⚕️Sugar, weight loss and PCOS

What I'm reading, monitoring and eating to reverse a common hormonal disorder

👋 Hi from Helen. 2022 is the year I committed to figuring out the next steps with my 20-year-old diagnosis of Polycystic Ovary Syndrome (PCOS). In case you are wondering, this is not a deadly disease and it mostly impacts women trying to get pregnant (a hurdle I overcame with a moderate amount of meds). Here is the definition from the Mayo Clinic:

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

I found out that this is what I had when I was 19 years old because I had infrequent and very painful menstrual periods. To combat this, I was prescribed birth control by an endocrinoloist.

As I wrote in my 22 for 22 (a post I did at the beginning of the year laying out my goals):

I am among 5-10% of women diagnosed with PCOS (Polycystic Ovary Syndrome) and I have been medicated for it since I was in college with the only technique known at the time - the birth control pill. But now, two decades later, I want to explore changes in diet as well as some homeopathic approaches to try to reduce/get rid of this.

My hypothesis is by adjusting my lifestyle and therefore losing weight, improving sleep, and reducing stress, I will be able to make meaningful strides in ridding myself of PCOS. I hope that by talking about this openly, it will help me stay the course and also find other people who are going through a similar journey. And yes, I am still baking cakes and eating a slice every time.

📈 📖 Read and observe: Glucose monitoring and books

Following Adam’s learnings during his sabbatical, I have now hooked myself up to a CGM (Continuous Glucose Monitoring) and have acquired a Signos subscription. Read Adam’s take on it in his post 🥂🩺L'Chaim: Health Gadgets and Subscriptions:

Signos is one of many companies that are bringing Continuous Glucose Monitoring to the masses. You get a Dexcom G6 CSM receiver and 3 months supply of monitors. You have to install two mobile apps to get it all to work (one of which is still using Apple’s TestFlight beta program). And you get access to a Facebook group of other users to provide feedback and share best practices.

A CSM will, as you’d expect, constantly monitor your glucose. Signos gives you pretty graphs on your phone and it integrates with Apple Watch so it’ll overlay exercises on top of the graph. You have to submit your own food journal so the exercise/diet full overlay over glucose takes shape.

The pitch is that you should keep your glucose in a narrow range. The Signos app is designed heavily around weight loss vs. any other health outcomes, so the theory is if you take a walk when your glucose spikes after a carb-heavy meal, you can be in a weight-loss window. Or avoid the foods you know spike your glucose.

Even though I am not new to glucose monitoring (I had gestational diabetes during my second pregnancy so had the joy of poking myself 6-7 times a day with a needle to get a glucose reading), I find that having a constant view of my glucose level is eye-opening and highly impactful. I am seeing how my mood and energy correlate to spikes in my glucose, as well as what actually happens during my sleep. I am optimistic about the insights I will get with this level of visibility and be able to tweak diet, exercise, and sleep accordingly. I have already declined to get my own scoop of ice cream twice (I did still have a bite from my kids’ though).

In addition to the monitoring, I am also reading two books:

Glucose Revolution by Jessie Inchauspe (#glucosegoddess on Instagram):

If you buy the premise that the key to better control of PCOS and your weight is by balancing your blood sugar, then Jessie has some simple actional hacks to help such as adjusting the sequence of food intake during your meal (the ideal order is fiber, protein/fat, carbs/sugar), and adding vinegar to your diet (maybe this explains why the Brits serve malt vinegar with french fries).

Additionally, I have purchased and plan on reading Beyond the Pill by Dr. Jolene Brighten.

Like so many women who were diagnosed with PCOS many years ago, the only solution offered and well understood at the time by endocrinologists was to be put on hormonal therapy (aka birth control) to manage this disorder. While I was able to get pregnant without serious interventions (though I did use progesterone pills), I am now curious and interested in understanding if I can get my body back and stop pumping hormones into it. It has been 20 years since I have seriously revisited the topic of what would it look like to cure PCOS - and books like Beyond the Pill at least tackle the issue and propose other options.

If you have come across other books, podcasts, or blogs on these topics, please share them with me.

🍏 Adjust food: Trying Weight Watchers

My personality requires external accountability in order for me to limit the number of desserts, alcohol, and delicious and rich meals that I consume. I have tried a variety of apps/programs over the years - South Beach Diet, Keto, Whole30, Paleo, and Noom to name a few. I have liked them all for different reasons, but seeing as I love gadgets and apps, I thought I would try Weight Watchers for a bit as well. In the past I have dismissed it because I was under the impression that WeightWatchers was mostly about their proprietary food and recipes but it is actually another way to gamify what you eat to try to fit into a budget that is set for you.

What I like about Weight Watchers is that it’s really about looking at your entire week and thinking about how you will spend your “points.” So it feels less daunting to slip up for a day or two, because there is a buffer of extra calories that you are able to tap into. I also like that you can earn extra “points” by exercising or eating more vegetables - so the right behaviors are incentivized.

What I don’t like about it: it heavily incentivized low-fat and artificial sweeteners, which isn’t quite right for me as I try to include good fats in a moderate amount into my diet. I also wish that there could be a common repository of food logging (the best one I’ve seen is the one that MyFitnessPal has) that all apps can integrate with.

I’ve been doing it for a couple of weeks and so far I am seeing positive results of losing about a pound a week. I have learned that losing more than that is unsustainable and less is not enough.

🏃‍♀️Be more strategic about exercise: Move after meals

I have now had a Peloton for over a year and have been going to F45 Strength Training on and off since early 2020. I love the combination of having an in-person boutique gym as well as classes on the go (for when I travel) as well as a stationary bike for when getting outside is not possible.

But as I study more about glucose and sugar, I am seeing that a key thing that I need to do is to move after most of my meals for 10-20 minutes. So that’s my goal - plan some amount of exercise to happen after meals to help me stabilize my glucose levels.

I am excited about longer days in the summer and being able to go on a walk with the kids or a friend after dinner.

🍃Try homeopathic remedies

About a year ago, I saw a homeopathic practitioner and was encouraged by all the vitamins and natural supplements that exist that can also help with PCOS by supporting my body in putting in place the right building blocks. I stopped at the time because the ACL injury took all my attention, but now I am going to revisit the approach we have landed on.

Some of the recommendations based on the blood work that we did included adding things like Ashwagandha, Vitamin D, and Vitamin B Complex to help balance out my body. I am hoping that with these natural remedies, my sleep and mood will also improve which is key to balancing out the glucose spikes.

💪🏻 All this amounts to getting off hormones

My goal with all this is to get my body to no longer be diagnosed with PCOS. I am encouraged by friends and acquaintances who have shared their success stories (usually involving lifestyle adjustments). After 20 years of this feeling like a given, it is exciting to explore what it would take to take this diagnosis into my own hands and give it my all to remove medical hormones from my body. Having said that, I am not interested in never having dessert again. So the goal for me is to find the right balance and maintain it.

This has been an awkward post to write - discussing weight, stress, and food battles is vulnerable and a little scary. But I know that sharing this makes me feel less alone in this journey so I am grateful for our readers who give me this space and virtual companionship as I embark on this health journey.