pcos and autoimmunity

New Study Shows We’ve Been Treating PCOS Weight Loss All Wrong


Ever wondered whether PCOS and autoimmunity are linked? If you’ve ever asked yourself if PCOS could be related to other female conditions like endometriosis then this was essentially the question you were asking. And it turns out that there may be a link as research has shown that PCOS – like endometriosis – could likely be an autoimmune condition.


PCOS and Autoimmunity: Research

This week marked the release of some groundbreaking research, but not for the reason the media picked up on. The article I found was titled: Could an Antibody Test Serve for Simple Diagnosis of PCOS?

Although I believe that the earlier PCOS is detected, the better, I’m more interested in how we reverse PCOS, especially PCOS weight gain and infertility. This latest research blows the current medical treatment protocols out of the water. The researchers described it as “paradigm shifting” – and it is.

Why? Because it shows that PCOS is most likely an autoimmune condition.

This means that to truly reverse PCOS, we need to do more than take metformin and spironolactone and eat a low GI diet. Treating autoimmune conditions requires addressing the root cause of why your body is attacking itself, not just masking the symptoms.


How PCOS Is An Autoimmune Condition

PCOS is characterised by an overproduction of hormones, usually testosterone. Gonadotropin releasing hormone (GnRH) causes the overproduction of hormones. Our ovaries have a GnRH receptor on them; activation of it causes the ovaries to produce hormones, such as luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, etc.

The study found that in PCOS, the GnRH receptor is confused and detects GnRH as a foreign object (like it would a virus). This causes the body to think it’s own cells are foreign objects and produce antibodies to it. We call this an autoimmune condition.

Other autoimmune conditions include Type 1 diabetes, coeliac disease, multiple sclerosis, rheumatoid arthritis, and endometriosis (this is possibly why there’s a connection with PCOS).

In the case of PCOS, the researchers think that these antibodies disrupt the normal messages between our brain and ovaries. This causes the ovaries to overproduce hormones. We’ve known for a while that PCOS is an inflammatory condition but not that it causes us to produce antibodies.


How Does Autoimmunity Impact PCOS Weight Loss?

If you go to your doctor complaining of PCOS weight gain, or infertility (and you’re overweight), the advice will (most likely) be to eat less and exercise more. But weight gain is actually a symptom of our immune system being on high alert. So instead of focussing on calories, we need to treat the root cause of the problem, the autoimmunity.


How To Treat Autoimmune Conditions:

1. Fix Your Gut Health

We know that the 10 trillion organisms in your digestive tract play a huge role in your health, specifically your weight.

You can think of these organisms like a garden in our digestive tract. In a garden, weeds will always be present, but if you have enough flowers then the weeds will be suppressed. If there aren’t enough flowers then the weeds take over and we have an overgrown garden on our hands.

A similar scenario happens in our intestines. Drugs like antibiotics, the contraceptive pill and ibuprofen all kill good bacteria and allow the bad bacteria to take over. Too much bad bacteria causes our gut to become leaky. Indeed, studies have proved that women with PCOS have fewer good bacteria and more bad bacteria than normal.

Leaky Gut and PCOS

You may have heard the term ‘leaky gut’ – but what does it actually mean?

The cells in our intestines should be tightly packed together to only let certain nutrients through. If the bacteria in our gut is unbalanced, this can cause those cells to drift apart. This results in holes and makes our once tight intestines very leaky.

The holes allow large proteins, like gluten, to pass into the bloodstream into the rest of the body. There, they’re detected as foreign invaders and our bodies produce antibodies to attack it.

The main researcher in this field, Alessio Fasano M.D., believes that all autoimmune conditions start with a leaky gut and that a leaky gut must be present for autoimmune conditions to start.

Fixing your gut requires more effort than simply taking a few probiotics. If there is an overgrowth of bad bacteria or yeast, we need to kill that off first. You can then introduce the good bacteria via probiotics, fermented food, and resistant starch to feed the good bacteria.

In the functional medicine world, we operate by the ‘test don’t guess’ policy. This means that I do a lot of testing to find out exactly what is (or is not) present in my patient’s gut, allowing me to make informed decisions about their treatment plan.

If you can’t do this, the best thing you can do is to eat fermented foods with every meal. Fermented foods are naturally high in probiotics to help to increase your gut’s good bacteria.

2. Remove Foods That You’re Intolerant To

While you’re healing your gut, you also want to remove foods that you are likely reacting to. Again, there are also functional tests available for this as well. I use the Cyrex test for this, as I find it the most accurate. If you are producing antibodies to these foods, they will show up on a test like the Cyrex. However, these tests can be expensive, so another alternative is to remove the most common foods that studies have shown we can become intolerant to with a leaky gut.


How Do Insulin Resistance and Carbs Fit Into All Of This?

Insulin resistance is pre-Type 2 diabetes and 70% of women with PCOS have insulin resistance. We used to think that insulin resistance was caused by too much sugar and not enough exercise, but we now know that it is much more complex than this.

Studies have shown that poor gut bacteria causes inflammation and insulin resistance, so your insulin resistance is very much connected to the whole leaky gut scenario. Although this doesn’t negate the need to remove sugar entirely from your diet, this is still the first step. But it means that you will also need to fix your gut health and remove foods that you’re intolerant to as well.


PCOS and Autoimmunity: Summary

New research has shown that PCOS is most likely an autoimmune condition. While there needs to be further research conducted to confirm this initial study, it does confirm the need to fix the underlying inflammation in PCOS.

There are two things we need to do to treat inflammation:
1. Fix our gut health
2. Remove foods from our diet that we are intolerant to

Some more blogs you might be interested in

misdiagnosed with pcos

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    1. Hi Anna, good question. The researchers need to repeat this agin to confirm their findings, but I think it could be why so many women with PCOS also have endometriosis. Whether you then develop endometriosis is another question, most women develop endometriosis around puberty and early teens, but it would be interesting to know how many develop it later.

      1. As someone with both PCOS and endometriosis, it’s important to analyze the “causation vs correlation” relationship… my PCOS was symptomatic before my endometriosis, but that doesn’t necessarily mean that my endometriosis was secondary to my PCOS. It’s better in this case to publicize the correlation between the two disorders, especially because there’s no diagnostic test (save for a laparoscopy) for endometriosis. That being said, the correlation between hypothyroidism, PCOS, and endometriosis is very high, as Clare has written about.

    2. I have had Was diagnoses with PCOS back in 1990. Recently I was diagnosed with Endometriosis. In January of this year my doctor did the ANA test and it came back positive for Mixed Connective Tissue Disease. The test was repeated to make sure it wasn’t a false positive. It was worse that the first one. Does a positive ANA test for someone with PCOS and Endometriosis just confirm the diagnosis or do I really have lupus. I am now on prednisone and Plaquenil along with the spironolactone and metformin. I am frustrated because I don’t feel like I am being treated holistically, just for individual symptoms.

    1. Hi Janna, that’s a great question. What I would say is that if your hormones are out of balance, and we are inflamed, then it can be like fighting a losing battle with calories. Weight regulation is a survival mechanism which our body controls tightly through hormones. If our body percieves that we are going into a famine (i.e. our inflammatory response is turned on), then it will hold on to every morsel of fat it can.

  1. This makes so much sense! This is why I found that when I removed dairy and gluten all my PCOS symptoms cleared up. Thank you for sharing

  2. Hello,
    Are you allowed to eat quinoa, brown rice and/or sweet potatoes? It seems like I can not from what I’ve been seeing on the internet.

    1. Hi Penni, quinoa and brown rice can cause a reaction for some people, the same way that gluten does, so I generally recommend avoiding these initially. Sweet potatoes are fine.

  3. Hi I have pcos, endometriosis, hypothyroidism and cero negative arthritis. Suffering a lot with these problems… anyone suggest what should I do. Taking the medication, but it’s not really helping

  4. Hello I want to cry I keep putting weight on and super active. I need help doctors push stomach operation for weight loss. I feel like I’m stuck in a fat body hate it. They have tried metformin and numerous other diabetic drugs side effects are awful

  5. I had a complete oophero-hysterectomy 20 years ago and with exercise and good diet I have been almost symptom free for 18 years until an auto accident. Since then I have NAFLD, severe abdominal pains and now severe spinal stenosis and empty sella. The Doctors all say that it can’t have anything to do with PCOS since my ovaries are gone. I thought PCOS was systemic and not just ovarian. I feel again like my hormones have gone crazy could the accident cause this due to inactivity and all the meds I was given?

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