreajamie/6-ways-to-boost-your-nutrient-absorption-by-improving-your-gut-health-2d2321189587

https://www.scientificamerican.com/article/soil-depletion-and-nutrition-loss/?redirect=1

Testosterone: Important For Both Men and Women

Testosterone plays a number of important roles in our health that may surprise you. 

For instance, did you know that women produce testosterone, too? It is not just a male sex hormone, although women require only one tenth the amount of testosterone that men do. 

We experience a spike in testosterone production during puberty, and beginning around age 30, it begins to decline. However, this process can be accelerated due to lifestyle factors, such as chronic stress or poor nutrition. 

It is important to maintain balanced testosterone levels throughout the lifespan. In sufficient amounts, testosterone promotes healthy libido and energy levels. It also plays a role in: 

• Bone density and health 

• Energy levels 

• Muscle mass 

• Regular sleep patterns 

• Production of red blood cells 

According to a recent study from the American Urology Association, testosterone levels have been steadily decreasing in men since 1991. The reasons for this decline in testosterone are multifaceted, but given the endocrine-disrupting chemicals present in everyday products, and the nutritional deficiencies in modern diets, it is no surprise that our hormonal health is suboptimal. 

If you feel this may be the case for you, keep reading. We will look at the common signs and symptoms of low testosterone, as well as natural treatment options. 

Testosterone In Men

Before we talk about the issues that can arise from low testosterone levels, it is important to understand its role in the male body. 

Men produce most of their testosterone in the testicles. The endocrine system in the brain is responsible for signaling to the body when it needs to produce testosterone. 

During puberty, this leads to muscle development and hair growth on the face and body. 

Testosterone is vital to male fertility and the production of healthy sperm. Along with this important function, healthy testosterone levels also promote bone health, metabolism, and cognitive functioning. 
Low testosterone can occur for a number of reasons. One of them is simply getting older– testosterone levels tend to drop about 1% after age 30. Imbalances that are not related to the natural aging process tend to be caused by: 

• Conditions such as diabetes or obesity

• Damage or injury to the testicles 

• Use of certain medications, such as antidepressants or narcotic painkillers 

• Excessive alcohol consumption 

Some of the telltale signs of low testosterone in males include:

• Decreased libido. Testosterone plays a large role in the male sex drive. Changes in libido are normal as we age, but a noticeable lack of interest may be due to hormonal imbalance. 

• General fatigue. Energy is linked to healthy testosterone levels. If you’ve been sleeping 8-9 hours a night and still feel fatigued, it might be worth getting your testosterone levels tested. 

• Difficulty getting or maintaining erection. Testosterone stimulates the brain to produce nitric oxide – a chemical that is needed to sustain an erection. Low testosterone interferes with this process and can add difficulty to your sex life. 

• Loss of muscle mass. Testosterone is one of the major factors in building and sustaining muscle mass.Low testosterone over time will have an impact on your muscles, even if you hit the gym everyday. 

• Mood swings & memory issues: Have you noticed an increase in moodiness, irritability, or even depression? It could be due to hormonal imbalance– testosterone plays a crucial role in regulating men’s mood and sleep cycles. 

Testosterone In Women 
While we tend to associate testosterone with men, in smaller amounts it is also an important component of women’s health. 

Women produce testosterone mainly in their ovaries, but the adrenal glands, fat cells, and skin cells produce it as well. Most of this testosterone gets converted into female sex hormones, though some is needed to maintain healthy energy levels and bodily functions. 

As well, testosterone is important for women in: 

• Promoting breast & bone health 

• Maintaining regular menstrual cycles 

• Cognitive health 

Like men, women experience lower testosterone levels as they age naturally. However, the most dramatic drop occurs during menopause. 

The normal range of testosterone levels for women are between 15 to 70 nanograms per deciliter (ng/dL) of blood. If levels are lower than this, women may experience: 

• Low sex drive 

• Irregular menstrual cycles 

• Osteoporosis 

And while having too much testosterone tends not to be a problem for men, in women numerous health issues can arise from an excess of this hormone. The most common is Polycystic Ovarian Syndrome (PCOS), affecting approximately 5 million women in the US. This condition can lead to reduced fertility, irregular periods, and skin problems like acne and abnormal hair growth. 

Supporting Healthy Hormone Levels

If you begin to notice any of these signs of low testosterone, be sure to talk with your health practitioner. They can test for hormone levels by performing a blood test, and then work with you to restore any imbalance. 

In addition, there are several natural ways you can support healthy hormone levels in your daily life. These include: 

• Regular physical activity. Research has found a strong association between exercise and testosterone production. Weight training and high intensity interval training (HIIT) are the most effective at boosting T, but any way you can get your body moving on a regular basis is key for overall health and hormones. 

• Reduce stress.  When we are chronically stressed, our bodies produce cortisol, the stress hormone, at the expense of other key hormones like testosterone. Finding techniques that work to reduce stress is a must for feeling your best and boosting testosterone levels. 

• Get enough sleep. Studies have found that when we lack sleep, our body cannot produce the necessary hormones and chemicals that keep it working optimally. This includes testosterone. Aiming for at least 7-8 hours of sleep every night will help maintain healthy testosterone levels.

• Testosterone replacement. Testosterone replacement therapy can be administered in several different ways - most commonly through injections, transdermal gels and creams. While gels and creams are an easy and convenient option, there are certain drawbacks to their efficacy and absorption due to sweating and friction. Injectables are the most reliable form of TRT and should be performed under the supervision of a knowledgeable practitioner.

Healthy Hormone Diet

Another major way you can boost testosterone levels in your daily life is through diet. 

Certain herbs and food groups can actually help your body produce testosterone naturally– no hormonal injections or implants needed. 

• Ashwagandha has been used in traditional Indian medicine for years to treat sexual dysfunction and infertility. Studies have associated the herb with increased testosterone.

• Zinc is needed for your body to make testosterone and in healthy sperm production. If you are deficient, supplementing zinc may be worthwhile. Otherwise, you can add zinc into your diet by eating quality red meat, eggs, chickpeas, and yogurt.  

• Healthy fats & protein. Research shows that men who eat low fat, low protein diets also have lowered testosterone levels. Instead of simple carbs and empty calories, prioritize avocados, nuts, dairy products, and meats into your diet. 

• Magnesium can enhance your quality of sleep, which is vital to testosterone production. Supplementation can be useful, along with eating magnesium-rich foods like dark chocolate, sunflower seeds, and bananas. 

As always, talk with your practitioner before introducing new herbs or supplements to your diet. 

Testosterone plays a role in a number of the body’s important functions. Balanced levels of this hormone are crucial for optimal health in both men & women. If you feel you have symptoms of low/high testosterone, it is worth considering hormone testing. From there, we can work on restoring your body’s natural balance of testosterone through the natural methods we discussed - give me a call to get started!

Sources

Barhum, L. (2018, July). 8 science-backed ways to boost testosterone naturally. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/322508#natural-ways-to-maintain-testosterone

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