11 January 2017

Gluten and PCOS Connection

I am often visited by clients who have PCOS, an endocrine disorder that impacts 5-10% of women worldwide. The true cause of PCOS is not yet known but experts believe it is due to the excess production of androgens, the male sex hormones. It was first recognized in 1935 by gynecologists as a cause for menstrual irregularities. However, it is now associated with a number of health problems like reproductive issues and metabolic disturbances.

Women with PCOS are generally obese are often advised by health experts to lose weight. Studies also confirm that even a marginal drop of 10% of body weight help to subside some of the symptoms of PCOS. Like most of my fellow nutritionists, I also used to prescribe my PCOS clients a low carb. diet for losing weight. Although my diets helped all my clients lose weight but what I noticed is some of the clients were still not very happy even after losing weight. They were still feeling bloated, constipated and had other health issues associated with PCOS. So I decided to do some research on it and what I found was something I could never have imagined – the gluten connection.

Though the research on this is still scarce but I have reasons to believe that your PCOS might be due the gluten in your diet. Initially I myself was a bit skeptical while introducing gluten free diet to my patients who despite weight loss were not reporting of much improvement in their symptoms. But to my utter amazement, I found all my patients who were complaining earlier now reported a marked improvement in their symptoms after following a strict Gluten free diet for 2-3 weeks.  However, I still do not advise gluten free diet to all my PCOS clients but I do get them all tested for gluten allergy before starting with the diet. And in case the tests are negative, I start with a normal PCOS weight loss diet and only if they report of no significant improvement in symptoms despite weight loss I put them on a gluten-free diet and till date it has not failed me.

Now let’s have a look at some of the facts on how gluten is related to PCOS.

GLUTEN AND PCOS CONNECTION


Gluten-a hormone disruptor:  Gluten is a known hormone disruptor in both males and females. Hormones disruptors are substances that interfere with the working of the endocrine system. They cause our bodies to over respond or under-respond to the release of hormones.
In polycystic ovarian syndrome, the hormones are already out of whack and inclusion of gluten contributes to further imbalance.

Gluten and Insulin Resistance: Several studies 1 have suggested that a diet high in gluten leads to the development of insulin resistance. This is because gluten acts directly on the islet cells of the pancreas responsible for the production of insulin and damages them.

Studies have now also proved that PCOS is associated with insulin resistance as well as with defects in insulin secretion 2. Insulin resistance is a condition where the cells of the body become less responsive to the effect of insulin. As a result, more insulin is then required to keep the blood sugar levels under control. Here is a very good definition of insulin resistance from medicine.net. “The diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues.  It is as if insulin is "knocking" on the door of muscle. The muscle hears the knock, opens up, and lets glucose in. But with insulin resistance, the muscle cannot hear the knocking of the insulin (the muscle is "resistant"). The pancreas makes more insulin, which increases insulin levels in the blood and causes a louder "knock." Eventually, the pancreas produces far more insulin than normal and the muscles continue to be resistant to the knock”. The increasing levels of insulin in the blood results in hyperandrogenism 2 (over production of androgens) which may ultimately lead to the development of PCOS.

Gluten and Chronic Inflammation: Polycystic ovarian syndrome is an inflammatory process 3, 4. Research suggests that PCOS women have higher markers of inflammation than women without this syndrome 3. Gluten present in wheat and other related grains is a known irritant and a contributor to chronic inflammation. Eating gluten or related products only exacerbates the inflammation problem in PCOS women.

SUMMING IT UP

There is no double-blind research, as on date, to show a connection between gluten and PCOS. However, if you are suffering from PCOS and not seeing any marked improvement in your PCOS symptoms despite weight loss I suggest why not you try the gluten free diet for a month and see how you feel? I am convinced that you will feel much better. Even if you are having trouble losing weight following a weight-loss diet you can still give gluten free a try and I am very much convinced that not only you will lose weight and will see a lot of improvement in your symptoms.

Have you or your loved one, given the gluten free diet a trial and seen improvement in PCOS symptoms. I would like to hear from you if you have. Please leave me a comment below...

 References:

1. Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression. J Nutr Biochem. 2013 Jun;24(6):1105-11. doi: 10.1016/j.jnutbio.2012.08.009. Epub 2012 Dec 17.
2. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997 Dec;18(6):774-800.
3. Is PCOS an inflammatory process? Fertil Steril. 2012 Jan; 97(1): 7–12.
4. Inflammation in Polycystic Ovary Syndrome: Underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012 Mar 10; 77(4): 300–305.
5. http://www.medicinenet.com/script/main/art.asp?articlekey=18822