Continuous inflammation is a big issue with PCOS
You’ve probably read it many times before and have very likely experienced it; chronic low-grade inflammation is a big problem in PCOS, but why is this so? There are actually a few potential reasons why we tend to have chronic low-grade inflammation from biological issues to dietary triggers such as glucose and potentially gluten. Let’s go into a little more detail here.
Why all of this inflammation?
Inflammation is, generally speaking, the body’s immune system response to a stimulus (2015). Inflammation occurs when the immune system fights against something that it believes could be potentially harmful. In situations such as cuts, bruises, breaks, sprains, infections and such, this certainly makes sense, however, the immune system doesn’t need to be “on high” constantly when there is nothing necessarily to fight, which is the case for women with PCOS, regardless of obesity. How exhausting for our bodies! According to Dr. Dokras and Dr. Duleba that performed many clinical trials to find the link between PCOS and inflammation, they stated that, “PCOS is associated with systemic inflammation as evidenced by elevation of multiple inflammation markers as C-reactive protein, interleukin-18, monocyte chemoattractant protein-1 and white blood count as well as endothelial dysfunction and increased oxidative stress”. Elevated levels of CRP, interleukin-18 and monocyte chemoattractant protein-1 are not only markers of inflammation, but they are also important markers for a future cardiovascular event, such as a heart attack (Dokras & Duleba, 2015), which, as you know, women with PCOS are at a higher risk of having a heart attack. Within those same clinical trials, the CRP (C-reactive protein) was not just elevated, but it was significantly elevated. In fact, the CRP was 96% greater in women with PCOS than in normal women (Dokras & Duleba, 2015).
CRPs are produced by the liver but are also directly produced in adipose (fat) tissue. Essentially, this indicates the more fat a woman has, the higher amount of CRP she will have in her blood stream. Something else to mention is in a variety of other well-documented studies, it has been shown that women with PCOS have a consistently elevated WBC (white blood cell) count (Gonzalez, 2013). This indicates that our bodies’ immune systems are constantly on the defense, and when our bodies are in constant defense, we have constant inflammation.
Here are some insights to controlling inflammation levels a little better.
Dietary triggers for inflammation
In the PCOS body, there are a few dietary triggers that can potentially lead to constant low-grade inflammation. According to a set of studies performed by a man named Dr. Gonzalez, he concluded that a diet trigger, such as glucose, is capable of inducing oxidative stress which stimulates an inflammatory response, and this diet-induced inflammation in particular could be the underpinning of insulin resistance in PCOS (Gonzalez, 2013). As you have learned in the “Carbohydrates and Insulin Resistance” Education section, a dietary trigger such as glucose stimulates our ovaries to produce an excess amount of androgens due to our bodies’ difficulty with processing carbohydrates properly. Within these studies, Dr. Gonzalez directly stated that inflammation, also, directly stimulates ovarian androgen production, as well! He even suggested that low-grade inflammation may even be the reason to why PCOS develops in the first place; however, this is still being investigated. So, we are getting A LOT of ovarian androgen production…this is a big issue for our PCOS. This is another large reason that we need to pay very close attention to the types, quantities and combinations of carbohydrates we consume.
Gluten has been a hot topic for many reasons, but the main reason is that it makes many people feel “inflamed” and “bloated”. These feelings are pretty familiar in PCOS. Unfortunately, there aren’t any studies directly linking gluten and PCOS, however, many women have reported remarkable improvements in their overall PCOS symptoms, as well as how they feel in general, by going gluten-free.It has been noted within a study performed in the United States, and a few others in Europe and the Middle East, nearly 6% of the women in the study that had unexplained infertility had undiagnosed Celiac’s Disease (Choi et al, 2012).
It was also noted within the study that sometimes, Celiac’s Disease can manifest as fertility issues, particularly in women (Choi et al, 2012). This may not be true particularly for you, but if you haven’t been tested of gluten intolerance and Celiac’s Disease, it may be a good idea to do so at your doctor’s.Gluten, itself, is a protein complex (containing both glutenins and gliadins) that is found in wheat (durum, emmer, spelt, farina, farro, KAMUT khorasan wheat, einkorn), barley, rye and triticale (CDF, 2016). This particular protein is responsible for “gluing” compounds together creating a “net” like structure that is unified, and easily sticks everything together; think of bread or pasta. This is the compound to which many people, nowadays, have an allergy or even have full-blow celiac’s disease.
In non-allergy and allergy alike, gluten has been linked to inflammation and as you know, women with PCOS struggle greatly with inflammation. Today, there are so many gluten-free-friendly options due to the prevalence in and preference to many people.
Complications of constant inflammation
I’ve been talking about women with PCOS having chronic low-grade inflammation, but what are the complications that come with low-grade inflammation? The truth is, many complications, and these are things I have identified; there are more to be discovered. It’s even suggested that constant low-grade inflammation due to poor dietary choices are the reasons behind all of the poor human health today. Low-grade inflammation can cause,
- Cancer (many different types)
- Heart disease (stroke, heart attack)
- Depression and anxiety
- Diabetes Type II
- Cognitive issues such as Alzheimer’s
As you can tell, many of these things we already suffer from, so it really makes you think the potential role that inflammation plays in our PCOS bodies.
Take home message-Knowledge IS Power
As you’ve learned, glucose is such a pesky compound for our management with PCOS. Aside from all of the complications with our ability to process glucose, it is a large source of inflammation for our PCOS bodies. Gluten also has its fair share of triggering inflammation in our bodies, as well. Monitoring these two compounds alone will have a tremendous influence on the expression of inflammation your body has, and the expression of your PCOS symptoms, as well as reducing your risk of the serious complications that come with chronic, low-grade inflammation.
Celiac Disease Foundation (2016). What is Gluten? Retrieved from https:\\celiac.org/live-gluten-free/glutenfreediet/what-is-gluten/
Choi, J. M., Green, P. H. R., Lebwohl, B., Lee, S. K., Muray, J. A., Sauer, M. V. & Wang, J. (2011). National Center for Biotechnology Information: Increased Prevalence of Celiac Disease in Patients with Unexplained Infertility in the United States: A Prospective Study. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122153/
Dokras, A. & Duleba, A. J. (2013). National Center for Biotechnology Information: Is PCOS an inflammatory process? Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245829/
Gonzalez, F. (2013). National Center for Biotechnology Information: Inflammation in Polycystic Ovary Syndrome: Underpinning of insulin resistance and ovarian dysfunction. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072482/