Polycystic ovarian syndrome (PCOS) is one of the most common conditions in reproductive-aged women. It is estimated that 8-13% of all reproductive-aged women have this condition and up to 70% of those women are undiagnosed. People with PCOS have cysts on their ovaries that cause hormonal symptoms such as:
- Irregular menstrual cycles
- Excessive hair growth
- Weight gain and weight loss resistance
- Scalp hair loss/thinning
- Oily skin/acne
Often we find that PCOS patients also have insulin resistance and/or type 2 diabetes. According to some studies, nearly 70% of women with PCOS also have insulin resistance. High levels of blood insulin increase androgen levels (male hormones such as testosterone). Excess androgens in females are mostly to blame for the undesirable effects of PCOS, including acne, weight gain, facial hair, and weight loss resistance.
Inflammation increases the risk for PCOS. Insulin resistance is just one cause of systemic inflammation. Gut health, stress levels, and weight gain can all contribute to inflammation as well.
Currently, health care providers recommend weight loss as a primary approach to PCOS relief. Fat cells cause inflammation, so this makes sense. However, as many people may already know, weight loss is not always as easy as it sounds! Insulin resistance can make losing weight through exercise feel impossible.
As far as medications, health care providers often prescribe combination birth control pills to adjust hormone levels, or metformin for insulin resistance. Neither of these approaches truly address the root cause of the insulin resistance and systemic inflammation.
The B Vitamin Cycle of Doom
Just like with most medications, the common prescriptions for PCOS have side effects. Both birth control pills and metformin are known to deplete B vitamins. Metformin specifically makes it more difficult for your body to absorb B12. Birth control pills, on the other hand, are known to cause nutritional deficiencies in folate, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc.
Why are B vitamin deficiencies so concerning? B12, also known as cobalamin, is a vitamin that is essential for brain health and nervous system function. It is needed for the creation of red blood cells, which help distribute oxygen to the rest of our bodies (including our brains). It is no wonder, then, that low B12 levels have been linked to dementia.
In addition to taking medications that deplete them, many people with PCOS have a specific gene mutation that makes it even more difficult to create active B vitamins. MTHFR is a gene that helps our bodies convert folate to an activated version that we need in order to use B12 (5-MTHF). Birth control pills deplete folate, B6 and B12 levels, so if you also have the MTHFR mutation then your body will really struggle to activate and utilize B12.
Some studies have suggested that women with PCOS are more likely to have a mutation on the MTHFR gene. So, due to medication side effects and/or gene mutations, people with PCOS often suffer from B vitamin deficiency (hence their association with Major depression).
What’s interesting is how much overlap there is between B vitamin deficiency symptoms and PCOS symptoms. It begs the question: Are PCOS symptoms made worse by B vitamin deficiency, caused by the very medications meant to bring the patient relief?
The Dr. Autoimmune Difference
Our office uses a functional medicine approach to identify and address the root cause of chronic conditions such as PCOS. Rather than using medications, we know how to help you provide your body with the tools it needs to correct imbalances naturally.
For example, our office uses continuous glucose monitoring technology to help our patients identify how certain foods affect their blood sugar. Our nutritionist works one on one with patients to develop plans that help their bodies regulate blood sugar levels more effectively. Once insulin resistance is under control, weight loss becomes much easier. Loss of excess fat= less inflammation= less PCOS symptoms.
The bottom line is that PCOS is not a life sentence- lifestyle changes such as exercise, supplementation, and diet change designed to address the root cause will provide relief. If you are ready to tackle your chronic condition and change your life naturally, click the “Start Your Journey” button at the bottom of this page.
Diabetes affects 11.3% of people in the US, and 90-95% of those people have type 2 diabetes. What many people may not know, however, is that all forms of diabetes will increase your risk of dementia. Glucose (sugar) is an essential source of energy for your brain, so when your insulin is not metabolizing it in a way that makes it useful, your brain misses out on important fuel. A pre-diabetic state is marked by insulin resistance, which is when your insulin cells can’t use glucose effectively.
Some early signs of insulin resistance include:
The catch is, even if you try to get your diabetes under control with medications such as metformin, you will still be increasing your chances of getting dementia.
The Misfortune of Metformin
Metformin may be prescribed as generic, or by brand names such as Fortamet or Glumetza. It is a commonly used drug for type 2 diabetes and has been prescribed to over 120 million people worldwide.
Numerous studies have shown a correlation between use of metformin and chronic vitamin B12 deficiency. Typically within one year of consistent usage of metformin, your ability to absorb B12 becomes compromised and you may experience symptoms of B12 deficiency including:
- Lightheadedness especially coming from seated to standing
- Feeling cold
- Muscle pain or weakness
- Tingling and numbness in the hands and feet
- Loss of reflexes, which may progress to depression, confusion, and memory loss
B12, also known as cobalamin, is a vitamin that is essential for brain health and nervous system function. It is needed for the creation of red blood cells, which help distribute oxygen to the rest of our bodies (including our brains). It is no wonder, then, that low B12 levels have been linked to dementia. Researchers Norbert Goebels, M.D. and Michael Soyka, M.D wrote:
“Cobalamin deficiency has been shown to be the most frequent associated physical disease in patients with dementia.”
So, diabetes can lead to dementia, and the medication for diabetes can also lead to dementia. Not to mention the recent national recall for metformin based on a batch containing a carcinogenic (cancer-causing) chemical. Is there no way to win here? Well, our office has a different approach.
What Else Can Cause B12 Deficiency?
Besides medications like metformin, there are other risk factors that can lead to a B12 deficiency. Age is one of these factors. Ten to thirty percent of people over the age of 50 produce too little stomach acid to release B12 from the foods they eat. A certain amount of stomach acid is required to break down the carrier foods and release the B12 vitamin. This could mean that even though you are eating foods that technically contain B12, you may not be breaking the food down enough to actually absorb the B12. The older you get, the less stomach acid you produce, so this risk only increases.
MTHFR is a gene that helps our bodies convert folate, A.K.A. vitamin B9, to an activated version that our bodies can use. All B vitamins need to be converted to their methylated forms in order for our bodies to use them. What does this have to do with B12?
Our bodies need activated (methylated) folate in order to use B12. So, when there is a mutation on our MTHFR gene, it affects our body’s ability to make activated folate, and therefore our ability to use B12. This creates an interesting dynamic where someone can have completely normal levels of B12 in their blood, but are actually deficient in the vitamin and have the corresponding symptoms.
At Dr. Autoimmune, we are able to order specialized blood tests to detect mutations on the MTHFR gene when Dr. Ian suspects this may be a concern.
Managing Diabetes Naturally
Instead of prescribing medications that increase your risk of dementia, our office seeks to address the underlying cause of your condition and develop a management plan using lifestyle changes and proper supplementation.
One tool we frequently use is a continuous glucose monitor (CGM) to help our clients learn exactly how different foods affect their blood sugar. While we use this tool to manage and make decisions about diet changes, we also dive deeper.
As we mentioned at the beginning of this article, insulin resistance is a precursor to diabetes. Insulin resistance is caused by systemic inflammation in the body. This can be caused by gut dysbiosis, food sensitivities (particularly to gluten), toxin exposure (such as mold), stress, and hormone imbalances, just to name a few.
By identifying and addressing these root causes, rather than managing symptoms with a band-aid medication, our patients find that their bodies have exceptional healing abilities when given the right tools! If you are ready to change your life, click the “Start Your Journey” button at the bottom of this page.
Dr. Ian recently went viral with a video about MTHFR and B12 deficiency related to metformin use. Make sure to subscribe to him on TikTok to get daily health tips and kernels of knowledge!