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Re: A letter from my Uncle Jim, the docFrom: Barbara (anonymous@obgyn.net)Sat, 8 Jul 2000 22:44:12 -0500 (CDT)
Way to go Uncle Jim! I wish my doctor had explained it that well to me! Thanks for sharing that letter Monica, it was a great, clear explanation. 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 > >________________________________________________________________________ >________________________________________________________________________ >________________________________________________________________________ >________________________________________________________________________ >
-- Barbara
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