Inflammatory PCOS
Ahh the final root cause of PCOS. All women have some level of chronic inflammation , but in this case this is the cause of your symptoms.
To determine if this specific type of PCOS is the main underlying factor for you, it is important to eliminate possibilities of Insulin Resistance, Adrenal, and Post-Pill PCOS. It often overlaps with Insulin-Resistant PCOS as prolonged insulin resistance leads to inflammation, which in turn exacerbates insulin resistance. If you identify with the signs of both Insulin-Resistant PCOS described earlier in this section and the indications of inflammation mentioned here, it is advisable to prioritize addressing insulin related issues before tackling inflammation.
Inflammation is a natural aspect of our immune system's reaction. It is crucial to have the right amount of inflammation as it aids in the healing of wounds and fighting off infections by sending immune cells to the affected area. For instance, if you happen to cut your finger, your body initiates an inflammatory response to that specific spot, increasing blood flow and summoning immune cells to combat any bacteria that may have entered the wound, thus assisting in its closure. However, if inflammation persists for an extended period without proper control, it can exacerbate the symptoms of PCOS. Prolonged inflammation has been found to stimulate the ovaries to produce higher levels of testosterone. This is akin to how elevated insulin levels prompt the ovaries to generate more testosterone. The increased levels of testosterone are then converted into DHT, which infiltrates the hair follicles, resulting in acne, hair loss on the scalp, and increased facial hair growth. The testosterone affects your egg quality and causes issues with regular ovulation.
In these circumstances, your body's defense mechanism becomes disoriented. Instead of fighting against foreign invaders, it mistakenly attacks your own tissues, resulting in elevated levels of inflammation. Hashimoto's thyroiditis is a prevalent autoimmune condition that I frequently encounter in my clients who also have PCOS. Research indicates that it is more commonly found in women with PCOS. Hashimoto's thyroiditis leads to the body attacking the thyroid gland, causing damage that hinders the production of sufficient thyroid hormones. This, in turn, leads to weight gain, fertility issues, and fatigue. There are over 80 other autoimmune conditions, each with varying symptoms depending on the affected body system. All autoimmune conditions generate inflammation and tissue damage, which can contribute to PCOS symptoms by increasing testosterone production. Some of the autoimmune conditions frequently observed alongside PCOS include celiac disease, Psoriasis, and arthritis. Persistent skin conditions like eczema and hives also contribute to heightened levels of inflammation through immune system activation. Gastrointestinal disorders play a significant role in overall inflammation. Conditions such as irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) weaken the lining of the digestive system, allowing food particles to escape into the bloodstream. These particles circulate in the blood where they shouldn't be, triggering the immune system to attack them. This commonly leads to food sensitivities and increased inflammation. If you experience this, you may notice that the list of foods you cannot tolerate is continuously expanding, or that you frequently experience bloating or irregular bowel patterns. Parasites, imbalances in gut bacteria, fungal overgrowth, and nutritional deficiencies also contribute to heightened inflammation. Lastly, an often overlooked cause of inflammation that I have observed in women with PCOS is excessive iron levels. Women of menstruating age often experience low iron levels due to monthly blood loss, and therefore, excessive iron is not commonly examined. However, in PCOS, long gaps between menstrual cycles are common. This means that if you have a genetic predisposition to higher iron levels and infrequent periods, you may be dealing with elevated iron levels. Iron is a crucial nutrient for energy and oxygen levels in the body but excessive amounts lead to increased inflammation.
There are numerous factors that lead to inflammation in Inflammatory PCOS, hence it is advisable to consult your doctor and undergo a comprehensive set of tests. These tests will evaluate not only the overall inflammation in your body but also potential factors contributing to the inflammation. Such an approach is crucial in confirming the root cause of PCOS. By doing so, you will gain insights into the key areas that require attention for reducing inflammation, such as assessing the health of your thyroid or gut.
Tests to measure inflammation levels:High sensitive C-reactive protein (hsCRP)Erythrocyte sedimentation rate (ESR).
Tests to assess causes of inflammation:Full thyroid panel (including TSH, T3, T4, and rT3)White blood cellsThyroid antibodies (thyroid peroxidase antibodies and antithyroglobulin antibodies)Gluten antibodiesVitamin DIron studies (including ferritin).
In this particular variant of PCOS, the main cause of elevated testosterone production in the ovaries is inflammation. Referred to as Inflammatory PCOS, it falls into the fourth category as it encompasses situations where individuals do not fit into the insulin resistance, adrenal, or post-pill profiles. Inflammatory PCOS involves various hidden factors that generate inflammation and worsen symptoms associated with PCOS. To establish an effective treatment plan, it is crucial to identify the source of excessive inflammation. Potential factors may include imbalances in thyroid hormones, poor gastrointestinal health, an overactive immune system, or consumption of foods that trigger sensitivities. Given the diverse nature of Inflammatory PCOS, there is no one-size-fits-all treatment, and it requires a process of elimination to determine the most impactful approach for each individual. It is possible that you may already have insight into key areas that need attention based on symptoms or previous testing to identify this PCOS subtype. However, if you need further guidance, I have provided additional tests that can assist you in identifying the underlying causes of your inflammation. In addition to removing the sources of increased inflammation, adopting an anti-inflammatory diet and incorporating natural anti-inflammatory supplements can help reduce inflammation throughout the body and support a less reactive immune system.
The formal criteria for diagnosing Polycystic Ovary Syndrome (PCOS) specifically states that it is essential to rule out hypothyroidism before officially diagnosing PCOS. The reason behind this is that imbalances in thyroid hormones can result in symptoms that are similar to those of PCOS. Unfortunately, I have encountered numerous women who have not undergone the necessary blood tests and later discover that their thyroid issues have been an underlying cause of their symptoms for a significant period of time.
Hypothyroidism, characterized by insufficient production of thyroid hormone, is the most prevalent type of thyroid imbalance. This condition leads to an increase in androgen production and hampers ovulation, causing irregular or absent menstrual periods and difficulties in conceiving. As you can observe, these symptoms closely resemble those of PCOS, which often contributes to the misdiagnosis of the condition. Additionally, it is common for individuals to have both PCOS and a thyroid disorder. Research indicates that approximately 25% of women with PCOS also experience imbalances in thyroid hormones. An underactive thyroid diminishes the body's sensitivity to insulin, which is the primary underlying cause of PCOS. Scientific studies demonstrate that treating hypothyroidism enhances insulin sensitivity, thereby addressing the root cause of PCOS.
Implementing an anti inflammatory diet is crucial to lowering the CRP levels. Working together we can achieve this.
Kate