Andreea Nitescu RD MSc

Andreea Nitescu RD MSc Registered Dietitian specializing in precision nutrition, the microbiome, genomics & longevity. Passionate about gut health and autoimmune diseases.

Love to help people achieve metabolic health and relieve symptoms of chronic diseases.

🪷 𝗟𝗶𝘃𝗲 𝗪𝗲𝗯𝗶𝗻𝗮𝗿: 𝗪𝗵𝘆 𝘆𝗼𝘂𝗿 𝗣𝗖𝗢𝗦 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀 𝗮𝗿𝗲𝗻’𝘁 𝗶𝗺𝗽𝗿𝗼𝘃𝗶𝗻𝗴(and what to do differently) 📅 Date: Sunday, 26 April 2026⏱️ Time...
19/04/2026

🪷 𝗟𝗶𝘃𝗲 𝗪𝗲𝗯𝗶𝗻𝗮𝗿: 𝗪𝗵𝘆 𝘆𝗼𝘂𝗿 𝗣𝗖𝗢𝗦 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀 𝗮𝗿𝗲𝗻’𝘁 𝗶𝗺𝗽𝗿𝗼𝘃𝗶𝗻𝗴
(and what to do differently)

📅 Date: Sunday, 26 April 2026
⏱️ Time: 11:00 AM – 1:00 PM (UK time)
🌐 Zoom
🎟️ Price: £50

If you have polycystic o***y syndrome (PCOS) and feel like nothing is really improving despite trying different diets, supplements, or advice — you’re not alone.

In my practice, a large proportion of the women I work with have PCOS, often alongside other health concerns. These can include:
✓ insulin resistance, prediabetes, type 2 diabetes, NAFLD/MASLD
✓ weight issues
✓ gut-related symptoms (such as bloating, IBS, SIBO, or acid reflux)
✓ infertility
✓ anxiety, low mood, or sleep disturbances.

The problem is usually not a lack of effort — but the fact that PCOS is not a single condition. Without understanding the underlying drivers, most approaches end up being too general to work.

In this session, I’ll walk you through a more integrated approach to PCOS, covering hormones, gut health, metabolism, genetics, and lifestyle.

A key focus of my work is the gut microbiome, which plays a central role in inflammation, metabolism, and hormonal balance — and is often overlooked.

🔎 We’ll look at:
✓ why symptoms often persist even when you feel like you’re doing everything “correctly”
✓ how different PCOS presentations require different strategies
✓ the connection between PCOS and gut issues such as bloating, IBS, SIBO, or reflux
✓ what is commonly missing from standard approaches
✓ dietary strategies that actually make a difference
✓ supplements and lifestyle approaches that can support PCOS

You’ll leave with a clearer framework and practical next steps, plus a handout and live Q&A.

👉 Link in comments to book your spot

🔹 What is Methylmalonic Acid (MMA)MMA is derived from methylmalonyl-CoA, an intermediate in:• Odd-chain fatty acid metab...
01/04/2026

🔹 What is Methylmalonic Acid (MMA)
MMA is derived from methylmalonyl-CoA, an intermediate in:
• Odd-chain fatty acid metabolism
• Branched-chain amino acids (valine, isoleucine)

Under normal conditions, it is rapidly converted and remains low.

➡️ Elevated MMA reflects a block in mitochondrial metabolism

🔹 The Critical Reaction
In mitochondria:
Methylmalonyl-CoA → Succinyl-CoA
• Catalyzed by methylmalonyl-CoA mutase (MUT)
• Feeds directly into the TCA cycle

🔹 Where B12 Comes In
This reaction requires adenosylcobalamin (AdoCbl) — the mitochondrial, active form of vitamin B12.

Without AdoCbl, the enzyme cannot function.

🔹 What Happens When This Pathway Breaks Down
• Methylmalonyl-CoA accumulates
• Converted → methylmalonic acid (MMA)
• MMA spills into blood and urine

This reflects functional impairment, not just intake.

Key insight:
Elevated MMA = impaired intracellular B12 utilization

• MMA is a sensitive marker of B12 deficiency at the tissue level
• Can rise even when serum B12 appears “normal”
• Reflects mitochondrial dysfunction specifically

🔹 Functional vs Absolute B12 Deficiency
You may see elevated MMA with:
• Impaired cellular conversion → AdoCbl
• Transport or trafficking issues
• Mitochondrial dysfunction
• Aging-related decline

Not all deficiencies are due to low intake.

Clinical Manifestations
• Fatigue/reduced energy production
• Neurological symptoms (paresthesia, cognitive changes)
• Impaired fatty acid & amino acid metabolism
Consistent with disrupted TCA cycle input

🔹 Why the Form of B12 Matters
Different forms of B12 serve different roles:
• Adenosylcobalamin → mitochondrial (MMA pathway)
• Methylcobalamin → cytosolic (methionine synthase)

Both are biologically active, but not interchangeable.

🔹 Practical Clinical Takeaway
If MMA is elevated:
• Consider functional B12 deficiency
• Assess underlying causes (absorption, metabolism, genetics)
• Consider targeted B12 support, including mitochondrial forms (e.g., adenosylcobalamin)

Testing Insight
In practice, I often use the Metabolomix+ test from Genova Diagnostics:
• Includes methylmalonic acid
• Assesses broader methylation & metabolic pathways

Helps identify functional imbalances, not just nutrient levels.

Don’t underestimate circadian metabolism.In PCOS, insulin is not just a metabolic hormone — it’s a driver of androgen pr...
01/04/2026

Don’t underestimate circadian metabolism.

In PCOS, insulin is not just a metabolic hormone — it’s a driver of androgen production.

Chronically high insulin (hyperinsulinemia) stimulates increased synthesis of androgens, including testosterone.

A randomized controlled trial in 60 lean women with PCOS tested whether meal timing alone could change this (PMID: 23688334).

Participants were assigned to two isocaloric diets (~1,800 kcal/day) for 90 days:

→ Breakfast-focused group (BF):
980 kcal breakfast • 640 kcal lunch • 190 kcal dinner

→ Dinner-focused group (D):
190 kcal breakfast • 640 kcal lunch • 980 kcal dinner

What happened in the breakfast-heavy group:
→ ↓ glucose AUC by 7%
→ ↓ insulin AUC by 54%
→ ↓ free testosterone by 50%
→ ↑ SHBG by 105%
→ ↓ GnRH-stimulated 17OHP by 39%
→ ↑ ovulation rates

No significant changes were observed in the dinner-heavy group.

Mechanism:
Improving insulin sensitivity reduces stimulation of ovarian cytochrome P450c17α, which lowers androgen production and supports improved ovulatory function.

This is a direct metabolic → endocrine link.

Translation:
Your body handles identical calories differently depending on when you eat them.

If you eat the bulk of your calories in the morning, you get higher insulin sensitivity and better glucose handling.

Other studies (PMID: 23512957) support these findings, showing that front-loading caloric intake earlier in the day improves glycemic control and insulin sensitivity.

From an evolutionary perspective, this makes sense — humans evolved eating the majority of their food during daylight hours, when activity, energy demand, and metabolic efficiency were highest. As a result, our circadian biology is still primed to handle nutrients more effectively earlier in the day.

Bottom line:
Meal timing is not just a lifestyle tweak.

It’s a metabolic intervention that directly affects ovarian hormone production.

Sometimes, traditional advice holds up remarkably well under scientific scrutiny:
“Breakfast like a king, lunch like a prince, dinner like a pauper.”

In practice, aligning caloric intake with circadian biology is something I often incorporate into patient protocols.

MCAS and MCAD are related, but they do not mean the same thing. This carousel breaks down the difference in a clear, sim...
20/03/2026

MCAS and MCAD are related, but they do not mean the same thing. This carousel breaks down the difference in a clear, simple way — swipe to learn more →

Next week I'll be joining the Global Longevity Federation conference (GLF 2026) virtually to speak about a topic that is...
19/03/2026

Next week I'll be joining the Global Longevity Federation conference (GLF 2026) virtually to speak about a topic that is near and dear to my heart:
🔹Gut microbiome signatures in centenarians: microbial profiles, metabolites, and pathogen-associated molecular patterns as potential modulators of longevity

My presentation will be on Day 2 (March 24th) at 12:10-12:30 GMT.

The conference will take place in Rome (IT) between 23-24 March, so if you're interested, head out to the Global Longevity Federation 2026 website to get a ticket.

Excited for this opportunity ✨

Your immune system isn’t just responding to pathogens—it’s interpreting signals.PAMPs (microbial) and DAMPs (damage-deri...
17/03/2026

Your immune system isn’t just responding to pathogens—it’s interpreting signals.

PAMPs (microbial) and DAMPs (damage-derived) are constantly being detected by the innate immune system, often through the same receptors.

This is where things get interesting:

You don’t just get inflammation from “bad microbes.”
You also get it from cellular stress, barrier damage, and host-derived signals.

This overlap is a key driver of chronic inflammation—and potentially aging.

If you’re only looking at microbiome composition, you’re missing a major part of the picture.

👉 Swipe to understand how PAMPs and DAMPs shape immune activation

01/03/2026

For most people, comfort foods are something like: mac and cheese, pizza, lasagna, ice cream, or apple pie.

For me, if I had to settle for one comfort food, this would be it: Cobb salad.

This time, I had a modified version:
• extra mature Cheddar instead of blue cheese
• corn salad (aka lamb's lettuce in the UK) and red lettuce — instead of romaine, iceberg and endive

The ingredients:
• grilled chicken
• avocado
• bacon
• cheese
• leafy greens
• tomatoes
• boiled eggs
• homemade EVOO basil and thyme croutons

The dressing was also modified: it had EVOO, balsamic vinegar, mustard, salt, and a bit of mayonnaise.

Absolutely divine 🤌🤌🤌

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