Fighting Ourselves: PCOS and Autoimmune Disease - PCOS Diva

Fighting Ourselves: PCOS and Autoimmune Disease

Guest post by Dr. Felice Gersh

As if it’s not enough to have acne, facial hair, thinning hair, irregular cycles, anxiety, depression, fertility and pregnancy problems, arthritis, irritable bowel syndrome, and resistant obesity (for the majority), now we must add autoimmune disease onto this distressing list.

We’ve covered many of the symptoms on that long list in other blog posts, so I’ll dive right into the topic of autoimmunity and why it’s now becoming more and more apparent that this is indeed a real issue for the PCOS community.

We now know so much more about autoimmunity than ever before. Here, in a brief summary of a very complex situation, is the story of the etiology of autoimmunity in women with PCOS.

Not surprisingly for those who have heard me speak or read my articles, the beginnings of autoimmunity reside in the deep recesses of the gut. The wrong bacteria typically inhabit the gut of women with PCOS and therefore do not create the essential protective mucous coating. This mucous coating, produced by “friendly” gut bacteria, is an essential barrier blocking the access of toxins produced by inappropriate types of bacteria, as well as those swallowed in the course of eating and drinking, from literally touching the enterocytes (lining cells of the colon which absorb nutrients). When these toxins, called Lipopolysaccharides, or endotoxins (toxins from within us) contact the gut lining cells, they create an inflammatory state. This, in turn, causes damage to the lining, and the enterocytes begin to separate from their neighboring cells, creating what is called impaired gut barrier function, or leaky gut. Normally, the enterocytes stay closely adherent to each other, in single file, with what are called “tight junctions.” As the cells separate, the spaces between the cells allow the toxins to freely pass through and into the tissues on the other side, the outer side of the gut lining cells. This tissue is the GALT (gut associated lymphoid tissue).

It turns out that 70-80% of our immune system lines the intestinal tract and is key to our overall metabolic, emotional, cognitive, and immune health. This translates to regulation of essentially all aspects of health, including reproductive.

Our GALT immune cells are there to protect us from gut related infections and to communicate our nutritional intake and status to our brain. It’s not designed to deal with leaky gut. As foreign particles from our food, called antigens, work their way across the “holes” between the enterocytes and into the GALT, the immune system tries to determine what’s going on. It’s unclear to the GALT what this invasion of foreign antigens means. And so, it does its programmed job; it creates antibodies to attack these antigens, trying to protect us from the invasion of particles from our food and pieces of bacteria.

A strange thing can happen over time. The immune system converts from making antibodies against the food and bacterial antigens to making antibodies against our own tissues! And that begins the process of autoimmunity – the production of antibodies against ourselves – essentially “friendly fire.” We’re now attacking ourselves!

The exact cell types of which particular organs get attacked by our own antibodies varies with the type of hostile bacteria growing within us and other factors still to be understood. It’s now been shown, for example, that women with certain types of bacteria develop rheumatoid arthritis more commonly. Autoimmune thyroid disease, often referred to as Hashimoto’s Thyroiditis, is the most common type of autoimmune disease which develops.

Autoimmunity is a serious condition and one which needs to be proactively managed by an integrative and functional medicine physician such as me. Sophisticated testing is necessary to evaluate the state of one’s antibodies, and happily, these are now readily available. The state of the gut needs analysis, to determine the gut microbiome situation. Inflammatory markers must be tested as well. Gluten antibodies, commonly found in those with leaky gut, must be tested for with the most advanced new tests. Autoimmunity is reversible, but to reverse it requires detecting its presence and a thorough evaluation.

The leaky gut must be healed and the immune system rebooted. I’ll share with you in my next blog how to immediately reduce your risk of developing an autoimmune disease and how to heal it if already established. I’ll also go into more detail on exactly why women with PCOS have a significantly higher incidence of autoimmunity compared with the general female population.

I have successfully reversed autoimmune thyroid disease in my practice and the great hope and potential exists for reversal of all autoimmune disease, particularly when detected at an early stage. I’ll share how in multiple sclerosis the myelin sheath, the covering of the nerves which dissipates in that condition, has actually been regenerated! All of this will be revealed in the second part of my blog series on PCOS and autoimmunity.

Dr. Felice Gersh is one of only a small number of fellowship trained integrative gynecologists in the nation. She blends the best of the world of natural and holistic medicine with state of the art functional and allopathic medical treatment. Because of her extensive knowledge of the complex inter-relationships of the body’s organs, she recognizes the need to investigate all aspects of health, always working to re-establish a healthy gastrointestinal tract, adequate sleep, good mood, great nutrition, high energy, and balanced hormones.

Expert in all areas of women’s health, and particularly of gynecological and reproductive matters, Dr. Gersh deals in an integrative manner with such uniquely female issues as polycystic ovary disease (PCOS).

She is currently writing a book on Polycystic Ovary Syndrome and writing a chapter on the same topic for a medical textbook.

You may contact Dr. Gersh at:

Integrative Medical Group of Irvine, 4968 Booth Circle, Suite 101, Irvine, California 92604



Phone: 949-753-7475

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  1. I’m curious, if the immune system can be rebooted and the leaky gut completely healed, does that mean once those things are back in functioning order you would no longer have those food intolerances and develop antibodies to things like Gluten and food intolerances?

  2. Dear dr. I had PCO since I was 23 and when I was 30 I diagnosed hashimto thyroditis then when 36 I had new autoimmune rheumatoid now i’m 38 &
    My question how to adjust immune system ? Any recommendations new drug or lab tests?