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A letter from my Uncle, a doctorFrom: Monica (anonymous@obgyn.net)Fri, 7 Jul 2000 11:53:50 -0500 (CDT)
Hi everyone! I sent a letter to my family about PCOS and my Uncle Jim, a doctor in IN wrote this back to me. I thought it was pretty helpful and wanted to pass it on. (I hope the length doesn't put you off! I'll just give you the important stuff.) "...Your medical facts are perfectly right. PCOS is genetically determined but not everyone has exactly the same genetic make-up so not everyone has exactly the same sympotms. Women your age are usually bothered by symptoms such as irregular periods, infertility, hair growth, etc. I see an older group of people who have diabetes, high blood pressure, high triglycerides, low HDL cholesterol, and heart disease. PCOS is just part of a larger syndrome called the Insulin Resistance Syndrome. People with this syndrome inherit a gene or genes that cause a resistance to the effect of insulin, which is mainly to keep the blood sugar in a normal range. The body responds to this my making more insulin. So long as the body can make enough insulin to overcome the resistance, the blood sugar will stay normal. Once the resistance gets so bad that the body can no longer make enough insulin to overcome the resistance, then the blood sugar stays high and you have diabetes. The problem is that these people always have too much insulin. The high insulin levels drive the body to make too many triglycerides. The high triglycerides cause a decrease in the HDL cholesterol (the good cholesterol). Also many people with the insulin resistance syndrome also develop high blood pressure. The diabetes, high blood pressure, and low HDL cholesterol lead to the development of arteriosclerosis (hardening of the arteries), which leads to heart attacks, strokes, gangrene, aneurysms, etc. Insulin resistance is inherited and probably runs in our family. However, the manifestations of the disease usually don't happen until you gain weight. Any excess fat on the body increases the resistance to insulin. Although it is more complicated than that, in a sense when blood circulates through fat, the insulin resistance gets worse, and when blood circulates through muscle, the insulin resistance is lowered. The best treatment for insulin resistance is to lose weight, or more accurately, to lose fat and gain muscle. The main thing that makes that happen is exercise. Diet is also important. However, if you lose weight only by dieting, you lose muscle as well as fat and you don't really make a significant change in the proportion of fat to muscle on the body. When you lose weight by dieting and exercising, you lose only fat and gain muscle and you actually correct the problem. The goal is to acheive a normal % of body fat, which is 15-20% for men and 20-25% for women. That is very difficult to acheive without getting regular exercise. There are medicines that help to combat the insulin resistance. As Monica mentioned (in her letter), Glucophage is perhaps the best one. Actos and Avandia also help. They are related to Rezulin, which Monica's cousin took before becoming pregnant with the twins. Rezulin has been taken off the market and is no longer available, but Actos and Avandia are probably just as good. There is some evidence that a group of medicines called ACE Inhibitors are also beneficial for people with insulin resistance. Again, Monica, you are to be commended on the excellent information you have given everyone on this important topic. If you have any questions about this, let me hear from you. Love, Uncle Jim" I hope this helps in our continued quest for more info! Best wishes to everyone! Monica :)
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