Fat Soluble Vitamins Deficiency in PCOS

​There has been a resurgence of a long forgotten group of vitamins. The Fat-Soluble Vitamins. Why? Deficiency is becoming epidemic here in America. A Majority of the population is walking around with at least one deficiency in fat-soluble vitamins. The most talked about are Vitamin D and K, so much so that pediatricians are now recommending supplementing infants, and giving newborns Vitamin K vaccines to prevent deadly issues with internal bleeding. YIKES! This could all be prevented with proper diet and lifestyle choices (enjoy some sunshine and eat some cholesterol…more below)

• VITAMIN A: (Beta-Carotene and Retinol) is essential for the health of our muscles, connective tissue, and eyes. When there is too much estrogen in the body, Vitamin A converts excess levels of active estrogen into inactive estrogen. It is essential for the growth and development of the embryo, specifically the eyes and nerves. It is also a stimulator of HGH (Human Growth Hormone) to signal embryo development. The form necessary for this is Retinol, which is found in animal foods, which luckily is often accompanied with fats to naturally aid in absorption. The issue is with food based Vitamin A (Beta-Carotene) which is often lost in cooking, or flushed because of a lack of fat for absorption. 
• VITAMIN D: This is so important in the treatment of PCOS, that I have a section below just for Vitamin D. Here is the deal, Vitamin D is not a vitamin at all…IT IS A HORMONE!!!! 
• VITAMIN E: Vitamin E is not a hormone, but it acts like a hormone. Specifically Progesterone. It works to mimic the affects of progesterone in the body, as well as reduce the negative affects of too much androgens (estrogen and testosterone). Not a commonly diagnosed deficiency, because it is not found in high concentrations in the blood, but in our tissues. I believe there is more Vitamin E deficiency present then we can accurately diagnose. Vitamin E is depleted by the over consumption of un-saturated fats (bad poly-unsaturated fats need Vitamin E to prevent oxidation), excess estrogens in the body (Vitamin E is an Estrogen Antagonist), as well as Fluoride. That all sounds all too familiar in our lives, eh? There is more information surfacing that Vitamin E is JUST AS IMPORTANT FOR TREATING PCOS AS VITAMIN D. Read Below
• VITAMIN K: Specifically K2, the level of deficiency in pregnancy is so vast, that newborns are injected with Vitamin K at birth to prevent issues with blood clotting. This is the only fat soluble vitamin that can be produced in the body…but (always a but…) you need to have an active and happy probiotic colony in the large intestines, and eat high amounts of fiber. The bacteria breakdown this fiber and produce Vitamin K. You are basically culturing vegetables in your intestines (like making internal sauerkraut). Yes, vitamin K works to clot blood, but it also helps to keep in flowing smoothly through the blood vessels. This is a delicate balance, and Vitamin K is a key. It is also an estrogen antagonist, much like Vitamin E, it helps to reduce the negative affects of too much estrogen. It binds to estrogen receptors and blocks estrogen.

For more detailed information and food sources of these vitamins, check out my previous post…click here

The Overlooked Role of Vitamin E in Treating PCOS

Vitamin E deserves more attention than it has been getting for reproduction. It is often overshadowed by the more easily diagnosed Vitamin D deficiency.

Without Vitamin E, our bodies cannot reproduce...period! 

Vitamin E is embedded into the lipid bilayer of our cells (the exterior "skin"). Although there is a lot of gaps in the research on Vitamin E and reproduction, there are some very good correlations.

• We KNOW that Vitamin E deficiency and Low Vitamin E levels are associated with Luteal Phase Defect
• We KNOW that Vitamin E deficiency and Low Vitamin E levels are associated with Anovulation
• We KNOW that Vitamin E deficiency and Low Vitamin E levels are associated with Frequent Miscarriage
• We KNOW Vitamin E is directly correlated with the amount of Progesterone, high Vitamin E and High Progesterone.
• We KNOW diets low in Vitamin E cause the Ovaries to produce more and smaller follicles and weak corpus luteum.
• We KNOW diets low in Vitamin E causes Ovaries to swell with neutral fats in the Ovarian Cortex (which should be in the lipid bilayer).
• We KNOW Vitamin E increases Endometrial Blood Flow to thicken the Endometrial Lining
• We KNOW Vitamin E increases the secretion of Progesterone from the Corpus Luteum and Endometrium to sustain pregnancy.
• We KNOW Vitamin E is found in the Pancreas and plays a role in Insulin Regulation
• We KNOW Vitamin E helps regulate the Thyroid Hormones
• We DON'T KNOW the mechanisms behind it.

What does this mean for those with Polycystic Ovarian Syndrome? Well, look at a lot of the functions of Vitamin E. Many of the issues associated with low levels of Vitamin E are symptoms of PCOS, are they not.

​The Important Role of Vitamin D in Treating PCOS

I want to highlight Vitamin D specifically, because in many women suffering fertility issues due to Polycystic Ovarian Syndrome, there is a level of Vitamin D deficiency. 

There are Vitamin D receptors on the Ovaries, Endometrium, Fallopian Tubes, and Placenta. The receptors are connected to nutrient availability. Why? Because if there is not enough food being consume (nutrient dense food, that is), then the body naturally knows it is not a opportune time for conception. This is primitive. The body would naturally encourage reproduction at times when the sunlight and foods are plentiful (gestation is 9-10 months), so that babies would be born at a time when breast milk would have the highest amounts of nutrition….conception in October, baby born in July. As the Vitamin D levels increase and attach to the ovaries, they stimulate the production of reproductive hormones at the different stages of menstruation (progesterone and estrogens). If there  is not enough Vitamin D attached to the ovaries, the ovaries do not release an egg for fertilization because the body is not nutritionally prepared for conception. It is a natural birth control, to make sure babies are born at a time that they are most likely to survive. And this is just the role of Vitamin D on ovulation and conception (although that is a pretty important link to other menstrual irregularities). 

Receptors are also in the endometrial lining of the uterus. Vitamin D attaches to these receptors and stimulates the production of progesterone to maintain the pregnancy. There is also a link between the Vitamin D deficiency and Endometriosis and other issues with Endometrium.

Receptors are also found on the growing placentas. Vitamin D attaches to these receptors and stimulates the production of progesterone  to maintain the pregnancy, as well as stimulates the growth of the embryo (specifically by stimulating bone growth, and hormone formation.)

There are many other benefits and needs for Vitamin D in the body (thyroid for one), but that is another blog…I am focusing solely on the role within reproductive hormones at this point. But, would welcome any questions you may have.

90% of Vitamin D comes from sunshine. Vitamin D deficiency can be characterized by the following symptoms; general bone pain or muscle pain and weakness; muscle cramping; unexplained depression; fatigue; lack of concentration; mood swings; anovulation; low sperm motility; childhood asthma; sleep irregularities. Unchecked Vitamin D deficiency can lead to severe conditions involving the Cardiovascular, Musculoskeletal, and Neurological systems. If you are experiencing any of the above symptoms as well as infertility, you may have a level of Vitamin D deficiency.

One study done at Yale University tested a group of women experiencing infertility. Only 7% had normal Vitamin D levels. Not a single patient with polycystic ovarian disease had normal Vitamin D levels. (ouch).

​Another study found that Vitamin D worked as a modulator for implantation of the fertilized egg and formation of the placenta. Which if deficient, could lead to miscarriage.

So, how much Vitamin D do you need? Well, that varies depending on your age, skin type and underlying health conditions. The body can make between 10,000-20,000IU from sun exposure alone, if conditions are right….wowzers….no supplement can match that without becoming toxic…truth. All supplements have a maximum that can be consumed before they become harmful. This is because they are synthetic vitamins, or separated vitamins. They are not found in their natural state and thus are missing many of the other nutrients, enzymes and chemicals that balance out and enable that specific vitamin in the body (sorry, another tangent). D2 is an example of this. It was the go to Vitamin D additive in milk, supplements, etc.. and it was found to be extremely hazardous. Supplements (if good), have switched to a D3. That being said there are times where diet and lifestyle are not enough and a supplement needs to be incorporated until levels are normal.

​I have my theory on the high rate of Vitamin D deficiency. I think there are two factors as to why people are not making enough of their own. 1) Too much sunscreen 2)Not enough cholesterol in the diet.  For the body to create Vitamin D, Cholesterol in the body interacts with UVB rays from the sun. The outcome is Vitamin D. How much sun exposure do you need…it varies from person to person. Those with fairer skin need less time, those with darker skin need more time. The general rule of thumb is 1/4 of the time it takes for you to get sunburned. Now, this only works if you have enough cholesterol in your blood stream. So, it is important to add in GOOD Cholesterol into your diet.

Breakfast #7 Broccoli Egg Scramble

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• 1 cup Broccoli Chopped
• 1/4 Onion, Chopped
• 2 Tbsp Bacon Grease
• 1 tsp Garlic Powder
• S/P
• 2 Eggs
• 1/4 Avocado
• 1 Tbsp Salsa

GI: 31
GL: 2

In a skillet heat 1 Tbsp grease, add onion and broccoli and cook until onion is translucent and broccoli is soft. Set Aside. In a bowl scramble egg and season with S/P/G. Add in 1 Tbsp grease, pour in 3 eggs scrambled, add broccoli mixture back in. Cook, stirring frequently, until eggs are cooked. Serve topped with Avocado and Salsa

Lunch #7 Nicoise Salad with Balsamic Vinaigrette 

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For Salad

• 1 cup packed Lettuce
• 1/8 pound Steamed Green Beans
• 2 oz. Tuna
• 1 Hard Boiled Egg
• 1/4 cup Olives
• 1/4 cup Artichoke Hearts
• 3 cherry tomatoes
• 1/4 cup Cucumber, sliced
• 1 sprig Fresh Dill

GI: 32
GL: 2

For Dressing

• 1/3 cup Olive Oil
• 1/4 cup Balsamic Vinegar
• 1/2 Lemon, juiced
• 1 tsp Dijon Mustard
• 1/2 tsp Herbs De Provence
• 1 clove Garlic
• S/P to taste

GI: 49
GL: 6

Complete Salad

GI: 32
GL: 3

In a bowl/container, add lettuce and chopped dill. Top with vegetables, tuna and egg. Drizzle enough dressing to coat, but not soak salad.

Dinner #7 Quick Sage Roasted Pork Chops; Bakes Sweet Potato; Sautéed Spinach

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Quick Sage Pork Chops

• 3-4 Pork Chops
• 1 Tbsp Sage, chopped
• 1 Onion, Chunked
• 1 Tbsp Bacon Grease
• 1 Tbsp High Heat Oil
• 1 Tbsp Apple Cider Vinegar
• S/P

Makes 3-4 Servings

GI: 29
GL: 1

Preheat oven to 350
Generously coat Pork Chops in S/P. In a cast iron skillet heat Bacon Grease and Oil. Add Pork Chops and cook until they are browned. Sprinkle with sage, flip. Arrange Onion between chops and and drizzle with apple cider vinegar. Slide into over and cook until chops are cooked through 10-20 minutes depending on thickness. 

Walnut Baked Sweet Potato

• 4 (4oz each) Small Sweet Potato
• 1 Tbsp High Heat Oil
• 2 Tbsp Walnut Oil
• 1/4 cup Walnuts, chopped

Makes 8 Servings

GI: 60
GL: 8

Preheat oven to 350
Pierce sweet potatoes with a fork. Massage the outside with oil. Place in oven unwrapped, with a baking sheet underneath. Cook until soft and juices are flowing. Remove, cut open and drizzle each with 1/2 Tbsp Walnut Oil and sprinkle with walnuts.

* NOTE: Sweet Potatoes are one of the "exemption foods." to some extent. It is still a glucose rich food, high in starch and sugar. BUT, it also contains chemicals that help insulin regulation. Small amounts balanced with larger amounts of fat and protein are okay on occasion. Just be sure it is fully balanced.

Sautéed Spinach and Squash

• 1/2 pound Fresh Spinach
• 2 medium Yellow Squash
• 2 Cloves Garlic
• 1 Tbsp Olive Oil
• 1/4 cup Chicken Stock
• S/P

Makes 4 Servings

GI: 32
GL: 2

In a skillet heat oil. Add garlic and cook until aromatic. Add squash and cook until beginning to soften. Add in spinach and cook until wilted. If dry, add chicken broth to prevent sticking and burning. Season with S/P.

Because of the added Sweet Potato, I calculated the GI and GL for the entire meal! For one serving of each item

GI: 48
GL: 10

This is a great example of how balancing high glycemic foods like sweet potatoes with larger amounts of fat and protein help to lessen the over load on the body.

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PCOS Nutrition Part 1: Basic Dietary Principles
PCOS Nutrition Part 2: Avoiding Dairy
PCOS Nutrition Part 3: Sugar
PCOS Nutrition Part 4: Glycemic Index vs. Glycemic Load
PCOS Nutrition Part 5: Building Your Meal
PCOS Nutrition Part 6: Understanding Hormones

​To Continue...
PCOS Nutrition Part 8: Increasing Dietary Fats
PCOS Nutrition Part 9: Top 10 Foods for PCOS
PCOS Nutrition Part 10: Tips for Implementing the PCOS Diet