Treatment of the excess hair growth associated with PCOS often consists of using the drug spironalactone and the use of birth control pills. Spironalactone is a very interesting drug used for decades as a salt depleting diuretic but also has an effect to block the action of the male hormone testosterone. The action of spironalactone to block testosterone was discovered when it was noticed that men using this diuretic developed tender nipples and breast enlargement (gynecomastia). Oral contraceptive agents are also useful to combat hirsutism because these agents also cause reduce testosterone levels by putting the ovary in a dormant “resting” state.  Cosmetic procedures are always another option to treat unwanted hair growth. Laser hair removal appears to be replacing the older modality of electrolysis for this purpose.

Can PCOS be cured? Once PCOS develops it can be controlled but not cured unless the ovaries are removed. At menopause  PCOS-related problems diminish as the ovary stops making sex hormones including testosterone which is one of the culprits during the reproductive years. A recent study published this year in the journal Pediatric Endocrinology showed that using metformin treatment in pre-adolescent girls thought to be at risk for PCOS reduces the risk and/or the severity of PCOS in later years. It may do this by blocking fat accumulation in the abdomen and liver which seems to set off the insulin resistance. Metformin is not FDA approved for this purpose and as a generic drug there is little profit potential in developing this treatment. I expect it will be many years before preventive therapy for PCOS will come before the FDA for approval .

This information is strictly for educational purposes. Due to high risk of toxicity of medical therapy in young women who can potentially become fertile under treatment for PCOS, no drug should be taken without the close supervision of a physician. The reader agrees to the Terms of Service of this website, metabolism.com

Maintaining ideal body weight with diet and exercise is also crucial for avoiding diabetes and prediabetes.In overweight adults for each2.2 pounds(1 kilogram) gained per year the risk of developing diabetes increases about 50% over the next ten years. By losing 2.2 pounds per year the risk of developing diabetes is reduced about33% for the next 10 years (J Epidemiol Community Health. 2000; 54(8):596-602).

Speak to your healthcare professional to find out if you are at risk for developing diabetes and to learn ways you can avoid it.

Gary Pepper M.D.

Editor-in-Chief, Metabolism.com

The terms of service for metabolism.com apply to this and all posts; http://www.metabolism.com/2008/09/06/terms-conditions-service-agreement/

Here’s what SweetiePie has to say;

Hello:

55 Year old female here, 200 lbs, hypothyroid smoke free for 6 months. Feeling great about being smoke free and this time its permanent and for real.

I have quit smoking and relapsed so many times in my life. And dieting, on again and off again for 40 years. Pfffft…..This time what prompted me to go to the doctor and quit was that my heart feels heavy and hurts sometimes. Not angina yet, but scary and depressing. I’m fine, it turns out, but I definitely needed to quit smoking and still need to exercise more and lose weight . I am no expert in the weight loss department, having had limited success with that over the years. I can see from this interesting thread that I am not as weight conscious as most of you, but I still thought I’d share what my doctors told me because it may help and inspire you the way it did to me: When I tried to bring up the weight gain and the overweight with doctors heres what they said: CARDIOLOGIST told me I’d have to be about 100 lbs over my ideal weight of 145 for the weight to be as stressful and damaging on my heart and cardiovascular as SMOKING, GP #1 told me the key was, instead of focusing on an ideal weight and size, was to focus on preventing DIABETES through NONSMOKING, AND EXERCISE just as important as wholesome diet, and GP #2 (I moved and needed a new doctor for my thyroid perscription) told me, after my bloodwork tested all ok, “why don’t you just forget about losing weight for a little while and focus on quitting SMOKING? Well, I took all of that advice, and this time, it worked! I’ve really kicked the smoking habit and finally found freedom from that deadly addiction. The “permission” from doctors to stop beating myself up about my weight freed me up mentally to do what I needed to do (giving myself plenty of rewards, including food treats and being lazy treats!) in order to become smoke free and never going back! I am ready now to step up to exercise and weight loss this year with the same strategy: Increased exercise first, food modification instead of deprivation. The reason for my post is to say stick with it but your QUIT is SO IMPORTANT – don’t ever let your desire to be thinner or to get back down to an ideal outweigh your resolve to stay SMOKE FREE. SMOKING is the singlemost damaging behavior -don’t lose sight of that! Never take another puff! Oh, btw I gained about 5% while quitting and my first goal is to go back down 5%.

Most of my diabetic patients are on medication since they are unable to maintain good glucose
control with diet and exercise only. If they succeed however, in achieving weight loss then the
diabetes medication must be reduced to prevent undesirable hypoglycemia (low blood sugar).
Hypoglycemia is potentially dangerous because the brain cannot function properly resulting in
abnormal behavior, loss of muscle control and even unconsciousness. Imagine this occurring
while behind the wheel? Down here in Florida this is all too common.

Many commercial weight loss programs have started targeting Type 2 diabetics (adult onset)
with their TV ads. These programs are generally administered by people without any medical
background. They cannot advise medication changes (not that you would want them to) without
breaking the law by practicing medicine without a license. The result, as with my patient, is the
development of potentially serious complications of hypoglycemia.

In a previous blog http://www.metabolism.com/2010/10/17/injured-diabetic-diet , I worried that this type of problem could develop with commercial weight loss programs. I didn’t expect to see evidence of it so soon and in my own exam room. If my patient’s wife didn’t stop and mention his new symptoms at the last moment
that day, I imagine a far worse outcome for her husband was possible.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

The latest drug to be rejected by the FDA is Lorgess (lorcaserin), developed by Arena Pharmaceuticals. This drug, not as effective as Qnexa, produced 5% body mass loss in about half of participants in clinical trials. Lab animals showed a tendency to develop breast tumors when exposed to the medication, adding to the FDA’s decision to reject the drug application based on safety concerns.

I am a strong advocate of drug safety and regulation. On the other hand we know obesity, and with it Type 2 diabetes, is epidemic in the U.S. I regard weight loss as the “holy grail” when treating type 2 diabetes and yet it is the most difficult goal to achieve. Any drug which could assist in weight loss is highly desirable in the treatment of Type 2 diabetes. Not only does blood sugar improve with weight loss but also blood pressure and cholesterol readings show declines. All three of these parameters are known to be prime contributors to the main cause of death in diabetics, cardiovascular disease.

It has already been 10 years since the last drug was approved specifically for a weight loss indication. The failure of these two latest medications to achieve approval is certain to cause the pharmaceutical industry to severely curtail if not abandon further investment in this type of drug development.

Why is the FDA so reluctant to approve a weight loss pill? This is a complex issue but requires an answer. A new weight loss inducing medication is certain to be highly anticipated and widely prescribed. Therefore, from the very first day of approval the FDA must take responsibility for the well being of millions of people who are likely to take the medication. We are a society which demands our medications deliver miraculous cures with no side-effects. If someone perceives they have been injured by a medication our legal system is primed to unleash brutal retribution on everyone remotely involved in the approval process. Abuse and injury with a medication designed to cause weight loss is almost a certainty. This is a no-win situation for the administration of the FDA.
I predict it will be at least another 10 years before a medication for weight loss is approved by the FDA. Unless there is a change in the climate of litigation in this country it will take longer than that. In the meantime the only new developments in weight loss drugs will be the result of exploiting appetite suppressant effects which are the “side-effect” of medications approved for other purposes.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

The intestines produce hormones which regulate blood sugar and appetite. GLP-1 is among the best known of these intestinal hormones. GLP-1 is the basis of a whole new generation of medications used to treat diabetes such as Byetta, Victoza, Januvia and Onglyza. GLP-1 lowers blood sugar, stimulates the pancreas and reduces appetite. After gastric by-pass increased amounts of GLP-1 are produced by the remaining intestine. In a study published in the Journal of Clinical Endocrinology and Metabolism (95:4072-4076, 2010), researchers at St. Luke’s Hospital in New York discovered that levels of oxyntomodulin, another intestinal hormone that suppresses appetite and acts like GLP-1 on blood sugar levels, is doubled after gastric by-pass.

These exciting discoveries help explain why obese diabetics can often be sent home without any medication to control blood sugar immediately after undergoing gastric by-pass surgery. Although most insurance plans do not cover gastric by-pass surgery, dramatic improvements in patients after the procedure with greatly reduced medication costs may convince insurance companies that paying for the procedure will result in better outcomes and save them money in the long run.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

Let me know if you agree with my impression, or am I biased by being an endocrinologist?

Gary Pepper, M.D.
Editor-in-chief, Metabolism.com

In some ways, your body is like a machine — it works best when it’s properly maintained and tuned up. Food is your fuel and when you fill your tank with lousy fuel, your engine sputters and stalls. If your body’s engine is sluggish and needs a jumpstart, spirulina and other green superfoods can help deliver the energy necessary to keep the machine running smoothly, avoiding a breakdown.

Spirulina is a ‘green superfood,’ a term used to describe various nutrient-rich natural supplements, which include Chlorella, Wheat Grass, Barley Grass, Alfalfa and Kelp. Unlike most store-bought supplements, the concentrated vitamins and minerals they provide are not synthetic. Green superfoods are whole foods harvested directly from nature and are exactly what your body needs to offset stress and to clear away toxins.

SAD is very sad indeed

S.A.D. stands for Standard American Diet – there was never a more apt acronym. The majority of U.S. citizens today subsist on processed fast food laden with refined carbohydrates and saturated fats. Meats are frequently tainted with growth hormones, antibiotics and pathogens. For people who manage to work the recommended five to nine daily servings of fruit and vegetables into their diet, modern agricultural techniques have stripped crops of many vitamins and minerals.

Processed and cooked foods, which are the cornerstones of the S.A.D, and beverages such as coffee, tea, soft drinks and alcohol create an acidic blood pH, encouraging the growth of bacteria, fungus and mold. In an overly acidic environment, the body literally begins to compost. Illnesses such as heart disease and diabetes are often the result of the composting process. Green superfoods have an alkalizing effect, counteracting the acidity caused by poor diet, stress and toxic overload and setting the stage for a return to good health.

Spirulina and Chlorella, the most super of the green superfoods

Spirulina is a blue-green algae whose name comes from its spiral coil shape. High quality spirulina thrives in both salt and fresh water in tropical climates and it is known to have nourished the Aztecs, who harvested the algae from Lake Texcoco. Some of the benefits of Spirulina are:

• Contains all of the essential amino acids vital to human health
• An excellent protein source for all vegetarians, including vegans
• Balances blood sugar by boosting glycogen, which offsets insulin
• Rich in GLA (gamma linolenic acid) and other essential fatty acids Delivers an array of vitamins, including the all-important folic acid
• High in potassium and a dozen other minerals
• Improves focus and mental clarity

Chlorella is a single-celled green algae whose name is derived from Greek and Latin words that translate to “little green.” In the 1940’s and 1950’s, intensive research was done on little green algae’s potential role in solving world hunger, due to its high protein content and its bounty of beneficial vitamins and minerals. The natural health community, meanwhile, has always touted Chlorella’s health-imparting properties, particularly in the area of detoxification. In addition to being the very best source of chlorophyll, here are some more of Chlorella supplement benefits:

• Rids the body of toxins and stored waste
• Tones and cleanses the blood
• Reduces body odor, acting as an internal deodorant
• Improves bowel health and reduces flatulence
• Naturally freshens the breath
• Clears the skin

Cereal grasses and seaweed

Wheat grass is a popular juicing ingredient due to its superior nutrition, which it delivers without raising blood sugar. It also helps to lower blood pressure.

Barley grass alkalizes the blood and strengthens the digestive system.

Alfalfa helps reduce LDL (low-density lipoprotein) or bad cholesterol, without affecting levels of HDL (high-density lipoprotein) or good cholesterol and studies are underway to determine its effectiveness at lowering blood sugar levels and its ability to invigorate the immune system.

Kelp is a brown-algae seaweed, which grows in abundant kelp forests in shallow oceans all around the world. Kelp is rich in iodine and therefore beneficial to overall thyroid health. Its high vitamin and mineral content promotes pituitary and adrenal gland health as well. It’s renowned for its contribution to lustrous hair and skin. Taken shortly after exposure, it can also mitigate the negative ramifications of heavy metals and irradiation.

Making the most of green superfoods

Incorporating Spirulina, Chlorella and other green superfoods into the diet is easy, since they are all available in powdered form. Simply mix the desired amount into salad dressing, or add it to soup, juice or water. The taste is fresh and green and the active enzymes of living food add a healthy dimension even to a less than healthy meal. Of course, pregnant or breastfeeding women and people taking medications should consult with their doctors before incorporating any new food into their diets.

Many people who regularly incorporate green superfoods into their daily regimen have reported increased energy, mental clarity and an overall healthy glow. When stress, toxic thoughts and an imperfect diet have left your body’s engine sluggish, green superfoods are a quick and easy way to put yourself back on the road to health. Long may you run!

About the Author
Tom Hines, co-owner of NutritionGeeks.com (MN #1 Now Foods herbal provider), has been working in the nutrition industry since 1997, is a competitive powerlifter, lives with his wife Netti and three boys TJ, Grady and Brock on the prairie in west central Minnesota, spends his leisure time coaching youth wrestling, working with his horses and being play toy #1 for his boys.

Maybe some other time. But it was fun while it lasted.

Gary Pepper, M.D., Editor-in-Chief, metabolism.com