Understanding Insulin Resistance

A lot of women with PCOS are insulin resistant (IR). For some IR has been shown to be the cause of their PCOS. If your PCOS is caused by IR, with lifestyle modifications alone, you can effectively decrease the severity of your symptoms and lead a better quality of life. To do so, you need to understand insulin resistance. 

Insulin Resistance (IR) as the name suggests, is a condition where the body becomes resistant to the hormone insulin. 

How does this happen?

Insulin is the hormone that helps to regulate blood sugar levels. When foods that contain carbohydrates are digested, they break down into glocuse (sugar) which is absorbed into the blood. This causes a spike in blood sugar levels. To counter that, the body releases the hormone insulin which helps bring down the blood sugar back to normal range. 


In people with insulin resistance, the cells in their body are less receptive to the hormone insulin. So when their blood sugar goes up and insulin is released, it has no effect on their blood sugar. This causes the blood glucose level to remain high. Because the cells are not responding, the body releases more and more insulin, in an attempt to bring the blood glucose back down to normal range. 
As a result, they not only have high blood sugar, they also end up with high levels of insulin circulating in the body which in turn leads to other hormonal disruptions that manifest as PCOS. Left unchecked, a person who is insulin resistant will go on to develop Type II Diabetes. 


You can find out if you are insulin resistant through a blood test. Without a blood test, if you notice your PCOS symptoms worsen as you put on more weight, then you probably have IR. Other symptoms of high blood sugar are:

• Fatigue
• Brain fogginess/inability to focus
• High blood sugar
• Sleepiness
• Intestinal bloating
• Weight gain
• Increased blood fat levels
• Increased weight gain
• Depression
• Dark patches on the skin

That's the short of it. You can read the long of it by clicking here. 


The best diet for someone with IR is a Low Glycemic Index Diet. The glycemic index measures the effects of certain foods on the blood sugar levels. The higher the GI value of a food, the higher it raises your blood sugar and you do not want that. So, you want to consume foods with a low GI so that your blood sugar levels are constant and your body doesn't need to pump out so much insulin.  


*


I've decided to tackle this topic bit by bit. Coming next next: The 10 Minute Diet Guide to Reducing Insulin Resistance.

On Track

My appointment today went well, despite the fact that two different guys rooted around in my vagina. The first guy I saw took down my history and did a physical exam and took some cervical swabs. While this was going on me and the nurse were discussing weight loss strategies. Coincidentally she too has PCOS and has been TTC for 8 years (we had a little chat on the side). After he was done, I saw the specialist, who did an intra-vaginal ultrasound. Unfortunately my ovaries are still coated in cysts. I saw them with my own eyes for the first time; both of them! They were beautiful, in a get-the-hell-away-from-there sense.

The specialist was very happy that I'd lost a lot of weight on my own, and I didn't even ask about Met, he prescribed it right away! He also said that my signs are all positive, and that his gut feeling tells him that I may ovulate on my own with continued weight loss. He said I should carry on with that and the Met, and hopefully something positive will happen but if I don't, I should come back again in 6 months (I'm praying I wouldn't have to; kind, sweet & understanding as he was, I'm not looking forward to a second encounter).

Well... so that's that then. I'll keep loosing weight, eating right, exercising, taking Met and keeping my friggin fingers crossed. I also have a scheduled hormone test on the 9th of June. Hoping they're all within range too.

I do wonder though if it is wise to take Metformin while on a Low GI diet. As usual I was too overwhelmed to ask the doctor there and then. Why do I only remember these things when I get home?

The whole point of a low GI diet is to eat foods that do not cause your blood sugar to rise sharply. And the purpose of Met is to make sure your blood sugar doesn't rise sharply... doing both seems like an over kill. I'm thinking, will I have ANY blood sugar at all?

Gynea Appointment

Not been blogging much lately. Dh's laptop kicked the bucket and he has tonnes of assignment so he's been borrowing mine.

**

Tomorrow is my first gynea appointment. When I was referred in early March, I hadn't had AF in 6 months. My doctor found that my womb lining was extremely thick after doing an ultrasound and she feared there was nothing more she could do to help, so she referred me.

While waiting for a referral, my first line of action was to grab my fertility by the balls and loose some weight. So far I've lost 14kg, and I've had AF every month. Almost all my symptoms have disappeared - acne,  dodgy hairs on my chest, chin and upper lip, eye brows that look like slugs, no periods, fatigue, general shittiness and low self-esteem - except for lack of ovulation.

I don't know what to expect tomorrow.... I don't know of my PCOS is caused by insulin resistance. I hope they will do a test to confirm if I'm insulin resistant. If I am, obviously, I will ask to be put on metformin, considering how much weight I've already lost on my own. A lot of women have ovulated while on met, if that's my situation, I hope to be one of them. I am also hoping they would do a scan to see if my tubes are healthy and unblocked and how much cycts I still have left. I'm keeping my fingers crossed and hoping those little bastards have vacated my ovaries!

Anyway, I pray it goes well. I know the NHS has it's shortcomings, so I'm prepared to take whatever comes my way without getting frustrated. It's about time I had professional attention. I've been battling this on my own for some time now.That loneliness in not understanding what was going on is one of the reasons I started this blog. I need an expert to help me achieve my goals. I'm tired of GP's telling me there's 'nothing they can do' or to 'keep loosing weight'.

We'll see how tomorrow goes. Wish me luck!

The Oats Got Me!!

I'm sick and tired of eating oats every single day. When I started low carbing, I was all gungho for oats, my freaking taste buds couldn't get enough. I've gradually grown into it, I'm pretty sure if you checked my DNA now you'll find strands of oat RNA lodged somewhere. There's just way too much fibre that I'm shitting twice a day now.

It's Muesli for breakfast, brown basmati rice and veggies for lunch and fruits for dinner or oat cake or oat flapjacks!

Let's look at other alternatives: there's bran, which I hate. Nothing can make bran sexy for me. Ever! You can give it all the plastic surgery in the world and it will still be bran to me. There's rye bread which I tried, but hated. It tasted too yeasty for me, reminded me of one guy that stood behind me while we were queueing up at the bank. His freaking alcoholic breath kept wafting into my nose. And when I moved forward, and away from him, he'd close the gap. People whose breaths reek of alcohol shouldn't be too conscientious about 'closing the gap' whenever they're in a queue. I didn't say anything, I didn't even want to see his face because I know it will be registered in my twisted mind for the rest of his life.

Then there's shredded wheat, which I love and apparently has a GI of 67, what can I do to lower it further? And of course, I hate bread because if I can't have it with jam or honey, I'd rather not have it at all. What else is there that's low carb and doesn't make me seethe with raw anger as I chomp down every bite?

What the heck else is out there, for crying out loud!!

I hate this shit! I'm a free spirited woman, nobody tells me what to eat or when or how or with whom or with what and why. I come and go like the freaking breeze! Low carbing is the only 'diet' I've ever stuck to for this long because it's the only one that's worked so far. Reverting to my previous lifestyle will be like purposely entering an elevator alone with a serial rapist. So I'm not going anywhere, you hear me, you low carb bastard!

Excuse me while I go on a fact finding mission *Off to the library* Got to find me some breakfast alternatives before I stab someone out of frustration. I can imagine the story breaking on BBC and there I am being hauled away screaming, 'It's the oats! The oats got me!!'

The Truth About Carbohydrates

I was forwarded this article from Sparkpeople which I'm subscribed to. It's concise and straight forward facts about our favourite food group. I have reproduced it here, though you can also read it by clicking on the link.

**

It’s true. A carbohydrate-rich diet can inflate appetite and girth. Low-carb diets do promote short-term weight loss, but are accompanied by some severe dangers. So what should you do? The truth is, you can have your carbs and eat them too—you just have to know how to choose them. 

The Truth about Carbohydrates

• Carbohydrates are the body's ideal fuel for most functions. They supply the body with the energy needed for the muscles, brain and central nervous system. In fact, the human brain depends exclusively on carbohydrates for its energy.
• Carbohydrates are found in fruits, vegetables, beans, dairy products, foods made from grain products, and sweeteners such as sugar, honey, molasses, and corn syrup.
• The body converts digestible (non-fiber) carbohydrates into glucose, which our cells use as fuel. Some carbs (simple) break down quickly into glucose while others (complex) are slowly broken down and enter the bloodstream more gradually.
• During digestion, all carbohydrates are broken down into glucose before they can enter the bloodstream where insulin helps the glucose enter the body’s cells. Some glucose is stored as glycogen in the liver and muscles for future use, like fueling a workout. If there is extra glucose, the body will store it as fat.

All carbohydrates are not created equal. 
There are basically three types of carbohydrates: 

1. Simple carbohydrates are composed of 1 or 2 sugar units that are broken down and digested quickly. 
   
   Recent research has shown that certain simple carbohydrate foods can cause extreme surges in blood sugar levels, which also increases insulin release. This can elevate appetite and the risk of excess fat storage. 
2. Complex carbohydrates (also referred to as starch) are made up of many sugar units and are found in both natural (brown rice) and refined (white bread) form. They are structurally more complex and take longer to be broken down and digested. 
   
   Complex carbohydrate foods have been shown to enter the blood stream gradually and trigger only a moderate rise in insulin levels, which stabilizes appetite and results in fewer carbohydrates that are stored as fat. Unrefined or ‘whole grain’ carbohydrates found in products like brown rice, whole wheat pasta and bran cereals are digested slowly. They contain vitamins, minerals and fiber which promote health. Fiber and nutrient-rich vegetables, fruits and beans which are carbohydrates also have many important functions for the body and are important for good health. 
3. Indigestible carbohydrates are also called fiber. The body is unable to breakdown fiber into small enough units for absorption. It is therefore not an energy source for the body but does promote health in many other ways.

Simple carbs, complex carbs, and fiber are found in many foods. Some provide important nutrients that promote health while others simply provide calories that promote girth. 

• Sugar, syrup, candy, honey, jams, jelly, molasses, and soft drinks contain simple carbohydrates and little if any nutrients.
• Fruits contain primarily simple carbohydrate but also valuable vitamins, minerals, fiber, and water.
• Vegetables contain varying amounts of simple and complex carbohydrates, vitamins, minerals, fiber, and water.
• Legumes such as beans, peas, lentils and soybeans contain complex carbohydrates, fiber, vitamins, minerals, and protein.
• Milk products contain simple carbohydrates along with protein, calcium and other nutrients.
• Grain products contain complex carbohydrates, fiber, vitamins, minerals, and protein. The amounts vary depending on the type of grain used and the amount of processing. Selecting whole grain options whenever possible is recommended.

What You Should Know About Low-Carbohydrate Diets
Following an extremely low-carbohydrate diet is disastrous, dangerous, and above all—boring! Carbohydrates are NOT the enemy. Including the appropriate amounts and types of carbohydrate-rich foods in your diet is essential for long-term health and weight loss/maintenance. 

The Body’s Immediate Reaction to Very Low Carbohydrate Diets 
When there is a severe deficit of carbohydrates, the body has several immediate reactions: 

• With no glucose available for energy, the body starts using protein from food for energy. Therefore this protein is no longer available for more important functions, such as making new cells, tissues, enzymes, hormones, and antibodies and the regulation of fluid balance.
• When carbohydrates are lacking, the body cannot burn fat in the correct way. Normally carbs combine with fat fragments to be used as energy. When carbs are not available, there is an incomplete breakdown of fat that produces a by-product called ketones. These ketones accumulate in the blood and in the urine causing ketosis, which is an abnormal state. Ketosis does cause a decrease in appetite because it's one of the body's protection mechanisms. It's an advantage to someone in a famine (which the body thinks it's experiencing) to lack an appetite because the search for food would be a waste of time and additional energy.
• Due to the lack of energy and the accumulation of ketones, low-carb diets are often accompanied by nausea, headaches, dizziness, fatigue, bad breath, and dehydration.
• Because of dehydration and a lack of fiber, constipation can result.
• Exercise and fitness performance is reduced on a low-carb diet. Do not be surprised if your energy level is so low that you cannot make it through your normal workout routine.

The Long-Term Effects of Low Carbohydrate Diets 
When you severely restrict carbohydrates, your consumption of protein and fat increases, which has several long-term effects: 

• The risk of many cancers increases when fruits, vegetables, whole grain products, and beans are eliminated from the diet.
• Protein foods are also high in purines, which are broken down into uric acid. Elevated levels of uric acid in the blood may lead to needle-like uric acid crystals in joints, causing gout.
• Kidney stones are more likely to form on high protein, ketosis-producing diets.
• Over time, high protein diets can cause a loss of calcium and lead to osteoporosis.
• The risk of heart disease is greatly increased on a low-carb diet that is high in protein, cholesterol, fat, and saturated fat. A temporary reduction in cholesterol levels may be experienced, but this is common with any weight loss.

The Million Dollar Question
How do you include carbohydrates in you diet in a safe, effective, and controlled way? The “Please KISS Me” (Please Keep It So Simple for Me) plan for carbohydrate control is a wonderful tool that only contains 3 simple rules: 

RULE 1: Include the following in your diet: 

• Fruits: 2-4 servings daily
• Vegetables: 3-5 servings daily
• Whole grain breads, muffins, bagels, rolls, pasta, noodles, crackers, cereal, and brown rice: 6-11 servings daily
• Legumes, beans and peas: 1-2 servings daily
• Low-fat and non-fat dairy products: 3 servings daily

RULE 2: Limit the following to less than 2 servings daily: 

• Fruit Juice
• Refined and processed white flour products (bread, muffins, bagels, rolls, pasta, noodles, crackers, cereal)
• White rice
• French fries
• Fried vegetables

RULE 3: Eliminate the following from your diet or eat only on occasion: 

• Sugary desserts, cookies, cakes, pies, candies
• Doughnuts and pastries
• Chips, cola and carbonated beverages
• Sugar, honey, syrup, jam, jelly, molasses

That’s it! A simple, effective carbohydrate-controlling plan that, when combined with your SparkDiet, allows you to reap the countless benefits of complex carbohydrates and fiber while enhancing your health and maintaining a healthy weight. The long term result will be a healthy you!


**