Symptoms of Insulin Resistance
Weight gain
Sugar cravings
Skin tags
Hypoglycemia
Rough or red bumps on upper arms
Dark skin patches on neck, knees, elbows, knuckles, chest, or groin
In a healthy system, insulin plays an important role in metabolism. This powerful hormone is produced by the pancreas and enters the bloodstream after a meal. Its main function is to transport glucose to cells throughout the body to be used for energy. When there is excess glucose, insulin delivers the glucose to muscles, fat, and the liver, which helps to lower the blood glucose levels by storing it and signaling the body to slow production of insulin. But in an unhealthy system, insulin resistance and hyperinsulinemia may result.
Between 50 and 70 percent of women with PCOS have some degree of insulin resistance. Insulin resistance may be caused by poor diet, ethnicity, certain diseases, hormones, steroid use, some medications, older age, sleep problems, and cigarette smoking. Although insulin resistance is often associated with obesity, research indicates that lean PCOS patients are also prone to insulin resistance. Research also indicates that the birth control pill may cause insulin resistance in all women, particularly those with PCOS.
Insulin resistance occurs when a person’s body does not react properly to the amount of insulin in the bloodstream. In a healthy system, after a meal, the pancreas creates insulin to balance the glucose in the blood. Ideally, the body detects if the level of glucose in the blood is still too high and signals the pancreas to create more insulin. The hope is that since there is more insulin, more glucose will be picked up.
Insulin in large quantities can be toxic to cells, so when there is too much insulin in the body over time, cells become insulin resistant in order to protect themselves. Alternatively, the hypothalamus may become insulin resistant and continue to send signals to the pancreas to create more insulin unnecessarily. When insulin resistance occurs, the insulin does not pick up or cannot deliver the glucose to the cells that need it. Glucose levels in the blood remain high, and diabetes and other serious health disorders may result.
Hyperinsulinemia results when more insulin is present in the bloodstream than is considered normal, usually as a result of insulin resistance. Although it is associated with diabetes, someone with hyperinsulinemia does not necessarily have diabetes.
Insulin resistance and hyperinsulinemia create a self-perpetuating and destructive cycle called the insulin resistance cycle. Insulin resistance creates chronically high levels of insulin, and those chronically high levels bombard cells, forcing them to protect themselves, thus perpetuating insulin resistance. Eventually, your pancreas can no longer keep up with the insulin demand. This means there is less insulin in the body to store and regulate glucose levels, and the result is diabetes.
In addition, high levels of insulin and insulin resistance sometimes pave the way for hyperandrogenism, excessive levels of male hormones. This may be the cause of missed periods and infertility in some women with PCOS. The relationship between hyperandrogenism and hyperinsulinemia in women with PCOS is unclear. Researchers disagree about whether hyperinsulinemia causes hyperandrogenism, hyperandrogenism causes hyperinsulinemia, or a third cause is responsible for both. One way or the other, we have a destructive cycle: insulin resistance leads to hyperandrogenism, which increases insulin levels.
A top priority of the Healing PCOS 21-Day Plan is to get your insulin under control.
HORMONE IMBALANCES
When my hair started falling out during high school, my mom took me to a dermatologist who did a scalp biopsy. When it came back negative, the hair loss as well as other symptoms such as fatigue, acne, and sporadic periods were written off as a result of stress. Things got worse as I grew older. I began gaining weight, growing facial hair, experiencing anxiety and depression, and still fighting the symptoms I had since puberty. The birth control pill that was supposed to be my “quick fix” manipulated my hormones, leaving me feeling moody and dull. I wish that I had had a better understanding then of how my hormones work and how hormone imbalances caused by diet and lifestyle choices could be the source of my symptoms.
Hormones are responsible for keeping your major bodily functions running smoothly, so when hormone levels become imbalanced, you’ll feel the effects in many ways. Hirsutism, acne, hair loss, higher stress levels, mood disorders, depression, anxiety, and infertility can all result.
The most common hormones that become imbalanced and the ones that you will learn to manage with the Healing PCOS 21-Day Plan are androgens, cortisol, progesterone, estrogen, and thyroid hormones.
Androgens: Androgens are male hormones, such as testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEA-S). In males, these steroid hormones are responsible for sexual development and muscle mass. In women, they play a much subtler, though no less important role. Among other things, they help us maintain muscle mass, regulate our weight, and keep our libidos humming. They are produced in the ovaries, adrenal glands, and fat cells. The problem isn’t that women with PCOS have androgens; it is that we typically have an excess. This androgen excess, or hyperandrogenism, affects about 25 percent of women with PCOS and is often the root cause of common symptoms such as hirsutism, acne, hair loss, and infertility.
Androgen excess may be caused by:
Ovarian dysfunction, which causes the ovaries to produce excess testosterone.
Insulin resistance, which signals the ovaries to produce excess testosterone.
Stress, which taxes the adrenal glands and stimulates the production of androgen hormones. For this reason, women with PCOS should practice stress relief from an early age.
Early adrenal activation, which initiates early puberty and correlates with increased lifelong androgen formation. Girls who experience early puberty may have an increased risk of developing PCOS.
Obesity.
Genetics.
Taking artificial hormones in birth control.
Individual hypersensitivity to a normal amount of androgen.
A defect in the hypothalamus, a part of the brain responsible for regulating the production of many hormones, including androgens.
Cortisol: Women with PCOS often make too much cortisol, the “stress hormone” produced in the adrenal glands. In fact, research indicates that many women with PCOS may naturally have higher cortisol levels. Being overweight also increases cortisol production.
Raised levels of cortisol change the way your body manages other critical hormones, putting you at risk for insulin resistance, anxiety, depression, and thyroid dysfunction. In addition, the overproduction of cortisol can overwork the adrenals to the point of adrenal fatigue. For this reason, stress—emotional or physical—takes more of a toll on women with PCOS than on those without it.
Progesterone: Progesterone is a hormone, produced mainly in the ovaries, that plays an important role in the menstrual cycle and maintaining and nourishing the body during pregnancy. After ovulation each month, progesterone helps thicken the uterine lining in preparation