How to Treat Polycystic Ovary Syndrome (PCOS) with Diet

Given the role that oxidant free radicals are thought to play in aging and disease, one reason fruits and vegetables may be so good for us is that they contain antioxidant compounds. As you can see at 0:20 in my video Benefits of Marjoram for Polycystic Ovary Syndrome (PCOS), different vegetables and herbs have different antioxidant content. When making a salad, for example, spinach, arugula, or red leaf lettuce may provide twice the antioxidants as butterhead lettuce, and choosing purple cabbage over green, or red onions over white can also boost the salad’s antioxidant power.

Fresh herbs are so powerful that even a small amount may double or even quadruple the antioxidant power of the entire meal. For instance, as you can see at 0:50 in my video, the total antioxidants in a simple salad of lettuce and tomato jump up by adding just a tablespoon of lemon balm leaves or half a tablespoon of oregano or mint. Adding marjoram, thyme, or sage not only adds great flavor to the salad, but effectively quadruples the antioxidant content at the same time, and adding a little fresh garlic or ginger to the dressing ups the antioxidant power even more.

Herbs are so antioxidant-rich that researchers decided to see if they might be able to reduce the DNA-damaging effects of radiation. Radioactive iodine is sometimes given to people with overactive thyroid glands or thyroid cancer to destroy part of the gland or take care of any remaining tumor cells after surgery. For days after the isotope injection, patients become so radioactive they are advised not to kiss or sleep close to anyone, including their pets, and if they breathe on a phone, they’re advised to wipe it “carefully” or cover it “with an easily removed plastic bag.” Other recommendations include “avoid[ing] splatter of radioactive urine,” not going near your kids, and basically just staying away from others as much as possible.

The treatment can be very effective, but all that radiation exposure appears to increase the risk of developing new cancers later on. In order to prevent the DNA damage associated with this treatment, researchers tested the ability of oregano to protect chromosomes of human blood cells in vitro from exposure to radioactive iodine. As you can see at 2:25 in my video, at baseline, about 1 in 100 of our blood cells show evidence of chromosomal damage. If radioactive iodine is added, though, it’s more like 1 in 8. What happens if, in addition to the radiation, increasing amounts of oregano extract are added? Chromosome damage is reduced by as much 70 percent. Researchers concluded that oregano extract “significantly protects” against DNA damage induced by the radioactive iodine in white blood cells. This was all done outside the body, though, which the researchers justified by saying it wouldn’t be particularly ethical to irradiate people for experimental research. True, but millions of people have been irradiated for treatment, and researchers could have studied them or, at the very least, they could have just had people eat the oregano and then irradiate their blood in vitro to model the amount of oregano compounds that actually make it into the bloodstream.

Other in vitro studies on oregano are similarly unsatisfying. In a comparison of the effects of various spice extracts, including bay leaves, fennel, lavender, oregano, paprika, parsley, rosemary, and thyme, oregano beat out all but bay leaves in its ability to suppress cervical cancer cell growth in vitro while leaving normal cells alone. But people tend to use oregano orally—that is, they typically eat it—so the relevance of these results are not clear.

Similarly, marjoram, an herb closely related to oregano, can suppress the growth of individual breast cancer cells in a petri dish, as you can see at 3:53 in my video, and even effectively whole human breast tumors grown in chicken eggs, which is something I’ve never seen before. Are there any clinical trials on oregano-family herbs on actual people? The only such clinical, randomized, control study I could find was a study on how marjoram tea affects the hormonal profile of women with polycystic ovary syndrome (PCOS). The most common cause of female fertility problems, PCOS affects up to one in eight young women and is characterized by excessive male hormones, resulting in excess body or facial hair, menstrual irregularities, and cysts in one’s ovaries that show up on ultrasounds.

Evidently, traditional medicine practitioners reported marjoram tea was beneficial for PCOS, but it had never been put to the test…until now. Drinking two daily cups of marjoram tea versus a placebo tea for one month did seem to beneficially affect the subjects’ hormonal profiles, which seems to offer credence to the claims of the traditional medicine practitioners. However, the study didn’t last long enough to confirm that actual symptoms improved as well, which is really what we care about.

Is there anything that’s been shown to help? Well, reducing one’s intake of dietary glycotoxins may help prevent and treat the disease. Over the past 2 decades there has been increasing evidence supporting an important contribution from food-derived advanced glycation end products (AGEs)…[to] increased oxidative stress and inflammation, processes that play a major role in the causation of chronic diseases,” potentially including polycystic ovary syndrome (PCOS). Women with PCOS tend to have nearly twice the circulating AGE levels in their bloodstream, as you can see at 0:33 in my video Best Foods for Polycystic Ovary Syndrome (PCOS). 

PCOS may be the most common hormonal abnormality among young women in the United States and is a common cause of infertility, menstrual dysfunction, and excess facial and body hair. The prevalence of obesity is also higher in women with PCOS. Since the highest AGE levels are found in broiled, grilled, fried, and roasted foods of “mostly animal origin,” is it possible that this causal chain starts with a bad diet? For instance, maybe eating lots of fried chicken leads to obesity, which in turn leads to PCOS. In that case, perhaps what we eat is only indirectly related to PCOS through weight gain. No, because the same link between high AGE levels and PCOS was found in lean women as well.

“As chronic inflammation and increased oxidative stress have been incriminated in the pathophysiology [or disease process] of PCOS, the role of AGEs as inflammatory and oxidant mediators, may be linked with the metabolic and reproductive abnormalities of the syndrome.” Further, the buildup of AGE inside polycystic ovaries themselves suggests a potential role of AGEs contributing to the actual disease process, beyond just some of its consequences.

RAGE is highly expressed in ovarian tissues. The receptor in the body for these advanced glycation end products, the “R” in RAGE, is concentrated in the ovaries, which may be particularly sensitive to its effect. So, AGEs might indeed be contributing to the cause of PCOS and infertility.

Does this mean we should just cut down on AGE-rich foods, such as meat, cheese, and eggs? Or hey, why not come up with drugs that block AGE absorption? We know AGEs have been implicated in the development of many chronic diseases. Specifically, food-derived AGEs play an important role because diet is a major source of these pro-inflammatory AGEs. Indeed, cutting down on these dietary glycotoxins reduces the inflammatory response, but the “argument is often made that stewed chicken would be less tasty than fried chicken…” Why not have your KFC and eat it, too? Just take an AGE-absorption blocking drug every time you eat it to reduce the absorption of the toxins. What’s more, it actually lowers AGE blood levels. This oral absorbent drug, AST-120, is just a preparation of activated charcoal, like what’s used for drug overdoses and when people are poisoned. I’m sure if you took some ipecac with your KFC, your levels would go down, too.

There’s another way to reduce absorption of AGEs, and that’s by reducing your intake in the first place. It’s simple, safe, and feasible. The first step is to stop smoking. The glycotoxins in cigarette smoke may contribute to increased heart disease and cancer in smokers. Then, decrease your intake of high-AGE foods, increase your intake of foods that may help pull AGEs out of your system, like mushrooms, and eat foods high in antioxidants, like berries, herbs, and spices. “Dietary AGE intake can be easily decreased by simply changing the method of cooking from a high dry heat application to a low heat and high humidity…” In other words, move away from broiling, searing, and frying to more stewing, steaming, and boiling.

What we eat, however, may be more important than how we cook it. At 4:00 in my video, I include a table showing the amounts of AGEs in various foods. For instance, boiled chicken contains less than half the glycotoxins of roasted chicken, but even deep-fried potatoes have less than boiled meat. We can also eat foods raw, which doesn’t work as well as for blood pudding, but raw nuts and nut butters may contain about 30 times less glycotoxins than roasted, and we can avoid high-AGE processed foods, like puffed, shredded, and flaked breakfast cereals.

Why does it matter? Because study after study has shown that switching to a low-AGE diet can lower the inflammation within our bodies. Even just a single meal high in AGEs can profoundly impair our arterial function within just two hours of consumption. At 4:54 in my video, you can see the difference between a meal of fried or broiled chicken breast and veggies compared with steamed or boiled chicken breast and veggies. Same ingredients, just different cooking methods. Even a steamed or boiled chicken meal can still impair arterial function, but significantly less than fried or broiled.

“Interestingly, the amount of AGEs administered [to subjects] during the HAGE [high-AGE] intervention was similar to the average estimated daily intake by the general population,” who typically follow the standard American diet. This is why we can decrease inflammation in people by putting them on a low-AGE diet, yet an increase in inflammation is less apparent when subjects switch from their regular diet to one high in AGEs. Indeed, they were already eating a high-AGE diet with so many of these glycotoxins.

Do we have evidence that reducing AGE intake actually helps with PCOS? Yes. Within just two months, researchers found differences from subjects’ baseline diets switched to a high-AGE diet and then to a low-AGE diet, with parallel changes in insulin sensitivity, oxidative stress, and hormonal status, as seen at 5:54 in my video. The take-home learning? Those with PCOS may want to try a low-AGE diet, which, in the study, meant restricting meat to once a week and eating it only boiled, poached, stewed, or steamed, as well as cutting out fast-food-type fare and soda.

What if instead of eating steamed chicken, we ate no meat at all? Rather than measuring blood levels, which vary with each meal, we can measure the level of glycotoxins stuck in our body tissues over time with a high-tech device that measures the amount of light our skin gives off because AGEs are fluorescent. And, not surprisingly, this turns out to be a strong predictor of overall mortality. So, the lower our levels, the better. The “one factor that was consistently associated with reduced [skin fluorescence]: a vegetarian diet.” This “suggests that a vegetarian diet may reduce exposure to preformed dietary AGE…potentially reduc[ing] tissue AGE,” as well as chronic disease risk


What’s so great about antioxidants? See my videos:

Just how many antioxidants do we need? Check out:

For a few simple tips on how to quickly boost the antioxidant content of your food with herbs and spices, see my video Antioxidants in a Pinch.

I touched on the benefits of spearmint tea for PCOS in Enhancing Athletic Performance with Peppermint. Another sorely under-recognized gynecological issue is endometriosis, which I discuss in How to Treat Endometriosis with Seaweed.

Because of AGEs, I no longer toast nuts or buy roasted nut butters, which is disappointing because I really enjoy those flavors so much more than untoasted and unroasted nuts. But, as Dr. McDougall likes to say, nothing tastes as good as healthy feels. For more on why it’s important to minimize our exposure to these toxic compounds, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

 

Make Sure Iodine is in Your Prenatal

Although severe iodine deficiency was eliminated in the United States nearly a century ago after the introduction of iodized salt, iodine intake has declined in recent decades. “Public health efforts to limit salt intake to decrease cardiovascular risk, in conjunction with increasing use of kosher salt and sea salt (neither of which contain iodine),” may in part be to blame. Not adding salt to foods is a good thing, as sodium is considered the second leading dietary killer in the world (second only to not eating enough fruit), but if you do add table salt, make sure it’s iodized. “It is a myth (often also false advertising) that ‘natural’ sea salt contains significant amounts of iodine.”

Fruits and vegetables provide iodine, but the amounts can vary depending on where it’s grown and how much iodine is in the soil. Because iodine is particularly important for fetal brain development, there’s a recommendation that “all US women who are pregnant, lactating, or even planning a pregnancy should ingest dietary supplements containing 150 mcg of potassium iodide per day,” which I discuss in my video Iodine Supplements Before, During, and After Pregnancy.

Is there evidence they’re not getting enough? We’d like to see urine levels over 150 mcg/L in pregnant women, but in the United States, pregnant women only average about 125 mcg/L. For example, a recent survey in New York City showed only about half of pregnant women were making the cut.

Don’t most pregnant women take prenatal vitamins, though? Only about half of prenatal multivitamins contain any iodine at all, and so only about one in five pregnant women in the United States are following the recommendations of the American Thyroid Association to take a daily iodine supplement, specifically in the form of potassium iodide rather than seaweed, as the levels in seaweed are subject to natural variability. Though the iodine content was as much as 90 percent off in some of the potassium iodide prenatal supplements, the kelp supplements varied even wider, off by as much as 170 percent.

Now, the American Thyroid Association admits it doesn’t have evidence that the current borderline insufficiency levels are leading to undesirable outcomes and so its rationale that all pregnant women take iodine supplements is a bit tenuous. Until such data are available, though, it figures better safe than sorry.

A randomized, placebo-controlled, interventional trial would answer the question once and for all, but the existing evidence for iodine supplementation during pregnancy is so convincing that it would be considered unethical to randomize pregnant women to a placebo.

When it comes to sufficient iodine intake during pregnancy, I’d recommend: Just do it.


Women eating plant-based diets may find this video of special importance: Pregnant Vegans at Risk for Iodine Deficiency.

This isn’t to say sea vegetables aren’t good for you in their own right. See Which Seaweed Is Most Protective Against Breast Cancer?.

For more videos on having a healthy pregnancy, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Treat Lupus with Turmeric

Different autoimmune diseases tend to target different organs. If our immune system attacks the insulin-producing cells in our pancreas, we can end up with type 1 diabetes. If it attacks our thyroid gland, we can end up with hypothyroidism. But, in the autoimmune disease lupus, our immune system attacks the very nucleus of our cells, often producing antibodies and attacking our DNA itself. So, lupus can damage any organ system and result in almost any complication. Women are nine times as likely to get it, and the peak age of diagnosis is too often at the peak of life. Hundreds of thousands, or even millions, of Americans suffer from this dreaded disease. One of the most common organ-threatening manifestations is kidney inflammation, occurring in as many as half of the patients.

Kidney inflammation is also one of the most serious effects of lupus, caused by the disease itself “or as a result of intense immunosuppressive drug toxicity.” Chemotherapy drugs like Cytoxan (cyclophosphamide), for example, can have severe, life-threatening side effects that may include leukemia and bladder cancer, and many women lose their hair and become permanently infertile. There is a desperate need for better treatment options.

As I show in my video Fighting Lupus with Turmeric: Good as Gold, oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure—the cardinal clinical manifestations in patients suffering from relapsing or refractory (meaning, untreatable) lupus kidney inflammation––according to a randomized, double-blind, placebo-controlled study. The study looked at proteinuria, the spilling of protein into the urine, “an ominous prognostic sign.” In the control group, three people got better, three people got worse, and the rest pretty much stayed the same. In the turmeric group, one got worse, one stayed the same, but the rest all got better.

Note that the researchers used turmeric, the whole spice, and not curcumin, which is an extracted component often given in pill form. They took women with out-of-control lupus and had them take a quarter teaspoon of turmeric with each meal for three months. From my local supermarket, that would come out to be about a nickel a dose, compared with $35,000 a year for one of the latest lupus drugs. Which of the two treatments do you imagine doctors are more likely to be told about?


For more on the anti-inflammatory effects of turmeric, see:

What about its anti-cancer effects?

For practical considerations, see Boosting the Bioavailability of Curcumin and Who Shouldn’t Consume Curcumin or Turmeric?.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: