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Re: A letter from my Uncle Jim, the doc
From: Jennifer (anonymous@obgyn.net)
Fri, 7 Jul 2000 19:23:45 -0500 (CDT)
Monica,
Great letter! Thanks for sharing it!
Jennifer
At Fri, 7 Jul 2000, Monica wrote:
>
>Hi everyone,
>I wrote a letter to my family about PCOS (on our family onelist site via
>the internet). My cousin Julie wrote back about her PCOS. Then my
>Uncle Jim, who is a doctor, wrote the following. I thought it was very
>helpful and wanted to pass it on to you. I hope the length doesn't put
>you off! p.s. I also sent a copy to the PCOS Medication Forum.
>p.s.s The "medical facts" he referres to are ones I passed on from both
>PCOS Forums.
>
>Dear Monica, Julie, and everyone else,
>
>--
>Monica and Julie, I want to congratulate you on your excellent
>discussion
>of PCOS (POLYCYSTIC OVARY SYNDROME). Your medical facts are perfectly
>right. PCOS is gentically determined but not everyone has exactly the
>same genetic make-up so not everyone has exactly the same symptoms.
>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 by 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 the
>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 you gain muscle and you actually correct the problem. Insofar
>as
>diet is concerned, calories are the main culprit. Any time you take in
>more calories than you burn up, everything gets worse. Probably some
>calories are worse than others. Anything that stimulates your body to
>make insulin can make things worse. Sugar is what stimulates the
>production of insulin. So it is advisable to avoid sugar, pop with
>sugar, candy, ice cream, pies, cakes, cookies, donuts, and anything that
>has sugar in it. For some people with severe insulin resistance they
>should also avoid bread, potatoes, rice, cereal, pasta, and other
>carbohydrates which are broken down in the body to form sugar. 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, Glucophage is perhaps the best one. Actos and Avandia
>also help. They are related to Rezulin, which Julie 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 and Julie, 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,
>Jim
>
>________________________________________________________________________
>________________________________________________________________________
>________________________________________________________________________
>________________________________________________________________________
>
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