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Monday, August 1, 2016

8 Steps to Reverse Your PCOS: Book Review


Many of my infertility patients have Polycystic Ovarian Syndrome (PCOS). It is a hormonal condition that affects around 15% of women across the world. Aside from infertility, it also causes weight gain, irregular menstrual cycles and anovulation, hair growth on face, back and chest, and increased risk of Type II diabetes.

Because of the prevalence, and emotional suffering caused by PCOS, I was happy to agree to review, Naturopathic Doctor, Fiona McCulloch's new book, 8 Steps to Reverse Your PCOS.

McCulloch is an ND located in North Toronto.  Given my work, I am surprised I hadn't previously heard of her!

The book's introduction gives a brief description of the 8 steps and includes a number of quizzes so readers can determine if they likely have PCOS.

Her 8 steps to reversing PCOS are:

1. Addressing inflammation
2. Treating insulin resistance
3. Balancing Adrenals
4. Treat excess androgens
5. Addressing hormonal imbalances
6. Balancing the thyroid
7. Creating a healthy environment
8. Eating a Balanced diet

The first chapter defines PCOS.  There is a lot of detailed 'science-y' information here, so if that interests you, you'll love it, if not, you'll gloss over it.

I am pleased that she mentions other conditions that mimic PCOS (and are often misdiagnosed as such), like hypothalamic amenorrhea).  For a great book on HA, check out this book.

The following chapters are dedicated to the 8 steps in her program.  Again, they contain a lot of information about the science behind everything, so some people may skim that stuff if they do not find it of interest. That being said, I think its useful to understand a health condition that you suffer from, and what causes it, so this information is important to include.

There are a few things McCullough takes about that make me uncomfortable.  One is leaky gut syndrome.  I have researched this before and found little evidence that the condition exists.  Also, she mentions the food sensitivity tests that I have discussed several times before.  I have found no concrete data that they are particularly useful tests that have any valid results. 

McCullough suggests a number of supplements and most are harmless except green tea EGCG, which can have very serious, potentially lethal side effects. I would recommend just drinking green tea instead.

I am pleased that she emphasizes the importance of regular exercise for women with PCOS, which is consistent with the research I have read.  It helps reduce insulin resistance and inflammation.

I am also thrilled that she mentions glucomannan to help manage insulin resistance.  What is it?  Its my beloved konjac! I have discussed on several occasions with some of the fertility doctors I work with, the potential of using it to help treat our PCOS patients. 

The only other thing that I don't love is her discussion of adrenal fatigue. But I will acknowledge that there is a lot of debate about it.  Alternative and integrative health care practitioners seem to believe its a real condition, but Western medicine just sees it as the result of too little sleep, too much chronic stress and/or poor nutrition.  In a way, I guess it doesn't really matter what you call it, the causes and consequences are essentially the same.

McCullough recommends a long list of herbs and supplements to help balance the adrenals.  I would first try regulating your sleep and minimizing/managing stress, if those areas are out of balance, first.  Then, before you take anything, consult a health professional, particularly if you are trying to conceive or are doing fertility treatments.

I do commend McCullough for suggesting women with PCOS try meditation/mindfulness/yoga, seek social connections with others dealing with PCOS, practice self-care and compassion, and, most importantly, seek counselling!

Following the chapters on each of the 8 steps, there is a large chapter devoted to PCOS and fertility, followed by one on menopause.  Again, this is awesome that she has given these important issues due attention.  I will stress, however, that you shouldn't start taking any herbs or supplements without consulting an ND and your fertility doctor first.

In the appendices, there are a number of PCOS-friendly recipes and a meal plan.  The recipes look fine, though many seem to have a shit-load of fat in them.  I think you can still get the benefits of healthy fats if you consume them in smaller doses, and eat lots of protein, while limiting your carb intake.  The problem with the recipes being very high fat is it makes them very high calorie.  If you can manage on very small portions, fine, but if you have a larger appetite, you may want to stick with less calorically dense meals so you can eat a larger volume.

Finally, there is a section with various resources about PCOS.

All-in-all, I am pretty impressed by the book.  I like that McCullough stresses that none of the supplements will give you really positive results if you don't also change your lifestyle in terms of diet and exercise. Here here! 

If you or someone you love is suffering from, or may be suffering from PCOS, than you will definitely benefit from reading this book.

Disclosure: I was sent this book to review, but all opinions on this blog are my own.