MTHFR and Insulin Resistance are two examples of why careful interpretation matters. MTHFR is an enzyme involved in folate metabolism and the methylation pathway. Certain genetic variants are common in the population, and research has explored possible relationships between MTHFR variants and various health outcomes.
But having an MTHFR variant does
not automatically mean that a person has infertility, PCOS, endometriosis, inflammation, or another particular disease. Genetic variation is part of biology. It is not a diagnosis by itself. Throughout the blog, and here at Ohel Shira, we will keep returning to the principle that a genetic variant is not a destiny.
Insulin Resistance is the next important example. Insulin helps regulate how the body handles glucose and energy. When tissues become less responsive to insulin, the body may compensate by producing more insulin. Insulin resistance is an important component of metabolic health and is particularly relevant to many women with PCOS. But even though this proves a metabolic connection, metabolic health is not determined by only one measurement.
It is influenced by many factors, including genetics, body composition, physical activity, nutrition, sleep, age, and other biological and environmental factors. This is why we need to move beyond simplistic statements such as, “Insulin is bad” because insulin isn't bad, it is essential. The question is how the system is functioning.
Reproductive health is also complex, along with the above examples and endometriosis and adenomyosis remind us of another important principle. Pain, bleeding, infertility, and other reproductive symptoms can have multiple contributing factors. These conditions cannot simply be reduced to: “You have too much estrogen”, or “You have inflammation”, or “You are insulin resistant”. These explanations may capture one piece of a much larger picture, but they do not replace a medical diagnosis. And importantly, a woman's symptoms are not her fault.
Lifestyle choices may influence health, but they do not mean that a woman has caused her own disease.
