By Dr. McKenzie Nisbet, ND

Body Fat & Blood Sugar

 

BODY FAT & BLOOD SUGAR

 

Weight gain and stubborn weight loss are common concerns in my practice. Poor dietary habits, sedentary lifestyles, nutrient deficiencies, under-active thyroid glands, hormone imbalances, blood sugar imbalances and insulin resistance are some of the many areas we address to promote sustainable weight loss. The latter two are especially common. Gaining control of your blood sugar and optimizing your insulin levels may be the missing piece of your puzzle to achieve balance and weight loss.

 

WHY DOES INSULIN RESISTANCE MATTER? 

Blood sugar imbalances and insulin resistance promote lipogenesis – fat storage. This means weight gain, which is linked to serious conditions such as type 2 diabetes, increased stroke risk, high blood pressure, high cholesterol, cardiovascular disease, Alzheimer’s, non-alcoholic fatty liver disease, sleep apnea, gallbladder disease, and polycystic ovarian syndrome (PCOS).

By stabilizing your blood sugar and re-sensitizing your cells to insulin you can stop the weight gain, promote weight loss and mitigate the conditions listed above. But there is no need to wait until a formal diagnosis is made to take action. In fact, insulin resistance and blood sugar imbalances often show up 10-20 years before a formal disease diagnosis is made. Take note of the signs of insulin resistance and start your prevention strategy now. Conditions like diabetes don’t show up overnight. The food you eat, your perception of stressors, how you spend your spare time, etc. will all either help or hinder your health. It is what you do daily matters. So, don’t wait for the diagnosis – start to identify signs and symptoms of insulin resistance and intervene early to help prevent the onset of disease and disability.

 

SIGNS & SYMPTOMS

  • Abdominal (visceral) fat
  • Difficulty losing weight
  • Cravings for carbohydrates or sugar
  • Fluid Retention & Bloating
  • Fatigue & Tiredness
  • Brain Fog & Poor Concentration
  • Headaches
  • Mood Swings, Anxiety & Irritability
  • Weakness
  • Insomnia
  • Dyslipidemia, such as increased cholesterol
  • Abnormal blood parameters, such as elevated CRP, hs-CRP, and ESR
  • Sleep-disordered breathing (sleep apnea)
  • Hormone dysregulation, such as PCOS (Anovulatory Androgen Dominance)

 

HOW DOES INSULIN RESISTANCE OCCUR?

When we eat, our blood glucose (blood sugar) levels rise which causes our pancreas to release insulin into the blood stream. Insulin’s job is to tell fat and muscle cells to absorb the glucose from the bloodstream. Any excess glucose gets stored in the liver as glycogen, which can be broken down into glucose when needed. This absorption causes the blood glucose levels to fall back to a normal level.

When we are insulin resistant, our fat, muscle and liver cells are less receptive to insulin. Therefore, more insulin is needed to persuade these cells to absorb glucose from the bloodstream. Our pancreas responds to the heightened blood glucose levels by producing more insulin (causing elevated insulin levels). Overtime the pancreas is unable to keep up with the demand for insulin and so glucose levels remain elevated in our blood stream. This high blood glucose result in pre-diabetes and eventually, type 2 diabetes.

 

HOW DO YOU STABILIZE BLOOD SUAGR & REVERSE INSULIN RESISTANCE?

The good news is there is so much you can do to reverse blood sugar imbalances and insulin resistance. This can be done via sustainable diet and lifestyle changes as well as supplementation to help give you a kick start!           

 

DIETARY MODIFICATIONS

Dietary changes such as avoiding processed foods, refined sugars, simple carbohydrates, and foods with a high glycemic index are a great place to start. Work on replacing these foods with a diet rich in whole foods, protein, fibre, healthy fats and vegetables! Following a Mediterranean diet, ketogenic or ketogenic-like diet, Whole 30 diet, or AIP (autoimmune paleo) diet can be helpful if you prefer a more structured approach to dietary changes. Intermittent fasting has also been shown to improve glucose and insulin parameters. Talk to your nutritionist or Naturopathic Doctor to determine the right approach for you! If you are type 1 diabetic or on blood glucose modulating / diabetic medication be sure to check with your medical or naturopathic medical doctor before making any major dietary or lifestyle changes.

 

NUTRACEUTICALS & BOTANICAL MEDICINE

Utilizing supplements along with dietary and lifestyle modification is a great way to improve your blood glucose and insulin levels. However, there are many products on the market promising to reverse diabetes or help you shed extra pounds that don’t actually have the research to back up their claims. When choosing to supplement you need to ensure it is the right substance, at the right dose and the right time. Your supplements should also be processed properly, be in the correct form to improve absorption (ie. capsule, tablet, liquid, powder, etc), not include any fillers or dyes, and be selected based on your specific needs.

Nutrients such as chromium picolinate and inositol have been shown to help improve insulin sensitivity. Myo- and d-chiro- inositol in particular, have been shown to mimic insulin and reduce postprandial glucose levels (reduce the spike in blood sugar after eating). Botanicals such as Vaccinium (Blueberry), Trigonella foenum-graecum (fenugreek), Ocimum santum (Holy basil), Cinnamomum spp.(Cinnamon) and Gymnema sylvestre (Gymnema) have all shown to be effective at blood sugar balancing. Gymnema, for example, has been shown to help control sugar cravings, modulate insulin secretion from the pancreas and reduce absorption of sugar molecules in the intestine, therefore reducing blood sugar.

It is a common misconception that “natural” is equivalent with “safe”. If you are considering approaching your blood sugar imbalances or insulin resistance from a more natural approach be sure to work closely with a Naturopathic Doctor. This is especially important if you are currently on medication or have a formal diabetes diagnosis.

Want to learn more? Set up a free 15-minute meet and greet appointment and let’s chat!

 

      https://www.ncbi.nlm.nih.gov/pubmed/2240915/,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/, https://www.ncbi.nlm.nih.gov/pubmed/6836034,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912882/, https://www.ncbi.nlm.nih.gov/pubmed/19761040,https://www.ncbi.nlm.nih.gov/pubmed/15487760,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5078644/,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027050/

By Dr. McKenzie Nisbet, ND

4 Drivers of PCOS

THE 4 DRIVERS OF PCOS

 

Polycystic Ovarian Syndrome (PCOS) affects 1 in 10 women of reproductive age. Before reading this article make sure you check out “What is PCOS? (and Why It Needs a New Name)” to learn about what qualifies as PCOS and how to get an appropriate diagnosis.

When it comes to treating PCOS you need to look deeper than the irregular periods, acne and androgen excess. You need to look for the underlying cause. Why is your cycle irregular? Where did the acne come from? Why are your hormones unbalanced in the first place? The answer can typically be boiled down to one (or more) of these four main drivers of PCOS. Once you know your driver(s) you can address the cause of your PCOS– not just the symptoms.

 

INSULIN RESISTANT PCOS

This is the most common driver, affecting up to 70% of women with PCOS. Insulin resistance impairs ovulation (a key feature in PCOS) by affecting androgen levels, LH levels, and proteins that bind to hormones in your blood.

[INSULIN RESISTANCE – Insulin’s job is to help move glucose (fuel from food) from your blood into your cells. Insulin resistance occurs when your cells, for various reasons, become resistant to the signalling power of insulin.]

Insulin resistance occur due to smoking, stress, sleep deprivation, alcohol, trans-fat, unhealthy gut bacteria, magnesium deficiency, and environmental toxins. All of which are very prevalent in North America.

Simple blood tests can be run to determine if you have insulin resistance. We can then target the causes of insulin resistance in your life. Lifestyle and dietary changes coupled with strategic supplementation can help reduce your body’s resistance to insulin and therefore improve your PCOS.

 

POST-PILL PCOS

The second driver of PCOS is the hormonal birth control pill. Studies show a link between the pill and androgen levels, insulin resistance, and (by design) an inhibition of ovulation.

After coming off the hormonal birth control pill your body is adapting to the removal of this hormonal ‘control’. Not everyone will experience unwanted changes when stopping the pill. However, if you’ve had menstrual issues or hormonal imbalances before starting the pill, you will likely experience some when stopping. These may include acne, unwanted hair growth, irregular periods, dysmenorrhea (painful periods), PMS (premenstrual syndrome), and/or a rise in androgens (especially if on an anti-androgen pill – commonly chosen if acne was a concern). Due to these changes you may fit the diagnostic criteria for PCOS. For many, post-pill PCOS is temporary and may resolve on its own with time. Strategically addressing hormonal imbalances and other minor/co- drivers can help resolve your PCOS and regulate your cycle sooner, helping you get back on track.

Talk to your health care provider about what to expect when coming off the pill so you know what is normal and what requires further investigation. Be sure to track your cycle while coming off the pill so you know if your body is adapting appropriately. To help reduce unwanted changes talk to your Naturopathic Doctor about how to prepare your body for this hormonal shift before you stop the pill.

 

INFLAMMATORY PCOS

Inflammation and environmental toxins are the third driver of PCOS.

Studies show endocrine disrupting chemicals (EDCs) such as bisphenol A (BPA) and phthalates may cause reproductive health problems such as infertility, premature ovarian failure, abnormal hormone levels (ie. excess androgens), and reduced ovulation. Studies also show that women with PCOS have higher levels of BPA in their bodies.

How do you combat this driver? You reduce your exposure. Removing many EDCs can be quite easy.

First: identify your exposures to ECDs.

Second: remove or replace these exposures with less harmful alternatives.

There are 3 easy places to start:

  1. Simply switching from plastic to glass – water bottles, kitchen containers, and choosing foods sold in glass containers.
  2. What you put on your body (shampoo, conditioner, body wash, face wash, moisturizer, make-up, hand soap, laundry detergent, etc).
  3. What you use to clean your house (kitchen cleaner, sprays, deodorizers).

For #2 and #3 visit ewg.org/SkinDeep and download the app “Think Dirty” on your phone. Type in the name and brand of the products you use. Each database will rank the products as Low-Hazard/Neutral (0-2), Moderate-Hazard/Half-and-Half (3-6), or High-Hazard/Dirty (7-10). Aim to replace your moderate/high-hazard products with low-hazard products to help reduce your exposure to harmful chemicals. You can do this all right away or over time – even one small change helps!

 

ADRENAL PCOS

If you have PCOS the main driver is likely one of the three mentioned above. In rare cases your adrenal glands may be the sole driver of your PCOS.

Your adrenal glands sit on top of your kidneys. You probably know them as the producers of cortisol (the stress hormone). But cortisol isn’t all these glands produce. DHEA-S (an androgen) also comes from the adrenal glands. Excess DHEA-S is linked to the presentation of PCOS and may be the only elevated androgen in up to 10% of PCOS patients.

To reduce this driver of PCOS first take a look at where your stress comes from. Is it family? Friends? Your relationship? Job-related? Finances? It’s likely a combination of a few, and at least one daily. So, what are you doing daily to reduce this stress?

Pick one of these stress-reduction techniques to try this week!

Mindful meditation. Download the app “Headspace.” This app contains guided mediations to help you master the skill of meditation.

Journaling. Use a regular notebook or one designed for mindfulness, such as “The Five Minute Journal.” Get your emotions and thoughts down on paper to help keep your mind clear.

Talk it out. Perceived social support is a strong protective factor for both depression and anxiety and helps foster coping strategies.

Nature Walks. Studies show spending time in nature can help reduce stress levels. This is also a great option for anyone who has difficulty with stationary meditation.

Working to reduce your stressors and your perception of these stressors can help ease the pressure on your adrenal glands. This can be done on your own or with the help of a professional (such as a psychotherapist). Nutraceuticals and botanical medicine can also be used to support your adrenal glands and modulate your stress levels. By improving adrenal function we can improve adrenal-driven PCOS.

That sums up the four main drivers of PCOS, but it is important to note there are other factors that may also be contributing to your PCOS. These include thyroid dysfunction, nutrient deficiencies, dietary restrictions, and elevated prolactin. Be sure to consult healthcare professional to ensure you are getting the appropriate testing and that all of your drivers of PCOS are being addressed.

To learn more book an appointment or a free 15-minute consultation here, or send me a private message here and get to know your options.

 

Resources:
INSULIN RESIATNCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872139/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018970/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334071/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680959/; Briden, Lara. Period Repair Manual. Lexington: 2015. OCP: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135453/, https://www.ncbi.nlm.nih.gov/pubmed/22811306/, https://www.webmd.com/sex/birth-control/stopping-pill-10-ways-body-changes#1; ENVIRONMENTAL: https://www.ncbi.nlm.nih.gov/pubmed/27559705, https://www.ncbi.nlm.nih.gov/pubmed/21193545, https://www.ncbi.nlm.nih.gov/pubmed/26063868; INFLAMMATORY: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245829/; ADRENALS: https://www.ncbi.nlm.nih.gov/pubmed/17932770, https://www.ncbi.nlm.nih.gov/pubmed/18950759. https://www.ncbi.nlm.nih.gov/pubmed/27336356, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772979/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709294/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921311/, image: http://www.thevitpro.com/uploads/8/4/1/7/8417615/303034.jpg

 

By Dr. McKenzie Nisbet, ND

What is PCOS? (and Why It Needs a New Name)

WHAT IS PCOS? (and Why It Needs a New Name)

 

PCOS is Polycystic Ovarian Syndrome and affects around 1 in 10 women of reproductive age.

The hallmarks of PCOS are anovulation (lack of ovulation) and high levels of androgens (such as testosterone). The signs and symptoms of PCOS can vary woman to woman and include: anovulation (determined by tracking your cycle), amenorrhea (no period), irregular periods, hirsutism (excess facial hair), acne, hair loss, weight gain, and/or infertility.

 

To be diagnosed with PCOS you must meet a set of criteria. The two main ones are the: “Rotterdam Criteria” and “Androgen Excess Society Criteria.” I prefer the “Androgen Excess Society Criteria” because it emphasizes the importance of anovulation and androgen excess.

The Rotterdam criteria does not require androgen excess and instead puts equal emphasis on “polycystic ovaries”. You may be asking: Why is this an issue? The name is “polycystic ovarian” syndrome? Shouldn’t that be a key player in diagnosing PCOS? This is why PCOS needs a new name.

Polycystic ovaries are not specific to women with PCOS. Polycystic ovaries are a normal finding in 23% of women (reporting no menstrual irregularities, no infertility, and no abnormal hair growth). Whether or not you have polycystic ovaries, cannot rule in or out PCOS. Therefore a name such as ‘Anovulatory Androgen Excess’ would be much more appropriate.

 

If you think you have PCOS, it is important that a proper diagnosis is made. If you have been diagnosed with PCOS only based on the results of a ultrasound talk to your healthcare provider about being reassessed. This involves a thorough evaluation of your menstrual cycle, acne, weight, and hair growth, as well as comprehensive laboratory testing (including androgens).

Based on your individual presentation of PCOS a unique treatment plan can then be created. In general, this involves addressing one (or more) of the four main drivers of PCOS: insulin resistance, a hormonal imbalance from stopping the birth control pill, inflammation, or adrenal abnormalities.

 

Questions? Send me a message here or book a free 15-minute discovery session here.

 

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563096/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872139/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069067/
Body Fat & Blood Sugar
4 Drivers of PCOS
What is PCOS? (and Why It Needs a New Name)