Susie G, is a 40 year old female with PCOS (Polycystic Ovary Syndrome). She has been struggling with fertility for the past 2 years. She tried in vitro fertilization once but they were only able to retrieve 3 eggs, and only one of the eggs was viable. Her menstrual cycle timing was off so they froze the egg and are going to continue with the implantation procedure in 3 months when they can better balance her hormonal cycle. Her menstrual cycle is longer than normal, varying from 32-40 days in length and they are hoping to get it better regulated.
She is coming to see you because her MD suggested that nutritional support with diet and lifestyle changes may benefit her condition. She skips meals and has some issues with IBS (constipation predominant). He also recommended starting acupuncture to help regulate her menstrual cycle. She is a generally happy person who loves her husband, has a stressful job with long working hours 4-5 days a week as a sales rep, and sometimes has drops in energy.
Her basic diet:
Breakfast – protein shake with berries/banana/almond milk or eggs and toast; 2 cups of coffee
Lunch – salad with chicken/Italian dressing or turkey sandwich with spinach/tomato/cheese/mustard on rye/whole wheat bread; water or herbal tea
Dinner – meat/chicken/fish/pork, carrots/green beans/broccoli/squash, potato/white rice/pasta; water, glass of wine
Snacks – none during day, chocolate/ice cream at night before bed
Usually orders out most of lunch/dinner meals because of late hours working
Conventional Labs and Observations (only abnormal results are noted, hence normal parts of each lab are not shown below):
CMP (comprehensive metabolic panel) – fasting blood glucose is high at 104
CBC with differential – all within normal limits but her MCV is high normal at 98 (normal according to Quest, high according to Clinical lab partners ranges)
Lipid panel – high total cholesterol at 224, high triglycerides at 160, low HDL at 32, LDL high at 160
Height 5’8”, Weight 205 lbs, BMI 31.2, (obese), apple shaped, blood pressure normal at 116/76
High hsCRP at 3.1 (high risk of CVD)
High DHEAs at 275 (indicative of PCOS)
1. a. What medical concerns did you notice from the information above (list ALL her medical symptoms and diagnoses that you found from the information above, remember to crosscheck with the PPTs from module 1 to see if any other diagnoses could fit her description/labs above)? 1/2 point
1. b. Given the information above and what you have learned from the PPTs from module 1, what other conventional lab tests may be warranted (this part not graded, just to make you think about what was discussed in class so far)?
2. What would you change about Susie’s diet to help reduce her symptoms/diagnoses (remember to look at food and liquid content)? Provide a basic food/liquid plan offering 3 EXAMPLES of each meal (hence 3 breakfast, 3 lunch, and 3 dinners) and 3 snacks that could help her lose weight. Realize she is short for time and try to keep the meals easy/quick to prepare (easy recipes are encouraged, be specific about serving sizes, etc). 2 points