PCOS: salivary hormones and blood sugar levels

I am back in Canada for a few weeks to visit my family and decided to take advantage of this time to try to get healthier… as always!

I had my first visit to a naturopathic doctor last month and I am quite happy at how holistic their approach is. It is so good to have every part of your body looked at and every organ considered to help you reach your optimal health.

Although my past blood analysis showed normal hormone levels, my naturopathic doctor wanted to check my salivary hormones. She also wanted to check what my fatigue was due to by checking my ferritin levels (to check for anemia), thyroid hormones (not only TSH, but also T3 and T4) and adrenal gland (by checking cortisol in am and at bedtime).

My ferritin was at 99! Higher than ever! I used to suffer from anemia and had 11-12 in the past while on eating whole grains, soy and legumes a la “regular” dietitian’s advice, up to 16 after many months of supplementing with high doses of iron! I am probably eating less iron in total than when eating fortified whole grains and taking iron supplements, but the iron is my food is more bio-available. I believe my improved ferritin levels because I eat more animal food and have decreased my phytate intake (anti-nutrient that inhibits iron absorption, among other things) by avoiding soy, grains and legumes.

All my thyroid hormones (TSH, T3 and T4) were within range.

However, my extremely low salivary cortisol levels at night (as you can see below) show that I might have adrenal fatigue.

My salivary hormones also show high testosterone and borderline low estrogen, which is pretty much typical for PCOS… I am glad I am not dealing with the symptoms associated with high testosterone levels(abnormal hair growth or hirsutism, acne, etc), but I attribute this to the fact that I am eating a clean, low-carb Paleo diet. I believe I might not be as fortunate should I have still been eating my former high-carb, high-grain diet after stopping taking the birth control pill (now almost 14 months ago… no cycle since)…

my salivary hormones (Dec 2011)

To see whether insulin resistance was involved for me (and it is for many women with PCOS), I decided to experiment with testing my blood sugar levels (see the results below).

my blood sugar levels (Jan 2012)

This is not good news… Some of my results are in the prediabetes and even diabetes range… I definitely don’t want to be following the Canadian or American Diabetes Association’s guidelines, which are definitely not strict enough if you want to stay healthy. Instead, I am comparing with what Chris Kresser recommends as optimal targets.

blood sugar target (www.chriskresser.com)

Fortunately, I can see that by keeping my carbs very low (probably around no more than 10 g per meal), I can normalize my blood sugar levels. (If you have diabetes, prediabetes or blood sugar issues, do not lower your carb intake without first talking to a doctor or dietitian specialized in low-carb diets, especially if taking medications).

My experiment clearly indicate, in my own opinion anyway, that I have serious insulin resistance problems. This probably explains why I put on weight so easily and need to be very careful about every bite I eat… During the holidays, after over 6 months of following a very restrictive diet (to control my post-infectious IBS, fructose malabsorption and SIBO), I took advantage of my increased tolerance by enjoying a bit more GAPS- and Paleo-friendly treats (cake, cookies and muffins made with coconut flour and honey, nuts and nut butter, fruits and butternut squash fries!) Although my GI system seemed to be fine with this, my high insulin levels helped my fat cells stored every one of these delicious bites…. Result: 6 lbs. weight gain in about 2 weeks. Needless to say, I have stopped coconut flour, honey, nut, fruits and higher-carb vegetables (squash, beets)…. but the weight doesn’t want to come off that easily it seems…

My plan:

  • My naturopathic doctor has recommended a detox plan for me, which I have been following for the last month and will last a few more weeks.
  • I was doing IF (intermittent fasting) to help with my weight/insulin resistance, but because of my adrenal fatigue, she prefers that I spread my food intake throughout the day.
  • To control my blood sugar levels, which will help me keep my insulin levels down and hopefully lower my testosterone levels as well, I will stick to a very-low-carb diet (around 20-30 g of carbs/day).
  • I want to start exercising every other day (something light like walking, snowshoeing and light resistance training). I have been too tired lately (probably bc of the adrenal fatigue), but I am feeling like I have a bit more energy since having started the detox. Exercising is great for improving insulin resistance, which appears to be the root cause of many cases of PCOS.
  • I will also continue doing my best to lose at least the weight that I gained during the holidays, and maybe more. Weight loss, if needed, is also a good way to improve insulin resistance.
  • Continue to aim for at least 8-9 hours of sleep (which I already do, except for when I have insomnia… like now!, which happens 1-2/week)…
  • Avoid stress or take more time to relax, play and enjoy life!

Any comments or suggestions are greatly appreciated!

Learn more about the Personal Paleo Code


When I started on the Paleo diet in 2010, I decided to stop taking the birth control pill at the beginning of December 2010. My periods didn’t start for a few cycles, but I didn’t worry as I am aware that post-pill amenorrhea is fairly common…. but after 6 months, I decided to consult. My doctor ran a few blood work to find out that my testosterone levels (total testosterone, DHEA, free testosterone, sex hormone binding globulin, free androgen index) and other hormones (including LH, FSH and thyroid) were fine. My doctor suggested I wait another 3 months because she considered the stress of moving to another country and my parasite infection possible causes for my amenorrhea… but nothing happened.

My doctor referred me for an ultrasound at the beginning of October after being amenorrhic for 10 months. As the ultrasound was being done, I could see the image on the screen looking like polycystic ovaries… I was told that I had 35 underdeveloped follicules of about 8 mm in length on my left ovary and 25 on my right. The OBGYN doctor told me right away that I had PCOS because of my amenorrhea and polycystic ovaries, even though my androgen hormone levels appear normal and I don’t suffer from hirsutism (abnormal hair growth) or acne.

polycystic ovary

To diagnose PCOS, which stands for polycystic ovarian syndrome, at least 2 of the following criteria need to be met according to the Rotterdam 2003 definition:

  • abnormal or absence of periods
  • polycystic ovaries diagnosed with ultrasound
  • excess androgen levels or clinical signs of excess androgen (hirsutism, male-pattern baldness, acne)
However, I only have PCO (polycystic ovaries) and not PCOS (polycystic ovarian syndrome) according to the Androgen Excess and PCOS Society criteria, which makes it very confusing to understand what is going on. This interesting article discuss the different phenotypes of PCOS created by the Rotterdam definition.
Basically, both PCO and PCOS are the leading cause of infertility and can lead to numerous other health problems. I consider myself very fortunate not having to deal with symptoms of high testosterone levels, but I am quite worried about my ability to conceive, naturally or at all, which is something my partner and I are considering within the next couple of years….
PCOS or PCO are thought to be cause by either high androgens (male hormones), high insulin levels or both (see diagram below). Considering that my androgen levels are normal, I presume that I may be hyperinsulinemic or insulin resistant, although I haven’t been tested for this parameter yet. This would explain why, although I am not terribly overweight, I have always been struggling to stay at my current weight, which is still about 15 to 20 lbs higher than where I would like it to be and where I was before starting on the pill. I was never able to keep my weight stable and at 5’8”, my weight have mostly ranged between 155 and 170 lbs… although I was able to reach my dream weight of 145 lbs on a couple of occasions in the past… but for no more than a week or two though…

Evidence-based guideline for the assessment and management of polycystic ovary syndromeEvidence-based guideline for the assessment and management of polycystic ovary syndrome, The Jean Hailes Foundation for Women’s Health on behalf of the PCOS Australian Alliance 2011

I believe that the Paleo diet is best for correcting the hormonal imbalances associated with PCO/PCOS. I know many women who were able to get their health and fertility back decreasing their carb intake and eliminating grains/gluten, such as Danfredo Rivera and The Primal Parent.

However, I am worried that it is not going to be enough for me. I haven been eating Paleo for a year now, strictly eliminating all grains, legumes and sugar. I have had some dairy, but only good quality grass-fed butter and maybe 3-4 serving of cheese in the last year… I have eliminated plastic and BPA from my life (women with PCOS have higher BPA levels in their blood), my diet is low in carbs and is based on high quality, free-range sources of protein, plenty of vegetables and healthy fats… but I still haven’t had a cycle for 12 months now… 😦

2011 was definitely not a good year health-wise for me. Just as I thought I had it figured out with my parasite infection, newly developed food intolerances, post-infectious IBS, SIBO, I got diagnosed with PCOS… 😦

I am not ready to give up yet but I believe I need the help of a healthcare provider as I honestly believe my diet is close to being perfect! I am also walking on a regular basis and was getting an average of 8-9 hours of sleep (before going on vacations last week, but I intend on going back to my good sleeping habits tonight now that I am back home!).

Maybe my liver needs some help? I probably need some more testing to assess my different hormone levels, determine whether I have hyperinsulinemia or insulin resistance? Maybe some herbs or natural supplements to promote fertility naturally could help? I will be meeting with a naturopathic doctor mid-December when I am back in Ottawa, Canada for the holidays…

…to be continued…

Learn more about the Personal Paleo Code