5 Types of PCOS and How to Treat Them- Which type are you? [Expert Interview] - PCOS Diva
5 Types of PCOS and How to Treat Them- Which type are you? [Expert Interview]

PCOS Podcast 48There is no one-size-fits-all PCOS diagnosis. “To see everyone with PCOS as having the same condition would be like to see everyone who has a headache as having the same condition,” says Dr. Lara Briden.  In her years of clinical experience, she has found 5 types of PCOS, each with unique requirements for treatment. Listen as this renowned expert discusses:

  • The 5 types of PCOS
  • Recommended (and not recommended) supplements or herbs for each type (including peony, licorice, Vitex, berberine, Inositols, selenium, zinc and vitamin D)
  • Foods to avoid
  • Questions for your doctor and the right way to ask them
  • The relationship between PCOS, Hashimoto’s, and Thyroid
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A full transcript follows.

 

Links mentioned in the podcast:

http://www.larabriden.com/the-curious-link-between-estrogen-and-histamine-intolerance/

http://www.larabriden.com/have-you-lost-your-period-to-a-low-carb-diet/

Leaky Gut and PCOS

 

Lara Briden2016Dr Lara Briden is naturopathic doctor with nearly 20 years experience treating PCOS. She runs a busy hormone clinic in Sydney, Australia, and is the author of the popular book Period Repair Manual: Natural Treatment for Better Hormones and Better Periods.

 

 

 

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Full Transcript: 

Amy: Hello. Welcome to another edition of the PCOS Diva podcast. This is your host, Amy Medling. I’m a certified health coach and I’m the founder of PCOS Diva. I’m here today with one of my favorite guests. We’ve recorded a couple of podcasts, and she agreed generously to come back onto the PCOS Diva podcast. I want to welcome Dr. Lara Briden.

 

Dr. Briden: Hi Amy. Thank you so much for having me again. It’s always a pleasure to speak with you.

 

Amy: Well, it’s wonderful to have you here and I’m excited about the topic that we are going to be speaking about. First I just want to give you a little intro. You are a naturopath doctor with nearly twenty years’ experience treating PCOS. You run a busy hormone clinic in Sydney, Australia, and you are the author of the popular book Period Repair Manual: Natural Treatment for Better Hormones and Better Periods. I have to tell you, my copy of my book is dog eared and looks like it’s been really loved. I’ve really enjoyed this book over the last year. I think you put it out in 2015.

 

Dr. Briden: Yeah, early last year. It’s been great. I refer to it as well. I’ve actually got it on my desk right now in case I need to look something up.

 

Amy: Yeah. I love the chapter on PCOS, which is really the topic of today’s podcast. We’re going to be talking about the four types of PCOS, four phenotypes that you’ve identified from twenty years of experience working with women with PCOS, and the treatments for each type. Before we get into that, I just want to let listeners know that if you enjoy Dr. Laura’s talk today as much as I love talking to her, you’re going to want to check out our two previous podcasts together. Podcast number 7 we talk about the risks of the pill for PCOS, and she gives some great alternatives for birth control if you’re on the pill for birth control reasons as well. Then number 19 we talk about herbal supplements for treating PCOS and Laura takes us through many of the different herbal remedies and how to use those. Two great podcasts to listen to as well.

 

Why don’t we dive into the four types of PCOS that you’ve identified, and maybe you could give us a little background about how you came to putting those descriptions in your book.

 

Dr. Briden: Okay. What was apparent to me pretty early on in my practice, as you say, twenty years ago, was that the women who were coming to me with a diagnosis of PCOS were not one group. They were meeting some of the same diagnostic criteria, but really I could see just from their general health and their health history that they’d come to that place from very different directions.

 

The way I see PCOS now is, it’s not one condition. It’s a set of symptoms, it’s a set of signs and symptoms, criteria, and the analogy I think of now is, it’s kind of like … To see everyone with PCOS as having the same condition would be like to see everyone who has a headache as having the same condition. As we know, headache is a symptom. Some people have it just because of sinus, some people because of migraine or muscle tension, and so it makes sense we don’t treat everyone with a headache in the same way. That’s how I see PCOS. I really try to get beneath the label, beneath the diagnosis, and look at what’s actually going on.

 

Amy: I know when I was reading your book I had this “aha” moment. My mother has PCOS, and gosh, now I have a little girl and I wonder, “Are those genes going to express themselves?” I feel like I may have been able to turn off that expression if I had a better diet when I was a teen. I had a horrible diet, and I think that the gluten and the dairy and the inflammatory foods may have triggered those genes. That’s just my own personal thoughts. One of your … We can get into the different types, but one of your types is an inflammatory PCOS. Maybe we could start there.

 

Dr. Briden: Yup. I think you’re right, I think you can with confidence know for your own daughter, if she grows up avoiding inflammatory foods and having better knowledge around that area, she could definitely prevent the expression of the high androgen picture. It is true that some women just genetically tend to the high androgen symptoms, but certainly as I know, as I’m sure you know with working with your own clients, that can be modified.

 

The inflammatory one is often one that, it’s one of the lesser common ones. The most common cause of PCOS or cause of androgen expression is insulin resistance, which we’ll come back to later. The inflammatory one’s pretty common, and I see it in women that are showing other signs of inflammation, including what to me are clear signs of either gluten sensitivity or dairy sensitivity, and that may even be expressing, showing up as a positive gluten reading on blood tests, and they have other inflammatory symptoms like psoriasis or skin problems, or chronic allergies or headaches, things like that.

 

Amy: Yeah, and that was something that I definitely dealt with was a lot of headaches when I was a teen, without really any reason why, and the joint pain too. I had a lot of joint pain, and I was an athlete. I felt like, “Oh, it’s just because I’m over-exercising,” but it’s so interesting to be able to make those connections now looking back. Boy, I’m so happy that I have this knowledge that then I can share with my daughter. Maybe you can talk, you’ve talked a little bit about what is the inflammatory PCOS, but how do you want to approach this? Should we talk about the treatments for each type?

 

Dr. Briden: Sure. Yeah, let’s stay on the topic of inflammatory PCOS and then talk about some of the treatments that I recommend. Just to clarify for your listeners as well, certainly there is research that inflammatory cytokines they’re called, that certain inflammatory products that you can measure in the blood, are elevated in PCOS sufferers compared to women without PCOS. There’s a couple research studies showing that the ovaries in PCOS have higher levels of inflammatory cytokines present. I would argue that that’s perhaps true to some degree for everyone who’s come under the PCOS diagnosis umbrella, but it seems to be more pronounced in certain women in my practice, a working diagnosis that I classify as having inflammatory PCOS.

 

The other thing that defines, for me, inflammatory PCOS is the absence of insulin resistance. If insulin resistance is present, then that’s the type. That’s the focus. I may also do anti-inflammatory things as well, but what we’re talking about now is this inflammatory type, where that’s the key feature and there’s no insulin resistance. It’s important, because a lot of these women will be quite frustrated reading the information, what they’re finding online. They’re seeing, for example, they need to follow an insulin-lowering diet and low carb diet, and that hasn’t been working for them. I would argue that’s because insulin resistance is not the driving cause in their case. They need to shift their focus to something a bit different.

 

Amy: Yeah, and I think that’s why I had such a hard time getting a diagnosis. I wasn’t diagnosed until I was thirty because I have that thin PCOS type and I didn’t have the … I think maybe there’s a low level of insulin resistance, but it certainly wasn’t showing up in labs. That’s why I really think that your inflammatory type really hit home with me. Going on obviously an anti-inflammatory diet is really important. I know I’ve- Yeah, go ahead.

 

Dr. Briden: That means avoiding inflammatory foods, some of the big ones such as wheat, cow dairy, vegetable oils. Sugar is inflammatory as well, so it’s not like women with inflammatory PCOS don’t have to … I think really anyone with PCOS or really anyone benefits from cutting back on sugary foods. That’s not unique to the insulin resistant PCOS.

 

Amy: Yeah. I’ve discovered a really great food allergy test through my local naturopath. It looks at a hundred and thirty-two different foods, and my husband just had it done, and he found out that he was allergic to both baker’s yeast and brewer’s yeast, and that was causing a lot of inflammation. Removing that from his diet has really made an enormous difference in his health and the inflammation levels. Looking at the common ones like gluten and dairy, but even looking at possibly getting a food allergy panel done to see what other foods might be causing you problems I think can be helpful.

 

Dr. Briden: I agree. Is that an IGG test?

 

Amy: Yeah, it’s KBMO I think is the company that does it. Go ahead.

 

Dr. Briden: Sorry. Yeah, I do order those sometimes. They’re not perfect, and certainly there’s people out there arguing, questioning the complete validity of that method of testing as a stand-alone testing, but I find it useful. I find it, certainly with some of my patients it’s alerted us to things. As you say, other food sensitivities like eggs. Eggs is a common one that shows up on there that are driving, contributing to inflammation.

 

Amy: Yeah. What kind of supplements or herbals do you recommend for inflammatory PCOS?

 

Dr. Briden: Great question. Actually one thing I’ll just interject with here is, what I see in this group of women with inflammatory PCOS, one thing on the blood test that I find quite useful is the positive thyroid antibodies. That’s a marker of autoimmune thyroid or autoimmunity that we know from the research is quite common with PCOS. This is the group where I see it most commonly. That’s a marker that the immune system is not happy, it’s a type of inflammation, it’s a type of autoimmunity. That improves very much from avoiding gluten products. That’s maybe a bit more specific type of testing your listeners could look at as well.

 

Amy: Does that mean that you have full-blown Hashimoto’s at that point?

 

Dr. Briden: No, not necessarily, no. No, the presence of thyroid autoimmunity, thyroid antibodies, is associated with Hashimoto’s, which is autoimmune thyroid disease, but the antibodies can be there and yet the thyroid function itself is still holding and there hasn’t been much damage yet visible on ultrasound. It’s kind of a, if you will, kind of like a milder version or pre-clinical presentation of that, but it’s still useful from a functional perspective just to understand that there is some autoimmunity happening and that therefore almost always implies that there’s some degree of intestinal permeability. Are your listeners familiar with that term? Is that something you’ve talked about before? Leaky gut?

 

Amy: Yes. Actually, Dr. Fiona McCulloch I think wrote a really great article on the site. I’ll reference that at the end of the podcast if people want to read it, hear more about it.

 

Dr. Briden: That’s probably a feature, that’s what I find to be a feature in this inflammatory PCOS type is intestinal permeability. Part of the treatment is to work at correcting that by avoiding the inflammatory foods. Some of the supplements that can help repair intestinal permeability is zinc. I love zinc, talk a lot about it in my book, doing courses of probiotics, perhaps turmeric, and then another herbal medicine which you and I spoke about last year in our podcast is berberine, which actually is a helpful treatment for different types of PCOS, but it’s helpful here because there’s research that shows it’s helpful for repairing leaky gut and reducing inflammation.

 

Amy: What do you think about fermented foods?

 

Dr. Briden: Well certainly I use them. I make my own sauerkraut and use that as a supportive measure. Just one caution thought, I’ve found if people are having a lot of fermented foods, they just need to be careful that they don’t have histamine intolerance, which is quite common amongst women for different reasons. I have an article about histamine on my blog. It can aggravate inflammatory symptoms, so if women are having a lot of fermented foods and not feeling that great, they might want to rethink that, or at least rethink the amount that they’re having.

 

Amy: Okay. I’m going to have to point to that under the podcast as well. I’m going to have to read that article. Anything else in terms of herbals or nutrients, before we move to the next type?

 

Dr. Briden: I think we’ve covered the main ones. I guess the other one would be potentially using selenium to modulate or regulate the immune system. It’s been shown to be helpful to reduce thyroid antibodies, so if antibodies are elevated, then that’s something to look at, and vitamin D, which is a strong immune modulator.

 

Amy: Yeah, and probably important for everyone with PCOS too.

 

Dr. Briden: Yes, but for different reasons.

 

Amy: Yeah, okay. All right, so which one should we talk on next?

 

Dr. Briden: Let’s talk about the insulin resistant PCOS, because it is the most common. I think it’s the seventy percent of the population of PCOS falls under that category. My take on it, what I’ve seen, the research and what experts say is that insulin resistance is a driving cause. Again, someone that has a genetic susceptibility to high androgens, to this kind of response, once insulin resistance is established, that’s what basically causes the ovaries to make too much testosterone and to not ovulate regularly. It’s a pretty important condition to correct.

 

Amy: It also plays into your hunger hormones too.

 

Dr. Briden: For sure.

 

Amy: Maybe you could describe that process for our listeners.

 

Dr. Briden: Yup. Having chronically elevated insulin as well as leptin, which usually goes hand in hand, creates a constant hunger feeling, and certainly makes it very difficult to lose weight. I just found an interesting reference that really, weight loss is not really possible until fasting insulin can come below 8. That’s a goal that I have with a lot of my patients, is to work at sensitizing the body to insulin so insulin will drop in the fasting state.

 

Amy: Yeah. I think a lot of women too have a hard time, like you said, with the hunger. They feel like they have to compulsively eat, and it’s like this vicious cycle. I think knowing that it’s not your willpower that’s really at play can be really freeing, that learning to be able to regulate your body chemistry is really what you need to be focusing on.

 

Dr. Briden: I agree. That’s the angle I take with my patients. It’s not about willpower, it’s about correcting metabolic function and being able to get to the place where you have more of a normal, healthy hunger with your meals and then appetite subsides between meals. That’s the normal appetite response.

 

Amy: If a woman believes that she … The seventy percent of women with PCOS who have insulin resistant and insulin PCOS, or insulin resistance PCOS, why don’t you give us some tips on how we can make the situation better?

 

Dr. Briden: I think the number one thing is to completely, at least temporarily, completely avoid high fructose sugar products. This is what I’ve found works. This is one of the strongest interventions. I separate that out, I separate high fructose foods from high carbohydrate foods more generally. Some women may benefit from going a bit further, and also I think reducing glucose starch foods like potatoes and rice and things like that, but I don’t want them to do that until they’ve first removed desserts and fruit juice and dried fruit and all of the high fructose foods, because that’s very damaging for insulin sensitivity. I have a new reference that I just tweeted a couple days ago, we can link to that, that fructose impairs insulin sensitivity more than glucose. It’s quite an interesting little … It’s an animal study, but it’s quite an interesting study.

 

Amy: What do you feel about fruit, like fresh fruits? Stick with the low glycemic, berries and green apple, that kind of thing?

 

Dr. Briden: Yes. Certainly I think for most people fruit is healthy and can be permitted, but it should never be a meal. That’s something I say to my patients. They can have a bit of fruit as part of something else, but they should really be eating the three meals a day with protein and vegetables as the core of it, and then a bit of fresh fruit for flavor and enjoyment around them.

 

Amy: Yeah. I’ll have a little fruit and berries in a smoothie or in the summertime I actually made a really delicious, it’s in my summer meal plans, mango mojito chicken. I like to use fruits for salsas and sauces. I made a mango sauce with mint and lime juice and fresh mango and a little green onion, and blended that up in my blender. That was sort of like a dipping sauce for the grilled chicken. I like your approach with fruit is part of, to make the meal sweeter, cure your sweet tooth, but have it with protein and maybe even a little fat.

 

Dr. Briden: Absolutely, yeah. That sounds delicious.

 

Amy: That was really yummy. Really getting rid of the fructose and the simple starches. For those women who kind of on the sugar rollercoaster, any tips on how to get off of that? It’s easy to say, but it’s harder to do.

 

Dr. Briden: I know, and for some people it’s a true addiction. I’ve seen that amongst my own patients. I’m very sympathetic to that, it’s real. You’re right, it’s very easy for us to sit here and say, “Just quit,” but it’s not always that easy in practice. The approach I take is to … I do give supplements to aid with insulin sensitivity and that itself improves sugar cravings. I start emphasizing protein meals, especially protein breakfasts, because that can really help. Then the next step is to make sure emotional support and getting enough sleep and feeling ready for the women to …

 

For most people it’s necessary to draw a line in the sand and say, “Okay, from this day, for the month of September, I’m going to quit sugar.” I do think that’s necessary for most people. It doesn’t seem to work to just cut back, because as long as you’re having any concentrated fructose, if you’re addicted to sugar, any amount of fructose will just maintain that basically, promote that. I hear this universally from my patients, that once they actually stop having it, they stop craving it.

 

Amy: Yeah. Again, it’s a physiological process. It’s not so much the willpower.

 

Dr. Briden: No. I talk about the freedom from sugar cravings, what a relief that is. It’s painful for a few days to go through the quitting, but then after it’s like you’re in this totally new, free space of, “Wow, I don’t even want it. I’m satisfied with my meals.”

 

Amy: Yeah. Early on in my journey I found, I don’t know if you’ve ever heard of Kathleen DesMaisons. She wrote the Sugar Addict’s Recovery book.

 

Dr. Briden: Yes, I have. Yup.

 

Amy: Potatoes, Not Prozac was another one of her books. She has an online community too I think, but you almost need to have a support network, maybe a buddy that’s doing this with you as well can be really helpful.

 

What about supplements and herbals for this type of PCOS?

 

Dr. Briden: Magnesium definitely is a strong quencher of sugar cravings. It helps with insulin sensitivity. Inositol, which I know you work with your clients and I’ve been prescribing more and more, Myo-inositol, and the folic acids, and also berberine comes in here as well. It actually helps with insulin sensitivity as well.

 

Amy: Great. Should we move on to the next type?

 

Dr. Briden: Yup.

 

Amy: Okay. What’s next?

 

Dr. Briden: Post-pill. This is a common … Actually you mentioned Fiona McCulloch, I was just reviewing her book again this morning. She talks about a tendency for PCOS to have this post-pill lack of periods, amenorrhea, and it’s certainly something I’ve seen. Basically the scenario is you might have someone who maybe had a PCOS tendency, but the diet was pretty good, never really had problems, until after they took the birth control pill and then tried to come off. Then they find that the communication between their pituitary and their ovaries, it’s a lot more difficult to start that up compared to other women.

 

The way that I define it, this is amongst women that have been diagnosed with PCOS but they’re not insulin resistant, doesn’t seem to be a strong inflammatory picture, their only thing is that they were fine before the pill, periods regular, no symptoms, and then when they stopped, the symptoms emerged.

 

Amy: Is there hope for these women?

 

Dr. Briden: Yes. This is one of the simpler types, because this is one I find responds quite well to the herbal medicine combination peony and licorice, which I use with all types of PCOS, but this is one where perhaps that’s kind of all they need. Maybe the diet’s already pretty good and they can tweak it a little bit, but primarily they just need some help stimulating that communication between the pituitary and the ovaries as almost a stand-alone treatment. I find that works quite well.

 

Amy: I think there’s a lot of women, they hear these herbals and they go online and look to purchase them on Amazon or wherever. I think that licorice and peony, it’s something that you’re not going to find online. I know Kan Herbs has a blend. Do you recommend that they work with a naturopath that would create a tincture for them, or do you think it’s okay to go buy them over the counter?

 

Dr. Briden: I think it’s an herbal medicine that should be used thoughtfully, so I will say to your listeners yes, ideally use it under the supervision of an herbalist or a naturopathic doctor. I guess the other thing to say is if they are going to use it on their own, which if they don’t have someone locally to work with, I guess that might be necessary, is just I emphasize the message that it’s not the kind of medicine that I give long-term. I wouldn’t say to someone, “Go on this and stay on this for years or even months.” It’s usually three to six months to take it temporarily and get things going, and it should work within that time. If it hasn’t improved things in that time, then perhaps it’s not the right medicine.

 

A big caution around it is that licorice not just can, but it will raise blood pressure. It has quite a strong effect on blood pressure, so for anyone who is already tending to high blood pressure it’s probably not a good choice. For anyone else just to monitor their blood pressure.

 

Amy: Do you have to use it synergistically? Could you just use the peony if you had blood pressure issues?

 

Dr. Briden: Yes. The research is that there is a synergistic effect, but yes, potentially that could be … Certainly there are herbal formulas for promoting ovulation where peony is used alone or in combination with other herbs.

 

Amy: I have to ask you about Vitex. I know that there are some women that do really well on Vitex to help trigger cycles, and then there’s others like me that it probably made my symptoms worse. Maybe you could address that.

 

Dr. Briden: I’m going to go so far as to say that for those women for whom Vitex worked well, I would say they probably didn’t have true PCOS. That’s my experience up to this point. A lot of women get given the label of PCOS, this is a podcast for another day perhaps. For one thing, PCOS cannot be diagnosed by ultrasound. There certainly are women out there who have been told they have PCOS, and I don’t think that’s really their hormonal picture. They don’t have the high androgens, they don’t have the elevated LH, and they have other things going on. For them, Vitex could be great, but for the true PCOS, when there’s androgens and LH present, I have found it’s usually not a very helpful herb, because I’ve found it can aggravate that picture.

 

Amy: Yeah, I think that’s important information to get out there, because I think that’s one of those herbals that people are Googling and searching, and a lot of women are just sort of taking it on their own, not realizing that it could maybe do more harm than good. Maybe we need to save that for another day, diving a little bit deeper for another day.

 

Dr. Briden: A whole podcast on that.

 

Amy: I know. What would be the fourth type of PCOS?

 

Dr. Briden: The fourth type, I call it the fourth type but really it’s just a mishmash of lots of other different things going on that have pushed someone into the PCOS description. I would actually come back to the fourth type, because I actually think there’s a fifth type, which I blogged about later in a post about androgen excess, which is … There are people for whom adrenal androgen excess is the main picture. I think that’s quite a different condition. I see true PCOS as primarily an ovarian androgen production, and failure to ovulate regularly. Then there’s this whole other picture where elevated DHEA, the main adrenal hormone, is the primary problem. There’s just been a new research study about that, that that’s really a different condition, and it responds well to adrenal treatment, whether with low-dose natural cortisol or looking at reducing stress and that kind of approach. That’s, I guess, a separate one.

 

Amy: Yeah, that’s interesting. I do think you’re absolutely right about the PCOS, it’s this collection of symptoms, and this whole initiative of changing the name, I don’t know if you’ve heard about that over in Australia, it doesn’t seem like it’s going to solve that problem at all.

 

Dr. Briden: It’s not, you’re right. We needed multiple names. We need someone to dissect it more officially and create, I’d say there’s probably two or three separate conditions that need separate names and a completely separate approach. Hopefully one day we’ll get there, but in the meantime women have to figure it out for themselves, hopefully with the aid of some of the work I’ve done.

 

Amy: Yeah. I love how you’ve taken the time to share your clinical experience and talk about it and blog about it, and your book, so that people can identify with these different types. I know you had mentioned Dr. Fiona McCulloch, she has a book coming out, it’s not available yet but will be this fall, and she does something, it’s a different outlook than yours, but similar work based on her clinical experience. These kind of resources are just so valuable to PCOS Divas who want to take charge of their health and realize that knowledge is power. If you’re enjoying this conversation, I highly recommend that you pick up Dr. Briden’s Period Repair Manual. You’re not going to regret it.

 

Let’s just close with that grouping of that fourth type, because I don’t think we went through that yet.

 

Dr. Briden: Yup. The fourth type would be, I call it the “hidden cause” PCOS. These are women who I can see have some ovarian … They’re still under the category of PCOS and have some ovarian androgen production, irregular periods, they’ve got hirsutism or androgen symptoms, and yet they don’t meet any of the previous criteria. They’re not insulin resistant, it didn’t happen after the pill, it’s like they’re just really floundering. What I’ve identified in my book is, certainly thyroid disease can be part of this. If there’s an undiagnosed thyroid condition I think that needs to be picked up, and that could be with blood tests for thyroid interpreted properly, and perhaps looking at that extra thyroid antibody test I talked about before.

 

Nutrient deficiency falls in here. Zinc deficiency, iodine deficiency, vitamin D deficiency, and then also the excess intake perhaps of too many soy products, too many artificial sweeteners. These can all impair proper ovarian function. Finally, this is the category where I see … Also sometimes women are trying to be too healthy. I guess they’ve been told they have PCOS at some point early on in their journey, and then they just try to fix that. They cut out all carbs and have very strong willpower, and it can happen that basically the lack of carbohydrate can shut down periods. I’ve grouped that here, and I also have a post on my blog called Have You Lost Your Period to a Low Carb Diet? There’s a sweet spot, right? Obviously some women do need to reduce carbs to get their periods back, but if some women maybe didn’t need to do that and went too far and lost their period that way.

 

Amy: Yeah, and I think it’s so important to say there’s really no one-size-fits-all approach to diet. Some women, like with severe insulin resistant PCOS, might thrive on a very low carb, and I’ve always felt that I need some, like brown rice or some quinoa or something, so I guess the way I describe it is “feeling grounded.” I don’t think I ever got to that point where I missed my period, but I’ve needed to feel grounded with some grains or some root vegetables. It’s so important to get in touch with how food makes you feel so that you can determine for yourself what diet is best for you too.

 

Dr. Briden: You are so right. No one-size-fits-all. That is a very important take-home message.

 

Amy: Yeah. There’s no one-size-fits-all PCOS either, as you’ve been explaining to us. There’s the fourth type, then you would be looking to supplement with the zinc and vitamin D and get your thyroid and more than just your TSH checked for thyroid?

 

Dr. Briden: Yeah, try to get TSH into an optimal age of what I would say is less than 2.5 for the TSH reading. What I say in my book, it’s about looking deeper, doing some detective work, and unfortunately your doctor may not be able or willing to help you with all of that without some guidance. One of the things I provide in my book is questions for your doctor, how to speak to your doctor.

 

For example, if you suspect that thyroid might be part of your picture, then you could say, if it’s true say, “There was this autoimmune thyroid disease in my family, therefore, doctor, would you think it’s suitable to do a bit of extra testing around this?” That kind of conversation, or say to the doctor, “I’m vegetarian, and I’ve heard that vegetarians are often deficient in zinc. Do you think it would be appropriate to test me for zinc and B12 and iodine?” Then phrased in that way, doctors are cooperative. They want the best thing for you as well.

 

Amy: Yeah, I think that’s a really fantastic approach. Dr. Lara, if somebody wants to learn more about your work, and I know you have a really fantastic blog that is quite active, you’re updating that regularly, how can they find you?

 

Dr. Briden: Yup. I’m at Lara Briden’s Healthy Hormone blog, which is just larabriden.com, and then they can find me @LaraBriden on Twitter, on Instagram, and on Facebook, and of course my book, Period Repair Manual, which is available from Amazon, iTunes, Kindle, Kobo, all the usual places.

 

Amy: Yeah, definitely pick up a copy. It’s going to be a well-worn, well-loved book like it is on my shelf. Thank you so much for joining us, and we’d love to have you come back sometime soon.

 

Dr. Briden: Any time. Thank you for having me, Amy.

 

Amy: Thank you everyone for listening, and I look forward to being with you again soon. Bye-bye.

 

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  • Samantha Avery

    Thank you so much for posting this! I have been searching for answers for my pcos since I do not seem to fit into any category.. (Normal insulin and glucose, normal tsh, just elevated testosterone, I am also a normal weight) I don’t seem to have any autoimmune problems, but I have always had extremely irregular periods which I think were exacerbated by the pill. i went off the pill in October and still no period :(! Any suggestions for a diet that can help my pcos? I am starting femara with my husband next month.. Fingers crossed!

  • Paola

    Hi-great info. Can you or the doc discuss more about the 5th type which is mostly the androgen excess. the doc mentioned it, but it wasn’t discussed very much in the interview or how to really treat it. she mentioned low-dose cortisol and less stress? is that it? There are many of us that have been put into the PCOS category when the main culprit is not the ovaries, but the adrenals. However, no real help from docs. So was hoping for a bit more info from Dr. Briden on this category. Thanks!

  • Anna

    Great article. I have recently been diagnosed with non insulin resistant PCOS. My only symptom is anovulation. I took licorine and peony for 4 months, but I think, it only made my symptoms worst. Before I had irregular periods, but few months after I strarted Licorine and Peony I stooped having any periods? Currently I am taking myo inositol. Would that help with non insulin resistant PCOS?

  • Paola

    Please any response? I sent my inquiry 3 months
    ago? There was no real info on the 5th type which I need help with other than
    to take a steroid, which in itself brings more problems. w And I dont see too
    many comments on this particular one, so any response would be appreciated?
    Please respond

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